AU Core Implementation Guide
0.2.2-preview - Preview Australia flag

This page is part of the Australian Core IG (v0.2.2-preview: AU Core) based on FHIR R4. For a full list of available versions, see the Directory of published versions

Resource Profile: AU Core Parity

Official URL: http://hl7.org.au/fhir/core/StructureDefinition/au-core-parity Version: 0.2.2-preview
Standards status: Draft Maturity Level: 0 Computable Name: AUCoreParity

Copyright/Legal: Used by permission of HL7 International, all rights reserved Creative Commons License. HL7 Australia© 2022+; Licensed Under Creative Commons No Rights Reserved.

This resource includes SNOMED Clinical Terms™ (SNOMED CT®) which is used by permission of the International Health Terminology Standards Development Organisation (IHTSDO). All rights reserved. SNOMED CT®, was originally created by The College of American Pathologists. “SNOMED” and “SNOMED CT” are registered trademarks of the IHTSDO. The rights to use and implement or implementation of SNOMED CT content are limited to the extent it is necessary to allow for the end use of this material. No further rights are granted in respect of the International Release and no further use of any SNOMED CT content by any other party is permitted.

This material contains content from LOINC (http://loinc.org). LOINC is copyright © 1995-2021, Regenstrief Institute, Inc. and the Logical Observation Identifiers Names and Codes (LOINC) Committee and is available at no cost under the license at http://loinc.org/license. LOINC® is a registered United States trademark of Regenstrief Institute, Inc.

All copies of this resource must include this copyright statement and all information contained in this statement.

This profile sets minimum expectations for an Observation resource to record, search, and fetch observations that represent parity count related to pregnancy at a point in time associated with a patient with standard coding and units. It is based on the core FHIR Observation resource and identifies the additional mandatory core elements, extensions, vocabularies and value sets that SHALL be present in the Observation resource when conforming to this profile. It provides the floor for standards development for specific uses cases in an Australian context.

Usage scenarios

The following are supported usage scenarios for this profile:

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

Comparison with other national and international specifications

A resource conforming to this profile is conformant to:

No equivalent International Patient Summary profile.

Conformance in reverse is not guaranteed, i.e. a resource conforming to International Patient Access 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.
  • Additional codes that translate or map to the Observation code or category codes are allowed. For example providing both a local code and the required code.

Specific feedback is sought on appropriate category values for Observations relating to pregnancy.

Usage:

Formal Views of Profile Content

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

This structure is derived from Observation

NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation C0..*ObservationParity
au-core-obs-02: At least value or data absent reason shall be present
... status S1..1coderegistered | preliminary | final | amended +
Fixed Value: final
... Slices for category S1..*CodeableConceptClassification of type of observation
Slice: Unordered, Open by pattern:$this
.... category:socialHistory 1..1CodeableConceptClassification of type of observation
Required Pattern: At least the following
..... coding1..*CodingCode defined by a terminology system
Fixed Value: (complex)
...... system1..1uriIdentity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category
...... code1..1codeSymbol in syntax defined by the system
Fixed Value: social-history
... code S1..1CodeableConceptType of observation (code / type)
Required Pattern: At least the following
.... coding1..*CodingCode defined by a terminology system
Fixed Value: (complex)
..... system1..1uriIdentity of the terminology system
Fixed Value: http://snomed.info/sct
..... code1..1codeSymbol in syntax defined by the system
Fixed Value: 364325004
.... Slices for coding 0..*CodingCode defined by a terminology system
Slice: Unordered, Open by value:code, value:system
..... coding:loincParity 0..1CodingLOINC Parity
...... system 1..1uriIdentity of the terminology system
Fixed Value: http://loinc.org
...... code 1..1codeSymbol in syntax defined by the system
Fixed Value: 11977-6
... encounter S0..1Reference(AU Core Encounter)Healthcare event during which this observation is made
... effective[x] S1..1Date, and optionally time, the observation was performed
.... effectiveDateTimedateTime
.... effectivePeriodPeriod
... performer S0..*Reference(AU Core Practitioner | AU Core PractitionerRole | AU Core Organization | AU Core Patient | AU Core RelatedPerson)Who is responsible for the observation
... value[x] SC0..1QuantityActual result
au-core-parity-01: Parity must be a whole number
.... system 1..1uriSystem that defines coded unit form
Fixed Value: http://unitsofmeasure.org
.... code 1..1codeCoded form of the unit
Fixed Value: 1
... dataAbsentReason SC0..1CodeableConceptWhy the result is missing

doco Documentation for this format

Constraints

IdGradePath(s)DetailsRequirements
au-core-obs-02errorObservationAt least value or data absent reason shall be present
: dataAbsentReason.exists() or value.exists()
au-core-parity-01errorObservation.value[x]Parity must be a whole number
: value.toString().contains('.').not()
NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation C0..*ObservationParity
au-core-obs-02: At least value or data absent reason shall be present
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... status ?!SΣ1..1coderegistered | preliminary | final | amended +
Binding: ObservationStatus (required): Codes providing the status of an observation.


Fixed Value: final
.... category:socialHistory 1..1CodeableConceptClassification of type of observation
Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.



Required Pattern: At least the following
..... coding1..*CodingCode defined by a terminology system
Fixed Value: (complex)
...... system1..1uriIdentity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category
...... code1..1codeSymbol in syntax defined by the system
Fixed Value: social-history
... code SΣ1..1CodeableConceptType of observation (code / type)
Binding: LOINCCodes (example): Codes identifying names of simple observations.


Required Pattern: At least the following
.... coding1..*CodingCode defined by a terminology system
Fixed Value: (complex)
..... system1..1uriIdentity of the terminology system
Fixed Value: http://snomed.info/sct
..... code1..1codeSymbol in syntax defined by the system
Fixed Value: 364325004
.... Slices for coding Σ0..*CodingCode defined by a terminology system
Slice: Unordered, Open by value:code, value:system
..... coding:loincParity Σ0..1CodingLOINC Parity
...... system Σ1..1uriIdentity of the terminology system
Fixed Value: http://loinc.org
...... code Σ1..1codeSymbol in syntax defined by the system
Fixed Value: 11977-6
... subject SΣ1..1Reference(Patient)Who and/or what the observation is about
... encounter SΣ0..1Reference(AU Core Encounter)Healthcare event during which this observation is made
... effective[x] SΣ1..1Date, and optionally time, the observation was performed
.... effectiveDateTimedateTime
.... effectivePeriodPeriod
... performer SΣ0..*Reference(AU Core Practitioner | AU Core PractitionerRole | AU Core Organization | AU Core Patient | AU Core RelatedPerson)Who is responsible for the observation
... value[x] SΣC0..1QuantityActual result
au-core-parity-01: Parity must be a whole number
.... comparator ?!Σ0..1code< | <= | >= | > - how to understand the value
Binding: QuantityComparator (required): How the Quantity should be understood and represented.

.... system ΣC1..1uriSystem that defines coded unit form
Fixed Value: http://unitsofmeasure.org
.... code Σ1..1codeCoded form of the unit
Fixed Value: 1
... dataAbsentReason SC0..1CodeableConceptWhy the result is missing
Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.


doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / Code
Observation.statusrequiredFixed Value: final
Observation.categorypreferredObservationCategoryCodes
Observation.category:socialHistorypreferredPattern: social-history
Observation.codeexamplePattern: SNOMED CT code 364325004
Observation.value[x].comparatorrequiredQuantityComparator
Observation.dataAbsentReasonextensibleDataAbsentReason

Constraints

IdGradePath(s)DetailsRequirements
au-core-obs-02errorObservationAt least value or data absent reason shall be present
: dataAbsentReason.exists() or value.exists()
au-core-parity-01errorObservation.value[x]Parity must be a whole number
: value.toString().contains('.').not()
NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation C0..*ObservationParity
au-core-obs-02: At least value or data absent reason shall be present
... id Σ0..1idLogical id of this artifact
... meta Σ0..1MetaMetadata about the resource
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... language 0..1codeLanguage of the resource content
Binding: CommonLanguages (preferred): A human language.

Additional BindingsPurpose
AllLanguagesMax Binding
... text 0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... extension 0..*ExtensionAdditional content defined by implementations
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... identifier Σ0..*IdentifierBusiness Identifier for observation
... basedOn Σ0..*Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest)Fulfills plan, proposal or order
... partOf Σ0..*Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy)Part of referenced event
... status ?!SΣ1..1coderegistered | preliminary | final | amended +
Binding: ObservationStatus (required): Codes providing the status of an observation.


Fixed Value: final
... Slices for category S1..*CodeableConceptClassification of type of observation
Slice: Unordered, Open by pattern:$this
Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.


.... category:socialHistory 1..1CodeableConceptClassification of type of observation
Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.



Required Pattern: At least the following
..... id0..1stringUnique id for inter-element referencing
..... extension0..*ExtensionAdditional content defined by implementations
..... coding1..*CodingCode defined by a terminology system
Fixed Value: (complex)
...... id0..1stringUnique id for inter-element referencing
...... extension0..*ExtensionAdditional content defined by implementations
...... system1..1uriIdentity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category
...... version0..1stringVersion of the system - if relevant
...... code1..1codeSymbol in syntax defined by the system
Fixed Value: social-history
...... display0..1stringRepresentation defined by the system
...... userSelected0..1booleanIf this coding was chosen directly by the user
..... text0..1stringPlain text representation of the concept
... code SΣ1..1CodeableConceptType of observation (code / type)
Binding: LOINCCodes (example): Codes identifying names of simple observations.


Required Pattern: At least the following
.... id0..1stringUnique id for inter-element referencing
.... extension0..*ExtensionAdditional content defined by implementations
.... coding1..*CodingCode defined by a terminology system
Fixed Value: (complex)
..... id0..1stringUnique id for inter-element referencing
..... extension0..*ExtensionAdditional content defined by implementations
..... system1..1uriIdentity of the terminology system
Fixed Value: http://snomed.info/sct
..... version0..1stringVersion of the system - if relevant
..... code1..1codeSymbol in syntax defined by the system
Fixed Value: 364325004
..... display0..1stringRepresentation defined by the system
..... userSelected0..1booleanIf this coding was chosen directly by the user
.... text0..1stringPlain text representation of the concept
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
.... Slices for coding Σ0..*CodingCode defined by a terminology system
Slice: Unordered, Open by value:code, value:system
..... coding:loincParity Σ0..1CodingLOINC Parity
...... id 0..1stringUnique id for inter-element referencing
...... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
...... system Σ1..1uriIdentity of the terminology system
Fixed Value: http://loinc.org
...... version Σ0..1stringVersion of the system - if relevant
...... code Σ1..1codeSymbol in syntax defined by the system
Fixed Value: 11977-6
...... display Σ0..1stringRepresentation defined by the system
...... userSelected Σ0..1booleanIf this coding was chosen directly by the user
.... text Σ0..1stringPlain text representation of the concept
... subject SΣ1..1Reference(Patient)Who and/or what the observation is about
... focus Σ0..*Reference(Resource)What the observation is about, when it is not about the subject of record
... encounter SΣ0..1Reference(AU Core Encounter)Healthcare event during which this observation is made
... effective[x] SΣ1..1Date, and optionally time, the observation was performed
.... effectiveDateTimedateTime
.... effectivePeriodPeriod
... issued Σ0..1instantDate/Time this version was made available
... performer SΣ0..*Reference(AU Core Practitioner | AU Core PractitionerRole | AU Core Organization | AU Core Patient | AU Core RelatedPerson)Who is responsible for the observation
... value[x] SΣC0..1QuantityActual result
au-core-parity-01: Parity must be a whole number
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
.... value Σ0..1decimalNumerical value (with implicit precision)
.... comparator ?!Σ0..1code< | <= | >= | > - how to understand the value
Binding: QuantityComparator (required): How the Quantity should be understood and represented.

.... unit Σ0..1stringUnit representation
.... system ΣC1..1uriSystem that defines coded unit form
Fixed Value: http://unitsofmeasure.org
.... code Σ1..1codeCoded form of the unit
Fixed Value: 1
... dataAbsentReason SC0..1CodeableConceptWhy the result is missing
Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.

... interpretation 0..*CodeableConceptHigh, low, normal, etc.
Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.


... note 0..*AnnotationComments about the observation
... bodySite 0..1CodeableConceptObserved body part
Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.

... method 0..1CodeableConceptHow it was done
Binding: ObservationMethods (example): Methods for simple observations.

... specimen 0..1Reference(Specimen)Specimen used for this observation
... device 0..1Reference(Device | DeviceMetric)(Measurement) Device
... referenceRange C0..*BackboneElementProvides guide for interpretation
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... low C0..1SimpleQuantityLow Range, if relevant
.... high C0..1SimpleQuantityHigh Range, if relevant
.... type 0..1CodeableConceptReference range qualifier
Binding: ObservationReferenceRangeMeaningCodes (preferred): Code for the meaning of a reference range.

.... appliesTo 0..*CodeableConceptReference range population
Binding: ObservationReferenceRangeAppliesToCodes (example): Codes identifying the population the reference range applies to.


.... age 0..1RangeApplicable age range, if relevant
.... text 0..1stringText based reference range in an observation
... hasMember Σ0..*Reference(Observation | QuestionnaireResponse | MolecularSequence)Related resource that belongs to the Observation group
... derivedFrom Σ0..*Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | Observation | MolecularSequence)Related measurements the observation is made from
... component Σ0..*BackboneElementComponent results
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... code Σ1..1CodeableConceptType of component observation (code / type)
Binding: LOINCCodes (example): Codes identifying names of simple observations.

.... value[x] Σ0..1Actual component result
..... valueQuantityQuantity
..... valueCodeableConceptCodeableConcept
..... valueStringstring
..... valueBooleanboolean
..... valueIntegerinteger
..... valueRangeRange
..... valueRatioRatio
..... valueSampledDataSampledData
..... valueTimetime
..... valueDateTimedateTime
..... valuePeriodPeriod
.... dataAbsentReason C0..1CodeableConceptWhy the component result is missing
Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.

.... interpretation 0..*CodeableConceptHigh, low, normal, etc.
Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.


.... referenceRange 0..*See referenceRange (Observation)Provides guide for interpretation of component result

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / Code
Observation.languagepreferredCommonLanguages
Additional Bindings Purpose
AllLanguages Max Binding
Observation.statusrequiredFixed Value: final
Observation.categorypreferredObservationCategoryCodes
Observation.category:socialHistorypreferredPattern: social-history
Observation.codeexamplePattern: SNOMED CT code 364325004
Observation.value[x].comparatorrequiredQuantityComparator
Observation.dataAbsentReasonextensibleDataAbsentReason
Observation.interpretationextensibleObservationInterpretationCodes
Observation.bodySiteexampleSNOMEDCTBodyStructures
Observation.methodexampleObservationMethods
Observation.referenceRange.typepreferredObservationReferenceRangeMeaningCodes
Observation.referenceRange.appliesToexampleObservationReferenceRangeAppliesToCodes
Observation.component.codeexampleLOINCCodes (a valid code from LOINC)
Observation.component.dataAbsentReasonextensibleDataAbsentReason
Observation.component.interpretationextensibleObservationInterpretationCodes

Constraints

IdGradePath(s)DetailsRequirements
au-core-obs-02errorObservationAt least value or data absent reason shall be present
: dataAbsentReason.exists() or value.exists()
au-core-parity-01errorObservation.value[x]Parity must be a whole number
: value.toString().contains('.').not()

This structure is derived from Observation

Summary

Mandatory: 4 elements (4 nested mandatory elements)
Must-Support: 9 elements
Fixed Value: 5 elements

Structures

This structure refers to these other structures:

Slices

This structure defines the following Slices:

  • The element Observation.category is sliced based on the value of pattern:$this
  • The element Observation.code.coding is sliced based on the values of value:code, value:system

Maturity: 0

Differential View

This structure is derived from Observation

NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation C0..*ObservationParity
au-core-obs-02: At least value or data absent reason shall be present
... status S1..1coderegistered | preliminary | final | amended +
Fixed Value: final
... Slices for category S1..*CodeableConceptClassification of type of observation
Slice: Unordered, Open by pattern:$this
.... category:socialHistory 1..1CodeableConceptClassification of type of observation
Required Pattern: At least the following
..... coding1..*CodingCode defined by a terminology system
Fixed Value: (complex)
...... system1..1uriIdentity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category
...... code1..1codeSymbol in syntax defined by the system
Fixed Value: social-history
... code S1..1CodeableConceptType of observation (code / type)
Required Pattern: At least the following
.... coding1..*CodingCode defined by a terminology system
Fixed Value: (complex)
..... system1..1uriIdentity of the terminology system
Fixed Value: http://snomed.info/sct
..... code1..1codeSymbol in syntax defined by the system
Fixed Value: 364325004
.... Slices for coding 0..*CodingCode defined by a terminology system
Slice: Unordered, Open by value:code, value:system
..... coding:loincParity 0..1CodingLOINC Parity
...... system 1..1uriIdentity of the terminology system
Fixed Value: http://loinc.org
...... code 1..1codeSymbol in syntax defined by the system
Fixed Value: 11977-6
... encounter S0..1Reference(AU Core Encounter)Healthcare event during which this observation is made
... effective[x] S1..1Date, and optionally time, the observation was performed
.... effectiveDateTimedateTime
.... effectivePeriodPeriod
... performer S0..*Reference(AU Core Practitioner | AU Core PractitionerRole | AU Core Organization | AU Core Patient | AU Core RelatedPerson)Who is responsible for the observation
... value[x] SC0..1QuantityActual result
au-core-parity-01: Parity must be a whole number
.... system 1..1uriSystem that defines coded unit form
Fixed Value: http://unitsofmeasure.org
.... code 1..1codeCoded form of the unit
Fixed Value: 1
... dataAbsentReason SC0..1CodeableConceptWhy the result is missing

doco Documentation for this format

Constraints

IdGradePath(s)DetailsRequirements
au-core-obs-02errorObservationAt least value or data absent reason shall be present
: dataAbsentReason.exists() or value.exists()
au-core-parity-01errorObservation.value[x]Parity must be a whole number
: value.toString().contains('.').not()

Key Elements View

NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation C0..*ObservationParity
au-core-obs-02: At least value or data absent reason shall be present
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... status ?!SΣ1..1coderegistered | preliminary | final | amended +
Binding: ObservationStatus (required): Codes providing the status of an observation.


Fixed Value: final
.... category:socialHistory 1..1CodeableConceptClassification of type of observation
Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.



Required Pattern: At least the following
..... coding1..*CodingCode defined by a terminology system
Fixed Value: (complex)
...... system1..1uriIdentity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category
...... code1..1codeSymbol in syntax defined by the system
Fixed Value: social-history
... code SΣ1..1CodeableConceptType of observation (code / type)
Binding: LOINCCodes (example): Codes identifying names of simple observations.


Required Pattern: At least the following
.... coding1..*CodingCode defined by a terminology system
Fixed Value: (complex)
..... system1..1uriIdentity of the terminology system
Fixed Value: http://snomed.info/sct
..... code1..1codeSymbol in syntax defined by the system
Fixed Value: 364325004
.... Slices for coding Σ0..*CodingCode defined by a terminology system
Slice: Unordered, Open by value:code, value:system
..... coding:loincParity Σ0..1CodingLOINC Parity
...... system Σ1..1uriIdentity of the terminology system
Fixed Value: http://loinc.org
...... code Σ1..1codeSymbol in syntax defined by the system
Fixed Value: 11977-6
... subject SΣ1..1Reference(Patient)Who and/or what the observation is about
... encounter SΣ0..1Reference(AU Core Encounter)Healthcare event during which this observation is made
... effective[x] SΣ1..1Date, and optionally time, the observation was performed
.... effectiveDateTimedateTime
.... effectivePeriodPeriod
... performer SΣ0..*Reference(AU Core Practitioner | AU Core PractitionerRole | AU Core Organization | AU Core Patient | AU Core RelatedPerson)Who is responsible for the observation
... value[x] SΣC0..1QuantityActual result
au-core-parity-01: Parity must be a whole number
.... comparator ?!Σ0..1code< | <= | >= | > - how to understand the value
Binding: QuantityComparator (required): How the Quantity should be understood and represented.

.... system ΣC1..1uriSystem that defines coded unit form
Fixed Value: http://unitsofmeasure.org
.... code Σ1..1codeCoded form of the unit
Fixed Value: 1
... dataAbsentReason SC0..1CodeableConceptWhy the result is missing
Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.


doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / Code
Observation.statusrequiredFixed Value: final
Observation.categorypreferredObservationCategoryCodes
Observation.category:socialHistorypreferredPattern: social-history
Observation.codeexamplePattern: SNOMED CT code 364325004
Observation.value[x].comparatorrequiredQuantityComparator
Observation.dataAbsentReasonextensibleDataAbsentReason

Constraints

IdGradePath(s)DetailsRequirements
au-core-obs-02errorObservationAt least value or data absent reason shall be present
: dataAbsentReason.exists() or value.exists()
au-core-parity-01errorObservation.value[x]Parity must be a whole number
: value.toString().contains('.').not()

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation C0..*ObservationParity
au-core-obs-02: At least value or data absent reason shall be present
... id Σ0..1idLogical id of this artifact
... meta Σ0..1MetaMetadata about the resource
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... language 0..1codeLanguage of the resource content
Binding: CommonLanguages (preferred): A human language.

Additional BindingsPurpose
AllLanguagesMax Binding
... text 0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... extension 0..*ExtensionAdditional content defined by implementations
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... identifier Σ0..*IdentifierBusiness Identifier for observation
... basedOn Σ0..*Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest)Fulfills plan, proposal or order
... partOf Σ0..*Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy)Part of referenced event
... status ?!SΣ1..1coderegistered | preliminary | final | amended +
Binding: ObservationStatus (required): Codes providing the status of an observation.


Fixed Value: final
... Slices for category S1..*CodeableConceptClassification of type of observation
Slice: Unordered, Open by pattern:$this
Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.


.... category:socialHistory 1..1CodeableConceptClassification of type of observation
Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.



Required Pattern: At least the following
..... id0..1stringUnique id for inter-element referencing
..... extension0..*ExtensionAdditional content defined by implementations
..... coding1..*CodingCode defined by a terminology system
Fixed Value: (complex)
...... id0..1stringUnique id for inter-element referencing
...... extension0..*ExtensionAdditional content defined by implementations
...... system1..1uriIdentity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category
...... version0..1stringVersion of the system - if relevant
...... code1..1codeSymbol in syntax defined by the system
Fixed Value: social-history
...... display0..1stringRepresentation defined by the system
...... userSelected0..1booleanIf this coding was chosen directly by the user
..... text0..1stringPlain text representation of the concept
... code SΣ1..1CodeableConceptType of observation (code / type)
Binding: LOINCCodes (example): Codes identifying names of simple observations.


Required Pattern: At least the following
.... id0..1stringUnique id for inter-element referencing
.... extension0..*ExtensionAdditional content defined by implementations
.... coding1..*CodingCode defined by a terminology system
Fixed Value: (complex)
..... id0..1stringUnique id for inter-element referencing
..... extension0..*ExtensionAdditional content defined by implementations
..... system1..1uriIdentity of the terminology system
Fixed Value: http://snomed.info/sct
..... version0..1stringVersion of the system - if relevant
..... code1..1codeSymbol in syntax defined by the system
Fixed Value: 364325004
..... display0..1stringRepresentation defined by the system
..... userSelected0..1booleanIf this coding was chosen directly by the user
.... text0..1stringPlain text representation of the concept
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
.... Slices for coding Σ0..*CodingCode defined by a terminology system
Slice: Unordered, Open by value:code, value:system
..... coding:loincParity Σ0..1CodingLOINC Parity
...... id 0..1stringUnique id for inter-element referencing
...... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
...... system Σ1..1uriIdentity of the terminology system
Fixed Value: http://loinc.org
...... version Σ0..1stringVersion of the system - if relevant
...... code Σ1..1codeSymbol in syntax defined by the system
Fixed Value: 11977-6
...... display Σ0..1stringRepresentation defined by the system
...... userSelected Σ0..1booleanIf this coding was chosen directly by the user
.... text Σ0..1stringPlain text representation of the concept
... subject SΣ1..1Reference(Patient)Who and/or what the observation is about
... focus Σ0..*Reference(Resource)What the observation is about, when it is not about the subject of record
... encounter SΣ0..1Reference(AU Core Encounter)Healthcare event during which this observation is made
... effective[x] SΣ1..1Date, and optionally time, the observation was performed
.... effectiveDateTimedateTime
.... effectivePeriodPeriod
... issued Σ0..1instantDate/Time this version was made available
... performer SΣ0..*Reference(AU Core Practitioner | AU Core PractitionerRole | AU Core Organization | AU Core Patient | AU Core RelatedPerson)Who is responsible for the observation
... value[x] SΣC0..1QuantityActual result
au-core-parity-01: Parity must be a whole number
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
.... value Σ0..1decimalNumerical value (with implicit precision)
.... comparator ?!Σ0..1code< | <= | >= | > - how to understand the value
Binding: QuantityComparator (required): How the Quantity should be understood and represented.

.... unit Σ0..1stringUnit representation
.... system ΣC1..1uriSystem that defines coded unit form
Fixed Value: http://unitsofmeasure.org
.... code Σ1..1codeCoded form of the unit
Fixed Value: 1
... dataAbsentReason SC0..1CodeableConceptWhy the result is missing
Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.

... interpretation 0..*CodeableConceptHigh, low, normal, etc.
Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.


... note 0..*AnnotationComments about the observation
... bodySite 0..1CodeableConceptObserved body part
Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.

... method 0..1CodeableConceptHow it was done
Binding: ObservationMethods (example): Methods for simple observations.

... specimen 0..1Reference(Specimen)Specimen used for this observation
... device 0..1Reference(Device | DeviceMetric)(Measurement) Device
... referenceRange C0..*BackboneElementProvides guide for interpretation
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... low C0..1SimpleQuantityLow Range, if relevant
.... high C0..1SimpleQuantityHigh Range, if relevant
.... type 0..1CodeableConceptReference range qualifier
Binding: ObservationReferenceRangeMeaningCodes (preferred): Code for the meaning of a reference range.

.... appliesTo 0..*CodeableConceptReference range population
Binding: ObservationReferenceRangeAppliesToCodes (example): Codes identifying the population the reference range applies to.


.... age 0..1RangeApplicable age range, if relevant
.... text 0..1stringText based reference range in an observation
... hasMember Σ0..*Reference(Observation | QuestionnaireResponse | MolecularSequence)Related resource that belongs to the Observation group
... derivedFrom Σ0..*Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | Observation | MolecularSequence)Related measurements the observation is made from
... component Σ0..*BackboneElementComponent results
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... code Σ1..1CodeableConceptType of component observation (code / type)
Binding: LOINCCodes (example): Codes identifying names of simple observations.

.... value[x] Σ0..1Actual component result
..... valueQuantityQuantity
..... valueCodeableConceptCodeableConcept
..... valueStringstring
..... valueBooleanboolean
..... valueIntegerinteger
..... valueRangeRange
..... valueRatioRatio
..... valueSampledDataSampledData
..... valueTimetime
..... valueDateTimedateTime
..... valuePeriodPeriod
.... dataAbsentReason C0..1CodeableConceptWhy the component result is missing
Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.

.... interpretation 0..*CodeableConceptHigh, low, normal, etc.
Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.


.... referenceRange 0..*See referenceRange (Observation)Provides guide for interpretation of component result

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / Code
Observation.languagepreferredCommonLanguages
Additional Bindings Purpose
AllLanguages Max Binding
Observation.statusrequiredFixed Value: final
Observation.categorypreferredObservationCategoryCodes
Observation.category:socialHistorypreferredPattern: social-history
Observation.codeexamplePattern: SNOMED CT code 364325004
Observation.value[x].comparatorrequiredQuantityComparator
Observation.dataAbsentReasonextensibleDataAbsentReason
Observation.interpretationextensibleObservationInterpretationCodes
Observation.bodySiteexampleSNOMEDCTBodyStructures
Observation.methodexampleObservationMethods
Observation.referenceRange.typepreferredObservationReferenceRangeMeaningCodes
Observation.referenceRange.appliesToexampleObservationReferenceRangeAppliesToCodes
Observation.component.codeexampleLOINCCodes (a valid code from LOINC)
Observation.component.dataAbsentReasonextensibleDataAbsentReason
Observation.component.interpretationextensibleObservationInterpretationCodes

Constraints

IdGradePath(s)DetailsRequirements
au-core-obs-02errorObservationAt least value or data absent reason shall be present
: dataAbsentReason.exists() or value.exists()
au-core-parity-01errorObservation.value[x]Parity must be a whole number
: value.toString().contains('.').not()

This structure is derived from Observation

Summary

Mandatory: 4 elements (4 nested mandatory elements)
Must-Support: 9 elements
Fixed Value: 5 elements

Structures

This structure refers to these other structures:

Slices

This structure defines the following Slices:

  • The element Observation.category is sliced based on the value of pattern:$this
  • The element Observation.code.coding is sliced based on the values of value:code, value:system

Maturity: 0

 

Other representations of profile: CSV, Excel, Schematron

Notes:

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.

Parameter(s) Conformance Type(s) Requirements (when used alone or in combination)
patient SHALL reference The client SHALL provide at least an id value and MAY provide both the Type and id values. The server SHALL support both.
patient+category SHALL reference+token
patient+category+date SHALL reference+token+date
patient+code SHALL reference+token
patient+category+status SHOULD reference+token+token
patient+code+date SHOULD reference+token+date
patient.identifier SHOULD reference.token The client SHALL provide both the system and code values. The server SHALL support both. The client SHOULD support search using IHI, Medicare Number, and DVA Number identifiers as defined in the AU Core Patient profile. The server SHOULD support search using the using IHI, Medicare Number, and DVA Number identifiers as defined in the AU Core Patient profile.
category MAY token The client SHALL provide at least a code value and MAY provide both the system and code values. The server SHALL support both.
code MAY token The client SHALL provide at least a code value and MAY provide both the system and code values. The server SHALL support both.
date MAY date A client SHALL provide a value precise to the second + time offset. A server SHALL support a value precise to the second + time offset.
status MAY token The client SHALL provide at least a code value and MAY provide both the system and code values. The server SHALL support both.

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=5678&_revinclude=Provenance:target
    3. GET [base]/Observation?patient.identifier=http://ns.electronichealth.net.au/id/medicare-number|32788511952
    4. 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={system|}[code]

    Example:

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

    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 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|364325004,http://loinc.org|9279-1,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)

  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={system|}[code]&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|survey&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 = survey (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={system|}[code]&status={system|}[code]{,{system|}[code],...}

    Example:

    1. GET [base]/Observation?patient=5678&category=http://terminology.hl7.org/CodeSystem/observation-category|survey&status=final
    2. GET [base]/Observation?patient=5678&category=http://terminology.hl7.org/CodeSystem/observation-category|survey&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://snomed.info/sct|364325004,http://loinc.org|9279-1,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|364325004,http://loinc.org|9279-1,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 report code(s) (how to search by reference and how to search by token and how to search by date)