Onconova Implementation Guide
0.2.0 - ci-build

Onconova Implementation Guide - Local Development build (v0.2.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

Resource Profile: Comorbidities Profile

Official URL: http://onconova.github.io/fhir/StructureDefinition/onconova-comorbidities Version: 0.2.0
Active as of 2025-10-17 Computable Name: OnconovaComorbidities

A profile representing comorbidities for a cancer patient, i.e. other health conditions that exist alongside the primary cancer diagnosis. Supports existing comorbidity panels such as the Charlson Comorbidity Index (CCI) and Elixhauser Comorbidity Index (ECI) with comorbidity indexes.

The profile constrains the mCODE Comorbidities profile to ensure consistent use of ICD-10 codes for documenting comorbid conditions, and to link the comorbidity information to the Onconova primary cancer condition profile.

Usages:

You can also check for usages in the FHIR IG Statistics

Formal Views of Profile Content

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

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Observation C 0..* Comorbidities(4.0.0) assessment observation
Constraints: obs-6, obs-7, com-1, com-req-1, com-req-2, com-req-3
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... Slices for extension S 0..* Extension Extension
Slice: Unordered, Open by value:url
Constraints: ext-1
.... extension:comorbidConditionPresent S 0..* (Complex) Related Condition Extension
URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-related-condition
Constraints: ext-1
..... extension 0..0
..... url 1..1 uri "http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-related-condition"
..... Slices for value[x] 1..1 Value of extension
Slice: Unordered, Open by type:$this
...... valueCodeableConcept CodeableConcept
...... valueReference Reference(Condition)
...... value[x]:valueCodeableConcept 0..1 CodeableConcept Value of extension
Binding: ICD10Conditions (0.2.0) (required)
.... extension:comorbidConditionAbsent S 0..* (Complex) Related Condition Absent Extension
URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-related-condition-absent
Constraints: ext-1
..... extension 0..0
..... url 1..1 uri "http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-related-condition-absent"
..... value[x] 1..1 CodeableConcept Value of extension
Binding: ICD10Conditions (0.2.0) (required)
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
Constraints: ext-1
... partOf Σ 0..* Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy) Not used in this profile
... status ?!SΣ 1..1 code (USCDI) registered | preliminary | final | amended +
Binding: ObservationStatus (required): Codes providing the status of an observation.
Required Pattern: final
... Slices for category S 1..* CodeableConcept (USCDI) Classification of type of observation
Slice: Unordered, Open by pattern:$this
Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
.... category:us-core S 0..* CodeableConcept (USCDI) Classification of type of observation
Binding: USCoreSimpleObservationCategory (6.1.0) (required): Note that other codes are permitted, see Required Bindings When Slicing by Value Sets
... code SΣ 1..1 CodeableConcept (USCDI) Type of observation (code / type)
Binding: LOINCCodes (preferred)
Required Pattern: At least the following
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... coding 1..* Coding Code defined by a terminology system
Fixed Value: (Complex)
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
..... system 1..1 uri Identity of the terminology system
Fixed Value: http://snomed.info/sct
..... version 0..1 string Version of the system - if relevant
..... code 1..1 code Symbol in syntax defined by the system
Fixed Value: 398192003
..... display 0..1 string Representation defined by the system
..... userSelected 0..1 boolean If this coding was chosen directly by the user
.... text 0..1 string Plain text representation of the concept
... subject SΣ 1..1 Reference(Cancer Patient Profile(0.2.0)) (USCDI) Who and/or what the observation is about
... focus SΣ 0..* Reference(Primary Cancer Condition Profile(0.2.0)) The Index Condition
... encounter Σ 0..1 Reference(Encounter) Not used in this profile
... effective[x] SΣ 0..1 dateTime S (USCDI) Clinically relevant time/time-period for observation
... issued Σ 0..1 instant Not used in this profile
... performer SΣ 0..* Reference(US Core Practitioner Profile(6.1.0) | US Core Organization Profile(6.1.0) | US Core Patient Profile(6.1.0) | PractitionerRole | US Core CareTeam Profile(6.1.0) | US Core RelatedPerson Profile(6.1.0)) (USCDI) Who is responsible for the observation
... value[x] SΣC 0..1 Quantity S Comorbidity Index Score
.... comparator ?!Σ 0..1 code < | <= | >= | > - how to understand the value
Binding: QuantityComparator (required): How the Quantity should be understood and represented.
.... unit Σ 0..1 string Unit representation
Required Pattern: 1
... interpretation 0..* CodeableConcept Not used in this profile
Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
... method 0..1 CodeableConcept Comorbidity framework used.
Binding: ComorbidityPanels (0.2.0) (required)
... referenceRange C 0..* BackboneElement Not used in this profile
Constraints: obs-3
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
Constraints: ext-1
... derivedFrom Σ 0..* Reference(Observation | US Core DocumentReference Profile(6.1.0) | US Core QuestionnaireResponse Profile(6.1.0) | ImagingStudy | Media | MolecularSequence) Not used in this profile

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
Observation.extension:comorbidConditionPresent.​value[x]:valueCodeableConcept Base required ICD-10 Codes 📍0.2.0 This IG
Observation.extension:comorbidConditionAbsent.​value[x] Base required ICD-10 Codes 📍0.2.0 This IG
Observation.status Base required ObservationStatus 📍4.0.1 FHIR Std.
Observation.category Base preferred Observation Category Codes 📍4.0.1 FHIR Std.
Observation.category:us-core Base required US Core Simple Observation Category 📍6.1.0 US Core v6.1
Observation.code Base preferred LOINC Codes 📍4.0.1 FHIR Std.
Observation.value[x].​comparator Base required QuantityComparator 📍4.0.1 FHIR Std.
Observation.interpretation Base extensible Observation Interpretation Codes 📍4.0.1 FHIR Std.
Observation.method Base required Comorbidity Panels 📍0.2.0 This IG

Constraints

Id Grade Path(s) Description Expression
com-1 error Observation If an index score is provided, then the comorbidity panel method must also be provided. valueQuantity.exists() implies method.exists()
com-req-1 error Observation The subject element is required and must be provided. subject.exists() and subject.resolve().is(Patient)
com-req-2 error Observation The effectiveDateTime element is required and must be provided. effectiveDateTime.exists() and effectiveDateTime.hasValue()
com-req-3 error Observation The focus element is required and must be provided. focus.exists() and focus.resolve().is(Condition)
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 Observation.implicitRules, Observation.extension, Observation.extension:comorbidConditionPresent, Observation.extension:comorbidConditionPresent.value[x], Observation.extension:comorbidConditionPresent.value[x]:valueCodeableConcept, Observation.extension:comorbidConditionAbsent, Observation.extension:comorbidConditionAbsent.value[x], Observation.modifierExtension, Observation.basedOn, Observation.partOf, Observation.status, Observation.category, Observation.category:us-core, Observation.code, Observation.subject, Observation.focus, Observation.encounter, Observation.effective[x], Observation.issued, Observation.performer, Observation.value[x], Observation.value[x].comparator, Observation.value[x].unit, Observation.interpretation, Observation.method, Observation.referenceRange, Observation.referenceRange.modifierExtension, Observation.derivedFrom All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ext-1 error Observation.extension, Observation.extension:comorbidConditionPresent, Observation.extension:comorbidConditionAbsent, Observation.modifierExtension, Observation.referenceRange.modifierExtension 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()

This structure is derived from Comorbidities

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Observation C 0..* Comorbidities(4.0.0) assessment observation
... Slices for extension Content/Rules for all slices
.... extension:comorbidConditionPresent 0..* RelatedCondition(4.0.0) Related Condition Extension
..... Slices for value[x] 1..1 CodeableConcept, Reference(Condition) Value of extension
Slice: Unordered, Open by type:$this
...... value[x]:valueCodeableConcept 0..1 CodeableConcept Value of extension
Binding: ICD10Conditions (0.2.0) (required)
.... extension:comorbidConditionAbsent 0..* RelatedConditionAbsent(4.0.0) Related Condition Absent Extension
..... value[x] 1..1 CodeableConcept Value of extension
Binding: ICD10Conditions (0.2.0) (required)
... basedOn 0..* Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest) Not used in this profile
... partOf 0..* Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy) Not used in this profile
... subject 1..1 Reference(Cancer Patient Profile(0.2.0)) (USCDI) Who and/or what the observation is about
... focus 0..* Reference(Primary Cancer Condition Profile(0.2.0)) The Index Condition
... encounter 0..1 Reference(Encounter) Not used in this profile
... effective[x] 0..1 dateTime (USCDI) Clinically relevant time/time-period for observation
... issued 0..1 instant Not used in this profile
... value[x] 0..1 Quantity Comorbidity Index Score
.... unit 0..1 string Unit representation
Required Pattern: 1
... interpretation 0..* CodeableConcept Not used in this profile
... method 0..1 CodeableConcept Comorbidity framework used.
Binding: ComorbidityPanels (0.2.0) (required)
... referenceRange 0..* BackboneElement Not used in this profile
... derivedFrom 0..* Reference(Observation | US Core DocumentReference Profile(6.1.0) | US Core QuestionnaireResponse Profile(6.1.0) | ImagingStudy | Media | MolecularSequence) Not used in this profile

doco Documentation for this format

Terminology Bindings (Differential)

Path Status Usage ValueSet Version Source
Observation.extension:comorbidConditionPresent.​value[x]:valueCodeableConcept Base required ICD-10 Codes 📍0.2.0 This IG
Observation.extension:comorbidConditionAbsent.​value[x] Base required ICD-10 Codes 📍0.2.0 This IG
Observation.method Base required Comorbidity Panels 📍0.2.0 This IG

Constraints

Id Grade Path(s) Description Expression
com-1 error Observation If an index score is provided, then the comorbidity panel method must also be provided. valueQuantity.exists() implies method.exists()
com-req-1 error Observation The subject element is required and must be provided. subject.exists() and subject.resolve().is(Patient)
com-req-2 error Observation The effectiveDateTime element is required and must be provided. effectiveDateTime.exists() and effectiveDateTime.hasValue()
com-req-3 error Observation The focus element is required and must be provided. focus.exists() and focus.resolve().is(Condition)
NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Observation C 0..* Comorbidities(4.0.0) assessment observation
Constraints: obs-6, obs-7, com-1, com-req-1, com-req-2, com-req-3
... id Σ 0..1 id Logical id of this artifact
... meta Σ 0..1 Meta Metadata about the resource
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... language 0..1 code Language of the resource content
Binding: CommonLanguages (preferred): A human language.
Additional BindingsPurpose
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
... Slices for extension S 0..* Extension Extension
Slice: Unordered, Open by value:url
Constraints: ext-1
.... extension:comorbidConditionPresent S 0..* (Complex) Related Condition Extension
URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-related-condition
Constraints: ext-1
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..0
..... url 1..1 uri "http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-related-condition"
..... Slices for value[x] 1..1 Value of extension
Slice: Unordered, Open by type:$this
...... valueCodeableConcept CodeableConcept
...... valueReference Reference(Condition)
...... value[x]:valueCodeableConcept 0..1 CodeableConcept Value of extension
Binding: ICD10Conditions (0.2.0) (required)
.... extension:comorbidConditionAbsent S 0..* (Complex) Related Condition Absent Extension
URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-related-condition-absent
Constraints: ext-1
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..0
..... url 1..1 uri "http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-related-condition-absent"
..... value[x] 1..1 CodeableConcept Value of extension
Binding: ICD10Conditions (0.2.0) (required)
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
Constraints: ext-1
... identifier Σ 0..* Identifier Business Identifier for observation
... basedOn Σ 0..* Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest) Not used in this profile
... partOf Σ 0..* Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy) Not used in this profile
... status ?!SΣ 1..1 code (USCDI) registered | preliminary | final | amended +
Binding: ObservationStatus (required): Codes providing the status of an observation.
Required Pattern: final
... Slices for category S 1..* CodeableConcept (USCDI) Classification of type of observation
Slice: Unordered, Open by pattern:$this
Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
.... category:us-core S 0..* CodeableConcept (USCDI) Classification of type of observation
Binding: USCoreSimpleObservationCategory (6.1.0) (required): Note that other codes are permitted, see Required Bindings When Slicing by Value Sets
... code SΣ 1..1 CodeableConcept (USCDI) Type of observation (code / type)
Binding: LOINCCodes (preferred)
Required Pattern: At least the following
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... coding 1..* Coding Code defined by a terminology system
Fixed Value: (Complex)
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
..... system 1..1 uri Identity of the terminology system
Fixed Value: http://snomed.info/sct
..... version 0..1 string Version of the system - if relevant
..... code 1..1 code Symbol in syntax defined by the system
Fixed Value: 398192003
..... display 0..1 string Representation defined by the system
..... userSelected 0..1 boolean If this coding was chosen directly by the user
.... text 0..1 string Plain text representation of the concept
... subject SΣ 1..1 Reference(Cancer Patient Profile(0.2.0)) (USCDI) Who and/or what the observation is about
... focus SΣ 0..* Reference(Primary Cancer Condition Profile(0.2.0)) The Index Condition
... encounter Σ 0..1 Reference(Encounter) Not used in this profile
... effective[x] SΣ 0..1 dateTime S (USCDI) Clinically relevant time/time-period for observation
... issued Σ 0..1 instant Not used in this profile
... performer SΣ 0..* Reference(US Core Practitioner Profile(6.1.0) | US Core Organization Profile(6.1.0) | US Core Patient Profile(6.1.0) | PractitionerRole | US Core CareTeam Profile(6.1.0) | US Core RelatedPerson Profile(6.1.0)) (USCDI) Who is responsible for the observation
... value[x] SΣC 0..1 Quantity S Comorbidity Index Score
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
Constraints: ext-1
.... value Σ 0..1 decimal Numerical value (with implicit precision)
.... comparator ?!Σ 0..1 code < | <= | >= | > - how to understand the value
Binding: QuantityComparator (required): How the Quantity should be understood and represented.
.... unit Σ 0..1 string Unit representation
Required Pattern: 1
.... system ΣC 0..1 uri System that defines coded unit form
.... code Σ 0..1 code Coded form of the unit
... dataAbsentReason C 0..1 CodeableConcept Why the result is missing
Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
... interpretation 0..* CodeableConcept Not used in this profile
Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
... note 0..* Annotation Comments about the observation
... bodySite 0..1 CodeableConcept Not used in this profile
Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
... method 0..1 CodeableConcept Comorbidity framework used.
Binding: ComorbidityPanels (0.2.0) (required)
... specimen 0..1 Reference(Specimen) Not used in this profile
... device 0..1 Reference(Device | DeviceMetric) Not used in this profile
... referenceRange C 0..* BackboneElement Not used in this profile
Constraints: obs-3
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Constraints: ext-1
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
Constraints: ext-1
.... low C 0..1 SimpleQuantity(4.0.1) Low Range, if relevant
.... high C 0..1 SimpleQuantity(4.0.1) High Range, if relevant
.... type 0..1 CodeableConcept Reference range qualifier
Binding: ObservationReferenceRangeMeaningCodes (preferred): Code for the meaning of a reference range.
.... appliesTo 0..* CodeableConcept Reference range population
Binding: ObservationReferenceRangeAppliesToCodes (example): Codes identifying the population the reference range applies to.
.... age 0..1 Range Applicable age range, if relevant
.... text 0..1 string Text based reference range in an observation
... hasMember Σ 0..* Reference(Observation | QuestionnaireResponse | MolecularSequence) Not used in this profile
... derivedFrom Σ 0..* Reference(Observation | US Core DocumentReference Profile(6.1.0) | US Core QuestionnaireResponse Profile(6.1.0) | ImagingStudy | Media | MolecularSequence) Not used in this profile
... component Σ 0..* BackboneElement Not used in this profile
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Constraints: ext-1
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
Constraints: ext-1
.... code Σ 1..1 CodeableConcept Type of component observation (code / type)
Binding: LOINCCodes (example): Codes identifying names of simple observations.
.... value[x] Σ 0..1 Actual component result
..... valueQuantity Quantity
..... valueCodeableConcept CodeableConcept
..... valueString string
..... valueBoolean boolean
..... valueInteger integer
..... valueRange Range
..... valueRatio Ratio
..... valueSampledData SampledData
..... valueTime time
..... valueDateTime dateTime
..... valuePeriod Period
.... dataAbsentReason C 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

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
Observation.language Base preferred Common Languages 📍4.0.1 FHIR Std.
Observation.extension:comorbidConditionPresent.​value[x]:valueCodeableConcept Base required ICD-10 Codes 📍0.2.0 This IG
Observation.extension:comorbidConditionAbsent.​value[x] Base required ICD-10 Codes 📍0.2.0 This IG
Observation.status Base required ObservationStatus 📍4.0.1 FHIR Std.
Observation.category Base preferred Observation Category Codes 📍4.0.1 FHIR Std.
Observation.category:us-core Base required US Core Simple Observation Category 📍6.1.0 US Core v6.1
Observation.code Base preferred LOINC Codes 📍4.0.1 FHIR Std.
Observation.value[x].​comparator Base required QuantityComparator 📍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 example SNOMED CT Body Structures 📍4.0.1 FHIR Std.
Observation.method Base required Comorbidity Panels 📍0.2.0 This IG
Observation.referenceRange.​type Base preferred Observation Reference Range Meaning Codes 📍4.0.1 FHIR Std.
Observation.referenceRange.​appliesTo Base example Observation Reference Range Applies To Codes 📍4.0.1 FHIR Std.
Observation.component.​code Base example LOINC Codes 📍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
com-1 error Observation If an index score is provided, then the comorbidity panel method must also be provided. valueQuantity.exists() implies method.exists()
com-req-1 error Observation The subject element is required and must be provided. subject.exists() and subject.resolve().is(Patient)
com-req-2 error Observation The effectiveDateTime element is required and must be provided. effectiveDateTime.exists() and effectiveDateTime.hasValue()
com-req-3 error Observation The focus element is required and must be provided. focus.exists() and focus.resolve().is(Condition)
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 Observation.meta, Observation.implicitRules, Observation.language, Observation.text, Observation.extension, Observation.extension:comorbidConditionPresent, Observation.extension:comorbidConditionPresent.value[x], Observation.extension:comorbidConditionPresent.value[x]:valueCodeableConcept, Observation.extension:comorbidConditionAbsent, Observation.extension:comorbidConditionAbsent.value[x], Observation.modifierExtension, Observation.identifier, Observation.basedOn, Observation.partOf, Observation.status, Observation.category, Observation.category:us-core, Observation.code, Observation.subject, Observation.focus, Observation.encounter, Observation.effective[x], Observation.issued, Observation.performer, Observation.value[x], Observation.value[x].extension, Observation.value[x].value, Observation.value[x].comparator, Observation.value[x].unit, Observation.value[x].system, Observation.value[x].code, Observation.dataAbsentReason, Observation.interpretation, Observation.note, Observation.bodySite, Observation.method, Observation.specimen, Observation.device, Observation.referenceRange, Observation.referenceRange.extension, Observation.referenceRange.modifierExtension, Observation.referenceRange.low, Observation.referenceRange.high, Observation.referenceRange.type, Observation.referenceRange.appliesTo, Observation.referenceRange.age, Observation.referenceRange.text, Observation.hasMember, Observation.derivedFrom, Observation.component, Observation.component.extension, Observation.component.modifierExtension, Observation.component.code, Observation.component.value[x], Observation.component.dataAbsentReason, Observation.component.interpretation, Observation.component.referenceRange All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ext-1 error Observation.extension, Observation.extension:comorbidConditionPresent, Observation.extension:comorbidConditionAbsent, Observation.modifierExtension, Observation.value[x].extension, Observation.referenceRange.extension, Observation.referenceRange.modifierExtension, Observation.component.extension, Observation.component.modifierExtension 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()

This structure is derived from Comorbidities

Summary

Structures

This structure refers to these other structures:

Slices

This structure defines the following Slices:

  • The element 1 is sliced based on the value of Observation.extension.value[x]

Key Elements View

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Observation C 0..* Comorbidities(4.0.0) assessment observation
Constraints: obs-6, obs-7, com-1, com-req-1, com-req-2, com-req-3
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... Slices for extension S 0..* Extension Extension
Slice: Unordered, Open by value:url
Constraints: ext-1
.... extension:comorbidConditionPresent S 0..* (Complex) Related Condition Extension
URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-related-condition
Constraints: ext-1
..... extension 0..0
..... url 1..1 uri "http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-related-condition"
..... Slices for value[x] 1..1 Value of extension
Slice: Unordered, Open by type:$this
...... valueCodeableConcept CodeableConcept
...... valueReference Reference(Condition)
...... value[x]:valueCodeableConcept 0..1 CodeableConcept Value of extension
Binding: ICD10Conditions (0.2.0) (required)
.... extension:comorbidConditionAbsent S 0..* (Complex) Related Condition Absent Extension
URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-related-condition-absent
Constraints: ext-1
..... extension 0..0
..... url 1..1 uri "http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-related-condition-absent"
..... value[x] 1..1 CodeableConcept Value of extension
Binding: ICD10Conditions (0.2.0) (required)
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
Constraints: ext-1
... partOf Σ 0..* Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy) Not used in this profile
... status ?!SΣ 1..1 code (USCDI) registered | preliminary | final | amended +
Binding: ObservationStatus (required): Codes providing the status of an observation.
Required Pattern: final
... Slices for category S 1..* CodeableConcept (USCDI) Classification of type of observation
Slice: Unordered, Open by pattern:$this
Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
.... category:us-core S 0..* CodeableConcept (USCDI) Classification of type of observation
Binding: USCoreSimpleObservationCategory (6.1.0) (required): Note that other codes are permitted, see Required Bindings When Slicing by Value Sets
... code SΣ 1..1 CodeableConcept (USCDI) Type of observation (code / type)
Binding: LOINCCodes (preferred)
Required Pattern: At least the following
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... coding 1..* Coding Code defined by a terminology system
Fixed Value: (Complex)
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
..... system 1..1 uri Identity of the terminology system
Fixed Value: http://snomed.info/sct
..... version 0..1 string Version of the system - if relevant
..... code 1..1 code Symbol in syntax defined by the system
Fixed Value: 398192003
..... display 0..1 string Representation defined by the system
..... userSelected 0..1 boolean If this coding was chosen directly by the user
.... text 0..1 string Plain text representation of the concept
... subject SΣ 1..1 Reference(Cancer Patient Profile(0.2.0)) (USCDI) Who and/or what the observation is about
... focus SΣ 0..* Reference(Primary Cancer Condition Profile(0.2.0)) The Index Condition
... encounter Σ 0..1 Reference(Encounter) Not used in this profile
... effective[x] SΣ 0..1 dateTime S (USCDI) Clinically relevant time/time-period for observation
... issued Σ 0..1 instant Not used in this profile
... performer SΣ 0..* Reference(US Core Practitioner Profile(6.1.0) | US Core Organization Profile(6.1.0) | US Core Patient Profile(6.1.0) | PractitionerRole | US Core CareTeam Profile(6.1.0) | US Core RelatedPerson Profile(6.1.0)) (USCDI) Who is responsible for the observation
... value[x] SΣC 0..1 Quantity S Comorbidity Index Score
.... comparator ?!Σ 0..1 code < | <= | >= | > - how to understand the value
Binding: QuantityComparator (required): How the Quantity should be understood and represented.
.... unit Σ 0..1 string Unit representation
Required Pattern: 1
... interpretation 0..* CodeableConcept Not used in this profile
Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
... method 0..1 CodeableConcept Comorbidity framework used.
Binding: ComorbidityPanels (0.2.0) (required)
... referenceRange C 0..* BackboneElement Not used in this profile
Constraints: obs-3
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
Constraints: ext-1
... derivedFrom Σ 0..* Reference(Observation | US Core DocumentReference Profile(6.1.0) | US Core QuestionnaireResponse Profile(6.1.0) | ImagingStudy | Media | MolecularSequence) Not used in this profile

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
Observation.extension:comorbidConditionPresent.​value[x]:valueCodeableConcept Base required ICD-10 Codes 📍0.2.0 This IG
Observation.extension:comorbidConditionAbsent.​value[x] Base required ICD-10 Codes 📍0.2.0 This IG
Observation.status Base required ObservationStatus 📍4.0.1 FHIR Std.
Observation.category Base preferred Observation Category Codes 📍4.0.1 FHIR Std.
Observation.category:us-core Base required US Core Simple Observation Category 📍6.1.0 US Core v6.1
Observation.code Base preferred LOINC Codes 📍4.0.1 FHIR Std.
Observation.value[x].​comparator Base required QuantityComparator 📍4.0.1 FHIR Std.
Observation.interpretation Base extensible Observation Interpretation Codes 📍4.0.1 FHIR Std.
Observation.method Base required Comorbidity Panels 📍0.2.0 This IG

Constraints

Id Grade Path(s) Description Expression
com-1 error Observation If an index score is provided, then the comorbidity panel method must also be provided. valueQuantity.exists() implies method.exists()
com-req-1 error Observation The subject element is required and must be provided. subject.exists() and subject.resolve().is(Patient)
com-req-2 error Observation The effectiveDateTime element is required and must be provided. effectiveDateTime.exists() and effectiveDateTime.hasValue()
com-req-3 error Observation The focus element is required and must be provided. focus.exists() and focus.resolve().is(Condition)
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 Observation.implicitRules, Observation.extension, Observation.extension:comorbidConditionPresent, Observation.extension:comorbidConditionPresent.value[x], Observation.extension:comorbidConditionPresent.value[x]:valueCodeableConcept, Observation.extension:comorbidConditionAbsent, Observation.extension:comorbidConditionAbsent.value[x], Observation.modifierExtension, Observation.basedOn, Observation.partOf, Observation.status, Observation.category, Observation.category:us-core, Observation.code, Observation.subject, Observation.focus, Observation.encounter, Observation.effective[x], Observation.issued, Observation.performer, Observation.value[x], Observation.value[x].comparator, Observation.value[x].unit, Observation.interpretation, Observation.method, Observation.referenceRange, Observation.referenceRange.modifierExtension, Observation.derivedFrom All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ext-1 error Observation.extension, Observation.extension:comorbidConditionPresent, Observation.extension:comorbidConditionAbsent, Observation.modifierExtension, Observation.referenceRange.modifierExtension 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()

Differential View

This structure is derived from Comorbidities

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Observation C 0..* Comorbidities(4.0.0) assessment observation
... Slices for extension Content/Rules for all slices
.... extension:comorbidConditionPresent 0..* RelatedCondition(4.0.0) Related Condition Extension
..... Slices for value[x] 1..1 CodeableConcept, Reference(Condition) Value of extension
Slice: Unordered, Open by type:$this
...... value[x]:valueCodeableConcept 0..1 CodeableConcept Value of extension
Binding: ICD10Conditions (0.2.0) (required)
.... extension:comorbidConditionAbsent 0..* RelatedConditionAbsent(4.0.0) Related Condition Absent Extension
..... value[x] 1..1 CodeableConcept Value of extension
Binding: ICD10Conditions (0.2.0) (required)
... basedOn 0..* Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest) Not used in this profile
... partOf 0..* Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy) Not used in this profile
... subject 1..1 Reference(Cancer Patient Profile(0.2.0)) (USCDI) Who and/or what the observation is about
... focus 0..* Reference(Primary Cancer Condition Profile(0.2.0)) The Index Condition
... encounter 0..1 Reference(Encounter) Not used in this profile
... effective[x] 0..1 dateTime (USCDI) Clinically relevant time/time-period for observation
... issued 0..1 instant Not used in this profile
... value[x] 0..1 Quantity Comorbidity Index Score
.... unit 0..1 string Unit representation
Required Pattern: 1
... interpretation 0..* CodeableConcept Not used in this profile
... method 0..1 CodeableConcept Comorbidity framework used.
Binding: ComorbidityPanels (0.2.0) (required)
... referenceRange 0..* BackboneElement Not used in this profile
... derivedFrom 0..* Reference(Observation | US Core DocumentReference Profile(6.1.0) | US Core QuestionnaireResponse Profile(6.1.0) | ImagingStudy | Media | MolecularSequence) Not used in this profile

doco Documentation for this format

Terminology Bindings (Differential)

Path Status Usage ValueSet Version Source
Observation.extension:comorbidConditionPresent.​value[x]:valueCodeableConcept Base required ICD-10 Codes 📍0.2.0 This IG
Observation.extension:comorbidConditionAbsent.​value[x] Base required ICD-10 Codes 📍0.2.0 This IG
Observation.method Base required Comorbidity Panels 📍0.2.0 This IG

Constraints

Id Grade Path(s) Description Expression
com-1 error Observation If an index score is provided, then the comorbidity panel method must also be provided. valueQuantity.exists() implies method.exists()
com-req-1 error Observation The subject element is required and must be provided. subject.exists() and subject.resolve().is(Patient)
com-req-2 error Observation The effectiveDateTime element is required and must be provided. effectiveDateTime.exists() and effectiveDateTime.hasValue()
com-req-3 error Observation The focus element is required and must be provided. focus.exists() and focus.resolve().is(Condition)

Snapshot View

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Observation C 0..* Comorbidities(4.0.0) assessment observation
Constraints: obs-6, obs-7, com-1, com-req-1, com-req-2, com-req-3
... id Σ 0..1 id Logical id of this artifact
... meta Σ 0..1 Meta Metadata about the resource
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... language 0..1 code Language of the resource content
Binding: CommonLanguages (preferred): A human language.
Additional BindingsPurpose
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
... Slices for extension S 0..* Extension Extension
Slice: Unordered, Open by value:url
Constraints: ext-1
.... extension:comorbidConditionPresent S 0..* (Complex) Related Condition Extension
URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-related-condition
Constraints: ext-1
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..0
..... url 1..1 uri "http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-related-condition"
..... Slices for value[x] 1..1 Value of extension
Slice: Unordered, Open by type:$this
...... valueCodeableConcept CodeableConcept
...... valueReference Reference(Condition)
...... value[x]:valueCodeableConcept 0..1 CodeableConcept Value of extension
Binding: ICD10Conditions (0.2.0) (required)
.... extension:comorbidConditionAbsent S 0..* (Complex) Related Condition Absent Extension
URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-related-condition-absent
Constraints: ext-1
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..0
..... url 1..1 uri "http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-related-condition-absent"
..... value[x] 1..1 CodeableConcept Value of extension
Binding: ICD10Conditions (0.2.0) (required)
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
Constraints: ext-1
... identifier Σ 0..* Identifier Business Identifier for observation
... basedOn Σ 0..* Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest) Not used in this profile
... partOf Σ 0..* Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy) Not used in this profile
... status ?!SΣ 1..1 code (USCDI) registered | preliminary | final | amended +
Binding: ObservationStatus (required): Codes providing the status of an observation.
Required Pattern: final
... Slices for category S 1..* CodeableConcept (USCDI) Classification of type of observation
Slice: Unordered, Open by pattern:$this
Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
.... category:us-core S 0..* CodeableConcept (USCDI) Classification of type of observation
Binding: USCoreSimpleObservationCategory (6.1.0) (required): Note that other codes are permitted, see Required Bindings When Slicing by Value Sets
... code SΣ 1..1 CodeableConcept (USCDI) Type of observation (code / type)
Binding: LOINCCodes (preferred)
Required Pattern: At least the following
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... coding 1..* Coding Code defined by a terminology system
Fixed Value: (Complex)
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
..... system 1..1 uri Identity of the terminology system
Fixed Value: http://snomed.info/sct
..... version 0..1 string Version of the system - if relevant
..... code 1..1 code Symbol in syntax defined by the system
Fixed Value: 398192003
..... display 0..1 string Representation defined by the system
..... userSelected 0..1 boolean If this coding was chosen directly by the user
.... text 0..1 string Plain text representation of the concept
... subject SΣ 1..1 Reference(Cancer Patient Profile(0.2.0)) (USCDI) Who and/or what the observation is about
... focus SΣ 0..* Reference(Primary Cancer Condition Profile(0.2.0)) The Index Condition
... encounter Σ 0..1 Reference(Encounter) Not used in this profile
... effective[x] SΣ 0..1 dateTime S (USCDI) Clinically relevant time/time-period for observation
... issued Σ 0..1 instant Not used in this profile
... performer SΣ 0..* Reference(US Core Practitioner Profile(6.1.0) | US Core Organization Profile(6.1.0) | US Core Patient Profile(6.1.0) | PractitionerRole | US Core CareTeam Profile(6.1.0) | US Core RelatedPerson Profile(6.1.0)) (USCDI) Who is responsible for the observation
... value[x] SΣC 0..1 Quantity S Comorbidity Index Score
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
Constraints: ext-1
.... value Σ 0..1 decimal Numerical value (with implicit precision)
.... comparator ?!Σ 0..1 code < | <= | >= | > - how to understand the value
Binding: QuantityComparator (required): How the Quantity should be understood and represented.
.... unit Σ 0..1 string Unit representation
Required Pattern: 1
.... system ΣC 0..1 uri System that defines coded unit form
.... code Σ 0..1 code Coded form of the unit
... dataAbsentReason C 0..1 CodeableConcept Why the result is missing
Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
... interpretation 0..* CodeableConcept Not used in this profile
Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
... note 0..* Annotation Comments about the observation
... bodySite 0..1 CodeableConcept Not used in this profile
Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
... method 0..1 CodeableConcept Comorbidity framework used.
Binding: ComorbidityPanels (0.2.0) (required)
... specimen 0..1 Reference(Specimen) Not used in this profile
... device 0..1 Reference(Device | DeviceMetric) Not used in this profile
... referenceRange C 0..* BackboneElement Not used in this profile
Constraints: obs-3
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Constraints: ext-1
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
Constraints: ext-1
.... low C 0..1 SimpleQuantity(4.0.1) Low Range, if relevant
.... high C 0..1 SimpleQuantity(4.0.1) High Range, if relevant
.... type 0..1 CodeableConcept Reference range qualifier
Binding: ObservationReferenceRangeMeaningCodes (preferred): Code for the meaning of a reference range.
.... appliesTo 0..* CodeableConcept Reference range population
Binding: ObservationReferenceRangeAppliesToCodes (example): Codes identifying the population the reference range applies to.
.... age 0..1 Range Applicable age range, if relevant
.... text 0..1 string Text based reference range in an observation
... hasMember Σ 0..* Reference(Observation | QuestionnaireResponse | MolecularSequence) Not used in this profile
... derivedFrom Σ 0..* Reference(Observation | US Core DocumentReference Profile(6.1.0) | US Core QuestionnaireResponse Profile(6.1.0) | ImagingStudy | Media | MolecularSequence) Not used in this profile
... component Σ 0..* BackboneElement Not used in this profile
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Constraints: ext-1
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
Constraints: ext-1
.... code Σ 1..1 CodeableConcept Type of component observation (code / type)
Binding: LOINCCodes (example): Codes identifying names of simple observations.
.... value[x] Σ 0..1 Actual component result
..... valueQuantity Quantity
..... valueCodeableConcept CodeableConcept
..... valueString string
..... valueBoolean boolean
..... valueInteger integer
..... valueRange Range
..... valueRatio Ratio
..... valueSampledData SampledData
..... valueTime time
..... valueDateTime dateTime
..... valuePeriod Period
.... dataAbsentReason C 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

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
Observation.language Base preferred Common Languages 📍4.0.1 FHIR Std.
Observation.extension:comorbidConditionPresent.​value[x]:valueCodeableConcept Base required ICD-10 Codes 📍0.2.0 This IG
Observation.extension:comorbidConditionAbsent.​value[x] Base required ICD-10 Codes 📍0.2.0 This IG
Observation.status Base required ObservationStatus 📍4.0.1 FHIR Std.
Observation.category Base preferred Observation Category Codes 📍4.0.1 FHIR Std.
Observation.category:us-core Base required US Core Simple Observation Category 📍6.1.0 US Core v6.1
Observation.code Base preferred LOINC Codes 📍4.0.1 FHIR Std.
Observation.value[x].​comparator Base required QuantityComparator 📍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 example SNOMED CT Body Structures 📍4.0.1 FHIR Std.
Observation.method Base required Comorbidity Panels 📍0.2.0 This IG
Observation.referenceRange.​type Base preferred Observation Reference Range Meaning Codes 📍4.0.1 FHIR Std.
Observation.referenceRange.​appliesTo Base example Observation Reference Range Applies To Codes 📍4.0.1 FHIR Std.
Observation.component.​code Base example LOINC Codes 📍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
com-1 error Observation If an index score is provided, then the comorbidity panel method must also be provided. valueQuantity.exists() implies method.exists()
com-req-1 error Observation The subject element is required and must be provided. subject.exists() and subject.resolve().is(Patient)
com-req-2 error Observation The effectiveDateTime element is required and must be provided. effectiveDateTime.exists() and effectiveDateTime.hasValue()
com-req-3 error Observation The focus element is required and must be provided. focus.exists() and focus.resolve().is(Condition)
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 Observation.meta, Observation.implicitRules, Observation.language, Observation.text, Observation.extension, Observation.extension:comorbidConditionPresent, Observation.extension:comorbidConditionPresent.value[x], Observation.extension:comorbidConditionPresent.value[x]:valueCodeableConcept, Observation.extension:comorbidConditionAbsent, Observation.extension:comorbidConditionAbsent.value[x], Observation.modifierExtension, Observation.identifier, Observation.basedOn, Observation.partOf, Observation.status, Observation.category, Observation.category:us-core, Observation.code, Observation.subject, Observation.focus, Observation.encounter, Observation.effective[x], Observation.issued, Observation.performer, Observation.value[x], Observation.value[x].extension, Observation.value[x].value, Observation.value[x].comparator, Observation.value[x].unit, Observation.value[x].system, Observation.value[x].code, Observation.dataAbsentReason, Observation.interpretation, Observation.note, Observation.bodySite, Observation.method, Observation.specimen, Observation.device, Observation.referenceRange, Observation.referenceRange.extension, Observation.referenceRange.modifierExtension, Observation.referenceRange.low, Observation.referenceRange.high, Observation.referenceRange.type, Observation.referenceRange.appliesTo, Observation.referenceRange.age, Observation.referenceRange.text, Observation.hasMember, Observation.derivedFrom, Observation.component, Observation.component.extension, Observation.component.modifierExtension, Observation.component.code, Observation.component.value[x], Observation.component.dataAbsentReason, Observation.component.interpretation, Observation.component.referenceRange All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ext-1 error Observation.extension, Observation.extension:comorbidConditionPresent, Observation.extension:comorbidConditionAbsent, Observation.modifierExtension, Observation.value[x].extension, Observation.referenceRange.extension, Observation.referenceRange.modifierExtension, Observation.component.extension, Observation.component.modifierExtension 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()

This structure is derived from Comorbidities

Summary

Structures

This structure refers to these other structures:

Slices

This structure defines the following Slices:

  • The element 1 is sliced based on the value of Observation.extension.value[x]

 

Other representations of profile: CSV, Excel, Schematron