AU Core Implementation Guide
2.0.0 - Working Standard

AU Core Implementation Guide - Downloaded Version 2.0.0 See the Directory of published versions

## Resource Profile: AU Core Body Temperature

Official URL: http://hl7.org.au/fhir/core/StructureDefinition/au-core-bodytemp | Version: 2.0.0
Standards status: Trial-use | Maturity Level: 2 | Computable Name: AUCoreBodyTemperature
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 profile sets minimum expectations for an Observation resource to record, search, and fetch body temperature observations with standard coding and units of measure. It is based on the FHIR Body Temperature Profile 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.

See Comparison with other national and international IGs for a comparison between AU Core profiles and profiles in other implementation guides.

### Usage Scenarios

The following are supported usage scenarios for this profile:

- Query for observations of body temperature associated with a patient
- Record or update an observation of body temperature associated with a patient

### 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 more specific codes - 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.

Usages:

- Examples for this Profile: Observation/bodytemp-1
- CapabilityStatements using this Profile: AU Core Requester CapabilityStatement and AU Core Responder CapabilityStatement

You can also check for usages in the FHIR IG Statistics

Changes since version 1.0.0:

- No changes

### Formal Views of Profile Content

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

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

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Observation | C | 0..* | observation-bodytemp | Body temperature Constraints: obs-6, obs-7, vs-2, au-core-obs-01
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
status | ?!SO Σ | 1..1 | code | registered | preliminary | final | amended + Binding: ObservationStatus (required)
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
Slices for category | SO | 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.
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
category:VSCat | SO | 1..1 | CodeableConcept | Classification of type of observation Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
coding | SO Σ | 1..* | Coding | Code defined by a terminology system
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
system | SO Σ | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
code | SO Σ | 1..1 | code | Symbol in syntax defined by the system Fixed Value: vital-signs
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
code | SO Σ | 1..1 | CodeableConcept | Body Temperature Binding: VitalSigns (extensible): This identifies the vital sign result type.
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
Slices for coding | Σ | 2..* | Coding | Code defined by a terminology system Slice: Unordered, Open by value:code, value:system
coding:BodyTempCode | 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: 8310-5
coding:snomedBodyTempCode | Σ | 1..1 | Coding | SNOMED CT Body Temperature
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: 386725007
subject | SO Σ | 1..1 | Reference(AU Core Patient) | Who and/or what the observation is about
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
effective[x] | SO Σ C | 1..1 | dateTime | Date, and optionally time, the observation was performed Constraints: vs-1
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
Slices for value[x] | S Σ C | 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 | SO Σ C | 0..1 | Quantity | Body temperature
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
value | SO Σ | 1..1 | decimal | Numerical value (with implicit precision)
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
comparator | ?!Σ | 0..1 | code | < | <= | >= | > - how to understand the value Binding: QuantityComparator (required): How the Quantity should be understood and represented.
unit | SO Σ | 1..1 | string | Unit representation
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
system | SO Σ C | 1..1 | uri | System that defines coded unit form Fixed Value: http://unitsofmeasure.org
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
code | SO Σ | 1..1 | code | Coded responses from the common UCUM units for vital signs value set. Binding: BodyTemperatureUnits (required)
Additional Bindings | Purpose
Metric Body Temperature Units | candidate
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
dataAbsentReason | SO C | 0..1 | CodeableConcept | Why the result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
bodySite | C | 0..1 | CodeableConcept | Observed body part Binding: Body Site (preferred) Constraints: au-core-obs-02
component | SO Σ C | 0..* | BackboneElement | Used when reporting systolic and diastolic blood pressure. Constraints: vs-3
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
code | SO Σ | 1..1 | CodeableConcept | Type of component observation (code / type) Binding: VitalSigns (extensible): This identifies the vital sign result type.
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
value[x] | SO Σ C | 0..1 |  | Vital Sign Value recorded with UCUM Binding: VitalSignsUnits (extensible): Common UCUM units for recording Vital Signs.
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
valueQuantity |  |  | Quantity |
valueCodeableConcept |  |  | CodeableConcept |
valueString |  |  | string |
valueBoolean |  |  | boolean |
valueInteger |  |  | integer |
valueRange |  |  | Range |
valueRatio |  |  | Ratio |
valueSampledData |  |  | SampledData |
valueTime |  |  | time |
valueDateTime |  |  | dateTime |
valuePeriod |  |  | Period |
dataAbsentReason | SO C | 0..1 | CodeableConcept | Why the component result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
Observation.status | Base | required | ObservationStatus | 📍4.0.1 | FHIR Std.
Observation.category | Base | preferred | Observation Category Codes | 📍4.0.1 | FHIR Std.
Observation.category:VSCat | Base | preferred | Observation Category Codes | 📍4.0.1 | FHIR Std.
Observation.code | Base | extensible | Vital Signs | 📍4.0.1 | FHIR Std.
Observation.value[x]:valueQuantity.​comparator | Base | required | QuantityComparator | 📍4.0.1 | FHIR Std.
Observation.value[x]:valueQuantity.​code | Base | required | Body Temperature Units | 📦4.0.1 | FHIR Std.
Observation.dataAbsentReason | Base | extensible | DataAbsentReason | 📍4.0.1 | FHIR Std.
Observation.bodySite | Base | preferred | Body Site | ⏿1.0.2 | tx.hl7.org.au
Observation.component.​code | Base | extensible | Vital Signs | 📍4.0.1 | FHIR Std.
Observation.component.​value[x] | Base | extensible | Vital Signs Units | 📍4.0.1 | FHIR Std.
Observation.component.​dataAbsentReason | Base | extensible | DataAbsentReason | 📍4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
au-core-obs-01 | error | Observation | At least value or data absent reason shall be present | `dataAbsentReason.exists() or value.exists()`
au-core-obs-02 | error | Observation.bodySite | If a coded body site is provided, at least one coding shall be from SNOMED CT | `coding.exists() implies coding.where(system='http://snomed.info/sct').exists()`
dom-2 | error | Observation | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | Observation | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource | `contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()`
dom-4 | error | Observation | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated | `contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()`
dom-5 | error | Observation | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | Observation | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`
obs-6 | error | Observation | dataAbsentReason SHALL only be present if Observation.value[x] is not present | `dataAbsentReason.empty() or value.empty()`
obs-7 | error | Observation | If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present | `value.empty() or component.code.where(coding.intersect(%resource.code.coding).exists()).empty()`
vs-1 | error | Observation.effective[x] | if Observation.effective[x] is dateTime and has a value then that value shall be precise to the day | `$this is dateTime implies $this.toString().length() >= 10`
vs-2 | error | Observation | If there is no component or hasMember element then either a value[x] or a data absent reason must be present. | `(component.empty() and hasMember.empty()) implies (dataAbsentReason.exists() or value.exists())`
vs-3 | error | Observation.component | If there is no a value a data absent reason must be present | `value.exists() or dataAbsentReason.exists()`

This structure is derived from observation-bodytemp

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Observation | C | 0..* | observation-bodytemp | Body temperature Constraints: au-core-obs-01
status | O | 1..1 | code | registered | preliminary | final | amended +
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
category | O | 1..* | CodeableConcept | Classification of type of observation
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
Slices for category |  |  |  | Content/Rules for all slices
category:VSCat | O | 1..1 | CodeableConcept | Classification of type of observation
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
coding | O | 1..* | Coding | Code defined by a terminology system
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
system | O | 1..1 | uri | Identity of the terminology system
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
code | O | 1..1 | code | Symbol in syntax defined by the system
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
code | O | 1..1 | CodeableConcept | Body Temperature
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
coding |  | 2..* | Coding | Code defined by a terminology system
Slices for coding |  |  |  | Content/Rules for all slices
coding:snomedBodyTempCode |  | 1..1 | Coding | SNOMED CT Body Temperature
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: 386725007
subject | O | 1..1 | Reference(AU Core Patient) | Who and/or what the observation is about
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
effective[x] | O | 1..1 | dateTime | Date, and optionally time, the observation was performed
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
valueQuantity | O C | 0..1 | Quantity | Body temperature
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
value | O | 1..1 | decimal | Numerical value (with implicit precision)
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
unit | O | 1..1 | string | Unit representation
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
system | O | 1..1 | uri | System that defines coded unit form
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
code | O | 1..1 | code | Coded responses from the common UCUM units for vital signs value set. Binding: BodyTemperatureUnits (required)
Additional Bindings | Purpose
Metric Body Temperature Units | candidate
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
dataAbsentReason | O C | 0..1 | CodeableConcept | Why the result is missing
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
bodySite | C | 0..1 | CodeableConcept | Observed body part Binding: Body Site (preferred) Constraints: au-core-obs-02
component | O | 0..* | BackboneElement | Used when reporting systolic and diastolic blood pressure.
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
code | O | 1..1 | CodeableConcept | Type of component observation (code / type)
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
value[x] | O | 0..1 | Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period | Vital Sign Value recorded with UCUM
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
dataAbsentReason | O | 0..1 | CodeableConcept | Why the component result is missing
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
Documentation for this format

#### Terminology Bindings (Differential)

Path | Status | Usage | ValueSet | Version | Source
Observation.valueQuantity.​code | Base | required | Body Temperature Units | 📦4.0.1 | FHIR Std.
Observation.bodySite | Base | preferred | Body Site | ⏿1.0.2 | tx.hl7.org.au

#### Constraints

Id | Grade | Path(s) | Description | Expression
au-core-obs-01 | error | Observation | At least value or data absent reason shall be present | `dataAbsentReason.exists() or value.exists()`
au-core-obs-02 | error | Observation.bodySite | If a coded body site is provided, at least one coding shall be from SNOMED CT | `coding.exists() implies coding.where(system='http://snomed.info/sct').exists()`

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Observation | C | 0..* | observation-bodytemp | Body temperature Constraints: obs-6, obs-7, vs-2, au-core-obs-01
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 This profile does not constrain the narrative in regard to content, language, or traceability to data elements
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 | ?!SO Σ | 1..1 | code | registered | preliminary | final | amended + Binding: ObservationStatus (required)
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
Slices for category | SO | 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.
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
category:VSCat | SO | 1..1 | CodeableConcept | Classification of type of observation Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
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 | SO Σ | 1..* | Coding | Code defined by a terminology system
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
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 | SO Σ | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
version | Σ | 0..1 | string | Version of the system - if relevant
code | SO Σ | 1..1 | code | Symbol in syntax defined by the system Fixed Value: vital-signs
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
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 | SO Σ | 1..1 | CodeableConcept | Body Temperature Binding: VitalSigns (extensible): This identifies the vital sign result type.
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
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:BodyTempCode | 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: 8310-5
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:snomedBodyTempCode | Σ | 1..1 | Coding | SNOMED CT Body Temperature
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: 386725007
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 | SO Σ | 1..1 | Reference(AU Core Patient) | Who and/or what the observation is about
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
focus | Σ | 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] | SO Σ C | 1..1 | dateTime | Date, and optionally time, the observation was performed Constraints: vs-1
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
issued | Σ | 0..1 | instant | Date/Time this version was made available
performer | Σ | 0..* | Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson) | Who is responsible for the observation
Slices for value[x] | S Σ C | 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 | SO Σ C | 0..1 | Quantity | Body temperature
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
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 | SO Σ | 1..1 | decimal | Numerical value (with implicit precision)
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
comparator | ?!Σ | 0..1 | code | < | <= | >= | > - how to understand the value Binding: QuantityComparator (required): How the Quantity should be understood and represented.
unit | SO Σ | 1..1 | string | Unit representation
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
system | SO Σ C | 1..1 | uri | System that defines coded unit form Fixed Value: http://unitsofmeasure.org
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
code | SO Σ | 1..1 | code | Coded responses from the common UCUM units for vital signs value set. Binding: BodyTemperatureUnits (required)
Additional Bindings | Purpose
Metric Body Temperature Units | candidate
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
dataAbsentReason | SO C | 0..1 | CodeableConcept | Why the result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
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: Body Site (preferred) Constraints: au-core-obs-02
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 Constraints: obs-3
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(4.0.1) | Low Range, if relevant
high | C | 0..1 | SimpleQuantity(4.0.1) | 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 | SO Σ C | 0..* | BackboneElement | Used when reporting systolic and diastolic blood pressure. Constraints: vs-3
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
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 | SO Σ | 1..1 | CodeableConcept | Type of component observation (code / type) Binding: VitalSigns (extensible): This identifies the vital sign result type.
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
value[x] | SO Σ C | 0..1 |  | Vital Sign Value recorded with UCUM Binding: VitalSignsUnits (extensible): Common UCUM units for recording Vital Signs.
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
valueQuantity |  |  | Quantity |
valueCodeableConcept |  |  | CodeableConcept |
valueString |  |  | string |
valueBoolean |  |  | boolean |
valueInteger |  |  | integer |
valueRange |  |  | Range |
valueRatio |  |  | Ratio |
valueSampledData |  |  | SampledData |
valueTime |  |  | time |
valueDateTime |  |  | dateTime |
valuePeriod |  |  | Period |
dataAbsentReason | SO C | 0..1 | CodeableConcept | Why the component result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
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 | Status | Usage | ValueSet | Version | Source
Observation.language | Base | preferred | Common Languages | 📍4.0.1 | FHIR Std.
Observation.status | Base | required | ObservationStatus | 📍4.0.1 | FHIR Std.
Observation.category | Base | preferred | Observation Category Codes | 📍4.0.1 | FHIR Std.
Observation.category:VSCat | Base | preferred | Observation Category Codes | 📍4.0.1 | FHIR Std.
Observation.code | Base | extensible | Vital Signs | 📍4.0.1 | FHIR Std.
Observation.value[x]:valueQuantity.​comparator | Base | required | QuantityComparator | 📍4.0.1 | FHIR Std.
Observation.value[x]:valueQuantity.​code | Base | required | Body Temperature Units | 📦4.0.1 | FHIR Std.
Observation.dataAbsentReason | Base | extensible | DataAbsentReason | 📍4.0.1 | FHIR Std.
Observation.interpretation | Base | extensible | Observation Interpretation Codes | 📍4.0.1 | FHIR Std.
Observation.bodySite | Base | preferred | Body Site | ⏿1.0.2 | tx.hl7.org.au
Observation.method | Base | example | Observation Methods | 📍4.0.1 | FHIR Std.
Observation.referenceRange.​type | Base | preferred | Observation Reference Range Meaning Codes | 📍4.0.1 | FHIR Std.
Observation.referenceRange.​appliesTo | Base | example | Observation Reference Range Applies To Codes | 📍4.0.1 | FHIR Std.
Observation.component.​code | Base | extensible | Vital Signs | 📍4.0.1 | FHIR Std.
Observation.component.​value[x] | Base | extensible | Vital Signs Units | 📍4.0.1 | FHIR Std.
Observation.component.​dataAbsentReason | Base | extensible | DataAbsentReason | 📍4.0.1 | FHIR Std.
Observation.component.​interpretation | Base | extensible | Observation Interpretation Codes | 📍4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
au-core-obs-01 | error | Observation | At least value or data absent reason shall be present | `dataAbsentReason.exists() or value.exists()`
au-core-obs-02 | error | Observation.bodySite | If a coded body site is provided, at least one coding shall be from SNOMED CT | `coding.exists() implies coding.where(system='http://snomed.info/sct').exists()`
dom-2 | error | Observation | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | Observation | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource | `contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()`
dom-4 | error | Observation | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated | `contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()`
dom-5 | error | Observation | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | Observation | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`
obs-3 | error | Observation.referenceRange | Must have at least a low or a high or text | `low.exists() or high.exists() or text.exists()`
obs-6 | error | Observation | dataAbsentReason SHALL only be present if Observation.value[x] is not present | `dataAbsentReason.empty() or value.empty()`
obs-7 | error | Observation | If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present | `value.empty() or component.code.where(coding.intersect(%resource.code.coding).exists()).empty()`
vs-1 | error | Observation.effective[x] | if Observation.effective[x] is dateTime and has a value then that value shall be precise to the day | `$this is dateTime implies $this.toString().length() >= 10`
vs-2 | error | Observation | If there is no component or hasMember element then either a value[x] or a data absent reason must be present. | `(component.empty() and hasMember.empty()) implies (dataAbsentReason.exists() or value.exists())`
vs-3 | error | Observation.component | If there is no a value a data absent reason must be present | `value.exists() or dataAbsentReason.exists()`

This structure is derived from observation-bodytemp

Summary

Mandatory: 3 elements
Fixed: 2 elements

Structures

This structure refers to these other structures:

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

Maturity: 2

Key Elements View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Observation | C | 0..* | observation-bodytemp | Body temperature Constraints: obs-6, obs-7, vs-2, au-core-obs-01
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
status | ?!SO Σ | 1..1 | code | registered | preliminary | final | amended + Binding: ObservationStatus (required)
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
Slices for category | SO | 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.
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
category:VSCat | SO | 1..1 | CodeableConcept | Classification of type of observation Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
coding | SO Σ | 1..* | Coding | Code defined by a terminology system
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
system | SO Σ | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
code | SO Σ | 1..1 | code | Symbol in syntax defined by the system Fixed Value: vital-signs
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
code | SO Σ | 1..1 | CodeableConcept | Body Temperature Binding: VitalSigns (extensible): This identifies the vital sign result type.
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
Slices for coding | Σ | 2..* | Coding | Code defined by a terminology system Slice: Unordered, Open by value:code, value:system
coding:BodyTempCode | 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: 8310-5
coding:snomedBodyTempCode | Σ | 1..1 | Coding | SNOMED CT Body Temperature
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: 386725007
subject | SO Σ | 1..1 | Reference(AU Core Patient) | Who and/or what the observation is about
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
effective[x] | SO Σ C | 1..1 | dateTime | Date, and optionally time, the observation was performed Constraints: vs-1
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
Slices for value[x] | S Σ C | 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 | SO Σ C | 0..1 | Quantity | Body temperature
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
value | SO Σ | 1..1 | decimal | Numerical value (with implicit precision)
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
comparator | ?!Σ | 0..1 | code | < | <= | >= | > - how to understand the value Binding: QuantityComparator (required): How the Quantity should be understood and represented.
unit | SO Σ | 1..1 | string | Unit representation
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
system | SO Σ C | 1..1 | uri | System that defines coded unit form Fixed Value: http://unitsofmeasure.org
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
code | SO Σ | 1..1 | code | Coded responses from the common UCUM units for vital signs value set. Binding: BodyTemperatureUnits (required)
Additional Bindings | Purpose
Metric Body Temperature Units | candidate
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
dataAbsentReason | SO C | 0..1 | CodeableConcept | Why the result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
bodySite | C | 0..1 | CodeableConcept | Observed body part Binding: Body Site (preferred) Constraints: au-core-obs-02
component | SO Σ C | 0..* | BackboneElement | Used when reporting systolic and diastolic blood pressure. Constraints: vs-3
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
code | SO Σ | 1..1 | CodeableConcept | Type of component observation (code / type) Binding: VitalSigns (extensible): This identifies the vital sign result type.
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
value[x] | SO Σ C | 0..1 |  | Vital Sign Value recorded with UCUM Binding: VitalSignsUnits (extensible): Common UCUM units for recording Vital Signs.
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
valueQuantity |  |  | Quantity |
valueCodeableConcept |  |  | CodeableConcept |
valueString |  |  | string |
valueBoolean |  |  | boolean |
valueInteger |  |  | integer |
valueRange |  |  | Range |
valueRatio |  |  | Ratio |
valueSampledData |  |  | SampledData |
valueTime |  |  | time |
valueDateTime |  |  | dateTime |
valuePeriod |  |  | Period |
dataAbsentReason | SO C | 0..1 | CodeableConcept | Why the component result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
Observation.status | Base | required | ObservationStatus | 📍4.0.1 | FHIR Std.
Observation.category | Base | preferred | Observation Category Codes | 📍4.0.1 | FHIR Std.
Observation.category:VSCat | Base | preferred | Observation Category Codes | 📍4.0.1 | FHIR Std.
Observation.code | Base | extensible | Vital Signs | 📍4.0.1 | FHIR Std.
Observation.value[x]:valueQuantity.​comparator | Base | required | QuantityComparator | 📍4.0.1 | FHIR Std.
Observation.value[x]:valueQuantity.​code | Base | required | Body Temperature Units | 📦4.0.1 | FHIR Std.
Observation.dataAbsentReason | Base | extensible | DataAbsentReason | 📍4.0.1 | FHIR Std.
Observation.bodySite | Base | preferred | Body Site | ⏿1.0.2 | tx.hl7.org.au
Observation.component.​code | Base | extensible | Vital Signs | 📍4.0.1 | FHIR Std.
Observation.component.​value[x] | Base | extensible | Vital Signs Units | 📍4.0.1 | FHIR Std.
Observation.component.​dataAbsentReason | Base | extensible | DataAbsentReason | 📍4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
au-core-obs-01 | error | Observation | At least value or data absent reason shall be present | `dataAbsentReason.exists() or value.exists()`
au-core-obs-02 | error | Observation.bodySite | If a coded body site is provided, at least one coding shall be from SNOMED CT | `coding.exists() implies coding.where(system='http://snomed.info/sct').exists()`
dom-2 | error | Observation | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | Observation | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource | `contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()`
dom-4 | error | Observation | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated | `contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()`
dom-5 | error | Observation | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | Observation | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`
obs-6 | error | Observation | dataAbsentReason SHALL only be present if Observation.value[x] is not present | `dataAbsentReason.empty() or value.empty()`
obs-7 | error | Observation | If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present | `value.empty() or component.code.where(coding.intersect(%resource.code.coding).exists()).empty()`
vs-1 | error | Observation.effective[x] | if Observation.effective[x] is dateTime and has a value then that value shall be precise to the day | `$this is dateTime implies $this.toString().length() >= 10`
vs-2 | error | Observation | If there is no component or hasMember element then either a value[x] or a data absent reason must be present. | `(component.empty() and hasMember.empty()) implies (dataAbsentReason.exists() or value.exists())`
vs-3 | error | Observation.component | If there is no a value a data absent reason must be present | `value.exists() or dataAbsentReason.exists()`

Differential View

This structure is derived from observation-bodytemp

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Observation | C | 0..* | observation-bodytemp | Body temperature Constraints: au-core-obs-01
status | O | 1..1 | code | registered | preliminary | final | amended +
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
category | O | 1..* | CodeableConcept | Classification of type of observation
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
Slices for category |  |  |  | Content/Rules for all slices
category:VSCat | O | 1..1 | CodeableConcept | Classification of type of observation
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
coding | O | 1..* | Coding | Code defined by a terminology system
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
system | O | 1..1 | uri | Identity of the terminology system
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
code | O | 1..1 | code | Symbol in syntax defined by the system
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
code | O | 1..1 | CodeableConcept | Body Temperature
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
coding |  | 2..* | Coding | Code defined by a terminology system
Slices for coding |  |  |  | Content/Rules for all slices
coding:snomedBodyTempCode |  | 1..1 | Coding | SNOMED CT Body Temperature
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: 386725007
subject | O | 1..1 | Reference(AU Core Patient) | Who and/or what the observation is about
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
effective[x] | O | 1..1 | dateTime | Date, and optionally time, the observation was performed
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
valueQuantity | O C | 0..1 | Quantity | Body temperature
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
value | O | 1..1 | decimal | Numerical value (with implicit precision)
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
unit | O | 1..1 | string | Unit representation
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
system | O | 1..1 | uri | System that defines coded unit form
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
code | O | 1..1 | code | Coded responses from the common UCUM units for vital signs value set. Binding: BodyTemperatureUnits (required)
Additional Bindings | Purpose
Metric Body Temperature Units | candidate
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
dataAbsentReason | O C | 0..1 | CodeableConcept | Why the result is missing
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
bodySite | C | 0..1 | CodeableConcept | Observed body part Binding: Body Site (preferred) Constraints: au-core-obs-02
component | O | 0..* | BackboneElement | Used when reporting systolic and diastolic blood pressure.
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
code | O | 1..1 | CodeableConcept | Type of component observation (code / type)
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
value[x] | O | 0..1 | Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period | Vital Sign Value recorded with UCUM
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
dataAbsentReason | O | 0..1 | CodeableConcept | Why the component result is missing
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
Documentation for this format

#### Terminology Bindings (Differential)

Path | Status | Usage | ValueSet | Version | Source
Observation.valueQuantity.​code | Base | required | Body Temperature Units | 📦4.0.1 | FHIR Std.
Observation.bodySite | Base | preferred | Body Site | ⏿1.0.2 | tx.hl7.org.au

#### Constraints

Id | Grade | Path(s) | Description | Expression
au-core-obs-01 | error | Observation | At least value or data absent reason shall be present | `dataAbsentReason.exists() or value.exists()`
au-core-obs-02 | error | Observation.bodySite | If a coded body site is provided, at least one coding shall be from SNOMED CT | `coding.exists() implies coding.where(system='http://snomed.info/sct').exists()`

Snapshot View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Observation | C | 0..* | observation-bodytemp | Body temperature Constraints: obs-6, obs-7, vs-2, au-core-obs-01
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 This profile does not constrain the narrative in regard to content, language, or traceability to data elements
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 | ?!SO Σ | 1..1 | code | registered | preliminary | final | amended + Binding: ObservationStatus (required)
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
Slices for category | SO | 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.
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
category:VSCat | SO | 1..1 | CodeableConcept | Classification of type of observation Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
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 | SO Σ | 1..* | Coding | Code defined by a terminology system
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
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 | SO Σ | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
version | Σ | 0..1 | string | Version of the system - if relevant
code | SO Σ | 1..1 | code | Symbol in syntax defined by the system Fixed Value: vital-signs
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
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 | SO Σ | 1..1 | CodeableConcept | Body Temperature Binding: VitalSigns (extensible): This identifies the vital sign result type.
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
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:BodyTempCode | 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: 8310-5
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:snomedBodyTempCode | Σ | 1..1 | Coding | SNOMED CT Body Temperature
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: 386725007
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 | SO Σ | 1..1 | Reference(AU Core Patient) | Who and/or what the observation is about
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
focus | Σ | 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] | SO Σ C | 1..1 | dateTime | Date, and optionally time, the observation was performed Constraints: vs-1
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
issued | Σ | 0..1 | instant | Date/Time this version was made available
performer | Σ | 0..* | Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson) | Who is responsible for the observation
Slices for value[x] | S Σ C | 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 | SO Σ C | 0..1 | Quantity | Body temperature
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
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 | SO Σ | 1..1 | decimal | Numerical value (with implicit precision)
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
comparator | ?!Σ | 0..1 | code | < | <= | >= | > - how to understand the value Binding: QuantityComparator (required): How the Quantity should be understood and represented.
unit | SO Σ | 1..1 | string | Unit representation
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
system | SO Σ C | 1..1 | uri | System that defines coded unit form Fixed Value: http://unitsofmeasure.org
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
code | SO Σ | 1..1 | code | Coded responses from the common UCUM units for vital signs value set. Binding: BodyTemperatureUnits (required)
Additional Bindings | Purpose
Metric Body Temperature Units | candidate
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
dataAbsentReason | SO C | 0..1 | CodeableConcept | Why the result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
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: Body Site (preferred) Constraints: au-core-obs-02
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 Constraints: obs-3
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(4.0.1) | Low Range, if relevant
high | C | 0..1 | SimpleQuantity(4.0.1) | 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 | SO Σ C | 0..* | BackboneElement | Used when reporting systolic and diastolic blood pressure. Constraints: vs-3
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
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 | SO Σ | 1..1 | CodeableConcept | Type of component observation (code / type) Binding: VitalSigns (extensible): This identifies the vital sign result type.
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
value[x] | SO Σ C | 0..1 |  | Vital Sign Value recorded with UCUM Binding: VitalSignsUnits (extensible): Common UCUM units for recording Vital Signs.
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
valueQuantity |  |  | Quantity |
valueCodeableConcept |  |  | CodeableConcept |
valueString |  |  | string |
valueBoolean |  |  | boolean |
valueInteger |  |  | integer |
valueRange |  |  | Range |
valueRatio |  |  | Ratio |
valueSampledData |  |  | SampledData |
valueTime |  |  | time |
valueDateTime |  |  | dateTime |
valuePeriod |  |  | Period |
dataAbsentReason | SO C | 0..1 | CodeableConcept | Why the component result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
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 | Status | Usage | ValueSet | Version | Source
Observation.language | Base | preferred | Common Languages | 📍4.0.1 | FHIR Std.
Observation.status | Base | required | ObservationStatus | 📍4.0.1 | FHIR Std.
Observation.category | Base | preferred | Observation Category Codes | 📍4.0.1 | FHIR Std.
Observation.category:VSCat | Base | preferred | Observation Category Codes | 📍4.0.1 | FHIR Std.
Observation.code | Base | extensible | Vital Signs | 📍4.0.1 | FHIR Std.
Observation.value[x]:valueQuantity.​comparator | Base | required | QuantityComparator | 📍4.0.1 | FHIR Std.
Observation.value[x]:valueQuantity.​code | Base | required | Body Temperature Units | 📦4.0.1 | FHIR Std.
Observation.dataAbsentReason | Base | extensible | DataAbsentReason | 📍4.0.1 | FHIR Std.
Observation.interpretation | Base | extensible | Observation Interpretation Codes | 📍4.0.1 | FHIR Std.
Observation.bodySite | Base | preferred | Body Site | ⏿1.0.2 | tx.hl7.org.au
Observation.method | Base | example | Observation Methods | 📍4.0.1 | FHIR Std.
Observation.referenceRange.​type | Base | preferred | Observation Reference Range Meaning Codes | 📍4.0.1 | FHIR Std.
Observation.referenceRange.​appliesTo | Base | example | Observation Reference Range Applies To Codes | 📍4.0.1 | FHIR Std.
Observation.component.​code | Base | extensible | Vital Signs | 📍4.0.1 | FHIR Std.
Observation.component.​value[x] | Base | extensible | Vital Signs Units | 📍4.0.1 | FHIR Std.
Observation.component.​dataAbsentReason | Base | extensible | DataAbsentReason | 📍4.0.1 | FHIR Std.
Observation.component.​interpretation | Base | extensible | Observation Interpretation Codes | 📍4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
au-core-obs-01 | error | Observation | At least value or data absent reason shall be present | `dataAbsentReason.exists() or value.exists()`
au-core-obs-02 | error | Observation.bodySite | If a coded body site is provided, at least one coding shall be from SNOMED CT | `coding.exists() implies coding.where(system='http://snomed.info/sct').exists()`
dom-2 | error | Observation | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | Observation | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource | `contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()`
dom-4 | error | Observation | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated | `contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()`
dom-5 | error | Observation | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | Observation | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`
obs-3 | error | Observation.referenceRange | Must have at least a low or a high or text | `low.exists() or high.exists() or text.exists()`
obs-6 | error | Observation | dataAbsentReason SHALL only be present if Observation.value[x] is not present | `dataAbsentReason.empty() or value.empty()`
obs-7 | error | Observation | If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present | `value.empty() or component.code.where(coding.intersect(%resource.code.coding).exists()).empty()`
vs-1 | error | Observation.effective[x] | if Observation.effective[x] is dateTime and has a value then that value shall be precise to the day | `$this is dateTime implies $this.toString().length() >= 10`
vs-2 | error | Observation | If there is no component or hasMember element then either a value[x] or a data absent reason must be present. | `(component.empty() and hasMember.empty()) implies (dataAbsentReason.exists() or value.exists())`
vs-3 | error | Observation.component | If there is no a value a data absent reason must be present | `value.exists() or dataAbsentReason.exists()`

This structure is derived from observation-bodytemp

Summary

Mandatory: 3 elements
Fixed: 2 elements

Structures

This structure refers to these other structures:

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

Maturity: 2

Other representations of profile: CSV, Excel, Schematron

### Notes:

Below is an overview of the mandatory and optional search parameters and combined search parameters. See the AU Core CapabilityStatements for a complete list of supported RESTful interactions for this IG.

FHIR search operations are described here and the syntax used to describe AU Core interactions is defined 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+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 | MAY | `reference` | The requester SHALL provide at least an id value and MAY provide both the Type and id values. The responder SHALL support both. The requester SHOULD support chained search patient.identifier using IHI, Medicare Number, and DVA Number identifiers as defined in the AU Core Patient profile. The responder SHOULD support chained search patient.identifier using IHI, Medicare Number, and DVA Number identifiers as defined in the AU Core Patient profile.
category | MAY | `token` | The requester SHALL provide at least a code value and MAY provide both the system and code values. The responder SHALL support both. The requester SHALL support search using the 'vital-signs' category defined in this profile. The responder SHALL support search using the 'vital-signs' category defined in this profile.
code | MAY | `token` | The requester SHALL provide at least a code value and MAY provide both the system and code values. The responder SHALL support both. The requester SHALL support search using the LOINC codes defined in this profile. The responder SHALL support search using the LOINC codes defined in this profile.
date | MAY | `date` | A requester SHALL provide a value precise to the second + time offset. A responder SHALL support a value precise to the second + time offset. The requester SHALL support these search comparators `gt`, `lt`, `ge`, `le`. The responder SHALL support these search comparators `gt`, `lt`, `ge`, `le`. The requester SHOULD support `multipleAnd`, and if `multipleAnd` is supported, SHALL support the search comparators `gt`, `lt`, `ge`, `le`. The responder SHOULD support `multipleAnd`, and if `multipleAnd` is supported, SHALL support the search comparators `gt`, `lt`, `ge`, `le`.
status | MAY | `token` | The requester SHALL provide at least a code value and MAY provide both the system and code values. The responder SHALL support both. The requester SHALL support `multipleOr`.The responder SHALL support `multipleOr`.

#### Mandatory Search Parameters:

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

1. SHALL support searching using the combination of the `patient` and `category` search parameters:
   - 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)

2. SHALL support searching using the combination of the `patient` and `category` and `date` search parameters:
   - 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]]&...`), and if multipleAnd is supported, SHALL support the search comparators `gt,lt,ge,le`

   `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)

3. SHALL support searching using the combination of the `patient` and `code` search parameters:
   - 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|8310-5,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 chained searching of patient canonical identifier `patient.identifier` (e.g. `patient.identifier=[system|][code]`)

   `GET [base]/Observation?patient.identifier=[system|][code]`

   Example:

   1. GET [base]/Observation?patient.identifier=http://ns.electronichealth.net.au/id/medicare-number|32788511952
   2. 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. SHOULD support searching using the combination of the `patient` and `category` and `status` search parameters:
   - 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&status=final,preliminary

   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)

3. SHOULD support searching using the combination of the `patient` and `code` and `date` search parameters:
   - 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]]&...`), and if multipleAnd is supported, SHALL support the search comparators `gt,lt,ge,le`

   `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|8310-5,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|8310-5,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)