Usage scenarios

The following are supported usage scenarios for this profile:

• Query for observations of oxygen saturation associated with a patient
• Record or update an observation of oxygen saturation associated with a patient

Comparison with other national and international specifications

A resource conforming to this profile is conformant to:

• observation-oxygensat
  • and therefore conformant to International Patient Summary
• IPA-Observation

Analysis on equivalency of conformance to US Core Pulse Oximetry is outstanding.

Conformance in reverse is not guaranteed, i.e. a resource conforming to International Patient Access or International Patient Summary 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.
• 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 codes such as 8306-3 - Body height - lying in addition to 8302-2 - Body height. Several additional observation codes are provided in the FHIR core specification vital signs table.
• Observations MAY have [component] observations to qualify the vital sign observation. For example, 8478-0 - Mean blood pressure, 8887-2 - Heart rate device type, 8326-1 - Type of body temperature device. Several of these are provided in the FHIR core specification vital signs table.

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

This structure is derived from observation-oxygensat

Name	Flags	Card.	Type	Description & Constraints
Observation	C	0..*	observation-oxygensat	Oxygen saturation au-core-obs-02: At least value or data absent reason shall be present
status		1..1	code	registered | preliminary | final | amended + Fixed Value: final
code
coding		2..*	Coding	Code defined by a terminology system
coding:snomedOxygenSatCode		1..1	Coding	SNOMED CT Oxygen Saturation
system		1..1	uri	Identity of the terminology system Fixed Value: http://snomed.info/sct
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 103228002
subject		1..1	Reference(AU Core Patient)	Who and/or what the observation is about
encounter	S	0..1	Reference(AU Core Encounter)	Healthcare event during which this observation is made
effective[x]	C	1..1	dateTime	Date, and optionally time, the observation was performed 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]:valueQuantity	C	0..1	Quantity	Oxygen saturation
dataAbsentReason	SC	0..1	CodeableConcept	Why the result is missing
bodySite	C	0..1	CodeableConcept	Observed body part Binding: https://healthterminologies.gov.au/fhir/ValueSet/body-site-1 (preferred) au-core-obs-04: If a coded body site is provided, at least one code shall be from SNOMED CT
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet
Observation.bodySite	preferred	https://healthterminologies.gov.au/fhir/ValueSet/body-site-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-02	error	Observation	At least value or data absent reason shall be present : dataAbsentReason.exists() or value.exists()
au-core-obs-04	error	Observation.bodySite	If a coded body site is provided, at least one code shall be from SNOMED CT : coding.exists() implies coding.where(system='http://snomed.info/sct').exists()

Name	Flags	Card.	Type	Description & Constraints
Observation	C	0..*	observation-oxygensat	Oxygen saturation au-core-obs-02: 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
status	?!SΣ	1..1	code	registered | preliminary | final | amended + Binding: ObservationStatus (required) Fixed Value: final
Slices for category	S	1..*	CodeableConcept	Classification of type of observation Slice: Unordered, Open by value:coding.code, value:coding.system Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
category:VSCat	S	1..1	CodeableConcept	Classification of type of observation Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
coding	SΣ	1..*	Coding	Code defined by a terminology system
system	SΣ	1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category
code	SΣ	1..1	code	Symbol in syntax defined by the system Fixed Value: vital-signs
code	SΣ	1..1	CodeableConcept	Oxygen Saturation Binding: VitalSigns (extensible): This identifies the vital sign result type.
Slices for coding	Σ	2..*	Coding	Code defined by a terminology system Slice: Unordered, Open by value:code, value:system
coding:OxygenSatCode	Σ	1..1	Coding	Code defined by a terminology system
system	Σ	1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
code	Σ	1..1	code	Symbol in syntax defined by the system Fixed Value: 2708-6
coding:snomedOxygenSatCode	Σ	1..1	Coding	SNOMED CT Oxygen Saturation
system	Σ	1..1	uri	Identity of the terminology system Fixed Value: http://snomed.info/sct
code	Σ	1..1	code	Symbol in syntax defined by the system Fixed Value: 103228002
subject	SΣ	1..1	Reference(AU Core Patient)	Who and/or what the observation is about
encounter	SΣ	0..1	Reference(AU Core Encounter)	Healthcare event during which this observation is made
effective[x]	SΣC	1..1	dateTime	Date, and optionally time, the observation was performed au-core-obs-01: Date shall be at least to day
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
Slices for value[x]	SΣC	0..1	Quantity	Vital Signs value are recorded using the Quantity data type. For supporting observations such as Cuff size could use other datatypes such as CodeableConcept. Slice: Unordered, Closed by type:$this
value[x]:valueQuantity	SΣC	0..1	Quantity	Oxygen saturation
value	SΣ	1..1	decimal	Numerical value (with implicit precision)
comparator	?!Σ	0..1	code	< | <= | >= | > - how to understand the value Binding: QuantityComparator (required): How the Quantity should be understood and represented.
unit	SΣ	1..1	string	Unit representation
system	SΣC	1..1	uri	System that defines coded unit form Fixed Value: http://unitsofmeasure.org
code	SΣ	1..1	code	Coded responses from the common UCUM units for vital signs value set. Fixed Value: %
dataAbsentReason	SC	0..1	CodeableConcept	Why the result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
bodySite	C	0..1	CodeableConcept	Observed body part Binding: https://healthterminologies.gov.au/fhir/ValueSet/body-site-1 (preferred) au-core-obs-04: If a coded body site is provided, at least one code shall be from SNOMED CT
component	SΣC	0..*	BackboneElement	Used when reporting systolic and diastolic blood pressure.
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	SΣ	1..1	CodeableConcept	Type of component observation (code / type) Binding: VitalSigns (extensible): This identifies the vital sign result type.
value[x]	SΣC	0..1		Vital Sign Value recorded with UCUM Binding: VitalSignsUnits (required): Common UCUM units for recording Vital Signs.
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 / Code
Observation.status	required	Fixed Value: final
Observation.category	preferred	ObservationCategoryCodes
Observation.category:VSCat	preferred	ObservationCategoryCodes
Observation.code	extensible	VitalSigns
Observation.value[x]:valueQuantity.comparator	required	QuantityComparator
Observation.dataAbsentReason	extensible	DataAbsentReason
Observation.bodySite	preferred	https://healthterminologies.gov.au/fhir/ValueSet/body-site-1
Observation.component.code	extensible	VitalSigns
Observation.component.value[x]	required	VitalSignsUnits
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-02	error	Observation	At least value or data absent reason shall be present : dataAbsentReason.exists() or value.exists()
au-core-obs-04	error	Observation.bodySite	If a coded body site is provided, at least one code shall be from SNOMED CT : coding.exists() implies coding.where(system='http://snomed.info/sct').exists()

Name	Flags	Card.	Type	Description & Constraints
Observation	C	0..*	observation-oxygensat	Oxygen saturation au-core-obs-02: 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	Σ	0..*	Identifier	Business Identifier for observation
basedOn	Σ	0..*	Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest)	Fulfills plan, proposal or order
partOf	Σ	0..*	Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy)	Part of referenced event
status	?!SΣ	1..1	code	registered | preliminary | final | amended + Binding: ObservationStatus (required) Fixed Value: final
Slices for category	S	1..*	CodeableConcept	Classification of type of observation Slice: Unordered, Open by value:coding.code, value:coding.system Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
category:VSCat	S	1..1	CodeableConcept	Classification of type of observation 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	SΣ	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	SΣ	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	SΣ	1..1	code	Symbol in syntax defined by the system Fixed Value: vital-signs
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	Oxygen Saturation Binding: VitalSigns (extensible): This identifies the vital sign result type.
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
Slices for coding	Σ	2..*	Coding	Code defined by a terminology system Slice: Unordered, Open by value:code, value:system
coding:OxygenSatCode	Σ	1..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://loinc.org
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: 2708-6
display	Σ	0..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
coding:snomedOxygenSatCode	Σ	1..1	Coding	SNOMED CT Oxygen Saturation
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://snomed.info/sct
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: 103228002
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
subject	SΣ	1..1	Reference(AU Core Patient)	Who and/or what the observation is about
focus	Σ	0..*	Reference(Resource)	What the observation is about, when it is not about the subject of record
encounter	SΣ	0..1	Reference(AU Core Encounter)	Healthcare event during which this observation is made
effective[x]	SΣC	1..1	dateTime	Date, and optionally time, the observation was performed au-core-obs-01: Date shall be at least to day
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
Slices for value[x]	SΣC	0..1	Quantity	Vital Signs value are recorded using the Quantity data type. For supporting observations such as Cuff size could use other datatypes such as CodeableConcept. Slice: Unordered, Closed by type:$this
value[x]:valueQuantity	SΣC	0..1	Quantity	Oxygen saturation
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
value	SΣ	1..1	decimal	Numerical value (with implicit precision)
comparator	?!Σ	0..1	code	< | <= | >= | > - how to understand the value Binding: QuantityComparator (required): How the Quantity should be understood and represented.
unit	SΣ	1..1	string	Unit representation
system	SΣC	1..1	uri	System that defines coded unit form Fixed Value: http://unitsofmeasure.org
code	SΣ	1..1	code	Coded responses from the common UCUM units for vital signs value set. Fixed Value: %
dataAbsentReason	SC	0..1	CodeableConcept	Why the result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation		0..*	CodeableConcept	High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
note		0..*	Annotation	Comments about the observation
bodySite	C	0..1	CodeableConcept	Observed body part Binding: https://healthterminologies.gov.au/fhir/ValueSet/body-site-1 (preferred) au-core-obs-04: If a coded body site is provided, at least one code shall be from SNOMED CT
method		0..1	CodeableConcept	How it was done Binding: ObservationMethods (example): Methods for simple observations.
specimen		0..1	Reference(Specimen)	Specimen used for this observation
device		0..1	Reference(Device | DeviceMetric)	(Measurement) Device
referenceRange	C	0..*	BackboneElement	Provides guide for interpretation
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
low	C	0..1	SimpleQuantity	Low Range, if relevant
high	C	0..1	SimpleQuantity	High Range, if relevant
type		0..1	CodeableConcept	Reference range qualifier Binding: ObservationReferenceRangeMeaningCodes (preferred): Code for the meaning of a reference range.
appliesTo		0..*	CodeableConcept	Reference range population Binding: ObservationReferenceRangeAppliesToCodes (example): Codes identifying the population the reference range applies to.
age		0..1	Range	Applicable age range, if relevant
text		0..1	string	Text based reference range in an observation
hasMember	Σ	0..*	Reference(QuestionnaireResponse | MolecularSequence | Vital Signs Profile)	Used when reporting vital signs panel components
derivedFrom	Σ	0..*	Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | MolecularSequence | Vital Signs Profile)	Related measurements the observation is made from
component	SΣC	0..*	BackboneElement	Used when reporting systolic and diastolic blood pressure.
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	Type of component observation (code / type) Binding: VitalSigns (extensible): This identifies the vital sign result type.
value[x]	SΣC	0..1		Vital Sign Value recorded with UCUM Binding: VitalSignsUnits (required): Common UCUM units for recording Vital Signs.
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 / Code
Observation.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding
Observation.status	required	Fixed Value: final
Observation.category	preferred	ObservationCategoryCodes
Observation.category:VSCat	preferred	ObservationCategoryCodes
Observation.code	extensible	VitalSigns
Observation.value[x]:valueQuantity.comparator	required	QuantityComparator
Observation.dataAbsentReason	extensible	DataAbsentReason
Observation.interpretation	extensible	ObservationInterpretationCodes
Observation.bodySite	preferred	https://healthterminologies.gov.au/fhir/ValueSet/body-site-1
Observation.method	example	ObservationMethods
Observation.referenceRange.type	preferred	ObservationReferenceRangeMeaningCodes
Observation.referenceRange.appliesTo	example	ObservationReferenceRangeAppliesToCodes
Observation.component.code	extensible	VitalSigns
Observation.component.value[x]	required	VitalSignsUnits
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-02	error	Observation	At least value or data absent reason shall be present : dataAbsentReason.exists() or value.exists()
au-core-obs-04	error	Observation.bodySite	If a coded body site is provided, at least one code shall be from SNOMED CT : coding.exists() implies coding.where(system='http://snomed.info/sct').exists()

Differential View

This structure is derived from observation-oxygensat

Name	Flags	Card.	Type	Description & Constraints
Observation	C	0..*	observation-oxygensat	Oxygen saturation au-core-obs-02: At least value or data absent reason shall be present
status		1..1	code	registered | preliminary | final | amended + Fixed Value: final
code
coding		2..*	Coding	Code defined by a terminology system
coding:snomedOxygenSatCode		1..1	Coding	SNOMED CT Oxygen Saturation
system		1..1	uri	Identity of the terminology system Fixed Value: http://snomed.info/sct
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 103228002
subject		1..1	Reference(AU Core Patient)	Who and/or what the observation is about
encounter	S	0..1	Reference(AU Core Encounter)	Healthcare event during which this observation is made
effective[x]	C	1..1	dateTime	Date, and optionally time, the observation was performed 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]:valueQuantity	C	0..1	Quantity	Oxygen saturation
dataAbsentReason	SC	0..1	CodeableConcept	Why the result is missing
bodySite	C	0..1	CodeableConcept	Observed body part Binding: https://healthterminologies.gov.au/fhir/ValueSet/body-site-1 (preferred) au-core-obs-04: If a coded body site is provided, at least one code shall be from SNOMED CT
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet
Observation.bodySite	preferred	https://healthterminologies.gov.au/fhir/ValueSet/body-site-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-02	error	Observation	At least value or data absent reason shall be present : dataAbsentReason.exists() or value.exists()
au-core-obs-04	error	Observation.bodySite	If a coded body site is provided, at least one code shall be from SNOMED CT : coding.exists() implies coding.where(system='http://snomed.info/sct').exists()

Key Elements View

Name	Flags	Card.	Type	Description & Constraints
Observation	C	0..*	observation-oxygensat	Oxygen saturation au-core-obs-02: 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
status	?!SΣ	1..1	code	registered | preliminary | final | amended + Binding: ObservationStatus (required) Fixed Value: final
Slices for category	S	1..*	CodeableConcept	Classification of type of observation Slice: Unordered, Open by value:coding.code, value:coding.system Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
category:VSCat	S	1..1	CodeableConcept	Classification of type of observation Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
coding	SΣ	1..*	Coding	Code defined by a terminology system
system	SΣ	1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category
code	SΣ	1..1	code	Symbol in syntax defined by the system Fixed Value: vital-signs
code	SΣ	1..1	CodeableConcept	Oxygen Saturation Binding: VitalSigns (extensible): This identifies the vital sign result type.
Slices for coding	Σ	2..*	Coding	Code defined by a terminology system Slice: Unordered, Open by value:code, value:system
coding:OxygenSatCode	Σ	1..1	Coding	Code defined by a terminology system
system	Σ	1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
code	Σ	1..1	code	Symbol in syntax defined by the system Fixed Value: 2708-6
coding:snomedOxygenSatCode	Σ	1..1	Coding	SNOMED CT Oxygen Saturation
system	Σ	1..1	uri	Identity of the terminology system Fixed Value: http://snomed.info/sct
code	Σ	1..1	code	Symbol in syntax defined by the system Fixed Value: 103228002
subject	SΣ	1..1	Reference(AU Core Patient)	Who and/or what the observation is about
encounter	SΣ	0..1	Reference(AU Core Encounter)	Healthcare event during which this observation is made
effective[x]	SΣC	1..1	dateTime	Date, and optionally time, the observation was performed au-core-obs-01: Date shall be at least to day
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
Slices for value[x]	SΣC	0..1	Quantity	Vital Signs value are recorded using the Quantity data type. For supporting observations such as Cuff size could use other datatypes such as CodeableConcept. Slice: Unordered, Closed by type:$this
value[x]:valueQuantity	SΣC	0..1	Quantity	Oxygen saturation
value	SΣ	1..1	decimal	Numerical value (with implicit precision)
comparator	?!Σ	0..1	code	< | <= | >= | > - how to understand the value Binding: QuantityComparator (required): How the Quantity should be understood and represented.
unit	SΣ	1..1	string	Unit representation
system	SΣC	1..1	uri	System that defines coded unit form Fixed Value: http://unitsofmeasure.org
code	SΣ	1..1	code	Coded responses from the common UCUM units for vital signs value set. Fixed Value: %
dataAbsentReason	SC	0..1	CodeableConcept	Why the result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
bodySite	C	0..1	CodeableConcept	Observed body part Binding: https://healthterminologies.gov.au/fhir/ValueSet/body-site-1 (preferred) au-core-obs-04: If a coded body site is provided, at least one code shall be from SNOMED CT
component	SΣC	0..*	BackboneElement	Used when reporting systolic and diastolic blood pressure.
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	SΣ	1..1	CodeableConcept	Type of component observation (code / type) Binding: VitalSigns (extensible): This identifies the vital sign result type.
value[x]	SΣC	0..1		Vital Sign Value recorded with UCUM Binding: VitalSignsUnits (required): Common UCUM units for recording Vital Signs.
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 / Code
Observation.status	required	Fixed Value: final
Observation.category	preferred	ObservationCategoryCodes
Observation.category:VSCat	preferred	ObservationCategoryCodes
Observation.code	extensible	VitalSigns
Observation.value[x]:valueQuantity.comparator	required	QuantityComparator
Observation.dataAbsentReason	extensible	DataAbsentReason
Observation.bodySite	preferred	https://healthterminologies.gov.au/fhir/ValueSet/body-site-1
Observation.component.code	extensible	VitalSigns
Observation.component.value[x]	required	VitalSignsUnits
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-02	error	Observation	At least value or data absent reason shall be present : dataAbsentReason.exists() or value.exists()
au-core-obs-04	error	Observation.bodySite	If a coded body site is provided, at least one code shall be from SNOMED CT : coding.exists() implies coding.where(system='http://snomed.info/sct').exists()

Snapshot View

Name	Flags	Card.	Type	Description & Constraints
Observation	C	0..*	observation-oxygensat	Oxygen saturation au-core-obs-02: 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	Σ	0..*	Identifier	Business Identifier for observation
basedOn	Σ	0..*	Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest)	Fulfills plan, proposal or order
partOf	Σ	0..*	Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy)	Part of referenced event
status	?!SΣ	1..1	code	registered | preliminary | final | amended + Binding: ObservationStatus (required) Fixed Value: final
Slices for category	S	1..*	CodeableConcept	Classification of type of observation Slice: Unordered, Open by value:coding.code, value:coding.system Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
category:VSCat	S	1..1	CodeableConcept	Classification of type of observation 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	SΣ	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	SΣ	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	SΣ	1..1	code	Symbol in syntax defined by the system Fixed Value: vital-signs
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	Oxygen Saturation Binding: VitalSigns (extensible): This identifies the vital sign result type.
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
Slices for coding	Σ	2..*	Coding	Code defined by a terminology system Slice: Unordered, Open by value:code, value:system
coding:OxygenSatCode	Σ	1..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://loinc.org
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: 2708-6
display	Σ	0..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
coding:snomedOxygenSatCode	Σ	1..1	Coding	SNOMED CT Oxygen Saturation
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://snomed.info/sct
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: 103228002
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
subject	SΣ	1..1	Reference(AU Core Patient)	Who and/or what the observation is about
focus	Σ	0..*	Reference(Resource)	What the observation is about, when it is not about the subject of record
encounter	SΣ	0..1	Reference(AU Core Encounter)	Healthcare event during which this observation is made
effective[x]	SΣC	1..1	dateTime	Date, and optionally time, the observation was performed au-core-obs-01: Date shall be at least to day
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
Slices for value[x]	SΣC	0..1	Quantity	Vital Signs value are recorded using the Quantity data type. For supporting observations such as Cuff size could use other datatypes such as CodeableConcept. Slice: Unordered, Closed by type:$this
value[x]:valueQuantity	SΣC	0..1	Quantity	Oxygen saturation
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
value	SΣ	1..1	decimal	Numerical value (with implicit precision)
comparator	?!Σ	0..1	code	< | <= | >= | > - how to understand the value Binding: QuantityComparator (required): How the Quantity should be understood and represented.
unit	SΣ	1..1	string	Unit representation
system	SΣC	1..1	uri	System that defines coded unit form Fixed Value: http://unitsofmeasure.org
code	SΣ	1..1	code	Coded responses from the common UCUM units for vital signs value set. Fixed Value: %
dataAbsentReason	SC	0..1	CodeableConcept	Why the result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation		0..*	CodeableConcept	High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
note		0..*	Annotation	Comments about the observation
bodySite	C	0..1	CodeableConcept	Observed body part Binding: https://healthterminologies.gov.au/fhir/ValueSet/body-site-1 (preferred) au-core-obs-04: If a coded body site is provided, at least one code shall be from SNOMED CT
method		0..1	CodeableConcept	How it was done Binding: ObservationMethods (example): Methods for simple observations.
specimen		0..1	Reference(Specimen)	Specimen used for this observation
device		0..1	Reference(Device | DeviceMetric)	(Measurement) Device
referenceRange	C	0..*	BackboneElement	Provides guide for interpretation
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
low	C	0..1	SimpleQuantity	Low Range, if relevant
high	C	0..1	SimpleQuantity	High Range, if relevant
type		0..1	CodeableConcept	Reference range qualifier Binding: ObservationReferenceRangeMeaningCodes (preferred): Code for the meaning of a reference range.
appliesTo		0..*	CodeableConcept	Reference range population Binding: ObservationReferenceRangeAppliesToCodes (example): Codes identifying the population the reference range applies to.
age		0..1	Range	Applicable age range, if relevant
text		0..1	string	Text based reference range in an observation
hasMember	Σ	0..*	Reference(QuestionnaireResponse | MolecularSequence | Vital Signs Profile)	Used when reporting vital signs panel components
derivedFrom	Σ	0..*	Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | MolecularSequence | Vital Signs Profile)	Related measurements the observation is made from
component	SΣC	0..*	BackboneElement	Used when reporting systolic and diastolic blood pressure.
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	Type of component observation (code / type) Binding: VitalSigns (extensible): This identifies the vital sign result type.
value[x]	SΣC	0..1		Vital Sign Value recorded with UCUM Binding: VitalSignsUnits (required): Common UCUM units for recording Vital Signs.
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 / Code
Observation.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding
Observation.status	required	Fixed Value: final
Observation.category	preferred	ObservationCategoryCodes
Observation.category:VSCat	preferred	ObservationCategoryCodes
Observation.code	extensible	VitalSigns
Observation.value[x]:valueQuantity.comparator	required	QuantityComparator
Observation.dataAbsentReason	extensible	DataAbsentReason
Observation.interpretation	extensible	ObservationInterpretationCodes
Observation.bodySite	preferred	https://healthterminologies.gov.au/fhir/ValueSet/body-site-1
Observation.method	example	ObservationMethods
Observation.referenceRange.type	preferred	ObservationReferenceRangeMeaningCodes
Observation.referenceRange.appliesTo	example	ObservationReferenceRangeAppliesToCodes
Observation.component.code	extensible	VitalSigns
Observation.component.value[x]	required	VitalSignsUnits
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-02	error	Observation	At least value or data absent reason shall be present : dataAbsentReason.exists() or value.exists()
au-core-obs-04	error	Observation.bodySite	If a coded body site is provided, at least one code shall be from SNOMED CT : coding.exists() implies coding.where(system='http://snomed.info/sct').exists()

This structure is derived from observation-oxygensat

Summary

Mandatory: 3 elements
Must-Support: 3 elements
Fixed Value: 3 elements

Structures

This structure refers to these other structures:

• AU Core Patient (http://hl7.org.au/fhir/core/StructureDefinition/au-core-patient)
• AU Core Encounter (http://hl7.org.au/fhir/core/StructureDefinition/au-core-encounter)
• 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)

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=vital-signs

   Example:

   1. GET [base]/Observation?patient=5678&category=vital-signs

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

3. 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=vital-signs&date={gt|lt|ge|le}[date]{&date={gt|lt|ge|le}[date]&...}

   Example:

   1. GET [base]/Observation?patient=5678&category=vital-signs&date=ge2020-01-01T00:00:00Z

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

4. 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://snomed.info/sct|364075005,http://loinc.org|2708-6,http://loinc.org|85354-9

   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)

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=vital-signs&status={system|}[code]{,{system|}[code],...}

   Example:

   1. GET [base]/Observation?patient=5678&category=vital-signs&status=final
   2. GET [base]/Observation?patient=5678&category=vital-signs&_revinclude=Provenance:target

   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://snomed.info/sct|364075005,http://loinc.org|2708-6,http://loinc.org|85354-9&date=ge2020-01-01T00:00:00Z
   2. GET [base]/Observation?patient.identifier=http://example.org/fhir/mrn|12345&code=http://snomed.info/sct|364075005,http://loinc.org|2708-6,http://loinc.org|85354-9&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)