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        CDC National Healthcare Safety Network (NHSN) Digital Quality Measures (dQM) Content Package IG
        2.0.0 - Release 2 US

        This page is part of the NHSN Digital Quality Measures (dQM) Content Package Implementation Guide (v2.0.0: Release) based on FHIR (HL7? FHIR? Standard) R4. This is the current published version. For a full list of available versions, see the Directory of published versions

        Resource Profile: ACH Monthly Event Observation - Vital Signs

        Official URL: http://www.cy118119.com/nhsn/fhirportal/dqm/ig/StructureDefinition/ach-monthly-observation-vitals Version: 2.0.0
        Standards status: Trial-use Maturity Level: 2 Computable Name: AcuteCareHospitalMonthlyReportingVitalsObservation

        This profile contains Required and Must Support data elements for reporting observation-vital signs information to the NHSN Acute Care Hospital (ACH) Monthly Digital Quality Measure. This profile inherits from the US Core 6.1.0 Vital Signs

        Usages:

        You can also check for usages in the FHIR IG Statistics

        Changes since version 1.0.0:

      1. The resource metadata has changed (description)
      2. The data elements list has changed
      3. One or more text definitions, invariants or bindings have changed

        4. Formal Views of Profile Content

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

        Name Flags Card. Type Description & Constraints????Filter: Filtersdoco
        .. Observation C 0..* USCoreVitalSignsProfile(6.1.0) US Core Vital Signs Profile
        Constraints: obs-6, obs-7, vs-2
        ... id SΣ 1..1 id
        (NHSN-MS)
        Logical id of this artifact
        ... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
        ... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
        .... reference SΣC 1..1 string
        (NHSN-MS)
        Literal reference, Relative, internal or absolute URL
        ... status ?!SΣ 1..1 code
        (NHSN-MS)
        (USCDI) registered | preliminary | final | amended +
        Binding: ObservationStatus (required)
        ... Slices for category S 1..* CodeableConcept
        (NHSN-MS)
        (USCDI) 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
        (NHSN-MS)
        (USCDI) Classification of type of observation
        Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
        ..... coding SΣ 1..* Coding (USCDI) Code defined by a terminology system
        ...... system SΣ 1..1 uri (USCDI) Identity of the terminology system
        Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category
        ...... code SΣ 1..1 code (USCDI) Symbol in syntax defined by the system
        Fixed Value: vital-signs
        ... code SΣ 1..1 CodeableConcept
        (NHSN-MS)
        (USCDI) Coded Responses from C-CDA Vital Sign Results
        Binding: US Core Vital Signs ValueSet (extensible): The vital sign codes from the base FHIR and US Core Vital Signs.
        ... subject SΣ 1..1 Reference(Cross-Measure Patient Profile) {b}
        (NHSN-MS)
        (USCDI) Who and/or what the observation is about
        .... reference SΣC 1..1 string
        (NHSN-MS)
        Literal reference, Relative, internal or absolute URL
        ... encounter SΣ 0..1 Reference(Encounter) {b}
        (NHSN-MS)
        Healthcare event during which this observation is made
        .... reference SΣC 1..1 string
        (NHSN-MS)
        Literal reference, Relative, internal or absolute URL
        ... effective[x] SΣC 1..1
        (NHSN-MS)
        (USCDI) Often just a dateTime for Vital Signs
        Constraints: vs-1
        .... effectiveDateTime dateTime S
        .... effectivePeriod Period
        ... issued SΣ 0..1 instant
        (NHSN-MS)
        Date/Time this version was made available
        ... value[x] SΣC 0..1
        (NHSN-MS)
        (USCDI) Vital Signs Value
        Binding: VitalSignsUnits (extensible): Common UCUM units for recording Vital Signs.
        .... valueQuantity Quantity S
        .... valueCodeableConcept CodeableConcept
        .... valueString string
        .... valueBoolean boolean
        .... valueInteger integer
        .... valueRange Range
        .... valueRatio Ratio
        .... valueSampledData SampledData
        .... valueTime time
        .... valueDateTime dateTime
        .... valuePeriod Period
        ... dataAbsentReason SC 0..1 CodeableConcept (USCDI) Why the result is missing
        Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
        ... interpretation S 0..* CodeableConcept
        (NHSN-MS)
        (QI-Core) High, low, normal, etc.
        Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
        ... bodySite S 0..1 CodeableConcept
        (NHSN-MS)
        Observed body part
        Binding: SNOMEDCTBodyStructures (extensible)
        ... method S 0..1 CodeableConcept
        (NHSN-MS)
        How it was done
        Binding: ObservationMethods (extensible)
        ... referenceRange SC 0..* BackboneElement
        (NHSN-MS)
        Provides guide for interpretation
        Constraints: obs-3
        .... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
        .... low SC 0..1 SimpleQuantity
        (NHSN-MS)
        Low Range, if relevant
        .... high SC 0..1 SimpleQuantity
        (NHSN-MS)
        High Range, if relevant
        .... age S 0..1 Range
        (NHSN-MS)
        Applicable age range, if relevant
        ... hasMember SΣ 0..* Reference(QuestionnaireResponse | MolecularSequence | Vital Signs Profile) {b}
        (NHSN-MS)
        Used when reporting vital signs panel components
        .... reference SΣC 1..1 string
        (NHSN-MS)
        Literal reference, Relative, internal or absolute URL
        ... component SΣC 0..* BackboneElement
        (NHSN-MS)
        (USCDI) Component observations
        Constraints: vs-3
        .... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
        .... code SΣ 1..1 CodeableConcept
        (NHSN-MS)
        (USCDI) Type of component observation (code / type)
        Binding: LOINCCodes (extensible)
        .... value[x] SΣC 0..1
        (NHSN-MS)
        (USCDI) Vital Sign Component Value
        Binding: VitalSignsUnits (extensible): Common UCUM units for recording Vital Signs.
        ..... valueQuantity Quantity S
        ..... valueCodeableConcept CodeableConcept
        ..... valueString string
        ..... valueBoolean boolean
        ..... valueInteger integer
        ..... valueRange Range
        ..... valueRatio Ratio
        ..... valueSampledData SampledData
        ..... valueTime time
        ..... valueDateTime dateTime
        ..... valuePeriod Period
        .... dataAbsentReason SC 0..1 CodeableConcept (USCDI) Why the component result is missing
        Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
        .... interpretation S 0..* CodeableConcept
        (NHSN-MS)
        High, low, normal, etc.
        Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
        .... referenceRange S 0..* BackboneElement
        (NHSN-MS)
        Provides guide for interpretation of component result
        ..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
        ..... low SC 0..1 SimpleQuantity(4.0.1)
        (NHSN-MS)
        Low Range, if relevant
        ..... high SC 0..1 SimpleQuantity(4.0.1)
        (NHSN-MS)
        High Range, if relevant
        ..... age S 0..1 Range
        (NHSN-MS)
        Applicable age range, if relevant

        doco 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 US Core Vital Signs ValueSet ??6.1.0 US Core v6.1
        Observation.value[x] Base extensible Vital Signs 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 extensible SNOMED CT Body Structures ??4.0.1 FHIR Std.
        Observation.method Base extensible Observation Methods ??4.0.1 FHIR Std.
        Observation.component.?code Base extensible LOINC Codes ??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
        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 USCoreVitalSignsProfile

        Name Flags Card. Type Description & Constraints????Filter: Filtersdoco
        .. Observation 0..* USCoreVitalSignsProfile(6.1.0) US Core Vital Signs Profile
        ... id S 1..1 id
        (NHSN-MS)
        Logical id of this artifact
        ... meta
        .... Slices for extension Content/Rules for all slices
        ..... extension:link-received-date-extension 0..1 dateTime Received Date
        URL: http://www.cy118119.com/nhsn/fhirportal/dqm/ig/StructureDefinition/link-received-date-extension
        ... partOf S 0..* Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy) {b}
        (NHSN-MS)
        Part of referenced event
        .... reference S 1..1 string
        (NHSN-MS)
        Literal reference, Relative, internal or absolute URL
        ... category 1..* CodeableConcept (NHSN-MS)(USCDI) Classification of type of observation
        ... Slices for category Content/Rules for all slices
        .... category:VSCat 1..1 CodeableConcept (NHSN-MS)(USCDI) Classification of type of observation
        ... code 1..1 CodeableConcept (NHSN-MS)(USCDI) Coded Responses from C-CDA Vital Sign Results
        ... subject 1..1 Reference(Cross-Measure Patient Profile) {b} (NHSN-MS)(USCDI) Who and/or what the observation is about
        .... reference S 1..1 string
        (NHSN-MS)
        Literal reference, Relative, internal or absolute URL
        ... encounter S 0..1 Reference(Encounter) {b}
        (NHSN-MS)
        Healthcare event during which this observation is made
        .... reference S 1..1 string
        (NHSN-MS)
        Literal reference, Relative, internal or absolute URL
        ... effective[x] 1..1 dateTime, Period (NHSN-MS)(USCDI) Often just a dateTime for Vital Signs
        ... issued S 0..1 instant
        (NHSN-MS)
        Date/Time this version was made available
        ... value[x] 0..1 Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period (NHSN-MS)(USCDI) Vital Signs Value
        ... interpretation S 0..* CodeableConcept
        (NHSN-MS)
        (QI-Core) High, low, normal, etc.
        ... bodySite S 0..1 CodeableConcept
        (NHSN-MS)
        Observed body part
        Binding: SNOMEDCTBodyStructures (extensible)
        ... method S 0..1 CodeableConcept
        (NHSN-MS)
        How it was done
        Binding: ObservationMethods (extensible)
        ... referenceRange S 0..* BackboneElement
        (NHSN-MS)
        Provides guide for interpretation
        .... low S 0..1 SimpleQuantity
        (NHSN-MS)
        Low Range, if relevant
        .... high S 0..1 SimpleQuantity
        (NHSN-MS)
        High Range, if relevant
        .... age S 0..1 Range
        (NHSN-MS)
        Applicable age range, if relevant
        ... hasMember S 0..* Reference(QuestionnaireResponse | MolecularSequence | Vital Signs Profile) {b}
        (NHSN-MS)
        Used when reporting vital signs panel components
        .... reference S 1..1 string
        (NHSN-MS)
        Literal reference, Relative, internal or absolute URL
        ... component 0..* BackboneElement (NHSN-MS)(USCDI) Component observations
        .... code 1..1 CodeableConcept (NHSN-MS)(USCDI) Type of component observation (code / type)
        Binding: LOINCCodes (extensible)
        .... value[x] 0..1 Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period (NHSN-MS)(USCDI) Vital Sign Component Value
        .... interpretation S 0..* CodeableConcept
        (NHSN-MS)
        High, low, normal, etc.
        .... referenceRange S 0..* BackboneElement
        (NHSN-MS)
        Provides guide for interpretation of component result
        ..... low S 0..1 SimpleQuantity(4.0.1)
        (NHSN-MS)
        Low Range, if relevant
        ..... high S 0..1 SimpleQuantity(4.0.1)
        (NHSN-MS)
        High Range, if relevant
        ..... age S 0..1 Range
        (NHSN-MS)
        Applicable age range, if relevant

        doco Documentation for this format

        Terminology Bindings (Differential)

        Path Status Usage ValueSet Version Source
        Observation.bodySite Base extensible SNOMED CT Body Structures ??4.0.1 FHIR Std.
        Observation.method Base extensible Observation Methods ??4.0.1 FHIR Std.
        Observation.component.?code Base extensible LOINC Codes ??4.0.1 FHIR Std.
        Name Flags Card. Type Description & Constraints????Filter: Filtersdoco
        .. Observation C 0..* USCoreVitalSignsProfile(6.1.0) US Core Vital Signs Profile
        Constraints: obs-6, obs-7, vs-2
        ... id SΣ 1..1 id
        (NHSN-MS)
        Logical id of this artifact
        ... meta Σ 0..1 Meta Metadata about the resource
        .... id 0..1 string Unique id for inter-element referencing
        .... Slices for extension 0..* Extension Additional content defined by implementations
        Slice: Unordered, Open by value:url
        ..... extension:link-received-date-extension 0..1 dateTime Received Date
        URL: http://www.cy118119.com/nhsn/fhirportal/dqm/ig/StructureDefinition/link-received-date-extension
        .... versionId Σ 0..1 id Version specific identifier
        .... lastUpdated Σ 0..1 instant When the resource version last changed
        .... source Σ 0..1 uri Identifies where the resource comes from
        .... profile Σ 0..* canonical(StructureDefinition) Profiles this resource claims to conform to
        .... security Σ 0..* Coding Security Labels applied to this resource
        Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
        .... tag Σ 0..* Coding Tags applied to this resource
        Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".
        ... 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 SΣ 0..* Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy) {b}
        (NHSN-MS)
        Part of referenced event
        .... id 0..1 string Unique id for inter-element referencing
        .... extension 0..* Extension Additional content defined by implementations
        Slice: Unordered, Open by value:url
        .... reference SΣC 1..1 string
        (NHSN-MS)
        Literal reference, Relative, internal or absolute URL
        .... type Σ 0..1 uri Type the reference refers to (e.g. "Patient")
        Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
        .... identifier Σ 0..1 Identifier Logical reference, when literal reference is not known
        .... display Σ 0..1 string Text alternative for the resource
        ... status ?!SΣ 1..1 code
        (NHSN-MS)
        (USCDI) registered | preliminary | final | amended +
        Binding: ObservationStatus (required)
        ... Slices for category S 1..* CodeableConcept
        (NHSN-MS)
        (USCDI) 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
        (NHSN-MS)
        (USCDI) 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 (USCDI) 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 (USCDI) 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 (USCDI) 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
        (NHSN-MS)
        (USCDI) Coded Responses from C-CDA Vital Sign Results
        Binding: US Core Vital Signs ValueSet (extensible): The vital sign codes from the base FHIR and US Core Vital Signs.
        ... subject SΣ 1..1 Reference(Cross-Measure Patient Profile) {b}
        (NHSN-MS)
        (USCDI) Who and/or what the observation is about
        .... id 0..1 string Unique id for inter-element referencing
        .... extension 0..* Extension Additional content defined by implementations
        Slice: Unordered, Open by value:url
        .... reference SΣC 1..1 string
        (NHSN-MS)
        Literal reference, Relative, internal or absolute URL
        .... type Σ 0..1 uri Type the reference refers to (e.g. "Patient")
        Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
        .... identifier Σ 0..1 Identifier Logical reference, when literal reference is not known
        .... display Σ 0..1 string Text alternative for the resource
        ... focus Σ 0..* Reference(Resource) What the observation is about, when it is not about the subject of record
        ... encounter SΣ 0..1 Reference(Encounter) {b}
        (NHSN-MS)
        Healthcare event during which this observation is made
        .... id 0..1 string Unique id for inter-element referencing
        .... extension 0..* Extension Additional content defined by implementations
        Slice: Unordered, Open by value:url
        .... reference SΣC 1..1 string
        (NHSN-MS)
        Literal reference, Relative, internal or absolute URL
        .... type Σ 0..1 uri Type the reference refers to (e.g. "Patient")
        Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
        .... identifier Σ 0..1 Identifier Logical reference, when literal reference is not known
        .... display Σ 0..1 string Text alternative for the resource
        ... effective[x] SΣC 1..1
        (NHSN-MS)
        (USCDI) Often just a dateTime for Vital Signs
        Constraints: vs-1
        .... effectiveDateTime dateTime S
        .... effectivePeriod Period
        ... issued SΣ 0..1 instant
        (NHSN-MS)
        Date/Time this version was made available
        ... performer Σ 0..* Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson) Who is responsible for the observation
        ... value[x] SΣC 0..1
        (NHSN-MS)
        (USCDI) Vital Signs Value
        Binding: VitalSignsUnits (extensible): Common UCUM units for recording Vital Signs.
        .... valueQuantity Quantity S
        .... valueCodeableConcept CodeableConcept
        .... valueString string
        .... valueBoolean boolean
        .... valueInteger integer
        .... valueRange Range
        .... valueRatio Ratio
        .... valueSampledData SampledData
        .... valueTime time
        .... valueDateTime dateTime
        .... valuePeriod Period
        ... dataAbsentReason SC 0..1 CodeableConcept (USCDI) Why the result is missing
        Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
        ... interpretation S 0..* CodeableConcept
        (NHSN-MS)
        (QI-Core) High, low, normal, etc.
        Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
        ... note 0..* Annotation Comments about the observation
        ... bodySite S 0..1 CodeableConcept
        (NHSN-MS)
        Observed body part
        Binding: SNOMEDCTBodyStructures (extensible)
        ... method S 0..1 CodeableConcept
        (NHSN-MS)
        How it was done
        Binding: ObservationMethods (extensible)
        ... specimen 0..1 Reference(Specimen) Specimen used for this observation
        ... device 0..1 Reference(Device | DeviceMetric) (Measurement) Device
        ... referenceRange SC 0..* BackboneElement
        (NHSN-MS)
        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 SC 0..1 SimpleQuantity
        (NHSN-MS)
        Low Range, if relevant
        .... high SC 0..1 SimpleQuantity
        (NHSN-MS)
        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 S 0..1 Range
        (NHSN-MS)
        Applicable age range, if relevant
        .... text 0..1 string Text based reference range in an observation
        ... hasMember SΣ 0..* Reference(QuestionnaireResponse | MolecularSequence | Vital Signs Profile) {b}
        (NHSN-MS)
        Used when reporting vital signs panel components
        .... id 0..1 string Unique id for inter-element referencing
        .... extension 0..* Extension Additional content defined by implementations
        Slice: Unordered, Open by value:url
        .... reference SΣC 1..1 string
        (NHSN-MS)
        Literal reference, Relative, internal or absolute URL
        .... type Σ 0..1 uri Type the reference refers to (e.g. "Patient")
        Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
        .... identifier Σ 0..1 Identifier Logical reference, when literal reference is not known
        .... display Σ 0..1 string Text alternative for the resource
        ... derivedFrom Σ 0..* Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | MolecularSequence | Vital Signs Profile) Related measurements the observation is made from
        ... component SΣC 0..* BackboneElement
        (NHSN-MS)
        (USCDI) Component observations
        Constraints: vs-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
        .... code SΣ 1..1 CodeableConcept
        (NHSN-MS)
        (USCDI) Type of component observation (code / type)
        Binding: LOINCCodes (extensible)
        .... value[x] SΣC 0..1
        (NHSN-MS)
        (USCDI) Vital Sign Component Value
        Binding: VitalSignsUnits (extensible): Common UCUM units for recording Vital Signs.
        ..... valueQuantity Quantity S
        ..... valueCodeableConcept CodeableConcept
        ..... valueString string
        ..... valueBoolean boolean
        ..... valueInteger integer
        ..... valueRange Range
        ..... valueRatio Ratio
        ..... valueSampledData SampledData
        ..... valueTime time
        ..... valueDateTime dateTime
        ..... valuePeriod Period
        .... dataAbsentReason SC 0..1 CodeableConcept (USCDI) Why the component result is missing
        Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
        .... interpretation S 0..* CodeableConcept
        (NHSN-MS)
        High, low, normal, etc.
        Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
        .... referenceRange S 0..* BackboneElement
        (NHSN-MS)
        Provides guide for interpretation of component result
        ..... id 0..1 string Unique id for inter-element referencing
        ..... extension 0..* Extension Additional content defined by implementations
        ..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
        ..... low SC 0..1 SimpleQuantity(4.0.1)
        (NHSN-MS)
        Low Range, if relevant
        ..... high SC 0..1 SimpleQuantity(4.0.1)
        (NHSN-MS)
        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 S 0..1 Range
        (NHSN-MS)
        Applicable age range, if relevant
        ..... text 0..1 string Text based reference range in an observation

        doco Documentation for this format

        Terminology Bindings

        Path Status Usage ValueSet Version Source
        Observation.meta.security Base extensible SecurityLabels ??4.0.1 FHIR Std.
        Observation.meta.tag Base example Common Tags ??4.0.1 FHIR Std.
        Observation.language Base preferred Common Languages ??4.0.1 FHIR Std.
        Observation.partOf.type Base extensible ResourceType ??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 US Core Vital Signs ValueSet ??6.1.0 US Core v6.1
        Observation.subject.?type Base extensible ResourceType ??4.0.1 FHIR Std.
        Observation.encounter.?type Base extensible ResourceType ??4.0.1 FHIR Std.
        Observation.value[x] Base extensible Vital Signs 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 extensible SNOMED CT Body Structures ??4.0.1 FHIR Std.
        Observation.method Base extensible 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.hasMember.?type Base extensible ResourceType ??4.0.1 FHIR Std.
        Observation.component.?code Base extensible LOINC Codes ??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.
        Observation.component.?referenceRange.type Base preferred Observation Reference Range Meaning Codes ??4.0.1 FHIR Std.
        Observation.component.?referenceRange.appliesTo Base example Observation Reference Range Applies To Codes ??4.0.1 FHIR Std.

        Constraints

        Id Grade Path(s) Description Expression
        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 USCoreVitalSignsProfile

        Summary

        Mandatory: 2 elements(3 nested mandatory elements)
        Must-Support: 21 elements

        Structures

        This structure refers to these other structures:

        Extensions

        This structure refers to these extensions:

        Maturity: 2

        Key Elements View

        Name Flags Card. Type Description & Constraints????Filter: Filtersdoco
        .. Observation C 0..* USCoreVitalSignsProfile(6.1.0) US Core Vital Signs Profile
        Constraints: obs-6, obs-7, vs-2
        ... id SΣ 1..1 id
        (NHSN-MS)
        Logical id of this artifact
        ... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
        ... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
        .... reference SΣC 1..1 string
        (NHSN-MS)
        Literal reference, Relative, internal or absolute URL
        ... status ?!SΣ 1..1 code
        (NHSN-MS)
        (USCDI) registered | preliminary | final | amended +
        Binding: ObservationStatus (required)
        ... Slices for category S 1..* CodeableConcept
        (NHSN-MS)
        (USCDI) 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
        (NHSN-MS)
        (USCDI) Classification of type of observation
        Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
        ..... coding SΣ 1..* Coding (USCDI) Code defined by a terminology system
        ...... system SΣ 1..1 uri (USCDI) Identity of the terminology system
        Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category
        ...... code SΣ 1..1 code (USCDI) Symbol in syntax defined by the system
        Fixed Value: vital-signs
        ... code SΣ 1..1 CodeableConcept
        (NHSN-MS)
        (USCDI) Coded Responses from C-CDA Vital Sign Results
        Binding: US Core Vital Signs ValueSet (extensible): The vital sign codes from the base FHIR and US Core Vital Signs.
        ... subject SΣ 1..1 Reference(Cross-Measure Patient Profile) {b}
        (NHSN-MS)
        (USCDI) Who and/or what the observation is about
        .... reference SΣC 1..1 string
        (NHSN-MS)
        Literal reference, Relative, internal or absolute URL
        ... encounter SΣ 0..1 Reference(Encounter) {b}
        (NHSN-MS)
        Healthcare event during which this observation is made
        .... reference SΣC 1..1 string
        (NHSN-MS)
        Literal reference, Relative, internal or absolute URL
        ... effective[x] SΣC 1..1
        (NHSN-MS)
        (USCDI) Often just a dateTime for Vital Signs
        Constraints: vs-1
        .... effectiveDateTime dateTime S
        .... effectivePeriod Period
        ... issued SΣ 0..1 instant
        (NHSN-MS)
        Date/Time this version was made available
        ... value[x] SΣC 0..1
        (NHSN-MS)
        (USCDI) Vital Signs Value
        Binding: VitalSignsUnits (extensible): Common UCUM units for recording Vital Signs.
        .... valueQuantity Quantity S
        .... valueCodeableConcept CodeableConcept
        .... valueString string
        .... valueBoolean boolean
        .... valueInteger integer
        .... valueRange Range
        .... valueRatio Ratio
        .... valueSampledData SampledData
        .... valueTime time
        .... valueDateTime dateTime
        .... valuePeriod Period
        ... dataAbsentReason SC 0..1 CodeableConcept (USCDI) Why the result is missing
        Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
        ... interpretation S 0..* CodeableConcept
        (NHSN-MS)
        (QI-Core) High, low, normal, etc.
        Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
        ... bodySite S 0..1 CodeableConcept
        (NHSN-MS)
        Observed body part
        Binding: SNOMEDCTBodyStructures (extensible)
        ... method S 0..1 CodeableConcept
        (NHSN-MS)
        How it was done
        Binding: ObservationMethods (extensible)
        ... referenceRange SC 0..* BackboneElement
        (NHSN-MS)
        Provides guide for interpretation
        Constraints: obs-3
        .... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
        .... low SC 0..1 SimpleQuantity
        (NHSN-MS)
        Low Range, if relevant
        .... high SC 0..1 SimpleQuantity
        (NHSN-MS)
        High Range, if relevant
        .... age S 0..1 Range
        (NHSN-MS)
        Applicable age range, if relevant
        ... hasMember SΣ 0..* Reference(QuestionnaireResponse | MolecularSequence | Vital Signs Profile) {b}
        (NHSN-MS)
        Used when reporting vital signs panel components
        .... reference SΣC 1..1 string
        (NHSN-MS)
        Literal reference, Relative, internal or absolute URL
        ... component SΣC 0..* BackboneElement
        (NHSN-MS)
        (USCDI) Component observations
        Constraints: vs-3
        .... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
        .... code SΣ 1..1 CodeableConcept
        (NHSN-MS)
        (USCDI) Type of component observation (code / type)
        Binding: LOINCCodes (extensible)
        .... value[x] SΣC 0..1
        (NHSN-MS)
        (USCDI) Vital Sign Component Value
        Binding: VitalSignsUnits (extensible): Common UCUM units for recording Vital Signs.
        ..... valueQuantity Quantity S
        ..... valueCodeableConcept CodeableConcept
        ..... valueString string
        ..... valueBoolean boolean
        ..... valueInteger integer
        ..... valueRange Range
        ..... valueRatio Ratio
        ..... valueSampledData SampledData
        ..... valueTime time
        ..... valueDateTime dateTime
        ..... valuePeriod Period
        .... dataAbsentReason SC 0..1 CodeableConcept (USCDI) Why the component result is missing
        Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
        .... interpretation S 0..* CodeableConcept
        (NHSN-MS)
        High, low, normal, etc.
        Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
        .... referenceRange S 0..* BackboneElement
        (NHSN-MS)
        Provides guide for interpretation of component result
        ..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
        ..... low SC 0..1 SimpleQuantity(4.0.1)
        (NHSN-MS)
        Low Range, if relevant
        ..... high SC 0..1 SimpleQuantity(4.0.1)
        (NHSN-MS)
        High Range, if relevant
        ..... age S 0..1 Range
        (NHSN-MS)
        Applicable age range, if relevant

        doco 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 US Core Vital Signs ValueSet ??6.1.0 US Core v6.1
        Observation.value[x] Base extensible Vital Signs 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 extensible SNOMED CT Body Structures ??4.0.1 FHIR Std.
        Observation.method Base extensible Observation Methods ??4.0.1 FHIR Std.
        Observation.component.?code Base extensible LOINC Codes ??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
        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()

        Differential View

        This structure is derived from USCoreVitalSignsProfile

        Name Flags Card. Type Description & Constraints????Filter: Filtersdoco
        .. Observation 0..* USCoreVitalSignsProfile(6.1.0) US Core Vital Signs Profile
        ... id S 1..1 id
        (NHSN-MS)
        Logical id of this artifact
        ... meta
        .... Slices for extension Content/Rules for all slices
        ..... extension:link-received-date-extension 0..1 dateTime Received Date
        URL: http://www.cy118119.com/nhsn/fhirportal/dqm/ig/StructureDefinition/link-received-date-extension
        ... partOf S 0..* Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy) {b}
        (NHSN-MS)
        Part of referenced event
        .... reference S 1..1 string
        (NHSN-MS)
        Literal reference, Relative, internal or absolute URL
        ... category 1..* CodeableConcept (NHSN-MS)(USCDI) Classification of type of observation
        ... Slices for category Content/Rules for all slices
        .... category:VSCat 1..1 CodeableConcept (NHSN-MS)(USCDI) Classification of type of observation
        ... code 1..1 CodeableConcept (NHSN-MS)(USCDI) Coded Responses from C-CDA Vital Sign Results
        ... subject 1..1 Reference(Cross-Measure Patient Profile) {b} (NHSN-MS)(USCDI) Who and/or what the observation is about
        .... reference S 1..1 string
        (NHSN-MS)
        Literal reference, Relative, internal or absolute URL
        ... encounter S 0..1 Reference(Encounter) {b}
        (NHSN-MS)
        Healthcare event during which this observation is made
        .... reference S 1..1 string
        (NHSN-MS)
        Literal reference, Relative, internal or absolute URL
        ... effective[x] 1..1 dateTime, Period (NHSN-MS)(USCDI) Often just a dateTime for Vital Signs
        ... issued S 0..1 instant
        (NHSN-MS)
        Date/Time this version was made available
        ... value[x] 0..1 Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period (NHSN-MS)(USCDI) Vital Signs Value
        ... interpretation S 0..* CodeableConcept
        (NHSN-MS)
        (QI-Core) High, low, normal, etc.
        ... bodySite S 0..1 CodeableConcept
        (NHSN-MS)
        Observed body part
        Binding: SNOMEDCTBodyStructures (extensible)
        ... method S 0..1 CodeableConcept
        (NHSN-MS)
        How it was done
        Binding: ObservationMethods (extensible)
        ... referenceRange S 0..* BackboneElement
        (NHSN-MS)
        Provides guide for interpretation
        .... low S 0..1 SimpleQuantity
        (NHSN-MS)
        Low Range, if relevant
        .... high S 0..1 SimpleQuantity
        (NHSN-MS)
        High Range, if relevant
        .... age S 0..1 Range
        (NHSN-MS)
        Applicable age range, if relevant
        ... hasMember S 0..* Reference(QuestionnaireResponse | MolecularSequence | Vital Signs Profile) {b}
        (NHSN-MS)
        Used when reporting vital signs panel components
        .... reference S 1..1 string
        (NHSN-MS)
        Literal reference, Relative, internal or absolute URL
        ... component 0..* BackboneElement (NHSN-MS)(USCDI) Component observations
        .... code 1..1 CodeableConcept (NHSN-MS)(USCDI) Type of component observation (code / type)
        Binding: LOINCCodes (extensible)
        .... value[x] 0..1 Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period (NHSN-MS)(USCDI) Vital Sign Component Value
        .... interpretation S 0..* CodeableConcept
        (NHSN-MS)
        High, low, normal, etc.
        .... referenceRange S 0..* BackboneElement
        (NHSN-MS)
        Provides guide for interpretation of component result
        ..... low S 0..1 SimpleQuantity(4.0.1)
        (NHSN-MS)
        Low Range, if relevant
        ..... high S 0..1 SimpleQuantity(4.0.1)
        (NHSN-MS)
        High Range, if relevant
        ..... age S 0..1 Range
        (NHSN-MS)
        Applicable age range, if relevant

        doco Documentation for this format

        Terminology Bindings (Differential)

        Path Status Usage ValueSet Version Source
        Observation.bodySite Base extensible SNOMED CT Body Structures ??4.0.1 FHIR Std.
        Observation.method Base extensible Observation Methods ??4.0.1 FHIR Std.
        Observation.component.?code Base extensible LOINC Codes ??4.0.1 FHIR Std.

        Snapshot View

        Name Flags Card. Type Description & Constraints????Filter: Filtersdoco
        .. Observation C 0..* USCoreVitalSignsProfile(6.1.0) US Core Vital Signs Profile
        Constraints: obs-6, obs-7, vs-2
        ... id SΣ 1..1 id
        (NHSN-MS)
        Logical id of this artifact
        ... meta Σ 0..1 Meta Metadata about the resource
        .... id 0..1 string Unique id for inter-element referencing
        .... Slices for extension 0..* Extension Additional content defined by implementations
        Slice: Unordered, Open by value:url
        ..... extension:link-received-date-extension 0..1 dateTime Received Date
        URL: http://www.cy118119.com/nhsn/fhirportal/dqm/ig/StructureDefinition/link-received-date-extension
        .... versionId Σ 0..1 id Version specific identifier
        .... lastUpdated Σ 0..1 instant When the resource version last changed
        .... source Σ 0..1 uri Identifies where the resource comes from
        .... profile Σ 0..* canonical(StructureDefinition) Profiles this resource claims to conform to
        .... security Σ 0..* Coding Security Labels applied to this resource
        Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
        .... tag Σ 0..* Coding Tags applied to this resource
        Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".
        ... 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 SΣ 0..* Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy) {b}
        (NHSN-MS)
        Part of referenced event
        .... id 0..1 string Unique id for inter-element referencing
        .... extension 0..* Extension Additional content defined by implementations
        Slice: Unordered, Open by value:url
        .... reference SΣC 1..1 string
        (NHSN-MS)
        Literal reference, Relative, internal or absolute URL
        .... type Σ 0..1 uri Type the reference refers to (e.g. "Patient")
        Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
        .... identifier Σ 0..1 Identifier Logical reference, when literal reference is not known
        .... display Σ 0..1 string Text alternative for the resource
        ... status ?!SΣ 1..1 code
        (NHSN-MS)
        (USCDI) registered | preliminary | final | amended +
        Binding: ObservationStatus (required)
        ... Slices for category S 1..* CodeableConcept
        (NHSN-MS)
        (USCDI) 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
        (NHSN-MS)
        (USCDI) 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 (USCDI) 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 (USCDI) 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 (USCDI) 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
        (NHSN-MS)
        (USCDI) Coded Responses from C-CDA Vital Sign Results
        Binding: US Core Vital Signs ValueSet (extensible): The vital sign codes from the base FHIR and US Core Vital Signs.
        ... subject SΣ 1..1 Reference(Cross-Measure Patient Profile) {b}
        (NHSN-MS)
        (USCDI) Who and/or what the observation is about
        .... id 0..1 string Unique id for inter-element referencing
        .... extension 0..* Extension Additional content defined by implementations
        Slice: Unordered, Open by value:url
        .... reference SΣC 1..1 string
        (NHSN-MS)
        Literal reference, Relative, internal or absolute URL
        .... type Σ 0..1 uri Type the reference refers to (e.g. "Patient")
        Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
        .... identifier Σ 0..1 Identifier Logical reference, when literal reference is not known
        .... display Σ 0..1 string Text alternative for the resource
        ... focus Σ 0..* Reference(Resource) What the observation is about, when it is not about the subject of record
        ... encounter SΣ 0..1 Reference(Encounter) {b}
        (NHSN-MS)
        Healthcare event during which this observation is made
        .... id 0..1 string Unique id for inter-element referencing
        .... extension 0..* Extension Additional content defined by implementations
        Slice: Unordered, Open by value:url
        .... reference SΣC 1..1 string
        (NHSN-MS)
        Literal reference, Relative, internal or absolute URL
        .... type Σ 0..1 uri Type the reference refers to (e.g. "Patient")
        Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
        .... identifier Σ 0..1 Identifier Logical reference, when literal reference is not known
        .... display Σ 0..1 string Text alternative for the resource
        ... effective[x] SΣC 1..1
        (NHSN-MS)
        (USCDI) Often just a dateTime for Vital Signs
        Constraints: vs-1
        .... effectiveDateTime dateTime S
        .... effectivePeriod Period
        ... issued SΣ 0..1 instant
        (NHSN-MS)
        Date/Time this version was made available
        ... performer Σ 0..* Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson) Who is responsible for the observation
        ... value[x] SΣC 0..1
        (NHSN-MS)
        (USCDI) Vital Signs Value
        Binding: VitalSignsUnits (extensible): Common UCUM units for recording Vital Signs.
        .... valueQuantity Quantity S
        .... valueCodeableConcept CodeableConcept
        .... valueString string
        .... valueBoolean boolean
        .... valueInteger integer
        .... valueRange Range
        .... valueRatio Ratio
        .... valueSampledData SampledData
        .... valueTime time
        .... valueDateTime dateTime
        .... valuePeriod Period
        ... dataAbsentReason SC 0..1 CodeableConcept (USCDI) Why the result is missing
        Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
        ... interpretation S 0..* CodeableConcept
        (NHSN-MS)
        (QI-Core) High, low, normal, etc.
        Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
        ... note 0..* Annotation Comments about the observation
        ... bodySite S 0..1 CodeableConcept
        (NHSN-MS)
        Observed body part
        Binding: SNOMEDCTBodyStructures (extensible)
        ... method S 0..1 CodeableConcept
        (NHSN-MS)
        How it was done
        Binding: ObservationMethods (extensible)
        ... specimen 0..1 Reference(Specimen) Specimen used for this observation
        ... device 0..1 Reference(Device | DeviceMetric) (Measurement) Device
        ... referenceRange SC 0..* BackboneElement
        (NHSN-MS)
        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 SC 0..1 SimpleQuantity
        (NHSN-MS)
        Low Range, if relevant
        .... high SC 0..1 SimpleQuantity
        (NHSN-MS)
        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 S 0..1 Range
        (NHSN-MS)
        Applicable age range, if relevant
        .... text 0..1 string Text based reference range in an observation
        ... hasMember SΣ 0..* Reference(QuestionnaireResponse | MolecularSequence | Vital Signs Profile) {b}
        (NHSN-MS)
        Used when reporting vital signs panel components
        .... id 0..1 string Unique id for inter-element referencing
        .... extension 0..* Extension Additional content defined by implementations
        Slice: Unordered, Open by value:url
        .... reference SΣC 1..1 string
        (NHSN-MS)
        Literal reference, Relative, internal or absolute URL
        .... type Σ 0..1 uri Type the reference refers to (e.g. "Patient")
        Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
        .... identifier Σ 0..1 Identifier Logical reference, when literal reference is not known
        .... display Σ 0..1 string Text alternative for the resource
        ... derivedFrom Σ 0..* Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | MolecularSequence | Vital Signs Profile) Related measurements the observation is made from
        ... component SΣC 0..* BackboneElement
        (NHSN-MS)
        (USCDI) Component observations
        Constraints: vs-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
        .... code SΣ 1..1 CodeableConcept
        (NHSN-MS)
        (USCDI) Type of component observation (code / type)
        Binding: LOINCCodes (extensible)
        .... value[x] SΣC 0..1
        (NHSN-MS)
        (USCDI) Vital Sign Component Value
        Binding: VitalSignsUnits (extensible): Common UCUM units for recording Vital Signs.
        ..... valueQuantity Quantity S
        ..... valueCodeableConcept CodeableConcept
        ..... valueString string
        ..... valueBoolean boolean
        ..... valueInteger integer
        ..... valueRange Range
        ..... valueRatio Ratio
        ..... valueSampledData SampledData
        ..... valueTime time
        ..... valueDateTime dateTime
        ..... valuePeriod Period
        .... dataAbsentReason SC 0..1 CodeableConcept (USCDI) Why the component result is missing
        Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
        .... interpretation S 0..* CodeableConcept
        (NHSN-MS)
        High, low, normal, etc.
        Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
        .... referenceRange S 0..* BackboneElement
        (NHSN-MS)
        Provides guide for interpretation of component result
        ..... id 0..1 string Unique id for inter-element referencing
        ..... extension 0..* Extension Additional content defined by implementations
        ..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
        ..... low SC 0..1 SimpleQuantity(4.0.1)
        (NHSN-MS)
        Low Range, if relevant
        ..... high SC 0..1 SimpleQuantity(4.0.1)
        (NHSN-MS)
        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 S 0..1 Range
        (NHSN-MS)
        Applicable age range, if relevant
        ..... text 0..1 string Text based reference range in an observation

        doco Documentation for this format

        Terminology Bindings

        Path Status Usage ValueSet Version Source
        Observation.meta.security Base extensible SecurityLabels ??4.0.1 FHIR Std.
        Observation.meta.tag Base example Common Tags ??4.0.1 FHIR Std.
        Observation.language Base preferred Common Languages ??4.0.1 FHIR Std.
        Observation.partOf.type Base extensible ResourceType ??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 US Core Vital Signs ValueSet ??6.1.0 US Core v6.1
        Observation.subject.?type Base extensible ResourceType ??4.0.1 FHIR Std.
        Observation.encounter.?type Base extensible ResourceType ??4.0.1 FHIR Std.
        Observation.value[x] Base extensible Vital Signs 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 extensible SNOMED CT Body Structures ??4.0.1 FHIR Std.
        Observation.method Base extensible 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.hasMember.?type Base extensible ResourceType ??4.0.1 FHIR Std.
        Observation.component.?code Base extensible LOINC Codes ??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.
        Observation.component.?referenceRange.type Base preferred Observation Reference Range Meaning Codes ??4.0.1 FHIR Std.
        Observation.component.?referenceRange.appliesTo Base example Observation Reference Range Applies To Codes ??4.0.1 FHIR Std.

        Constraints

        Id Grade Path(s) Description Expression
        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 USCoreVitalSignsProfile

        Summary

        Mandatory: 2 elements(3 nested mandatory elements)
        Must-Support: 21 elements

        Structures

        This structure refers to these other structures:

        Extensions

        This structure refers to these extensions:

        Maturity: 2

        ?

        Other representations of profile: CSV, Excel, Schematron


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