Name	Flags	Card.	Type	Description & Constraints
Observation	C	0..*	observation-vitalsigns	FHIR Vital Signs Profile dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources dom-3: 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 dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated dom-5: If a resource is contained in another resource, it SHALL NOT have a security label dom-6: A resource should have narrative for robust management obs-6: dataAbsentReason SHALL only be present if Observation.value[x] is not present obs-7: If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present vs-2: If there is no component or hasMember element then either a value[x] or a data absent reason must be present. orderingProvider-with-ehrOrderId: If Observation.orderingProvider is present, then Observation.ehrOrderId must be present.
meta	SΣ	1..1	Meta	Metadata about the resource ele-1: All FHIR elements must have a @value or children
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created ele-1: All FHIR elements must have a @value or children
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
extension:ehrOrderId		0..1	string	The EHR's identifier for the order. URL: https://fhir.xealth.io/StructureDefinition/extension-ehr-order-id ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
extension:orderingProvider		0..1	(Complex)	The name and identifier of the ordering provider. If identifier is present, then name must be as well, and vice versa. URL: https://fhir.xealth.io/StructureDefinition/extension-ordering-provider ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
basedOn	SΣ	1..*	Reference(ServiceRequest)	The Xealth order this Observation is based on. ele-1: All FHIR elements must have a @value or children
status	?!SΣ	1..1	code	registered | preliminary | final | amended + Binding: Xealth Observation Valid Status Value Set (required) ele-1: All FHIR elements must have a @value or children
Slices for category	S	1..*	CodeableConcept	Classification of type of observation Slice: Unordered, Open by value:coding.code, value:coding.system Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories. ele-1: All FHIR elements must have a @value or children
category:VSCat	S	1..1	CodeableConcept	Classification of type of observation Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories. ele-1: All FHIR elements must have a @value or children
coding	SΣ	1..*	Coding	Code defined by a terminology system ele-1: All FHIR elements must have a @value or children
system	SΣ	1..1	uri	Identity of the terminology system ele-1: All FHIR elements must have a @value or children Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category
code	SΣ	1..1	code	Symbol in syntax defined by the system ele-1: All FHIR elements must have a @value or children Fixed Value: vital-signs
code	SΣ	1..1	CodeableConcept	Coded Responses from C-CDA Vital Sign Results Binding: VitalSigns (extensible): This identifies the vital sign result type. ele-1: All FHIR elements must have a @value or children
Slices for coding	SΣ	1..*	Coding	Code defined by a terminology system Slice: Unordered, Open by pattern:system ele-1: All FHIR elements must have a @value or children
coding:loincCode	SΣ	1..1	Coding	Code defined by a terminology system ele-1: All FHIR elements must have a @value or children
system	Σ	1..1	uri	Identity of the terminology system ele-1: All FHIR elements must have a @value or children Required Pattern: http://loinc.org
subject	SΣ	1..1	Reference(Patient)	The patient this Observation is made about. ele-1: All FHIR elements must have a @value or children
effective[x]	SΣC	1..1	dateTime	Often just a dateTime for Vital Signs ele-1: All FHIR elements must have a @value or children vs-1: if Observation.effective[x] is dateTime and has a value then that value shall be precise to the day
performer	SΣ	1..*	Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson)	Who is responsible for the observation ele-1: All FHIR elements must have a @value or children
value[x]	SΣC	1..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. ele-1: All FHIR elements must have a @value or children
dataAbsentReason	SC	0..1	CodeableConcept	Why the result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing. ele-1: All FHIR elements must have a @value or children
component	SΣC	0..*	BackboneElement	Used when reporting systolic and diastolic blood pressure. ele-1: All FHIR elements must have a @value or children vs-3: If there is no a value a data absent reason must be present
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
code	SΣ	1..1	CodeableConcept	Type of component observation (code / type) Binding: VitalSigns (extensible): This identifies the vital sign result type. ele-1: All FHIR elements must have a @value or children
Slices for coding	SΣ	1..*	Coding	Code defined by a terminology system Slice: Unordered, Open by pattern:system ele-1: All FHIR elements must have a @value or children
coding:loincCode	SΣ	1..1	Coding	Code defined by a terminology system ele-1: All FHIR elements must have a @value or children
system	Σ	1..1	uri	Identity of the terminology system ele-1: All FHIR elements must have a @value or children Required Pattern: http://loinc.org
Slices for value[x]	SΣC	0..1	CodeableConcept	Vital Sign Value recorded with UCUM Slice: Unordered, Closed by type:$this Binding: VitalSignsUnits (extensible): Common UCUM units for recording Vital Signs. ele-1: All FHIR elements must have a @value or children
value[x]:valueCodeableConcept	SΣC	0..1	CodeableConcept	Vital Sign Value recorded with UCUM Binding: VitalSignsUnits (extensible): Common UCUM units for recording Vital Signs. ele-1: All FHIR elements must have a @value or children
Slices for coding	SΣ	1..*	Coding	Code defined by a terminology system Slice: Unordered, Open by pattern:system ele-1: All FHIR elements must have a @value or children
coding:loincCode	SΣ	1..1	Coding	Code defined by a terminology system ele-1: All FHIR elements must have a @value or children
system	Σ	1..1	uri	Identity of the terminology system ele-1: All FHIR elements must have a @value or children Required Pattern: http://loinc.org
dataAbsentReason	SC	0..1	CodeableConcept	Why the component result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing. ele-1: All FHIR elements must have a @value or children
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
Observation.status	required	XealthObservationValidStatusVS https://fhir.xealth.io/ValueSet/xealth-observation-valid-status-vs from this IG
Observation.category	preferred	ObservationCategoryCodes http://hl7.org/fhir/ValueSet/observation-category from the FHIR Standard
Observation.category:VSCat	preferred	ObservationCategoryCodes http://hl7.org/fhir/ValueSet/observation-category from the FHIR Standard
Observation.code	extensible	VitalSigns http://hl7.org/fhir/ValueSet/observation-vitalsignresult from the FHIR Standard
Observation.dataAbsentReason	extensible	DataAbsentReason http://hl7.org/fhir/ValueSet/data-absent-reason from the FHIR Standard
Observation.component.code	extensible	VitalSigns http://hl7.org/fhir/ValueSet/observation-vitalsignresult from the FHIR Standard
Observation.component.value[x]	extensible	VitalSignsUnits http://hl7.org/fhir/ValueSet/ucum-vitals-common|4.0.1 from the FHIR Standard
Observation.component.value[x]:valueCodeableConcept	extensible	VitalSignsUnits http://hl7.org/fhir/ValueSet/ucum-vitals-common|4.0.1 from the FHIR Standard
Observation.component.dataAbsentReason	extensible	DataAbsentReason http://hl7.org/fhir/ValueSet/data-absent-reason from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
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()
orderingProvider-with-ehrOrderId	error	Observation	If Observation.orderingProvider is present, then Observation.ehrOrderId must be present. : extension.exists(url = 'https://fhir.xealth.io/StructureDefinition/extension-ordering-provider') implies extension.exists(url = 'https://fhir.xealth.io/StructureDefinition/extension-ehr-order-id')
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()

Name	Flags	Card.	Type	Description & Constraints
Observation	C	0..*	observation-vitalsigns	FHIR Vital Signs Profile orderingProvider-with-ehrOrderId: If Observation.orderingProvider is present, then Observation.ehrOrderId must be present.
meta	S	1..1	Meta	Metadata about the resource
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:ehrOrderId		0..1	string	The EHR's identifier for the order. URL: https://fhir.xealth.io/StructureDefinition/extension-ehr-order-id
extension:orderingProvider		0..1	(Complex)	The name and identifier of the ordering provider. If identifier is present, then name must be as well, and vice versa. URL: https://fhir.xealth.io/StructureDefinition/extension-ordering-provider
basedOn	S	1..*	Reference(ServiceRequest)	The Xealth order this Observation is based on.
status		1..1	code	registered | preliminary | final | amended + Binding: Xealth Observation Valid Status Value Set (required)
code
Slices for coding	S	1..*	Coding	Code defined by a terminology system Slice: Unordered, Open by pattern:system
coding:loincCode	S	1..1	Coding	Code defined by a terminology system
system		1..1	uri	Identity of the terminology system Required Pattern: http://loinc.org
subject		1..1	Reference(Patient)	The patient this Observation is made about.
effective[x]		1..1	dateTime	Often just a dateTime for Vital Signs
performer	S	1..*	Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson)	Who is responsible for the observation
value[x]		1..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.
component
code
Slices for coding	S	1..*	Coding	Code defined by a terminology system Slice: Unordered, Open by pattern:system
coding:loincCode	S	1..1	Coding	Code defined by a terminology system
system		1..1	uri	Identity of the terminology system Required Pattern: http://loinc.org
value[x]		0..1	CodeableConcept	Vital Sign Value recorded with UCUM Slice: Unordered, Open by type:$this
valueCodeableConcept		0..1	CodeableConcept	Vital Sign Value recorded with UCUM
Slices for coding	S	1..*	Coding	Code defined by a terminology system Slice: Unordered, Open by pattern:system
coding:loincCode	S	1..1	Coding	Code defined by a terminology system
system		1..1	uri	Identity of the terminology system Required Pattern: http://loinc.org
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
Observation.status	required	XealthObservationValidStatusVS https://fhir.xealth.io/ValueSet/xealth-observation-valid-status-vs from this IG

Constraints

Id	Grade	Path(s)	Details	Requirements
orderingProvider-with-ehrOrderId	error	Observation	If Observation.orderingProvider is present, then Observation.ehrOrderId must be present. : extension.exists(url = 'https://fhir.xealth.io/StructureDefinition/extension-ordering-provider') implies extension.exists(url = 'https://fhir.xealth.io/StructureDefinition/extension-ehr-order-id')

Name	Flags	Card.	Type	Description & Constraints
Observation	C	0..*	observation-vitalsigns	FHIR Vital Signs Profile obs-6: dataAbsentReason SHALL only be present if Observation.value[x] is not present obs-7: If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present vs-2: If there is no component or hasMember element then either a value[x] or a data absent reason must be present. orderingProvider-with-ehrOrderId: If Observation.orderingProvider is present, then Observation.ehrOrderId must be present.
id	Σ	0..1	id	Logical id of this artifact
meta	SΣ	1..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:ehrOrderId		0..1	string	The EHR's identifier for the order. URL: https://fhir.xealth.io/StructureDefinition/extension-ehr-order-id
extension:orderingProvider		0..1	(Complex)	The name and identifier of the ordering provider. If identifier is present, then name must be as well, and vice versa. URL: https://fhir.xealth.io/StructureDefinition/extension-ordering-provider
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	0..*	Identifier	Business Identifier for observation
basedOn	SΣ	1..*	Reference(ServiceRequest)	The Xealth order this Observation is based on.
partOf	Σ	0..*	Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy)	Part of referenced event
status	?!SΣ	1..1	code	registered | preliminary | final | amended + Binding: Xealth Observation Valid Status Value Set (required)
Slices for category	S	1..*	CodeableConcept	Classification of type of observation Slice: Unordered, Open by value:coding.code, value:coding.system Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
category:VSCat	S	1..1	CodeableConcept	Classification of type of observation Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
coding	SΣ	1..*	Coding	Code defined by a terminology system
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	SΣ	1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category
version	Σ	0..1	string	Version of the system - if relevant
code	SΣ	1..1	code	Symbol in syntax defined by the system Fixed Value: vital-signs
display	Σ	0..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
text	Σ	0..1	string	Plain text representation of the concept
code	SΣ	1..1	CodeableConcept	Coded Responses from C-CDA Vital Sign Results Binding: VitalSigns (extensible): This identifies the vital sign result type.
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
Slices for coding	SΣ	1..*	Coding	Code defined by a terminology system Slice: Unordered, Open by pattern:system
coding:loincCode	SΣ	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 Required Pattern: http://loinc.org
version	Σ	0..1	string	Version of the system - if relevant
code	Σ	0..1	code	Symbol in syntax defined by the system
display	Σ	0..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
text	Σ	0..1	string	Plain text representation of the concept
subject	SΣ	1..1	Reference(Patient)	The patient this Observation is made about.
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]	SΣC	1..1	dateTime	Often just a dateTime for Vital Signs vs-1: if Observation.effective[x] is dateTime and has a value then that value shall be precise to the day
issued	Σ	0..1	instant	Date/Time this version was made available
performer	SΣ	1..*	Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson)	Who is responsible for the observation
value[x]	SΣC	1..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.
dataAbsentReason	SC	0..1	CodeableConcept	Why the result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation		0..*	CodeableConcept	High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
note		0..*	Annotation	Comments about the observation
bodySite		0..1	CodeableConcept	Observed body part Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
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 obs-3: Must have at least a low or a high or text
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
low	C	0..1	SimpleQuantity	Low Range, if relevant
high	C	0..1	SimpleQuantity	High Range, if relevant
type		0..1	CodeableConcept	Reference range qualifier Binding: ObservationReferenceRangeMeaningCodes (preferred): Code for the meaning of a reference range.
appliesTo		0..*	CodeableConcept	Reference range population Binding: ObservationReferenceRangeAppliesToCodes (example): Codes identifying the population the reference range applies to.
age		0..1	Range	Applicable age range, if relevant
text		0..1	string	Text based reference range in an observation
hasMember	Σ	0..*	Reference(QuestionnaireResponse | MolecularSequence | Vital Signs Profile)	Used when reporting vital signs panel components
derivedFrom	Σ	0..*	Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | MolecularSequence | Vital Signs Profile)	Related measurements the observation is made from
component	SΣC	0..*	BackboneElement	Used when reporting systolic and diastolic blood pressure. vs-3: If there is no a value a data absent reason must be present
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	SΣ	1..1	CodeableConcept	Type of component observation (code / type) Binding: VitalSigns (extensible): This identifies the vital sign result type.
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	SΣ	1..*	Coding	Code defined by a terminology system Slice: Unordered, Open by pattern:system
coding:loincCode	SΣ	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 Required Pattern: http://loinc.org
version	Σ	0..1	string	Version of the system - if relevant
code	Σ	0..1	code	Symbol in syntax defined by the system
display	Σ	0..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
text	Σ	0..1	string	Plain text representation of the concept
Slices for value[x]	SΣC	0..1	CodeableConcept	Vital Sign Value recorded with UCUM Slice: Unordered, Closed by type:$this Binding: VitalSignsUnits (extensible): Common UCUM units for recording Vital Signs.
value[x]:valueCodeableConcept	SΣC	0..1	CodeableConcept	Vital Sign Value recorded with UCUM Binding: VitalSignsUnits (extensible): Common UCUM units for recording Vital Signs.
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	SΣ	1..*	Coding	Code defined by a terminology system Slice: Unordered, Open by pattern:system
coding:loincCode	SΣ	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 Required Pattern: http://loinc.org
version	Σ	0..1	string	Version of the system - if relevant
code	Σ	0..1	code	Symbol in syntax defined by the system
display	Σ	0..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
text	Σ	0..1	string	Plain text representation of the concept
dataAbsentReason	SC	0..1	CodeableConcept	Why the component result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation		0..*	CodeableConcept	High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
referenceRange		0..*	See referenceRange (Observation)	Provides guide for interpretation of component result
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
Observation.language	preferred	CommonLanguages http://hl7.org/fhir/ValueSet/languages from the FHIR Standard Additional Bindings Purpose AllLanguages Max Binding
Observation.status	required	XealthObservationValidStatusVS https://fhir.xealth.io/ValueSet/xealth-observation-valid-status-vs from this IG
Observation.category	preferred	ObservationCategoryCodes http://hl7.org/fhir/ValueSet/observation-category from the FHIR Standard
Observation.category:VSCat	preferred	ObservationCategoryCodes http://hl7.org/fhir/ValueSet/observation-category from the FHIR Standard
Observation.code	extensible	VitalSigns http://hl7.org/fhir/ValueSet/observation-vitalsignresult from the FHIR Standard
Observation.dataAbsentReason	extensible	DataAbsentReason http://hl7.org/fhir/ValueSet/data-absent-reason from the FHIR Standard
Observation.interpretation	extensible	ObservationInterpretationCodes http://hl7.org/fhir/ValueSet/observation-interpretation from the FHIR Standard
Observation.bodySite	example	SNOMEDCTBodyStructures http://hl7.org/fhir/ValueSet/body-site from the FHIR Standard
Observation.method	example	ObservationMethods http://hl7.org/fhir/ValueSet/observation-methods from the FHIR Standard
Observation.referenceRange.type	preferred	ObservationReferenceRangeMeaningCodes http://hl7.org/fhir/ValueSet/referencerange-meaning from the FHIR Standard
Observation.referenceRange.appliesTo	example	ObservationReferenceRangeAppliesToCodes http://hl7.org/fhir/ValueSet/referencerange-appliesto from the FHIR Standard
Observation.component.code	extensible	VitalSigns http://hl7.org/fhir/ValueSet/observation-vitalsignresult from the FHIR Standard
Observation.component.value[x]	extensible	VitalSignsUnits http://hl7.org/fhir/ValueSet/ucum-vitals-common|4.0.1 from the FHIR Standard
Observation.component.value[x]:valueCodeableConcept	extensible	VitalSignsUnits http://hl7.org/fhir/ValueSet/ucum-vitals-common|4.0.1 from the FHIR Standard
Observation.component.dataAbsentReason	extensible	DataAbsentReason http://hl7.org/fhir/ValueSet/data-absent-reason from the FHIR Standard
Observation.component.interpretation	extensible	ObservationInterpretationCodes http://hl7.org/fhir/ValueSet/observation-interpretation from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
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()
orderingProvider-with-ehrOrderId	error	Observation	If Observation.orderingProvider is present, then Observation.ehrOrderId must be present. : extension.exists(url = 'https://fhir.xealth.io/StructureDefinition/extension-ordering-provider') implies extension.exists(url = 'https://fhir.xealth.io/StructureDefinition/extension-ehr-order-id')
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()

Summary

Mandatory: 7 elements(6 nested mandatory elements)
Must-Support: 9 elements

Extensions

This structure refers to these extensions:

• https://fhir.xealth.io/StructureDefinition/extension-ehr-order-id
• https://fhir.xealth.io/StructureDefinition/extension-ordering-provider

Slices

This structure defines the following Slices:

• The element 1 is sliced based on the value of Observation.code.coding
• The element 1 is sliced based on the value of Observation.component.code.coding
• The element 1 is sliced based on the value of Observation.component.value[x]
• The element 1 is sliced based on the value of Observation.component.valueCodeableConcept.coding

Name	Flags	Card.	Type	Description & Constraints
Observation	C	0..*	observation-vitalsigns	FHIR Vital Signs Profile dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources dom-3: 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 dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated dom-5: If a resource is contained in another resource, it SHALL NOT have a security label dom-6: A resource should have narrative for robust management obs-6: dataAbsentReason SHALL only be present if Observation.value[x] is not present obs-7: If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present vs-2: If there is no component or hasMember element then either a value[x] or a data absent reason must be present. orderingProvider-with-ehrOrderId: If Observation.orderingProvider is present, then Observation.ehrOrderId must be present.
meta	SΣ	1..1	Meta	Metadata about the resource ele-1: All FHIR elements must have a @value or children
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created ele-1: All FHIR elements must have a @value or children
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
extension:ehrOrderId		0..1	string	The EHR's identifier for the order. URL: https://fhir.xealth.io/StructureDefinition/extension-ehr-order-id ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
extension:orderingProvider		0..1	(Complex)	The name and identifier of the ordering provider. If identifier is present, then name must be as well, and vice versa. URL: https://fhir.xealth.io/StructureDefinition/extension-ordering-provider ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
basedOn	SΣ	1..*	Reference(ServiceRequest)	The Xealth order this Observation is based on. ele-1: All FHIR elements must have a @value or children
status	?!SΣ	1..1	code	registered | preliminary | final | amended + Binding: Xealth Observation Valid Status Value Set (required) ele-1: All FHIR elements must have a @value or children
Slices for category	S	1..*	CodeableConcept	Classification of type of observation Slice: Unordered, Open by value:coding.code, value:coding.system Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories. ele-1: All FHIR elements must have a @value or children
category:VSCat	S	1..1	CodeableConcept	Classification of type of observation Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories. ele-1: All FHIR elements must have a @value or children
coding	SΣ	1..*	Coding	Code defined by a terminology system ele-1: All FHIR elements must have a @value or children
system	SΣ	1..1	uri	Identity of the terminology system ele-1: All FHIR elements must have a @value or children Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category
code	SΣ	1..1	code	Symbol in syntax defined by the system ele-1: All FHIR elements must have a @value or children Fixed Value: vital-signs
code	SΣ	1..1	CodeableConcept	Coded Responses from C-CDA Vital Sign Results Binding: VitalSigns (extensible): This identifies the vital sign result type. ele-1: All FHIR elements must have a @value or children
Slices for coding	SΣ	1..*	Coding	Code defined by a terminology system Slice: Unordered, Open by pattern:system ele-1: All FHIR elements must have a @value or children
coding:loincCode	SΣ	1..1	Coding	Code defined by a terminology system ele-1: All FHIR elements must have a @value or children
system	Σ	1..1	uri	Identity of the terminology system ele-1: All FHIR elements must have a @value or children Required Pattern: http://loinc.org
subject	SΣ	1..1	Reference(Patient)	The patient this Observation is made about. ele-1: All FHIR elements must have a @value or children
effective[x]	SΣC	1..1	dateTime	Often just a dateTime for Vital Signs ele-1: All FHIR elements must have a @value or children vs-1: if Observation.effective[x] is dateTime and has a value then that value shall be precise to the day
performer	SΣ	1..*	Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson)	Who is responsible for the observation ele-1: All FHIR elements must have a @value or children
value[x]	SΣC	1..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. ele-1: All FHIR elements must have a @value or children
dataAbsentReason	SC	0..1	CodeableConcept	Why the result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing. ele-1: All FHIR elements must have a @value or children
component	SΣC	0..*	BackboneElement	Used when reporting systolic and diastolic blood pressure. ele-1: All FHIR elements must have a @value or children vs-3: If there is no a value a data absent reason must be present
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
code	SΣ	1..1	CodeableConcept	Type of component observation (code / type) Binding: VitalSigns (extensible): This identifies the vital sign result type. ele-1: All FHIR elements must have a @value or children
Slices for coding	SΣ	1..*	Coding	Code defined by a terminology system Slice: Unordered, Open by pattern:system ele-1: All FHIR elements must have a @value or children
coding:loincCode	SΣ	1..1	Coding	Code defined by a terminology system ele-1: All FHIR elements must have a @value or children
system	Σ	1..1	uri	Identity of the terminology system ele-1: All FHIR elements must have a @value or children Required Pattern: http://loinc.org
Slices for value[x]	SΣC	0..1	CodeableConcept	Vital Sign Value recorded with UCUM Slice: Unordered, Closed by type:$this Binding: VitalSignsUnits (extensible): Common UCUM units for recording Vital Signs. ele-1: All FHIR elements must have a @value or children
value[x]:valueCodeableConcept	SΣC	0..1	CodeableConcept	Vital Sign Value recorded with UCUM Binding: VitalSignsUnits (extensible): Common UCUM units for recording Vital Signs. ele-1: All FHIR elements must have a @value or children
Slices for coding	SΣ	1..*	Coding	Code defined by a terminology system Slice: Unordered, Open by pattern:system ele-1: All FHIR elements must have a @value or children
coding:loincCode	SΣ	1..1	Coding	Code defined by a terminology system ele-1: All FHIR elements must have a @value or children
system	Σ	1..1	uri	Identity of the terminology system ele-1: All FHIR elements must have a @value or children Required Pattern: http://loinc.org
dataAbsentReason	SC	0..1	CodeableConcept	Why the component result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing. ele-1: All FHIR elements must have a @value or children
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
Observation.status	required	XealthObservationValidStatusVS https://fhir.xealth.io/ValueSet/xealth-observation-valid-status-vs from this IG
Observation.category	preferred	ObservationCategoryCodes http://hl7.org/fhir/ValueSet/observation-category from the FHIR Standard
Observation.category:VSCat	preferred	ObservationCategoryCodes http://hl7.org/fhir/ValueSet/observation-category from the FHIR Standard
Observation.code	extensible	VitalSigns http://hl7.org/fhir/ValueSet/observation-vitalsignresult from the FHIR Standard
Observation.dataAbsentReason	extensible	DataAbsentReason http://hl7.org/fhir/ValueSet/data-absent-reason from the FHIR Standard
Observation.component.code	extensible	VitalSigns http://hl7.org/fhir/ValueSet/observation-vitalsignresult from the FHIR Standard
Observation.component.value[x]	extensible	VitalSignsUnits http://hl7.org/fhir/ValueSet/ucum-vitals-common|4.0.1 from the FHIR Standard
Observation.component.value[x]:valueCodeableConcept	extensible	VitalSignsUnits http://hl7.org/fhir/ValueSet/ucum-vitals-common|4.0.1 from the FHIR Standard
Observation.component.dataAbsentReason	extensible	DataAbsentReason http://hl7.org/fhir/ValueSet/data-absent-reason from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
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()
orderingProvider-with-ehrOrderId	error	Observation	If Observation.orderingProvider is present, then Observation.ehrOrderId must be present. : extension.exists(url = 'https://fhir.xealth.io/StructureDefinition/extension-ordering-provider') implies extension.exists(url = 'https://fhir.xealth.io/StructureDefinition/extension-ehr-order-id')
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()

Name	Flags	Card.	Type	Description & Constraints
Observation	C	0..*	observation-vitalsigns	FHIR Vital Signs Profile orderingProvider-with-ehrOrderId: If Observation.orderingProvider is present, then Observation.ehrOrderId must be present.
meta	S	1..1	Meta	Metadata about the resource
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:ehrOrderId		0..1	string	The EHR's identifier for the order. URL: https://fhir.xealth.io/StructureDefinition/extension-ehr-order-id
extension:orderingProvider		0..1	(Complex)	The name and identifier of the ordering provider. If identifier is present, then name must be as well, and vice versa. URL: https://fhir.xealth.io/StructureDefinition/extension-ordering-provider
basedOn	S	1..*	Reference(ServiceRequest)	The Xealth order this Observation is based on.
status		1..1	code	registered | preliminary | final | amended + Binding: Xealth Observation Valid Status Value Set (required)
code
Slices for coding	S	1..*	Coding	Code defined by a terminology system Slice: Unordered, Open by pattern:system
coding:loincCode	S	1..1	Coding	Code defined by a terminology system
system		1..1	uri	Identity of the terminology system Required Pattern: http://loinc.org
subject		1..1	Reference(Patient)	The patient this Observation is made about.
effective[x]		1..1	dateTime	Often just a dateTime for Vital Signs
performer	S	1..*	Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson)	Who is responsible for the observation
value[x]		1..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.
component
code
Slices for coding	S	1..*	Coding	Code defined by a terminology system Slice: Unordered, Open by pattern:system
coding:loincCode	S	1..1	Coding	Code defined by a terminology system
system		1..1	uri	Identity of the terminology system Required Pattern: http://loinc.org
value[x]		0..1	CodeableConcept	Vital Sign Value recorded with UCUM Slice: Unordered, Open by type:$this
valueCodeableConcept		0..1	CodeableConcept	Vital Sign Value recorded with UCUM
Slices for coding	S	1..*	Coding	Code defined by a terminology system Slice: Unordered, Open by pattern:system
coding:loincCode	S	1..1	Coding	Code defined by a terminology system
system		1..1	uri	Identity of the terminology system Required Pattern: http://loinc.org
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
Observation.status	required	XealthObservationValidStatusVS https://fhir.xealth.io/ValueSet/xealth-observation-valid-status-vs from this IG

Constraints

Id	Grade	Path(s)	Details	Requirements
orderingProvider-with-ehrOrderId	error	Observation	If Observation.orderingProvider is present, then Observation.ehrOrderId must be present. : extension.exists(url = 'https://fhir.xealth.io/StructureDefinition/extension-ordering-provider') implies extension.exists(url = 'https://fhir.xealth.io/StructureDefinition/extension-ehr-order-id')

Name	Flags	Card.	Type	Description & Constraints
Observation	C	0..*	observation-vitalsigns	FHIR Vital Signs Profile obs-6: dataAbsentReason SHALL only be present if Observation.value[x] is not present obs-7: If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present vs-2: If there is no component or hasMember element then either a value[x] or a data absent reason must be present. orderingProvider-with-ehrOrderId: If Observation.orderingProvider is present, then Observation.ehrOrderId must be present.
id	Σ	0..1	id	Logical id of this artifact
meta	SΣ	1..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:ehrOrderId		0..1	string	The EHR's identifier for the order. URL: https://fhir.xealth.io/StructureDefinition/extension-ehr-order-id
extension:orderingProvider		0..1	(Complex)	The name and identifier of the ordering provider. If identifier is present, then name must be as well, and vice versa. URL: https://fhir.xealth.io/StructureDefinition/extension-ordering-provider
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	0..*	Identifier	Business Identifier for observation
basedOn	SΣ	1..*	Reference(ServiceRequest)	The Xealth order this Observation is based on.
partOf	Σ	0..*	Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy)	Part of referenced event
status	?!SΣ	1..1	code	registered | preliminary | final | amended + Binding: Xealth Observation Valid Status Value Set (required)
Slices for category	S	1..*	CodeableConcept	Classification of type of observation Slice: Unordered, Open by value:coding.code, value:coding.system Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
category:VSCat	S	1..1	CodeableConcept	Classification of type of observation Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
coding	SΣ	1..*	Coding	Code defined by a terminology system
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	SΣ	1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category
version	Σ	0..1	string	Version of the system - if relevant
code	SΣ	1..1	code	Symbol in syntax defined by the system Fixed Value: vital-signs
display	Σ	0..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
text	Σ	0..1	string	Plain text representation of the concept
code	SΣ	1..1	CodeableConcept	Coded Responses from C-CDA Vital Sign Results Binding: VitalSigns (extensible): This identifies the vital sign result type.
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
Slices for coding	SΣ	1..*	Coding	Code defined by a terminology system Slice: Unordered, Open by pattern:system
coding:loincCode	SΣ	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 Required Pattern: http://loinc.org
version	Σ	0..1	string	Version of the system - if relevant
code	Σ	0..1	code	Symbol in syntax defined by the system
display	Σ	0..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
text	Σ	0..1	string	Plain text representation of the concept
subject	SΣ	1..1	Reference(Patient)	The patient this Observation is made about.
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]	SΣC	1..1	dateTime	Often just a dateTime for Vital Signs vs-1: if Observation.effective[x] is dateTime and has a value then that value shall be precise to the day
issued	Σ	0..1	instant	Date/Time this version was made available
performer	SΣ	1..*	Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson)	Who is responsible for the observation
value[x]	SΣC	1..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.
dataAbsentReason	SC	0..1	CodeableConcept	Why the result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation		0..*	CodeableConcept	High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
note		0..*	Annotation	Comments about the observation
bodySite		0..1	CodeableConcept	Observed body part Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
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 obs-3: Must have at least a low or a high or text
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
low	C	0..1	SimpleQuantity	Low Range, if relevant
high	C	0..1	SimpleQuantity	High Range, if relevant
type		0..1	CodeableConcept	Reference range qualifier Binding: ObservationReferenceRangeMeaningCodes (preferred): Code for the meaning of a reference range.
appliesTo		0..*	CodeableConcept	Reference range population Binding: ObservationReferenceRangeAppliesToCodes (example): Codes identifying the population the reference range applies to.
age		0..1	Range	Applicable age range, if relevant
text		0..1	string	Text based reference range in an observation
hasMember	Σ	0..*	Reference(QuestionnaireResponse | MolecularSequence | Vital Signs Profile)	Used when reporting vital signs panel components
derivedFrom	Σ	0..*	Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | MolecularSequence | Vital Signs Profile)	Related measurements the observation is made from
component	SΣC	0..*	BackboneElement	Used when reporting systolic and diastolic blood pressure. vs-3: If there is no a value a data absent reason must be present
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	SΣ	1..1	CodeableConcept	Type of component observation (code / type) Binding: VitalSigns (extensible): This identifies the vital sign result type.
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	SΣ	1..*	Coding	Code defined by a terminology system Slice: Unordered, Open by pattern:system
coding:loincCode	SΣ	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 Required Pattern: http://loinc.org
version	Σ	0..1	string	Version of the system - if relevant
code	Σ	0..1	code	Symbol in syntax defined by the system
display	Σ	0..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
text	Σ	0..1	string	Plain text representation of the concept
Slices for value[x]	SΣC	0..1	CodeableConcept	Vital Sign Value recorded with UCUM Slice: Unordered, Closed by type:$this Binding: VitalSignsUnits (extensible): Common UCUM units for recording Vital Signs.
value[x]:valueCodeableConcept	SΣC	0..1	CodeableConcept	Vital Sign Value recorded with UCUM Binding: VitalSignsUnits (extensible): Common UCUM units for recording Vital Signs.
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	SΣ	1..*	Coding	Code defined by a terminology system Slice: Unordered, Open by pattern:system
coding:loincCode	SΣ	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 Required Pattern: http://loinc.org
version	Σ	0..1	string	Version of the system - if relevant
code	Σ	0..1	code	Symbol in syntax defined by the system
display	Σ	0..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
text	Σ	0..1	string	Plain text representation of the concept
dataAbsentReason	SC	0..1	CodeableConcept	Why the component result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation		0..*	CodeableConcept	High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
referenceRange		0..*	See referenceRange (Observation)	Provides guide for interpretation of component result
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
Observation.language	preferred	CommonLanguages http://hl7.org/fhir/ValueSet/languages from the FHIR Standard Additional Bindings Purpose AllLanguages Max Binding
Observation.status	required	XealthObservationValidStatusVS https://fhir.xealth.io/ValueSet/xealth-observation-valid-status-vs from this IG
Observation.category	preferred	ObservationCategoryCodes http://hl7.org/fhir/ValueSet/observation-category from the FHIR Standard
Observation.category:VSCat	preferred	ObservationCategoryCodes http://hl7.org/fhir/ValueSet/observation-category from the FHIR Standard
Observation.code	extensible	VitalSigns http://hl7.org/fhir/ValueSet/observation-vitalsignresult from the FHIR Standard
Observation.dataAbsentReason	extensible	DataAbsentReason http://hl7.org/fhir/ValueSet/data-absent-reason from the FHIR Standard
Observation.interpretation	extensible	ObservationInterpretationCodes http://hl7.org/fhir/ValueSet/observation-interpretation from the FHIR Standard
Observation.bodySite	example	SNOMEDCTBodyStructures http://hl7.org/fhir/ValueSet/body-site from the FHIR Standard
Observation.method	example	ObservationMethods http://hl7.org/fhir/ValueSet/observation-methods from the FHIR Standard
Observation.referenceRange.type	preferred	ObservationReferenceRangeMeaningCodes http://hl7.org/fhir/ValueSet/referencerange-meaning from the FHIR Standard
Observation.referenceRange.appliesTo	example	ObservationReferenceRangeAppliesToCodes http://hl7.org/fhir/ValueSet/referencerange-appliesto from the FHIR Standard
Observation.component.code	extensible	VitalSigns http://hl7.org/fhir/ValueSet/observation-vitalsignresult from the FHIR Standard
Observation.component.value[x]	extensible	VitalSignsUnits http://hl7.org/fhir/ValueSet/ucum-vitals-common|4.0.1 from the FHIR Standard
Observation.component.value[x]:valueCodeableConcept	extensible	VitalSignsUnits http://hl7.org/fhir/ValueSet/ucum-vitals-common|4.0.1 from the FHIR Standard
Observation.component.dataAbsentReason	extensible	DataAbsentReason http://hl7.org/fhir/ValueSet/data-absent-reason from the FHIR Standard
Observation.component.interpretation	extensible	ObservationInterpretationCodes http://hl7.org/fhir/ValueSet/observation-interpretation from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
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()
orderingProvider-with-ehrOrderId	error	Observation	If Observation.orderingProvider is present, then Observation.ehrOrderId must be present. : extension.exists(url = 'https://fhir.xealth.io/StructureDefinition/extension-ordering-provider') implies extension.exists(url = 'https://fhir.xealth.io/StructureDefinition/extension-ehr-order-id')
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()

Summary

Mandatory: 7 elements(6 nested mandatory elements)
Must-Support: 9 elements

Extensions

This structure refers to these extensions:

• https://fhir.xealth.io/StructureDefinition/extension-ehr-order-id
• https://fhir.xealth.io/StructureDefinition/extension-ordering-provider

Slices

This structure defines the following Slices:

• The element 1 is sliced based on the value of Observation.code.coding
• The element 1 is sliced based on the value of Observation.component.code.coding
• The element 1 is sliced based on the value of Observation.component.value[x]
• The element 1 is sliced based on the value of Observation.component.valueCodeableConcept.coding