Smart Bear Implementation Guide
3.4.1 - ci-build

Smart Bear Implementation Guide - Local Development build (v3.4.1) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

Resource Profile: ExergameSitting2Pitch - Detailed Descriptions

Active as of 2024-09-17

Definitions for the ExergameSitting2Pitch resource profile.

Guidance on how to interpret the contents of this table can be found here

0. Observation
2. Observation.extension
4. Observation.extension.extension
Control0..0
6. Observation.extension.url
Pattern Valuehttps://holobalance.eu/fhir/extension-exercise-difficulty
8. Observation.extension.value[x]
[x] NoteSeeChoice of Data Typesfor further information about how to use [x]
SlicingThis element introduces a set of slices on Observation.extension.value[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • type @ $this
  • 10. Observation.extension.value[x]:valueCodeableConcept
    Slice NamevalueCodeableConcept
    Control0..1
    TypeCodeableConcept
    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
    Pattern Value{
      "coding" : [{
        "system" : "https://holobalance.eu/fhir/codesystem-exercise-difficulty",
        "code" : "<<functionalLevel>>",
        "display" : "Exercise Progression Level"
      }]
    }
    12. Observation.identifier
    NoteThis is a business identifier, not a resource identifier (see discussion)
    Control2..?
    SlicingThis element introduces a set of slices on Observation.identifier. The slices areUnordered and Open, and can be differentiated using the following discriminators:
    • value @ system
    • 14. Observation.identifier:TrainingId
      Slice NameTrainingId
      NoteThis is a business identifier, not a resource identifier (see discussion)
      Control1..1
      16. Observation.identifier:TrainingId.system
      Control1..?
      Pattern Valuehttps://holobalance.eu/fhir/identifiers/exercise-instance
      18. Observation.identifier:TrainingId.value
      Pattern Value<<traininglogid>>
      20. Observation.identifier:SessionId
      Slice NameSessionId
      NoteThis is a business identifier, not a resource identifier (see discussion)
      Control1..1
      22. Observation.identifier:SessionId.system
      Control1..?
      Pattern Valuehttps://holobalance.eu/fhir/identifiers/exercise-session
      24. Observation.identifier:SessionId.value
      Pattern Value<<sessionid>>
      26. Observation.status
      Pattern Valuefinal
      28. Observation.category
      Pattern Value{
        "coding" : [{
          "system" : "http://terminology.hl7.org/CodeSystem/observation-category",
          "code" : "activity",
          "display" : "Activity"
        }]
      }
      30. Observation.code
      Pattern Value{
        "coding" : [{
          "system" : "https://holobalance.eu/fhir/CodeSystem/exercise-type",
          "code" : "1169",
          "display" : "Exergame Sitting 2 – Pitch"
        }]
      }
      32. Observation.subject
      Control1..?
      TypeReference(HolobalancePatient)
      34. Observation.effective[x]
      Control1..?
      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
      SlicingThis element introduces a set of slices on Observation.effective[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
      • type @ $this
      • 36. Observation.effective[x]:effectiveDateTime
        Slice NameeffectiveDateTime
        Control1..1
        TypedateTime
        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        38. Observation.component
        Control10..?
        SlicingThis element introduces a set of slices on Observation.component. The slices areUnordered and Open, and can be differentiated using the following discriminators:
        • value @ code
        • 40. Observation.component:numberOfExerciseRepetitionsCompleted
          Slice NamenumberOfExerciseRepetitionsCompleted
          Control1..1
          42. Observation.component:numberOfExerciseRepetitionsCompleted.code
          44. Observation.component:numberOfExerciseRepetitionsCompleted.code.coding
          Pattern Value{
            "system" : "http://snomed.info/sct",
            "code" : "1202026006",
            "display" : "Number of exercise repetitions completed"
          }
          46. Observation.component:numberOfExerciseRepetitionsCompleted.code.coding.version
          NoteThis is a business version Id, not a resource version Id (see discussion)
          Pattern Valuehttp://snomed.info/sct/900000000000207008/version/20220228
          48. Observation.component:numberOfExerciseRepetitionsCompleted.code.text
          Pattern ValueTotal number of head movements performed
          50. Observation.component:numberOfExerciseRepetitionsCompleted.value[x]
          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
          SlicingThis element introduces a set of slices on Observation.component.value[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
          • type @ $this
          • 52. Observation.component:numberOfExerciseRepetitionsCompleted.value[x]:valueQuantity
            Slice NamevalueQuantity
            Control0..1
            TypeQuantity
            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
            Pattern Value{
              "value" : 0,
              "unit" : "Number",
              "system" : "http://unitsofmeasure.org",
              "code" : "#"
            }
            54. Observation.component:sagittalPlaneBodyPosition
            Slice NamesagittalPlaneBodyPosition
            Control1..1
            56. Observation.component:sagittalPlaneBodyPosition.code
            58. Observation.component:sagittalPlaneBodyPosition.code.coding
            Pattern Value{
              "system" : "http://loinc.org",
              "code" : "72282-7",
              "display" : "Sagittal plane body position"
            }
            60. Observation.component:sagittalPlaneBodyPosition.code.coding.version
            NoteThis is a business version Id, not a resource version Id (see discussion)
            Pattern Value2.69
            62. Observation.component:sagittalPlaneBodyPosition.value[x]
            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
            SlicingThis element introduces a set of slices on Observation.component.value[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
            • type @ $this
            • 64. Observation.component:sagittalPlaneBodyPosition.value[x]:valueSampledData
              Slice NamevalueSampledData
              Control0..1
              TypeSampledData
              [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
              66. Observation.component:sagittalPlaneBodyPosition.value[x]:valueSampledData.origin
              Pattern Value{
                "unit" : "degree",
                "system" : "http://unitsofmeasure.org",
                "code" : "deg"
              }
              68. Observation.component:sagittalPlaneBodyPosition.value[x]:valueSampledData.period
              Pattern Value15000
              70. Observation.component:sagittalPlaneBodyPosition.value[x]:valueSampledData.dimensions
              Pattern Value1
              72. Observation.component:sagittalPlaneBodyPosition.value[x]:valueSampledData.data
              Pattern Value<<posture|FlattenedArrayOddRemoved>>
              74. Observation.component:timeSpentExercising
              Slice NametimeSpentExercising
              Control1..1
              76. Observation.component:timeSpentExercising.code
              Pattern Value{
                "coding" : [{
                  "system" : "http://snomed.info/sct",
                  "code" : "228450008",
                  "display" : "Time spent exercising"
                }]
              }
              78. Observation.component:timeSpentExercising.value[x]
              [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
              SlicingThis element introduces a set of slices on Observation.component.value[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
              • type @ $this
              • 80. Observation.component:timeSpentExercising.value[x]:valueQuantity
                Slice NamevalueQuantity
                Control0..1
                TypeQuantity
                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                Pattern Value{
                  "value" : 0,
                  "unit" : "second",
                  "system" : "http://unitsofmeasure.org",
                  "code" : "s"
                }
                82. Observation.component:performanceBasedMeasureScore
                Slice NameperformanceBasedMeasureScore
                Control1..1
                84. Observation.component:performanceBasedMeasureScore.code
                86. Observation.component:performanceBasedMeasureScore.code.coding
                Pattern Value{
                  "system" : "http://loinc.org",
                  "code" : "89191-1",
                  "display" : "Performance-based measure score"
                }
                88. Observation.component:performanceBasedMeasureScore.code.coding.version
                NoteThis is a business version Id, not a resource version Id (see discussion)
                Pattern Value2.69
                90. Observation.component:performanceBasedMeasureScore.value[x]
                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                SlicingThis element introduces a set of slices on Observation.component.value[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                • type @ $this
                • 92. Observation.component:performanceBasedMeasureScore.value[x]:valueQuantity
                  Slice NamevalueQuantity
                  Control0..1
                  TypeQuantity
                  [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                  Pattern Value{
                    "value" : 0,
                    "unit" : "score",
                    "system" : "http://unitsofmeasure.org",
                    "code" : "{score}"
                  }
                  94. Observation.component:disorientated
                  Slice Namedisorientated
                  Control1..1
                  96. Observation.component:disorientated.code
                  Pattern Value{
                    "coding" : [{
                      "system" : "http://snomed.info/sct",
                      "code" : "62476001",
                      "display" : "Disorientated"
                    }]
                  }
                  98. Observation.component:disorientated.value[x]
                  [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                  SlicingThis element introduces a set of slices on Observation.component.value[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                  • type @ $this
                  • 100. Observation.component:disorientated.value[x]:valueBoolean
                    Slice NamevalueBoolean
                    Control0..1
                    Typeboolean
                    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Pattern Valuetrue
                    102. Observation.component:disorientated.value[x]:valueCodeableConcept
                    Slice NamevalueCodeableConcept
                    Control0..1
                    TypeCodeableConcept
                    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                    Pattern Value{
                      "coding" : [{
                        "system" : "http://snomed.info/sct",
                        "code" : "<<disoriented|SeverityCode>>",
                        "display" : "<<disoriented|SeverityCodeDisplay>>"
                      }]
                    }
                    104. Observation.component:abnormalVision
                    Slice NameabnormalVision
                    Control1..1
                    106. Observation.component:abnormalVision.code
                    Pattern Value{
                      "coding" : [{
                        "system" : "http://snomed.info/sct",
                        "code" : "7973008",
                        "display" : "Abnormal vision"
                      }]
                    }
                    108. Observation.component:abnormalVision.value[x]
                    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                    SlicingThis element introduces a set of slices on Observation.component.value[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                    • type @ $this
                    • 110. Observation.component:abnormalVision.value[x]:valueBoolean
                      Slice NamevalueBoolean
                      Control0..1
                      Typeboolean
                      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Pattern Valuetrue
                      112. Observation.component:abnormalVision.value[x]:valueCodeableConcept
                      Slice NamevalueCodeableConcept
                      Control0..1
                      TypeCodeableConcept
                      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                      Pattern Value{
                        "coding" : [{
                          "system" : "http://snomed.info/sct",
                          "code" : "<<blurryvision|SeverityCode>>",
                          "display" : "<<blurryvision|SeverityCodeDisplay>>"
                        }]
                      }
                      114. Observation.component:dizziness
                      Slice Namedizziness
                      Control1..1
                      116. Observation.component:dizziness.code
                      Pattern Value{
                        "coding" : [{
                          "system" : "http://snomed.info/sct",
                          "code" : "404640003",
                          "display" : "Dizziness"
                        }]
                      }
                      118. Observation.component:dizziness.value[x]
                      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                      SlicingThis element introduces a set of slices on Observation.component.value[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                      • type @ $this
                      • 120. Observation.component:dizziness.value[x]:valueBoolean
                        Slice NamevalueBoolean
                        Control0..1
                        Typeboolean
                        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Pattern Valuetrue
                        122. Observation.component:dizziness.value[x]:valueCodeableConcept
                        Slice NamevalueCodeableConcept
                        Control0..1
                        TypeCodeableConcept
                        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                        Pattern Value{
                          "coding" : [{
                            "system" : "http://snomed.info/sct",
                            "code" : "<<dizzy|SeverityCode>>",
                            "display" : "<<dizzy|SeverityCodeDisplay>>"
                          }]
                        }
                        124. Observation.component:headache
                        Slice Nameheadache
                        Control1..1
                        126. Observation.component:headache.code
                        Pattern Value{
                          "coding" : [{
                            "system" : "http://snomed.info/sct",
                            "code" : "25064002",
                            "display" : "Headache"
                          }]
                        }
                        128. Observation.component:headache.value[x]
                        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                        SlicingThis element introduces a set of slices on Observation.component.value[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                        • type @ $this
                        • 130. Observation.component:headache.value[x]:valueBoolean
                          Slice NamevalueBoolean
                          Control0..1
                          Typeboolean
                          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Pattern Valuetrue
                          132. Observation.component:headache.value[x]:valueCodeableConcept
                          Slice NamevalueCodeableConcept
                          Control0..1
                          TypeCodeableConcept
                          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                          Pattern Value{
                            "coding" : [{
                              "system" : "http://snomed.info/sct",
                              "code" : "<<headache|SeverityCode>>",
                              "display" : "<<headache|SeverityCodeDisplay>>"
                            }]
                          }
                          134. Observation.component:neckJointRangeOfMovement
                          Slice NameneckJointRangeOfMovement
                          Control1..1
                          136. Observation.component:neckJointRangeOfMovement.code
                          Pattern Value{
                            "coding" : [{
                              "system" : "http://snomed.info/sct",
                              "code" : "404979006",
                              "display" : "Neck joint - range of movement"
                            }]
                          }
                          138. Observation.component:neckJointRangeOfMovement.code.text
                          Pattern ValueRange of head turns in pitch plane (Up-Down)
                          140. Observation.component:neckJointRangeOfMovement.value[x]
                          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                          SlicingThis element introduces a set of slices on Observation.component.value[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                          • type @ $this
                          • 142. Observation.component:neckJointRangeOfMovement.value[x]:valueSampledData
                            Slice NamevalueSampledData
                            Control0..1
                            TypeSampledData
                            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                            144. Observation.component:neckJointRangeOfMovement.value[x]:valueSampledData.extension
                            146. Observation.component:neckJointRangeOfMovement.value[x]:valueSampledData.extension.extension
                            Control0..0
                            148. Observation.component:neckJointRangeOfMovement.value[x]:valueSampledData.extension.url
                            Pattern Valuehttps://holobalance.eu/fhir/offsets
                            150. Observation.component:neckJointRangeOfMovement.value[x]:valueSampledData.extension.value[x]
                            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                            SlicingThis element introduces a set of slices on Observation.component.value[x].extension.value[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                            • type @ $this
                            • 152. Observation.component:neckJointRangeOfMovement.value[x]:valueSampledData.extension.value[x]:valueString
                              Slice NamevalueString
                              Control0..1
                              Typestring
                              [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                              Pattern Value<<offset|ValOfArrayOfKeyVal>>
                              154. Observation.component:neckJointRangeOfMovement.value[x]:valueSampledData.origin
                              Pattern Value{
                                "unit" : "degree",
                                "system" : "http://unitsofmeasure.org",
                                "code" : "deg"
                              }
                              156. Observation.component:neckJointRangeOfMovement.value[x]:valueSampledData.period
                              Pattern Value1000
                              158. Observation.component:neckJointRangeOfMovement.value[x]:valueSampledData.dimensions
                              Pattern Value1
                              160. Observation.component:neckJointRangeOfMovement.value[x]:valueSampledData.data
                              Pattern Value<<range|FlattenedArray>>
                              162. Observation.component:countsPerSecond
                              Slice NamecountsPerSecond
                              Control1..1
                              164. Observation.component:countsPerSecond.code
                              Pattern Value{
                                "coding" : [{
                                  "system" : "http://snomed.info/sct",
                                  "code" : "282108002",
                                  "display" : "Counts per second"
                                }]
                              }
                              166. Observation.component:countsPerSecond.code.text
                              Pattern ValueHead turns per second
                              168. Observation.component:countsPerSecond.value[x]
                              [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                              SlicingThis element introduces a set of slices on Observation.component.value[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                              • type @ $this
                              • 170. Observation.component:countsPerSecond.value[x]:valueSampledData
                                Slice NamevalueSampledData
                                Control0..1
                                TypeSampledData
                                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                172. Observation.component:countsPerSecond.value[x]:valueSampledData.extension
                                174. Observation.component:countsPerSecond.value[x]:valueSampledData.extension.extension
                                Control0..0
                                176. Observation.component:countsPerSecond.value[x]:valueSampledData.extension.url
                                Pattern Valuehttps://holobalance.eu/fhir/offsets
                                178. Observation.component:countsPerSecond.value[x]:valueSampledData.extension.value[x]
                                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                SlicingThis element introduces a set of slices on Observation.component.value[x].extension.value[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                • type @ $this
                                • 180. Observation.component:countsPerSecond.value[x]:valueSampledData.extension.value[x]:valueString
                                  Slice NamevalueString
                                  Control0..1
                                  Typestring
                                  [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                  Pattern Value<<offset|ValOfArrayOfKeyVal>>
                                  182. Observation.component:countsPerSecond.value[x]:valueSampledData.origin
                                  Pattern Value{
                                    "unit" : "per second",
                                    "system" : "http://unitsofmeasure.org",
                                    "code" : "/s"
                                  }
                                  184. Observation.component:countsPerSecond.value[x]:valueSampledData.period
                                  Pattern Value1000
                                  186. Observation.component:countsPerSecond.value[x]:valueSampledData.dimensions
                                  Pattern Value1
                                  188. Observation.component:countsPerSecond.value[x]:valueSampledData.data
                                  Pattern Value<<speed|FlattenedArray>>

                                  Guidance on how to interpret the contents of this table can be found here

                                  0. Observation
                                  Definition

                                  Measurements and simple assertions made about a patient, device or other subject.

                                  ShortMeasurements and simple assertions
                                  Comments

                                  Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc. Other resources are used to provide context for observations such as laboratory reports, etc.

                                  Control0..*
                                  Is Modifierfalse
                                  Summaryfalse
                                  Alternate NamesVital Signs, Measurement, Results, Tests
                                  Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
                                  dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (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: 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: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
                                  dom-6: A resource should have narrative for robust management (text.`div`.exists())
                                  obs-6: dataAbsentReason SHALL only be present if Observation.value[x] is not present (dataAbsentReason.empty() or value.empty())
                                  obs-7: If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present (value.empty() or component.code.where(coding.intersect(%resource.code.coding).exists()).empty())
                                  obs-6: dataAbsentReason SHALL only be present if Observation.value[x] is not present (dataAbsentReason.empty() or value.empty())
                                  obs-7: If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present (value.empty() or component.code.where(coding.intersect(%resource.code.coding).exists()).empty())
                                  2. Observation.implicitRules
                                  Definition

                                  A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

                                  ShortA set of rules under which this content was created
                                  Comments

                                  Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

                                  Control0..1
                                  Typeuri
                                  Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                  Summarytrue
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  4. Observation.modifierExtension
                                  Definition

                                  May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                  Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                  ShortExtensions that cannot be ignored
                                  Comments

                                  There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                  Control0..*
                                  TypeExtension
                                  Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
                                  Summaryfalse
                                  Requirements

                                  Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                  Alternate Namesextensions, user content
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                  6. Observation.identifier
                                  Definition

                                  A unique identifier assigned to this observation.

                                  ShortBusiness Identifier for observation
                                  NoteThis is a business identifier, not a resource identifier (see discussion)
                                  Control20..*
                                  TypeIdentifier
                                  Is Modifierfalse
                                  Summarytrue
                                  Requirements

                                  Allows observations to be distinguished and referenced.

                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  SlicingThis element introduces a set of slices on Observation.identifier. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                  • value @ system
                                  • 8. Observation.identifier:TrainingId
                                    Slice NameTrainingId
                                    Definition

                                    A unique identifier assigned to this observation.

                                    ShortBusiness Identifier for observation
                                    NoteThis is a business identifier, not a resource identifier (see discussion)
                                    Control10..1*
                                    TypeIdentifier
                                    Is Modifierfalse
                                    Summarytrue
                                    Requirements

                                    Allows observations to be distinguished and referenced.

                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    10. Observation.identifier:TrainingId.use
                                    Definition

                                    The purpose of this identifier.

                                    Shortusual | official | temp | secondary | old (If known)
                                    Comments

                                    Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

                                    Control0..1
                                    BindingThe codes SHALL be taken from IdentifierUsehttp://hl7.org/fhir/ValueSet/identifier-use|4.0.1
                                    (required to http://hl7.org/fhir/ValueSet/identifier-use|4.0.1)

                                    Identifies the purpose for this identifier, if known .

                                    Typecode
                                    Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                    Summarytrue
                                    Requirements

                                    Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    12. Observation.identifier:TrainingId.system
                                    Definition

                                    Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

                                    ShortThe namespace for the identifier value
                                    Comments

                                    Identifier.system is always case sensitive.

                                    Control10..1
                                    Typeuri
                                    Is Modifierfalse
                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                    Summarytrue
                                    Requirements

                                    There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

                                    Pattern Valuehttps://holobalance.eu/fhir/identifiers/exercise-instance
                                    Example<br/><b>General</b>:http://www.acme.com/identifiers/patient
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    14. Observation.identifier:TrainingId.value
                                    Definition

                                    The portion of the identifier typically relevant to the user and which is unique within the context of the system.

                                    ShortThe value that is unique
                                    Comments

                                    If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

                                    Control0..1
                                    Typestring
                                    Is Modifierfalse
                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                    Summarytrue
                                    Pattern Value<<traininglogid>>
                                    Example<br/><b>General</b>:123456
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    16. Observation.identifier:SessionId
                                    Slice NameSessionId
                                    Definition

                                    A unique identifier assigned to this observation.

                                    ShortBusiness Identifier for observation
                                    NoteThis is a business identifier, not a resource identifier (see discussion)
                                    Control10..1*
                                    TypeIdentifier
                                    Is Modifierfalse
                                    Summarytrue
                                    Requirements

                                    Allows observations to be distinguished and referenced.

                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    18. Observation.identifier:SessionId.use
                                    Definition

                                    The purpose of this identifier.

                                    Shortusual | official | temp | secondary | old (If known)
                                    Comments

                                    Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

                                    Control0..1
                                    BindingThe codes SHALL be taken from IdentifierUsehttp://hl7.org/fhir/ValueSet/identifier-use|4.0.1
                                    (required to http://hl7.org/fhir/ValueSet/identifier-use|4.0.1)

                                    Identifies the purpose for this identifier, if known .

                                    Typecode
                                    Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                    Summarytrue
                                    Requirements

                                    Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    20. Observation.identifier:SessionId.system
                                    Definition

                                    Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

                                    ShortThe namespace for the identifier value
                                    Comments

                                    Identifier.system is always case sensitive.

                                    Control10..1
                                    Typeuri
                                    Is Modifierfalse
                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                    Summarytrue
                                    Requirements

                                    There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

                                    Pattern Valuehttps://holobalance.eu/fhir/identifiers/exercise-session
                                    Example<br/><b>General</b>:http://www.acme.com/identifiers/patient
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    22. Observation.identifier:SessionId.value
                                    Definition

                                    The portion of the identifier typically relevant to the user and which is unique within the context of the system.

                                    ShortThe value that is unique
                                    Comments

                                    If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

                                    Control0..1
                                    Typestring
                                    Is Modifierfalse
                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                    Summarytrue
                                    Pattern Value<<sessionid>>
                                    Example<br/><b>General</b>:123456
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    24. Observation.status
                                    Definition

                                    The status of the result value.

                                    Shortregistered | preliminary | final | amended +
                                    Comments

                                    This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.

                                    Control1..1
                                    BindingThe codes SHALL be taken from ObservationStatushttp://hl7.org/fhir/ValueSet/observation-status|4.0.1
                                    (required to http://hl7.org/fhir/ValueSet/observation-status|4.0.1)

                                    Codes providing the status of an observation.

                                    Typecode
                                    Is Modifiertrue because This element is labeled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                    Summarytrue
                                    Requirements

                                    Need to track the status of individual results. Some results are finalized before the whole report is finalized.

                                    Pattern Valuefinal
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    26. Observation.category
                                    Definition

                                    A code that classifies the general type of observation being made.

                                    ShortClassification of type of observation
                                    Comments

                                    In addition to the required category valueset, this element allows various categorization schemes based on the owner’s definition of the category and effectively multiple categories can be used at once. The level of granularity is defined by the category concepts in the value set.

                                    Control0..*
                                    BindingThe codes SHOULD be taken from ObservationCategoryCodeshttp://hl7.org/fhir/ValueSet/observation-category
                                    (preferred to http://hl7.org/fhir/ValueSet/observation-category)

                                    Codes for high level observation categories.

                                    TypeCodeableConcept
                                    Is Modifierfalse
                                    Summaryfalse
                                    Requirements

                                    Used for filtering what observations are retrieved and displayed.

                                    Pattern Value{
                                      "coding" : [{
                                        "system" : "http://terminology.hl7.org/CodeSystem/observation-category",
                                        "code" : "activity",
                                        "display" : "Activity"
                                      }]
                                    }
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    28. Observation.code
                                    Definition

                                    Describes what was observed. Sometimes this is called the observation "name".

                                    ShortType of observation (code / type)
                                    Comments

                                    All code-value and, if present, component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

                                    Control1..1
                                    BindingFor example codes, see LOINCCodeshttp://hl7.org/fhir/ValueSet/observation-codes
                                    (example to http://hl7.org/fhir/ValueSet/observation-codes)

                                    Codes identifying names of simple observations.

                                    TypeCodeableConcept
                                    Is Modifierfalse
                                    Summarytrue
                                    Requirements

                                    Knowing what kind of observation is being made is essential to understanding the observation.

                                    Alternate NamesName
                                    Pattern Value{
                                      "coding" : [{
                                        "system" : "https://holobalance.eu/fhir/CodeSystem/exercise-type",
                                        "code" : "1169",
                                        "display" : "Exergame Sitting 2 – Pitch"
                                      }]
                                    }
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    30. Observation.subject
                                    Definition

                                    The patient, or group of patients, location, or device this observation is about and into whose record the observation is placed. If the actual focus of the observation is different from the subject (or a sample of, part, or region of the subject), the focus element or the code itself specifies the actual focus of the observation.

                                    ShortWho and/or what the observation is about
                                    Comments

                                    One would expect this element to be a cardinality of 1..1. The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.

                                    Control10..1
                                    TypeReference(HolobalancePatient, Patient, Group, Device, Location)
                                    Is Modifierfalse
                                    Summarytrue
                                    Requirements

                                    Observations have no value if you don't know who or what they're about.

                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    32. Observation.effective[x]
                                    Definition

                                    The time or time-period the observed value is asserted as being true. For biological subjects - e.g. human patients - this is usually called the "physiologically relevant time". This is usually either the time of the procedure or of specimen collection, but very often the source of the date/time is not known, only the date/time itself.

                                    ShortClinically relevant time/time-period for observation
                                    Comments

                                    At least a date should be present unless this observation is a historical report. For recording imprecise or "fuzzy" times (For example, a blood glucose measurement taken "after breakfast") use the Timing datatype which allow the measurement to be tied to regular life events.

                                    Control10..1
                                    TypedateTime, Period, Timing, instant
                                    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                    Is Modifierfalse
                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                    Summarytrue
                                    Requirements

                                    Knowing when an observation was deemed true is important to its relevance as well as determining trends.

                                    Alternate NamesOccurrence
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    SlicingThis element introduces a set of slices on Observation.effective[x]. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
                                    • type @ $this
                                    • 34. Observation.effective[x]:effectiveDateTime
                                      Slice NameeffectiveDateTime
                                      Definition

                                      The time or time-period the observed value is asserted as being true. For biological subjects - e.g. human patients - this is usually called the "physiologically relevant time". This is usually either the time of the procedure or of specimen collection, but very often the source of the date/time is not known, only the date/time itself.

                                      ShortClinically relevant time/time-period for observation
                                      Comments

                                      At least a date should be present unless this observation is a historical report. For recording imprecise or "fuzzy" times (For example, a blood glucose measurement taken "after breakfast") use the Timing datatype which allow the measurement to be tied to regular life events.

                                      Control10..1
                                      TypedateTime, Period, Timing, instant
                                      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                      Is Modifierfalse
                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                      Summarytrue
                                      Requirements

                                      Knowing when an observation was deemed true is important to its relevance as well as determining trends.

                                      Alternate NamesOccurrence
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      36. Observation.component
                                      Definition

                                      Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.

                                      ShortComponent results
                                      Comments

                                      For a discussion on the ways Observations can be assembled in groups together see Notes below.

                                      Control100..*
                                      TypeBackboneElement
                                      Is Modifierfalse
                                      Summarytrue
                                      Requirements

                                      Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      SlicingThis element introduces a set of slices on Observation.component. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                      • value @ code
                                      • 38. Observation.component.modifierExtension
                                        Definition

                                        May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                        Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                        ShortExtensions that cannot be ignored even if unrecognized
                                        Comments

                                        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                        Control0..*
                                        TypeExtension
                                        Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                        Summarytrue
                                        Requirements

                                        Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                        Alternate Namesextensions, user content, modifiers
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                        40. Observation.component.code
                                        Definition

                                        Describes what was observed. Sometimes this is called the observation "code".

                                        ShortType of component observation (code / type)
                                        Comments

                                        All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

                                        Control1..1
                                        BindingFor example codes, see LOINCCodeshttp://hl7.org/fhir/ValueSet/observation-codes
                                        (example to http://hl7.org/fhir/ValueSet/observation-codes)

                                        Codes identifying names of simple observations.

                                        TypeCodeableConcept
                                        Is Modifierfalse
                                        Summarytrue
                                        Requirements

                                        Knowing what kind of observation is being made is essential to understanding the observation.

                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        42. Observation.component:numberOfExerciseRepetitionsCompleted
                                        Slice NamenumberOfExerciseRepetitionsCompleted
                                        Definition

                                        Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.

                                        ShortComponent results
                                        Comments

                                        For a discussion on the ways Observations can be assembled in groups together see Notes below.

                                        Control10..1*
                                        TypeBackboneElement
                                        Is Modifierfalse
                                        Summarytrue
                                        Requirements

                                        Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        44. Observation.component:numberOfExerciseRepetitionsCompleted.modifierExtension
                                        Definition

                                        May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                        Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                        ShortExtensions that cannot be ignored even if unrecognized
                                        Comments

                                        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                        Control0..*
                                        TypeExtension
                                        Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                        Summarytrue
                                        Requirements

                                        Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                        Alternate Namesextensions, user content, modifiers
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                        46. Observation.component:numberOfExerciseRepetitionsCompleted.code
                                        Definition

                                        Describes what was observed. Sometimes this is called the observation "code".

                                        ShortType of component observation (code / type)
                                        Comments

                                        All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

                                        Control1..1
                                        BindingFor example codes, see LOINCCodeshttp://hl7.org/fhir/ValueSet/observation-codes
                                        (example to http://hl7.org/fhir/ValueSet/observation-codes)

                                        Codes identifying names of simple observations.

                                        TypeCodeableConcept
                                        Is Modifierfalse
                                        Summarytrue
                                        Requirements

                                        Knowing what kind of observation is being made is essential to understanding the observation.

                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        48. Observation.component:numberOfExerciseRepetitionsCompleted.code.coding
                                        Definition

                                        A reference to a code defined by a terminology system.

                                        ShortCode defined by a terminology system
                                        Comments

                                        Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                                        Control0..*
                                        TypeCoding
                                        Is Modifierfalse
                                        Summarytrue
                                        Requirements

                                        Allows for alternative encodings within a code system, and translations to other code systems.

                                        Pattern Value{
                                          "system" : "http://snomed.info/sct",
                                          "code" : "1202026006",
                                          "display" : "Number of exercise repetitions completed"
                                        }
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        50. Observation.component:numberOfExerciseRepetitionsCompleted.code.coding.version
                                        Definition

                                        The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

                                        ShortVersion of the system - if relevant
                                        Comments

                                        Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

                                        NoteThis is a business version Id, not a resource version Id (see discussion)
                                        Control0..1
                                        Typestring
                                        Is Modifierfalse
                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                        Summarytrue
                                        Pattern Valuehttp://snomed.info/sct/900000000000207008/version/20220228
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        52. Observation.component:numberOfExerciseRepetitionsCompleted.code.text
                                        Definition

                                        A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

                                        ShortPlain text representation of the concept
                                        Comments

                                        Very often the text is the same as a displayName of one of the codings.

                                        Control0..1
                                        Typestring
                                        Is Modifierfalse
                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                        Summarytrue
                                        Requirements

                                        The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

                                        Pattern ValueTotal number of head movements performed
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        54. Observation.component:numberOfExerciseRepetitionsCompleted.value[x]
                                        Definition

                                        The information determined as a result of making the observation, if the information has a simple value.

                                        ShortActual component result
                                        Comments

                                        Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

                                        Control0..1
                                        TypeChoice of: Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period
                                        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                        Is Modifierfalse
                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                        Summarytrue
                                        Requirements

                                        An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        SlicingThis element introduces a set of slices on Observation.component.value[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                        • type @ $this
                                        • 56. Observation.component:numberOfExerciseRepetitionsCompleted.value[x]:valueQuantity
                                          Slice NamevalueQuantity
                                          Definition

                                          The information determined as a result of making the observation, if the information has a simple value.

                                          ShortActual component result
                                          Comments

                                          Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

                                          Control0..1
                                          TypeQuantity, dateTime, boolean, string, SampledData, Period, Ratio, integer, time, Range, CodeableConcept
                                          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                          Is Modifierfalse
                                          Summarytrue
                                          Requirements

                                          An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                                          Pattern Value{
                                            "value" : 0,
                                            "unit" : "Number",
                                            "system" : "http://unitsofmeasure.org",
                                            "code" : "#"
                                          }
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          58. Observation.component:sagittalPlaneBodyPosition
                                          Slice NamesagittalPlaneBodyPosition
                                          Definition

                                          Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.

                                          ShortComponent results
                                          Comments

                                          For a discussion on the ways Observations can be assembled in groups together see Notes below.

                                          Control10..1*
                                          TypeBackboneElement
                                          Is Modifierfalse
                                          Summarytrue
                                          Requirements

                                          Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          60. Observation.component:sagittalPlaneBodyPosition.modifierExtension
                                          Definition

                                          May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                          Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                          ShortExtensions that cannot be ignored even if unrecognized
                                          Comments

                                          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                          Control0..*
                                          TypeExtension
                                          Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                          Summarytrue
                                          Requirements

                                          Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                          Alternate Namesextensions, user content, modifiers
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                          62. Observation.component:sagittalPlaneBodyPosition.code
                                          Definition

                                          Describes what was observed. Sometimes this is called the observation "code".

                                          ShortType of component observation (code / type)
                                          Comments

                                          All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

                                          Control1..1
                                          BindingFor example codes, see LOINCCodeshttp://hl7.org/fhir/ValueSet/observation-codes
                                          (example to http://hl7.org/fhir/ValueSet/observation-codes)

                                          Codes identifying names of simple observations.

                                          TypeCodeableConcept
                                          Is Modifierfalse
                                          Summarytrue
                                          Requirements

                                          Knowing what kind of observation is being made is essential to understanding the observation.

                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          64. Observation.component:sagittalPlaneBodyPosition.code.coding
                                          Definition

                                          A reference to a code defined by a terminology system.

                                          ShortCode defined by a terminology system
                                          Comments

                                          Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                                          Control0..*
                                          TypeCoding
                                          Is Modifierfalse
                                          Summarytrue
                                          Requirements

                                          Allows for alternative encodings within a code system, and translations to other code systems.

                                          Pattern Value{
                                            "system" : "http://loinc.org",
                                            "code" : "72282-7",
                                            "display" : "Sagittal plane body position"
                                          }
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          66. Observation.component:sagittalPlaneBodyPosition.code.coding.version
                                          Definition

                                          The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

                                          ShortVersion of the system - if relevant
                                          Comments

                                          Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

                                          NoteThis is a business version Id, not a resource version Id (see discussion)
                                          Control0..1
                                          Typestring
                                          Is Modifierfalse
                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                          Summarytrue
                                          Pattern Value2.69
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          68. Observation.component:sagittalPlaneBodyPosition.value[x]
                                          Definition

                                          The information determined as a result of making the observation, if the information has a simple value.

                                          ShortActual component result
                                          Comments

                                          Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

                                          Control0..1
                                          TypeChoice of: Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period
                                          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                          Is Modifierfalse
                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                          Summarytrue
                                          Requirements

                                          An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          SlicingThis element introduces a set of slices on Observation.component.value[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                          • type @ $this
                                          • 70. Observation.component:sagittalPlaneBodyPosition.value[x]:valueSampledData
                                            Slice NamevalueSampledData
                                            Definition

                                            The information determined as a result of making the observation, if the information has a simple value.

                                            ShortActual component result
                                            Comments

                                            Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

                                            Control0..1
                                            TypeSampledData, dateTime, boolean, string, Quantity, Period, Ratio, integer, time, Range, CodeableConcept
                                            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                            Is Modifierfalse
                                            Summarytrue
                                            Requirements

                                            An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            72. Observation.component:sagittalPlaneBodyPosition.value[x]:valueSampledData.origin
                                            Definition

                                            The base quantity that a measured value of zero represents. In addition, this provides the units of the entire measurement series.

                                            ShortZero value and units
                                            Control1..1
                                            TypeQuantity(SimpleQuantity)
                                            Is Modifierfalse
                                            Summarytrue
                                            Pattern Value{
                                              "unit" : "degree",
                                              "system" : "http://unitsofmeasure.org",
                                              "code" : "deg"
                                            }
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            74. Observation.component:sagittalPlaneBodyPosition.value[x]:valueSampledData.period
                                            Definition

                                            The length of time between sampling times, measured in milliseconds.

                                            ShortNumber of milliseconds between samples
                                            Comments

                                            This is usually a whole number.

                                            Control1..1
                                            Typedecimal
                                            Is Modifierfalse
                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                            Summarytrue
                                            Pattern Value15000
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            76. Observation.component:sagittalPlaneBodyPosition.value[x]:valueSampledData.dimensions
                                            Definition

                                            The number of sample points at each time point. If this value is greater than one, then the dimensions will be interlaced - all the sample points for a point in time will be recorded at once.

                                            ShortNumber of sample points at each time point
                                            Comments

                                            If there is more than one dimension, the code for the type of data will define the meaning of the dimensions (typically ECG data).

                                            Control1..1
                                            TypepositiveInt
                                            Is Modifierfalse
                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                            Summarytrue
                                            Pattern Value1
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            78. Observation.component:sagittalPlaneBodyPosition.value[x]:valueSampledData.data
                                            Definition

                                            A series of data points which are decimal values separated by a single space (character u20). The special values "E" (error), "L" (below detection limit) and "U" (above detection limit) can also be used in place of a decimal value.

                                            ShortDecimal values with spaces, or "E" | "U" | "L"
                                            Comments

                                            Data may be missing if it is omitted for summarization purposes. In general, data is required for any actual use of a SampledData.

                                            Control0..1
                                            Typestring
                                            Is Modifierfalse
                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                            Summaryfalse
                                            Pattern Value<<posture|FlattenedArrayOddRemoved>>
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            80. Observation.component:timeSpentExercising
                                            Slice NametimeSpentExercising
                                            Definition

                                            Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.

                                            ShortComponent results
                                            Comments

                                            For a discussion on the ways Observations can be assembled in groups together see Notes below.

                                            Control10..1*
                                            TypeBackboneElement
                                            Is Modifierfalse
                                            Summarytrue
                                            Requirements

                                            Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            82. Observation.component:timeSpentExercising.modifierExtension
                                            Definition

                                            May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                            Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                            ShortExtensions that cannot be ignored even if unrecognized
                                            Comments

                                            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                            Control0..*
                                            TypeExtension
                                            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                            Summarytrue
                                            Requirements

                                            Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                            Alternate Namesextensions, user content, modifiers
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                            84. Observation.component:timeSpentExercising.code
                                            Definition

                                            Describes what was observed. Sometimes this is called the observation "code".

                                            ShortType of component observation (code / type)
                                            Comments

                                            All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

                                            Control1..1
                                            BindingFor example codes, see LOINCCodeshttp://hl7.org/fhir/ValueSet/observation-codes
                                            (example to http://hl7.org/fhir/ValueSet/observation-codes)

                                            Codes identifying names of simple observations.

                                            TypeCodeableConcept
                                            Is Modifierfalse
                                            Summarytrue
                                            Requirements

                                            Knowing what kind of observation is being made is essential to understanding the observation.

                                            Pattern Value{
                                              "coding" : [{
                                                "system" : "http://snomed.info/sct",
                                                "code" : "228450008",
                                                "display" : "Time spent exercising"
                                              }]
                                            }
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            86. Observation.component:timeSpentExercising.value[x]
                                            Definition

                                            The information determined as a result of making the observation, if the information has a simple value.

                                            ShortActual component result
                                            Comments

                                            Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

                                            Control0..1
                                            TypeChoice of: Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period
                                            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                            Is Modifierfalse
                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                            Summarytrue
                                            Requirements

                                            An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            SlicingThis element introduces a set of slices on Observation.component.value[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                            • type @ $this
                                            • 88. Observation.component:timeSpentExercising.value[x]:valueQuantity
                                              Slice NamevalueQuantity
                                              Definition

                                              The information determined as a result of making the observation, if the information has a simple value.

                                              ShortActual component result
                                              Comments

                                              Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

                                              Control0..1
                                              TypeQuantity, dateTime, boolean, string, SampledData, Period, Ratio, integer, time, Range, CodeableConcept
                                              [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                              Is Modifierfalse
                                              Summarytrue
                                              Requirements

                                              An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                                              Pattern Value{
                                                "value" : 0,
                                                "unit" : "second",
                                                "system" : "http://unitsofmeasure.org",
                                                "code" : "s"
                                              }
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              90. Observation.component:performanceBasedMeasureScore
                                              Slice NameperformanceBasedMeasureScore
                                              Definition

                                              Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.

                                              ShortComponent results
                                              Comments

                                              For a discussion on the ways Observations can be assembled in groups together see Notes below.

                                              Control10..1*
                                              TypeBackboneElement
                                              Is Modifierfalse
                                              Summarytrue
                                              Requirements

                                              Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              92. Observation.component:performanceBasedMeasureScore.modifierExtension
                                              Definition

                                              May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                              Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                              ShortExtensions that cannot be ignored even if unrecognized
                                              Comments

                                              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                              Control0..*
                                              TypeExtension
                                              Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                              Summarytrue
                                              Requirements

                                              Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                              Alternate Namesextensions, user content, modifiers
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                              94. Observation.component:performanceBasedMeasureScore.code
                                              Definition

                                              Describes what was observed. Sometimes this is called the observation "code".

                                              ShortType of component observation (code / type)
                                              Comments

                                              All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

                                              Control1..1
                                              BindingFor example codes, see LOINCCodeshttp://hl7.org/fhir/ValueSet/observation-codes
                                              (example to http://hl7.org/fhir/ValueSet/observation-codes)

                                              Codes identifying names of simple observations.

                                              TypeCodeableConcept
                                              Is Modifierfalse
                                              Summarytrue
                                              Requirements

                                              Knowing what kind of observation is being made is essential to understanding the observation.

                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              96. Observation.component:performanceBasedMeasureScore.code.coding
                                              Definition

                                              A reference to a code defined by a terminology system.

                                              ShortCode defined by a terminology system
                                              Comments

                                              Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                                              Control0..*
                                              TypeCoding
                                              Is Modifierfalse
                                              Summarytrue
                                              Requirements

                                              Allows for alternative encodings within a code system, and translations to other code systems.

                                              Pattern Value{
                                                "system" : "http://loinc.org",
                                                "code" : "89191-1",
                                                "display" : "Performance-based measure score"
                                              }
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              98. Observation.component:performanceBasedMeasureScore.code.coding.version
                                              Definition

                                              The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

                                              ShortVersion of the system - if relevant
                                              Comments

                                              Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

                                              NoteThis is a business version Id, not a resource version Id (see discussion)
                                              Control0..1
                                              Typestring
                                              Is Modifierfalse
                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                              Summarytrue
                                              Pattern Value2.69
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              100. Observation.component:performanceBasedMeasureScore.value[x]
                                              Definition

                                              The information determined as a result of making the observation, if the information has a simple value.

                                              ShortActual component result
                                              Comments

                                              Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

                                              Control0..1
                                              TypeChoice of: Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period
                                              [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                              Is Modifierfalse
                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                              Summarytrue
                                              Requirements

                                              An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              SlicingThis element introduces a set of slices on Observation.component.value[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                              • type @ $this
                                              • 102. Observation.component:performanceBasedMeasureScore.value[x]:valueQuantity
                                                Slice NamevalueQuantity
                                                Definition

                                                The information determined as a result of making the observation, if the information has a simple value.

                                                ShortActual component result
                                                Comments

                                                Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

                                                Control0..1
                                                TypeQuantity, dateTime, boolean, string, SampledData, Period, Ratio, integer, time, Range, CodeableConcept
                                                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                Is Modifierfalse
                                                Summarytrue
                                                Requirements

                                                An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                                                Pattern Value{
                                                  "value" : 0,
                                                  "unit" : "score",
                                                  "system" : "http://unitsofmeasure.org",
                                                  "code" : "{score}"
                                                }
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                104. Observation.component:disorientated
                                                Slice Namedisorientated
                                                Definition

                                                Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.

                                                ShortComponent results
                                                Comments

                                                For a discussion on the ways Observations can be assembled in groups together see Notes below.

                                                Control10..1*
                                                TypeBackboneElement
                                                Is Modifierfalse
                                                Summarytrue
                                                Requirements

                                                Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                106. Observation.component:disorientated.modifierExtension
                                                Definition

                                                May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                                Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                ShortExtensions that cannot be ignored even if unrecognized
                                                Comments

                                                There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                Control0..*
                                                TypeExtension
                                                Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                Summarytrue
                                                Requirements

                                                Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                Alternate Namesextensions, user content, modifiers
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                108. Observation.component:disorientated.code
                                                Definition

                                                Describes what was observed. Sometimes this is called the observation "code".

                                                ShortType of component observation (code / type)
                                                Comments

                                                All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

                                                Control1..1
                                                BindingFor example codes, see LOINCCodeshttp://hl7.org/fhir/ValueSet/observation-codes
                                                (example to http://hl7.org/fhir/ValueSet/observation-codes)

                                                Codes identifying names of simple observations.

                                                TypeCodeableConcept
                                                Is Modifierfalse
                                                Summarytrue
                                                Requirements

                                                Knowing what kind of observation is being made is essential to understanding the observation.

                                                Pattern Value{
                                                  "coding" : [{
                                                    "system" : "http://snomed.info/sct",
                                                    "code" : "62476001",
                                                    "display" : "Disorientated"
                                                  }]
                                                }
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                110. Observation.component:disorientated.value[x]
                                                Definition

                                                The information determined as a result of making the observation, if the information has a simple value.

                                                ShortActual component result
                                                Comments

                                                Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

                                                Control0..1
                                                TypeChoice of: Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period
                                                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                Is Modifierfalse
                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                Summarytrue
                                                Requirements

                                                An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                SlicingThis element introduces a set of slices on Observation.component.value[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                • type @ $this
                                                • 112. Observation.component:disorientated.value[x]:valueBoolean
                                                  Slice NamevalueBoolean
                                                  Definition

                                                  The information determined as a result of making the observation, if the information has a simple value.

                                                  ShortActual component result
                                                  Comments

                                                  Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

                                                  Control0..1
                                                  Typeboolean, dateTime, string, SampledData, Quantity, Period, Ratio, integer, time, Range, CodeableConcept
                                                  [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                  Is Modifierfalse
                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                  Summarytrue
                                                  Requirements

                                                  An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                                                  Pattern Valuetrue
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  114. Observation.component:disorientated.value[x]:valueCodeableConcept
                                                  Slice NamevalueCodeableConcept
                                                  Definition

                                                  The information determined as a result of making the observation, if the information has a simple value.

                                                  ShortActual component result
                                                  Comments

                                                  Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

                                                  Control0..1
                                                  TypeCodeableConcept, dateTime, boolean, string, SampledData, Quantity, Period, Ratio, integer, time, Range
                                                  [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                  Is Modifierfalse
                                                  Summarytrue
                                                  Requirements

                                                  An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                                                  Pattern Value{
                                                    "coding" : [{
                                                      "system" : "http://snomed.info/sct",
                                                      "code" : "<<disoriented|SeverityCode>>",
                                                      "display" : "<<disoriented|SeverityCodeDisplay>>"
                                                    }]
                                                  }
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  116. Observation.component:abnormalVision
                                                  Slice NameabnormalVision
                                                  Definition

                                                  Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.

                                                  ShortComponent results
                                                  Comments

                                                  For a discussion on the ways Observations can be assembled in groups together see Notes below.

                                                  Control10..1*
                                                  TypeBackboneElement
                                                  Is Modifierfalse
                                                  Summarytrue
                                                  Requirements

                                                  Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  118. Observation.component:abnormalVision.modifierExtension
                                                  Definition

                                                  May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                                  Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                  ShortExtensions that cannot be ignored even if unrecognized
                                                  Comments

                                                  There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                  Control0..*
                                                  TypeExtension
                                                  Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                  Summarytrue
                                                  Requirements

                                                  Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                  Alternate Namesextensions, user content, modifiers
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                  120. Observation.component:abnormalVision.code
                                                  Definition

                                                  Describes what was observed. Sometimes this is called the observation "code".

                                                  ShortType of component observation (code / type)
                                                  Comments

                                                  All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

                                                  Control1..1
                                                  BindingFor example codes, see LOINCCodeshttp://hl7.org/fhir/ValueSet/observation-codes
                                                  (example to http://hl7.org/fhir/ValueSet/observation-codes)

                                                  Codes identifying names of simple observations.

                                                  TypeCodeableConcept
                                                  Is Modifierfalse
                                                  Summarytrue
                                                  Requirements

                                                  Knowing what kind of observation is being made is essential to understanding the observation.

                                                  Pattern Value{
                                                    "coding" : [{
                                                      "system" : "http://snomed.info/sct",
                                                      "code" : "7973008",
                                                      "display" : "Abnormal vision"
                                                    }]
                                                  }
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  122. Observation.component:abnormalVision.value[x]
                                                  Definition

                                                  The information determined as a result of making the observation, if the information has a simple value.

                                                  ShortActual component result
                                                  Comments

                                                  Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

                                                  Control0..1
                                                  TypeChoice of: Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period
                                                  [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                  Is Modifierfalse
                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                  Summarytrue
                                                  Requirements

                                                  An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  SlicingThis element introduces a set of slices on Observation.component.value[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                  • type @ $this
                                                  • 124. Observation.component:abnormalVision.value[x]:valueBoolean
                                                    Slice NamevalueBoolean
                                                    Definition

                                                    The information determined as a result of making the observation, if the information has a simple value.

                                                    ShortActual component result
                                                    Comments

                                                    Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

                                                    Control0..1
                                                    Typeboolean, dateTime, string, SampledData, Quantity, Period, Ratio, integer, time, Range, CodeableConcept
                                                    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                    Is Modifierfalse
                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                    Summarytrue
                                                    Requirements

                                                    An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                                                    Pattern Valuetrue
                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    126. Observation.component:abnormalVision.value[x]:valueCodeableConcept
                                                    Slice NamevalueCodeableConcept
                                                    Definition

                                                    The information determined as a result of making the observation, if the information has a simple value.

                                                    ShortActual component result
                                                    Comments

                                                    Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

                                                    Control0..1
                                                    TypeCodeableConcept, dateTime, boolean, string, SampledData, Quantity, Period, Ratio, integer, time, Range
                                                    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                    Is Modifierfalse
                                                    Summarytrue
                                                    Requirements

                                                    An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                                                    Pattern Value{
                                                      "coding" : [{
                                                        "system" : "http://snomed.info/sct",
                                                        "code" : "<<blurryvision|SeverityCode>>",
                                                        "display" : "<<blurryvision|SeverityCodeDisplay>>"
                                                      }]
                                                    }
                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    128. Observation.component:dizziness
                                                    Slice Namedizziness
                                                    Definition

                                                    Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.

                                                    ShortComponent results
                                                    Comments

                                                    For a discussion on the ways Observations can be assembled in groups together see Notes below.

                                                    Control10..1*
                                                    TypeBackboneElement
                                                    Is Modifierfalse
                                                    Summarytrue
                                                    Requirements

                                                    Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    130. Observation.component:dizziness.modifierExtension
                                                    Definition

                                                    May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                                    Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                    ShortExtensions that cannot be ignored even if unrecognized
                                                    Comments

                                                    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                    Control0..*
                                                    TypeExtension
                                                    Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                    Summarytrue
                                                    Requirements

                                                    Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                    Alternate Namesextensions, user content, modifiers
                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                    132. Observation.component:dizziness.code
                                                    Definition

                                                    Describes what was observed. Sometimes this is called the observation "code".

                                                    ShortType of component observation (code / type)
                                                    Comments

                                                    All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

                                                    Control1..1
                                                    BindingFor example codes, see LOINCCodeshttp://hl7.org/fhir/ValueSet/observation-codes
                                                    (example to http://hl7.org/fhir/ValueSet/observation-codes)

                                                    Codes identifying names of simple observations.

                                                    TypeCodeableConcept
                                                    Is Modifierfalse
                                                    Summarytrue
                                                    Requirements

                                                    Knowing what kind of observation is being made is essential to understanding the observation.

                                                    Pattern Value{
                                                      "coding" : [{
                                                        "system" : "http://snomed.info/sct",
                                                        "code" : "404640003",
                                                        "display" : "Dizziness"
                                                      }]
                                                    }
                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    134. Observation.component:dizziness.value[x]
                                                    Definition

                                                    The information determined as a result of making the observation, if the information has a simple value.

                                                    ShortActual component result
                                                    Comments

                                                    Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

                                                    Control0..1
                                                    TypeChoice of: Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period
                                                    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                    Is Modifierfalse
                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                    Summarytrue
                                                    Requirements

                                                    An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    SlicingThis element introduces a set of slices on Observation.component.value[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                    • type @ $this
                                                    • 136. Observation.component:dizziness.value[x]:valueBoolean
                                                      Slice NamevalueBoolean
                                                      Definition

                                                      The information determined as a result of making the observation, if the information has a simple value.

                                                      ShortActual component result
                                                      Comments

                                                      Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

                                                      Control0..1
                                                      Typeboolean, dateTime, string, SampledData, Quantity, Period, Ratio, integer, time, Range, CodeableConcept
                                                      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                      Is Modifierfalse
                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                      Summarytrue
                                                      Requirements

                                                      An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                                                      Pattern Valuetrue
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      138. Observation.component:dizziness.value[x]:valueCodeableConcept
                                                      Slice NamevalueCodeableConcept
                                                      Definition

                                                      The information determined as a result of making the observation, if the information has a simple value.

                                                      ShortActual component result
                                                      Comments

                                                      Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

                                                      Control0..1
                                                      TypeCodeableConcept, dateTime, boolean, string, SampledData, Quantity, Period, Ratio, integer, time, Range
                                                      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                      Is Modifierfalse
                                                      Summarytrue
                                                      Requirements

                                                      An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                                                      Pattern Value{
                                                        "coding" : [{
                                                          "system" : "http://snomed.info/sct",
                                                          "code" : "<<dizzy|SeverityCode>>",
                                                          "display" : "<<dizzy|SeverityCodeDisplay>>"
                                                        }]
                                                      }
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      140. Observation.component:headache
                                                      Slice Nameheadache
                                                      Definition

                                                      Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.

                                                      ShortComponent results
                                                      Comments

                                                      For a discussion on the ways Observations can be assembled in groups together see Notes below.

                                                      Control10..1*
                                                      TypeBackboneElement
                                                      Is Modifierfalse
                                                      Summarytrue
                                                      Requirements

                                                      Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      142. Observation.component:headache.modifierExtension
                                                      Definition

                                                      May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                                      Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                      ShortExtensions that cannot be ignored even if unrecognized
                                                      Comments

                                                      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                      Control0..*
                                                      TypeExtension
                                                      Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                      Summarytrue
                                                      Requirements

                                                      Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                      Alternate Namesextensions, user content, modifiers
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                      144. Observation.component:headache.code
                                                      Definition

                                                      Describes what was observed. Sometimes this is called the observation "code".

                                                      ShortType of component observation (code / type)
                                                      Comments

                                                      All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

                                                      Control1..1
                                                      BindingFor example codes, see LOINCCodeshttp://hl7.org/fhir/ValueSet/observation-codes
                                                      (example to http://hl7.org/fhir/ValueSet/observation-codes)

                                                      Codes identifying names of simple observations.

                                                      TypeCodeableConcept
                                                      Is Modifierfalse
                                                      Summarytrue
                                                      Requirements

                                                      Knowing what kind of observation is being made is essential to understanding the observation.

                                                      Pattern Value{
                                                        "coding" : [{
                                                          "system" : "http://snomed.info/sct",
                                                          "code" : "25064002",
                                                          "display" : "Headache"
                                                        }]
                                                      }
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      146. Observation.component:headache.value[x]
                                                      Definition

                                                      The information determined as a result of making the observation, if the information has a simple value.

                                                      ShortActual component result
                                                      Comments

                                                      Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

                                                      Control0..1
                                                      TypeChoice of: Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period
                                                      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                      Is Modifierfalse
                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                      Summarytrue
                                                      Requirements

                                                      An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      SlicingThis element introduces a set of slices on Observation.component.value[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                      • type @ $this
                                                      • 148. Observation.component:headache.value[x]:valueBoolean
                                                        Slice NamevalueBoolean
                                                        Definition

                                                        The information determined as a result of making the observation, if the information has a simple value.

                                                        ShortActual component result
                                                        Comments

                                                        Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

                                                        Control0..1
                                                        Typeboolean, dateTime, string, SampledData, Quantity, Period, Ratio, integer, time, Range, CodeableConcept
                                                        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                        Is Modifierfalse
                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                        Summarytrue
                                                        Requirements

                                                        An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                                                        Pattern Valuetrue
                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        150. Observation.component:headache.value[x]:valueCodeableConcept
                                                        Slice NamevalueCodeableConcept
                                                        Definition

                                                        The information determined as a result of making the observation, if the information has a simple value.

                                                        ShortActual component result
                                                        Comments

                                                        Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

                                                        Control0..1
                                                        TypeCodeableConcept, dateTime, boolean, string, SampledData, Quantity, Period, Ratio, integer, time, Range
                                                        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                        Is Modifierfalse
                                                        Summarytrue
                                                        Requirements

                                                        An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                                                        Pattern Value{
                                                          "coding" : [{
                                                            "system" : "http://snomed.info/sct",
                                                            "code" : "<<headache|SeverityCode>>",
                                                            "display" : "<<headache|SeverityCodeDisplay>>"
                                                          }]
                                                        }
                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        152. Observation.component:neckJointRangeOfMovement
                                                        Slice NameneckJointRangeOfMovement
                                                        Definition

                                                        Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.

                                                        ShortComponent results
                                                        Comments

                                                        For a discussion on the ways Observations can be assembled in groups together see Notes below.

                                                        Control10..1*
                                                        TypeBackboneElement
                                                        Is Modifierfalse
                                                        Summarytrue
                                                        Requirements

                                                        Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        154. Observation.component:neckJointRangeOfMovement.modifierExtension
                                                        Definition

                                                        May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                                        Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                        ShortExtensions that cannot be ignored even if unrecognized
                                                        Comments

                                                        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                        Control0..*
                                                        TypeExtension
                                                        Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                        Summarytrue
                                                        Requirements

                                                        Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                        Alternate Namesextensions, user content, modifiers
                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                        156. Observation.component:neckJointRangeOfMovement.code
                                                        Definition

                                                        Describes what was observed. Sometimes this is called the observation "code".

                                                        ShortType of component observation (code / type)
                                                        Comments

                                                        All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

                                                        Control1..1
                                                        BindingFor example codes, see LOINCCodeshttp://hl7.org/fhir/ValueSet/observation-codes
                                                        (example to http://hl7.org/fhir/ValueSet/observation-codes)

                                                        Codes identifying names of simple observations.

                                                        TypeCodeableConcept
                                                        Is Modifierfalse
                                                        Summarytrue
                                                        Requirements

                                                        Knowing what kind of observation is being made is essential to understanding the observation.

                                                        Pattern Value{
                                                          "coding" : [{
                                                            "system" : "http://snomed.info/sct",
                                                            "code" : "404979006",
                                                            "display" : "Neck joint - range of movement"
                                                          }]
                                                        }
                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        158. Observation.component:neckJointRangeOfMovement.code.text
                                                        Definition

                                                        A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

                                                        ShortPlain text representation of the concept
                                                        Comments

                                                        Very often the text is the same as a displayName of one of the codings.

                                                        Control0..1
                                                        Typestring
                                                        Is Modifierfalse
                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                        Summarytrue
                                                        Requirements

                                                        The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

                                                        Pattern ValueRange of head turns in pitch plane (Up-Down)
                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        160. Observation.component:neckJointRangeOfMovement.value[x]
                                                        Definition

                                                        The information determined as a result of making the observation, if the information has a simple value.

                                                        ShortActual component result
                                                        Comments

                                                        Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

                                                        Control0..1
                                                        TypeChoice of: Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period
                                                        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                        Is Modifierfalse
                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                        Summarytrue
                                                        Requirements

                                                        An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        SlicingThis element introduces a set of slices on Observation.component.value[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                        • type @ $this
                                                        • 162. Observation.component:neckJointRangeOfMovement.value[x]:valueSampledData
                                                          Slice NamevalueSampledData
                                                          Definition

                                                          The information determined as a result of making the observation, if the information has a simple value.

                                                          ShortActual component result
                                                          Comments

                                                          Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

                                                          Control0..1
                                                          TypeSampledData, dateTime, boolean, string, Quantity, Period, Ratio, integer, time, Range, CodeableConcept
                                                          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                          Is Modifierfalse
                                                          Summarytrue
                                                          Requirements

                                                          An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          164. Observation.component:neckJointRangeOfMovement.value[x]:valueSampledData.origin
                                                          Definition

                                                          The base quantity that a measured value of zero represents. In addition, this provides the units of the entire measurement series.

                                                          ShortZero value and units
                                                          Control1..1
                                                          TypeQuantity(SimpleQuantity)
                                                          Is Modifierfalse
                                                          Summarytrue
                                                          Pattern Value{
                                                            "unit" : "degree",
                                                            "system" : "http://unitsofmeasure.org",
                                                            "code" : "deg"
                                                          }
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          166. Observation.component:neckJointRangeOfMovement.value[x]:valueSampledData.period
                                                          Definition

                                                          The length of time between sampling times, measured in milliseconds.

                                                          ShortNumber of milliseconds between samples
                                                          Comments

                                                          This is usually a whole number.

                                                          Control1..1
                                                          Typedecimal
                                                          Is Modifierfalse
                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                          Summarytrue
                                                          Pattern Value1000
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          168. Observation.component:neckJointRangeOfMovement.value[x]:valueSampledData.dimensions
                                                          Definition

                                                          The number of sample points at each time point. If this value is greater than one, then the dimensions will be interlaced - all the sample points for a point in time will be recorded at once.

                                                          ShortNumber of sample points at each time point
                                                          Comments

                                                          If there is more than one dimension, the code for the type of data will define the meaning of the dimensions (typically ECG data).

                                                          Control1..1
                                                          TypepositiveInt
                                                          Is Modifierfalse
                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                          Summarytrue
                                                          Pattern Value1
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          170. Observation.component:neckJointRangeOfMovement.value[x]:valueSampledData.data
                                                          Definition

                                                          A series of data points which are decimal values separated by a single space (character u20). The special values "E" (error), "L" (below detection limit) and "U" (above detection limit) can also be used in place of a decimal value.

                                                          ShortDecimal values with spaces, or "E" | "U" | "L"
                                                          Comments

                                                          Data may be missing if it is omitted for summarization purposes. In general, data is required for any actual use of a SampledData.

                                                          Control0..1
                                                          Typestring
                                                          Is Modifierfalse
                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                          Summaryfalse
                                                          Pattern Value<<range|FlattenedArray>>
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          172. Observation.component:countsPerSecond
                                                          Slice NamecountsPerSecond
                                                          Definition

                                                          Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.

                                                          ShortComponent results
                                                          Comments

                                                          For a discussion on the ways Observations can be assembled in groups together see Notes below.

                                                          Control10..1*
                                                          TypeBackboneElement
                                                          Is Modifierfalse
                                                          Summarytrue
                                                          Requirements

                                                          Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          174. Observation.component:countsPerSecond.modifierExtension
                                                          Definition

                                                          May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                                          Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                          ShortExtensions that cannot be ignored even if unrecognized
                                                          Comments

                                                          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                          Control0..*
                                                          TypeExtension
                                                          Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                          Summarytrue
                                                          Requirements

                                                          Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                          Alternate Namesextensions, user content, modifiers
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                          176. Observation.component:countsPerSecond.code
                                                          Definition

                                                          Describes what was observed. Sometimes this is called the observation "code".

                                                          ShortType of component observation (code / type)
                                                          Comments

                                                          All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

                                                          Control1..1
                                                          BindingFor example codes, see LOINCCodeshttp://hl7.org/fhir/ValueSet/observation-codes
                                                          (example to http://hl7.org/fhir/ValueSet/observation-codes)

                                                          Codes identifying names of simple observations.

                                                          TypeCodeableConcept
                                                          Is Modifierfalse
                                                          Summarytrue
                                                          Requirements

                                                          Knowing what kind of observation is being made is essential to understanding the observation.

                                                          Pattern Value{
                                                            "coding" : [{
                                                              "system" : "http://snomed.info/sct",
                                                              "code" : "282108002",
                                                              "display" : "Counts per second"
                                                            }]
                                                          }
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          178. Observation.component:countsPerSecond.code.text
                                                          Definition

                                                          A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

                                                          ShortPlain text representation of the concept
                                                          Comments

                                                          Very often the text is the same as a displayName of one of the codings.

                                                          Control0..1
                                                          Typestring
                                                          Is Modifierfalse
                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                          Summarytrue
                                                          Requirements

                                                          The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

                                                          Pattern ValueHead turns per second
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          180. Observation.component:countsPerSecond.value[x]
                                                          Definition

                                                          The information determined as a result of making the observation, if the information has a simple value.

                                                          ShortActual component result
                                                          Comments

                                                          Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

                                                          Control0..1
                                                          TypeChoice of: Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period
                                                          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                          Is Modifierfalse
                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                          Summarytrue
                                                          Requirements

                                                          An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          SlicingThis element introduces a set of slices on Observation.component.value[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                          • type @ $this
                                                          • 182. Observation.component:countsPerSecond.value[x]:valueSampledData
                                                            Slice NamevalueSampledData
                                                            Definition

                                                            The information determined as a result of making the observation, if the information has a simple value.

                                                            ShortActual component result
                                                            Comments

                                                            Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

                                                            Control0..1
                                                            TypeSampledData, dateTime, boolean, string, Quantity, Period, Ratio, integer, time, Range, CodeableConcept
                                                            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                            Is Modifierfalse
                                                            Summarytrue
                                                            Requirements

                                                            An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            184. Observation.component:countsPerSecond.value[x]:valueSampledData.origin
                                                            Definition

                                                            The base quantity that a measured value of zero represents. In addition, this provides the units of the entire measurement series.

                                                            ShortZero value and units
                                                            Control1..1
                                                            TypeQuantity(SimpleQuantity)
                                                            Is Modifierfalse
                                                            Summarytrue
                                                            Pattern Value{
                                                              "unit" : "per second",
                                                              "system" : "http://unitsofmeasure.org",
                                                              "code" : "/s"
                                                            }
                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            186. Observation.component:countsPerSecond.value[x]:valueSampledData.period
                                                            Definition

                                                            The length of time between sampling times, measured in milliseconds.

                                                            ShortNumber of milliseconds between samples
                                                            Comments

                                                            This is usually a whole number.

                                                            Control1..1
                                                            Typedecimal
                                                            Is Modifierfalse
                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                            Summarytrue
                                                            Pattern Value1000
                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            188. Observation.component:countsPerSecond.value[x]:valueSampledData.dimensions
                                                            Definition

                                                            The number of sample points at each time point. If this value is greater than one, then the dimensions will be interlaced - all the sample points for a point in time will be recorded at once.

                                                            ShortNumber of sample points at each time point
                                                            Comments

                                                            If there is more than one dimension, the code for the type of data will define the meaning of the dimensions (typically ECG data).

                                                            Control1..1
                                                            TypepositiveInt
                                                            Is Modifierfalse
                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                            Summarytrue
                                                            Pattern Value1
                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            190. Observation.component:countsPerSecond.value[x]:valueSampledData.data
                                                            Definition

                                                            A series of data points which are decimal values separated by a single space (character u20). The special values "E" (error), "L" (below detection limit) and "U" (above detection limit) can also be used in place of a decimal value.

                                                            ShortDecimal values with spaces, or "E" | "U" | "L"
                                                            Comments

                                                            Data may be missing if it is omitted for summarization purposes. In general, data is required for any actual use of a SampledData.

                                                            Control0..1
                                                            Typestring
                                                            Is Modifierfalse
                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                            Summaryfalse
                                                            Pattern Value<<speed|FlattenedArray>>
                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

                                                            Guidance on how to interpret the contents of this table can be found here

                                                            0. Observation
                                                            Definition

                                                            Measurements and simple assertions made about a patient, device or other subject.

                                                            ShortMeasurements and simple assertions
                                                            Comments

                                                            Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc. Other resources are used to provide context for observations such as laboratory reports, etc.

                                                            Control0..*
                                                            Is Modifierfalse
                                                            Summaryfalse
                                                            Alternate NamesVital Signs, Measurement, Results, Tests
                                                            Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
                                                            dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (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: 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: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
                                                            dom-6: A resource should have narrative for robust management (text.`div`.exists())
                                                            obs-6: dataAbsentReason SHALL only be present if Observation.value[x] is not present (dataAbsentReason.empty() or value.empty())
                                                            obs-7: If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present (value.empty() or component.code.where(coding.intersect(%resource.code.coding).exists()).empty())
                                                            2. Observation.id
                                                            Definition

                                                            The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

                                                            ShortLogical id of this artifact
                                                            Comments

                                                            The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

                                                            Control0..1
                                                            Typeid
                                                            Is Modifierfalse
                                                            Summarytrue
                                                            4. Observation.meta
                                                            Definition

                                                            The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.

                                                            ShortMetadata about the resource
                                                            Control0..1
                                                            TypeMeta
                                                            Is Modifierfalse
                                                            Summarytrue
                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            6. Observation.implicitRules
                                                            Definition

                                                            A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

                                                            ShortA set of rules under which this content was created
                                                            Comments

                                                            Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

                                                            Control0..1
                                                            Typeuri
                                                            Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                            Summarytrue
                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            8. Observation.language
                                                            Definition

                                                            The base language in which the resource is written.

                                                            ShortLanguage of the resource content
                                                            Comments

                                                            Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).

                                                            Control0..1
                                                            BindingThe codes SHOULD be taken from CommonLanguages
                                                            (preferred to http://hl7.org/fhir/ValueSet/languages)

                                                            A human language.

                                                            Additional BindingsPurpose
                                                            AllLanguagesMax Binding
                                                            Typecode
                                                            Is Modifierfalse
                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                            Summaryfalse
                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            10. Observation.text
                                                            Definition

                                                            A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.

                                                            ShortText summary of the resource, for human interpretation
                                                            Comments

                                                            Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.

                                                            Control0..1
                                                            TypeNarrative
                                                            Is Modifierfalse
                                                            Summaryfalse
                                                            Alternate Namesnarrative, html, xhtml, display
                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            12. Observation.contained
                                                            Definition

                                                            These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.

                                                            ShortContained, inline Resources
                                                            Comments

                                                            This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.

                                                            Control0..*
                                                            TypeResource
                                                            Is Modifierfalse
                                                            Summaryfalse
                                                            Alternate Namesinline resources, anonymous resources, contained resources
                                                            14. Observation.extension
                                                            Definition

                                                            May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                            ShortAdditional content defined by implementations
                                                            Comments

                                                            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                            Control0..*
                                                            TypeExtension
                                                            Is Modifierfalse
                                                            Summaryfalse
                                                            Alternate Namesextensions, user content
                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                            16. Observation.extension.id
                                                            Definition

                                                            Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                            ShortUnique id for inter-element referencing
                                                            Control0..1
                                                            Typestring
                                                            Is Modifierfalse
                                                            XML FormatIn the XML format, this property is represented as an attribute.
                                                            Summaryfalse
                                                            18. Observation.extension.extension
                                                            Definition

                                                            An Extension

                                                            ShortExtension
                                                            Control0..0
                                                            TypeExtension
                                                            Is Modifierfalse
                                                            Summaryfalse
                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                            SlicingThis element introduces a set of slices on Observation.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                            • value @ url
                                                            • 20. Observation.extension.url
                                                              Definition

                                                              Source of the definition for the extension code - a logical name or a URL.

                                                              Shortidentifies the meaning of the extension
                                                              Comments

                                                              The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

                                                              Control1..1
                                                              Typeuri
                                                              Is Modifierfalse
                                                              XML FormatIn the XML format, this property is represented as an attribute.
                                                              Summaryfalse
                                                              Pattern Valuehttps://holobalance.eu/fhir/extension-exercise-difficulty
                                                              22. Observation.extension.value[x]
                                                              Definition

                                                              Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

                                                              ShortValue of extension
                                                              Control0..1
                                                              TypeChoice of: base64Binary, boolean, canonical, code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, url, uuid, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference, SampledData, Signature, Timing, ContactDetail, Contributor, DataRequirement, Expression, ParameterDefinition, RelatedArtifact, TriggerDefinition, UsageContext, Dosage, Meta
                                                              [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                              Is Modifierfalse
                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                              Summaryfalse
                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              SlicingThis element introduces a set of slices on Observation.extension.value[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                              • type @ $this
                                                              • 24. Observation.extension.value[x]:valueCodeableConcept
                                                                Slice NamevalueCodeableConcept
                                                                Definition

                                                                Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

                                                                ShortValue of extension
                                                                Control0..1
                                                                TypeCodeableConcept
                                                                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                Is Modifierfalse
                                                                Summaryfalse
                                                                Pattern Value{
                                                                  "coding" : [{
                                                                    "system" : "https://holobalance.eu/fhir/codesystem-exercise-difficulty",
                                                                    "code" : "<<functionalLevel>>",
                                                                    "display" : "Exercise Progression Level"
                                                                  }]
                                                                }
                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                26. Observation.modifierExtension
                                                                Definition

                                                                May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                                                Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                                ShortExtensions that cannot be ignored
                                                                Comments

                                                                There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                Control0..*
                                                                TypeExtension
                                                                Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
                                                                Summaryfalse
                                                                Requirements

                                                                Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                                Alternate Namesextensions, user content
                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                28. Observation.identifier
                                                                Definition

                                                                A unique identifier assigned to this observation.

                                                                ShortBusiness Identifier for observation
                                                                NoteThis is a business identifier, not a resource identifier (see discussion)
                                                                Control2..*
                                                                TypeIdentifier
                                                                Is Modifierfalse
                                                                Summarytrue
                                                                Requirements

                                                                Allows observations to be distinguished and referenced.

                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                SlicingThis element introduces a set of slices on Observation.identifier. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                • value @ system
                                                                • 30. Observation.identifier:TrainingId
                                                                  Slice NameTrainingId
                                                                  Definition

                                                                  A unique identifier assigned to this observation.

                                                                  ShortBusiness Identifier for observation
                                                                  NoteThis is a business identifier, not a resource identifier (see discussion)
                                                                  Control1..1
                                                                  TypeIdentifier
                                                                  Is Modifierfalse
                                                                  Summarytrue
                                                                  Requirements

                                                                  Allows observations to be distinguished and referenced.

                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  32. Observation.identifier:TrainingId.id
                                                                  Definition

                                                                  Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                  ShortUnique id for inter-element referencing
                                                                  Control0..1
                                                                  Typestring
                                                                  Is Modifierfalse
                                                                  XML FormatIn the XML format, this property is represented as an attribute.
                                                                  Summaryfalse
                                                                  34. Observation.identifier:TrainingId.extension
                                                                  Definition

                                                                  May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                  ShortAdditional content defined by implementations
                                                                  Comments

                                                                  There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                  Control0..*
                                                                  TypeExtension
                                                                  Is Modifierfalse
                                                                  Summaryfalse
                                                                  Alternate Namesextensions, user content
                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                  SlicingThis element introduces a set of slices on Observation.identifier.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                  • value @ url
                                                                  • 36. Observation.identifier:TrainingId.use
                                                                    Definition

                                                                    The purpose of this identifier.

                                                                    Shortusual | official | temp | secondary | old (If known)
                                                                    Comments

                                                                    Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

                                                                    Control0..1
                                                                    BindingThe codes SHALL be taken from IdentifierUse
                                                                    (required to http://hl7.org/fhir/ValueSet/identifier-use|4.0.1)

                                                                    Identifies the purpose for this identifier, if known .

                                                                    Typecode
                                                                    Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                    Summarytrue
                                                                    Requirements

                                                                    Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    38. Observation.identifier:TrainingId.type
                                                                    Definition

                                                                    A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

                                                                    ShortDescription of identifier
                                                                    Comments

                                                                    This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.

                                                                    Control0..1
                                                                    BindingUnless not suitable, these codes SHALL be taken from Identifier Type Codes
                                                                    (extensible to http://hl7.org/fhir/ValueSet/identifier-type)

                                                                    A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

                                                                    TypeCodeableConcept
                                                                    Is Modifierfalse
                                                                    Summarytrue
                                                                    Requirements

                                                                    Allows users to make use of identifiers when the identifier system is not known.

                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    40. Observation.identifier:TrainingId.system
                                                                    Definition

                                                                    Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

                                                                    ShortThe namespace for the identifier value
                                                                    Comments

                                                                    Identifier.system is always case sensitive.

                                                                    Control1..1
                                                                    Typeuri
                                                                    Is Modifierfalse
                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                    Summarytrue
                                                                    Requirements

                                                                    There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

                                                                    Pattern Valuehttps://holobalance.eu/fhir/identifiers/exercise-instance
                                                                    Example<br/><b>General</b>:http://www.acme.com/identifiers/patient
                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    42. Observation.identifier:TrainingId.value
                                                                    Definition

                                                                    The portion of the identifier typically relevant to the user and which is unique within the context of the system.

                                                                    ShortThe value that is unique
                                                                    Comments

                                                                    If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

                                                                    Control0..1
                                                                    Typestring
                                                                    Is Modifierfalse
                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                    Summarytrue
                                                                    Pattern Value<<traininglogid>>
                                                                    Example<br/><b>General</b>:123456
                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    44. Observation.identifier:TrainingId.period
                                                                    Definition

                                                                    Time period during which identifier is/was valid for use.

                                                                    ShortTime period when id is/was valid for use
                                                                    Control0..1
                                                                    TypePeriod
                                                                    Is Modifierfalse
                                                                    Summarytrue
                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    46. Observation.identifier:TrainingId.assigner
                                                                    Definition

                                                                    Organization that issued/manages the identifier.

                                                                    ShortOrganization that issued id (may be just text)
                                                                    Comments

                                                                    The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

                                                                    Control0..1
                                                                    TypeReference(Organization)
                                                                    Is Modifierfalse
                                                                    Summarytrue
                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    48. Observation.identifier:SessionId
                                                                    Slice NameSessionId
                                                                    Definition

                                                                    A unique identifier assigned to this observation.

                                                                    ShortBusiness Identifier for observation
                                                                    NoteThis is a business identifier, not a resource identifier (see discussion)
                                                                    Control1..1
                                                                    TypeIdentifier
                                                                    Is Modifierfalse
                                                                    Summarytrue
                                                                    Requirements

                                                                    Allows observations to be distinguished and referenced.

                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    50. Observation.identifier:SessionId.id
                                                                    Definition

                                                                    Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                    ShortUnique id for inter-element referencing
                                                                    Control0..1
                                                                    Typestring
                                                                    Is Modifierfalse
                                                                    XML FormatIn the XML format, this property is represented as an attribute.
                                                                    Summaryfalse
                                                                    52. Observation.identifier:SessionId.extension
                                                                    Definition

                                                                    May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                    ShortAdditional content defined by implementations
                                                                    Comments

                                                                    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                    Control0..*
                                                                    TypeExtension
                                                                    Is Modifierfalse
                                                                    Summaryfalse
                                                                    Alternate Namesextensions, user content
                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                    SlicingThis element introduces a set of slices on Observation.identifier.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                    • value @ url
                                                                    • 54. Observation.identifier:SessionId.use
                                                                      Definition

                                                                      The purpose of this identifier.

                                                                      Shortusual | official | temp | secondary | old (If known)
                                                                      Comments

                                                                      Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

                                                                      Control0..1
                                                                      BindingThe codes SHALL be taken from IdentifierUse
                                                                      (required to http://hl7.org/fhir/ValueSet/identifier-use|4.0.1)

                                                                      Identifies the purpose for this identifier, if known .

                                                                      Typecode
                                                                      Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
                                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                      Summarytrue
                                                                      Requirements

                                                                      Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                      56. Observation.identifier:SessionId.type
                                                                      Definition

                                                                      A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

                                                                      ShortDescription of identifier
                                                                      Comments

                                                                      This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.

                                                                      Control0..1
                                                                      BindingUnless not suitable, these codes SHALL be taken from Identifier Type Codes
                                                                      (extensible to http://hl7.org/fhir/ValueSet/identifier-type)

                                                                      A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

                                                                      TypeCodeableConcept
                                                                      Is Modifierfalse
                                                                      Summarytrue
                                                                      Requirements

                                                                      Allows users to make use of identifiers when the identifier system is not known.

                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                      58. Observation.identifier:SessionId.system
                                                                      Definition

                                                                      Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

                                                                      ShortThe namespace for the identifier value
                                                                      Comments

                                                                      Identifier.system is always case sensitive.

                                                                      Control1..1
                                                                      Typeuri
                                                                      Is Modifierfalse
                                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                      Summarytrue
                                                                      Requirements

                                                                      There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

                                                                      Pattern Valuehttps://holobalance.eu/fhir/identifiers/exercise-session
                                                                      Example<br/><b>General</b>:http://www.acme.com/identifiers/patient
                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                      60. Observation.identifier:SessionId.value
                                                                      Definition

                                                                      The portion of the identifier typically relevant to the user and which is unique within the context of the system.

                                                                      ShortThe value that is unique
                                                                      Comments

                                                                      If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

                                                                      Control0..1
                                                                      Typestring
                                                                      Is Modifierfalse
                                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                      Summarytrue
                                                                      Pattern Value<<sessionid>>
                                                                      Example<br/><b>General</b>:123456
                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                      62. Observation.identifier:SessionId.period
                                                                      Definition

                                                                      Time period during which identifier is/was valid for use.

                                                                      ShortTime period when id is/was valid for use
                                                                      Control0..1
                                                                      TypePeriod
                                                                      Is Modifierfalse
                                                                      Summarytrue
                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                      64. Observation.identifier:SessionId.assigner
                                                                      Definition

                                                                      Organization that issued/manages the identifier.

                                                                      ShortOrganization that issued id (may be just text)
                                                                      Comments

                                                                      The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

                                                                      Control0..1
                                                                      TypeReference(Organization)
                                                                      Is Modifierfalse
                                                                      Summarytrue
                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                      66. Observation.basedOn
                                                                      Definition

                                                                      A plan, proposal or order that is fulfilled in whole or in part by this event. For example, a MedicationRequest may require a patient to have laboratory test performed before it is dispensed.

                                                                      ShortFulfills plan, proposal or order
                                                                      Control0..*
                                                                      TypeReference(CarePlan, DeviceRequest, ImmunizationRecommendation, MedicationRequest, NutritionOrder, ServiceRequest)
                                                                      Is Modifierfalse
                                                                      Summarytrue
                                                                      Requirements

                                                                      Allows tracing of authorization for the event and tracking whether proposals/recommendations were acted upon.

                                                                      Alternate NamesFulfills
                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                      68. Observation.partOf
                                                                      Definition

                                                                      A larger event of which this particular Observation is a component or step. For example, an observation as part of a procedure.

                                                                      ShortPart of referenced event
                                                                      Comments

                                                                      To link an Observation to an Encounter use encounter. See the Notes below for guidance on referencing another Observation.

                                                                      Control0..*
                                                                      TypeReference(MedicationAdministration, MedicationDispense, MedicationStatement, Procedure, Immunization, ImagingStudy)
                                                                      Is Modifierfalse
                                                                      Summarytrue
                                                                      Alternate NamesContainer
                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                      70. Observation.status
                                                                      Definition

                                                                      The status of the result value.

                                                                      Shortregistered | preliminary | final | amended +
                                                                      Comments

                                                                      This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.

                                                                      Control1..1
                                                                      BindingThe codes SHALL be taken from ObservationStatus
                                                                      (required to http://hl7.org/fhir/ValueSet/observation-status|4.0.1)

                                                                      Codes providing the status of an observation.

                                                                      Typecode
                                                                      Is Modifiertrue because This element is labeled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
                                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                      Summarytrue
                                                                      Requirements

                                                                      Need to track the status of individual results. Some results are finalized before the whole report is finalized.

                                                                      Pattern Valuefinal
                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                      72. Observation.category
                                                                      Definition

                                                                      A code that classifies the general type of observation being made.

                                                                      ShortClassification of type of observation
                                                                      Comments

                                                                      In addition to the required category valueset, this element allows various categorization schemes based on the owner’s definition of the category and effectively multiple categories can be used at once. The level of granularity is defined by the category concepts in the value set.

                                                                      Control0..*
                                                                      BindingThe codes SHOULD be taken from ObservationCategoryCodes
                                                                      (preferred to http://hl7.org/fhir/ValueSet/observation-category)

                                                                      Codes for high level observation categories.

                                                                      TypeCodeableConcept
                                                                      Is Modifierfalse
                                                                      Summaryfalse
                                                                      Requirements

                                                                      Used for filtering what observations are retrieved and displayed.

                                                                      Pattern Value{
                                                                        "coding" : [{
                                                                          "system" : "http://terminology.hl7.org/CodeSystem/observation-category",
                                                                          "code" : "activity",
                                                                          "display" : "Activity"
                                                                        }]
                                                                      }
                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                      74. Observation.code
                                                                      Definition

                                                                      Describes what was observed. Sometimes this is called the observation "name".

                                                                      ShortType of observation (code / type)
                                                                      Comments

                                                                      All code-value and, if present, component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

                                                                      Control1..1
                                                                      BindingFor example codes, see LOINCCodes
                                                                      (example to http://hl7.org/fhir/ValueSet/observation-codes)

                                                                      Codes identifying names of simple observations.

                                                                      TypeCodeableConcept
                                                                      Is Modifierfalse
                                                                      Summarytrue
                                                                      Requirements

                                                                      Knowing what kind of observation is being made is essential to understanding the observation.

                                                                      Alternate NamesName
                                                                      Pattern Value{
                                                                        "coding" : [{
                                                                          "system" : "https://holobalance.eu/fhir/CodeSystem/exercise-type",
                                                                          "code" : "1169",
                                                                          "display" : "Exergame Sitting 2 – Pitch"
                                                                        }]
                                                                      }
                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                      76. Observation.subject
                                                                      Definition

                                                                      The patient, or group of patients, location, or device this observation is about and into whose record the observation is placed. If the actual focus of the observation is different from the subject (or a sample of, part, or region of the subject), the focus element or the code itself specifies the actual focus of the observation.

                                                                      ShortWho and/or what the observation is about
                                                                      Comments

                                                                      One would expect this element to be a cardinality of 1..1. The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.

                                                                      Control1..1
                                                                      TypeReference(HolobalancePatient)
                                                                      Is Modifierfalse
                                                                      Summarytrue
                                                                      Requirements

                                                                      Observations have no value if you don't know who or what they're about.

                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                      78. Observation.focus
                                                                      Definition

                                                                      The actual focus of an observation when it is not the patient of record representing something or someone associated with the patient such as a spouse, parent, fetus, or donor. For example, fetus observations in a mother's record. The focus of an observation could also be an existing condition, an intervention, the subject's diet, another observation of the subject, or a body structure such as tumor or implanted device. An example use case would be using the Observation resource to capture whether the mother is trained to change her child's tracheostomy tube. In this example, the child is the patient of record and the mother is the focus.

                                                                      ShortWhat the observation is about, when it is not about the subject of record
                                                                      Comments

                                                                      Typically, an observation is made about the subject - a patient, or group of patients, location, or device - and the distinction between the subject and what is directly measured for an observation is specified in the observation code itself ( e.g., "Blood Glucose") and does not need to be represented separately using this element. Use specimen if a reference to a specimen is required. If a code is required instead of a resource use either bodysite for bodysites or the standard extension focusCode.

                                                                      Control0..*
                                                                      TypeReference(Resource)
                                                                      Is Modifierfalse
                                                                      Summarytrue
                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                      80. Observation.encounter
                                                                      Definition

                                                                      The healthcare event (e.g. a patient and healthcare provider interaction) during which this observation is made.

                                                                      ShortHealthcare event during which this observation is made
                                                                      Comments

                                                                      This will typically be the encounter the event occurred within, but some events may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter (e.g. pre-admission laboratory tests).

                                                                      Control0..1
                                                                      TypeReference(Encounter)
                                                                      Is Modifierfalse
                                                                      Summarytrue
                                                                      Requirements

                                                                      For some observations it may be important to know the link between an observation and a particular encounter.

                                                                      Alternate NamesContext
                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                      82. Observation.effective[x]
                                                                      Definition

                                                                      The time or time-period the observed value is asserted as being true. For biological subjects - e.g. human patients - this is usually called the "physiologically relevant time". This is usually either the time of the procedure or of specimen collection, but very often the source of the date/time is not known, only the date/time itself.

                                                                      ShortClinically relevant time/time-period for observation
                                                                      Comments

                                                                      At least a date should be present unless this observation is a historical report. For recording imprecise or "fuzzy" times (For example, a blood glucose measurement taken "after breakfast") use the Timing datatype which allow the measurement to be tied to regular life events.

                                                                      Control1..1
                                                                      TypedateTime
                                                                      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                      Is Modifierfalse
                                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                      Summarytrue
                                                                      Requirements

                                                                      Knowing when an observation was deemed true is important to its relevance as well as determining trends.

                                                                      Alternate NamesOccurrence
                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                      SlicingThis element introduces a set of slices on Observation.effective[x]. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
                                                                      • type @ $this
                                                                      • 84. Observation.effective[x]:effectiveDateTime
                                                                        Slice NameeffectiveDateTime
                                                                        Definition

                                                                        The time or time-period the observed value is asserted as being true. For biological subjects - e.g. human patients - this is usually called the "physiologically relevant time". This is usually either the time of the procedure or of specimen collection, but very often the source of the date/time is not known, only the date/time itself.

                                                                        ShortClinically relevant time/time-period for observation
                                                                        Comments

                                                                        At least a date should be present unless this observation is a historical report. For recording imprecise or "fuzzy" times (For example, a blood glucose measurement taken "after breakfast") use the Timing datatype which allow the measurement to be tied to regular life events.

                                                                        Control1..1
                                                                        TypedateTime
                                                                        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                        Is Modifierfalse
                                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                        Summarytrue
                                                                        Requirements

                                                                        Knowing when an observation was deemed true is important to its relevance as well as determining trends.

                                                                        Alternate NamesOccurrence
                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        86. Observation.issued
                                                                        Definition

                                                                        The date and time this version of the observation was made available to providers, typically after the results have been reviewed and verified.

                                                                        ShortDate/Time this version was made available
                                                                        Comments

                                                                        For Observations that don’t require review and verification, it may be the same as the lastUpdated time of the resource itself. For Observations that do require review and verification for certain updates, it might not be the same as the lastUpdated time of the resource itself due to a non-clinically significant update that doesn’t require the new version to be reviewed and verified again.

                                                                        Control0..1
                                                                        Typeinstant
                                                                        Is Modifierfalse
                                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                        Summarytrue
                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        88. Observation.performer
                                                                        Definition

                                                                        Who was responsible for asserting the observed value as "true".

                                                                        ShortWho is responsible for the observation
                                                                        Control0..*
                                                                        TypeReference(Practitioner, PractitionerRole, Organization, CareTeam, Patient, RelatedPerson)
                                                                        Is Modifierfalse
                                                                        Summarytrue
                                                                        Requirements

                                                                        May give a degree of confidence in the observation and also indicates where follow-up questions should be directed.

                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        90. Observation.value[x]
                                                                        Definition

                                                                        The information determined as a result of making the observation, if the information has a simple value.

                                                                        ShortActual result
                                                                        Comments

                                                                        An observation may have; 1) a single value here, 2) both a value and a set of related or component values, or 3) only a set of related or component values. If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

                                                                        Control0..1
                                                                        This element is affected by the following invariants: obs-7
                                                                        TypeChoice of: Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period
                                                                        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                        Is Modifierfalse
                                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                        Summarytrue
                                                                        Requirements

                                                                        An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        92. Observation.dataAbsentReason
                                                                        Definition

                                                                        Provides a reason why the expected value in the element Observation.value[x] is missing.

                                                                        ShortWhy the result is missing
                                                                        Comments

                                                                        Null or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "specimen unsatisfactory".

                                                                        The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Note that an observation may only be reported if there are values to report. For example differential cell counts values may be reported only when > 0. Because of these options, use-case agreements are required to interpret general observations for null or exceptional values.

                                                                        Control0..1
                                                                        This element is affected by the following invariants: obs-6
                                                                        BindingUnless not suitable, these codes SHALL be taken from DataAbsentReason
                                                                        (extensible to http://hl7.org/fhir/ValueSet/data-absent-reason)

                                                                        Codes specifying why the result (Observation.value[x]) is missing.

                                                                        TypeCodeableConcept
                                                                        Is Modifierfalse
                                                                        Summaryfalse
                                                                        Requirements

                                                                        For many results it is necessary to handle exceptional values in measurements.

                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        94. Observation.interpretation
                                                                        Definition

                                                                        A categorical assessment of an observation value. For example, high, low, normal.

                                                                        ShortHigh, low, normal, etc.
                                                                        Comments

                                                                        Historically used for laboratory results (known as 'abnormal flag' ), its use extends to other use cases where coded interpretations are relevant. Often reported as one or more simple compact codes this element is often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result.

                                                                        Control0..*
                                                                        BindingUnless not suitable, these codes SHALL be taken from ObservationInterpretationCodes
                                                                        (extensible to http://hl7.org/fhir/ValueSet/observation-interpretation)

                                                                        Codes identifying interpretations of observations.

                                                                        TypeCodeableConcept
                                                                        Is Modifierfalse
                                                                        Summaryfalse
                                                                        Requirements

                                                                        For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.

                                                                        Alternate NamesAbnormal Flag
                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        96. Observation.note
                                                                        Definition

                                                                        Comments about the observation or the results.

                                                                        ShortComments about the observation
                                                                        Comments

                                                                        May include general statements about the observation, or statements about significant, unexpected or unreliable results values, or information about its source when relevant to its interpretation.

                                                                        Control0..*
                                                                        TypeAnnotation
                                                                        Is Modifierfalse
                                                                        Summaryfalse
                                                                        Requirements

                                                                        Need to be able to provide free text additional information.

                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        98. Observation.bodySite
                                                                        Definition

                                                                        Indicates the site on the subject's body where the observation was made (i.e. the target site).

                                                                        ShortObserved body part
                                                                        Comments

                                                                        Only used if not implicit in code found in Observation.code. In many systems, this may be represented as a related observation instead of an inline component.

                                                                        If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use the standard extension bodySite.

                                                                        Control0..1
                                                                        BindingFor example codes, see SNOMEDCTBodyStructures
                                                                        (example to http://hl7.org/fhir/ValueSet/body-site)

                                                                        Codes describing anatomical locations. May include laterality.

                                                                        TypeCodeableConcept
                                                                        Is Modifierfalse
                                                                        Summaryfalse
                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        100. Observation.method
                                                                        Definition

                                                                        Indicates the mechanism used to perform the observation.

                                                                        ShortHow it was done
                                                                        Comments

                                                                        Only used if not implicit in code for Observation.code.

                                                                        Control0..1
                                                                        BindingFor example codes, see ObservationMethods
                                                                        (example to http://hl7.org/fhir/ValueSet/observation-methods)

                                                                        Methods for simple observations.

                                                                        TypeCodeableConcept
                                                                        Is Modifierfalse
                                                                        Summaryfalse
                                                                        Requirements

                                                                        In some cases, method can impact results and is thus used for determining whether results can be compared or determining significance of results.

                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        102. Observation.specimen
                                                                        Definition

                                                                        The specimen that was used when this observation was made.

                                                                        ShortSpecimen used for this observation
                                                                        Comments

                                                                        Should only be used if not implicit in code found in Observation.code. Observations are not made on specimens themselves; they are made on a subject, but in many cases by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).

                                                                        Control0..1
                                                                        TypeReference(Specimen)
                                                                        Is Modifierfalse
                                                                        Summaryfalse
                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        104. Observation.device
                                                                        Definition

                                                                        The device used to generate the observation data.

                                                                        Short(Measurement) Device
                                                                        Comments

                                                                        Note that this is not meant to represent a device involved in the transmission of the result, e.g., a gateway. Such devices may be documented using the Provenance resource where relevant.

                                                                        Control0..1
                                                                        TypeReference(Device, DeviceMetric)
                                                                        Is Modifierfalse
                                                                        Summaryfalse
                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        106. Observation.referenceRange
                                                                        Definition

                                                                        Guidance on how to interpret the value by comparison to a normal or recommended range. Multiple reference ranges are interpreted as an "OR". In other words, to represent two distinct target populations, two referenceRange elements would be used.

                                                                        ShortProvides guide for interpretation
                                                                        Comments

                                                                        Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this might not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.

                                                                        Control0..*
                                                                        TypeBackboneElement
                                                                        Is Modifierfalse
                                                                        Summaryfalse
                                                                        Requirements

                                                                        Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.

                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        obs-3: Must have at least a low or a high or text (low.exists() or high.exists() or text.exists())
                                                                        108. Observation.referenceRange.id
                                                                        Definition

                                                                        Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                        ShortUnique id for inter-element referencing
                                                                        Control0..1
                                                                        Typestring
                                                                        Is Modifierfalse
                                                                        XML FormatIn the XML format, this property is represented as an attribute.
                                                                        Summaryfalse
                                                                        110. Observation.referenceRange.extension
                                                                        Definition

                                                                        May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                        ShortAdditional content defined by implementations
                                                                        Comments

                                                                        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                        Control0..*
                                                                        TypeExtension
                                                                        Is Modifierfalse
                                                                        Summaryfalse
                                                                        Alternate Namesextensions, user content
                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                        112. Observation.referenceRange.modifierExtension
                                                                        Definition

                                                                        May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                                                        Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                                        ShortExtensions that cannot be ignored even if unrecognized
                                                                        Comments

                                                                        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                        Control0..*
                                                                        TypeExtension
                                                                        Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                        Summarytrue
                                                                        Requirements

                                                                        Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                                        Alternate Namesextensions, user content, modifiers
                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                        114. Observation.referenceRange.low
                                                                        Definition

                                                                        The value of the low bound of the reference range. The low bound of the reference range endpoint is inclusive of the value (e.g. reference range is >=5 - <=9). If the low bound is omitted, it is assumed to be meaningless (e.g. reference range is <=2.3).

                                                                        ShortLow Range, if relevant
                                                                        Control0..1
                                                                        This element is affected by the following invariants: obs-3
                                                                        TypeQuantity(SimpleQuantity)
                                                                        Is Modifierfalse
                                                                        Summaryfalse
                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        116. Observation.referenceRange.high
                                                                        Definition

                                                                        The value of the high bound of the reference range. The high bound of the reference range endpoint is inclusive of the value (e.g. reference range is >=5 - <=9). If the high bound is omitted, it is assumed to be meaningless (e.g. reference range is >= 2.3).

                                                                        ShortHigh Range, if relevant
                                                                        Control0..1
                                                                        This element is affected by the following invariants: obs-3
                                                                        TypeQuantity(SimpleQuantity)
                                                                        Is Modifierfalse
                                                                        Summaryfalse
                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        118. Observation.referenceRange.type
                                                                        Definition

                                                                        Codes to indicate the what part of the targeted reference population it applies to. For example, the normal or therapeutic range.

                                                                        ShortReference range qualifier
                                                                        Comments

                                                                        This SHOULD be populated if there is more than one range. If this element is not present then the normal range is assumed.

                                                                        Control0..1
                                                                        BindingThe codes SHOULD be taken from ObservationReferenceRangeMeaningCodes
                                                                        (preferred to http://hl7.org/fhir/ValueSet/referencerange-meaning)

                                                                        Code for the meaning of a reference range.

                                                                        TypeCodeableConcept
                                                                        Is Modifierfalse
                                                                        Summaryfalse
                                                                        Requirements

                                                                        Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc., - for proper interpretation.

                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        120. Observation.referenceRange.appliesTo
                                                                        Definition

                                                                        Codes to indicate the target population this reference range applies to. For example, a reference range may be based on the normal population or a particular sex or race. Multiple appliesTo are interpreted as an "AND" of the target populations. For example, to represent a target population of African American females, both a code of female and a code for African American would be used.

                                                                        ShortReference range population
                                                                        Comments

                                                                        This SHOULD be populated if there is more than one range. If this element is not present then the normal population is assumed.

                                                                        Control0..*
                                                                        BindingFor example codes, see ObservationReferenceRangeAppliesToCodes
                                                                        (example to http://hl7.org/fhir/ValueSet/referencerange-appliesto)

                                                                        Codes identifying the population the reference range applies to.

                                                                        TypeCodeableConcept
                                                                        Is Modifierfalse
                                                                        Summaryfalse
                                                                        Requirements

                                                                        Need to be able to identify the target population for proper interpretation.

                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        122. Observation.referenceRange.age
                                                                        Definition

                                                                        The age at which this reference range is applicable. This is a neonatal age (e.g. number of weeks at term) if the meaning says so.

                                                                        ShortApplicable age range, if relevant
                                                                        Control0..1
                                                                        TypeRange
                                                                        Is Modifierfalse
                                                                        Summaryfalse
                                                                        Requirements

                                                                        Some analytes vary greatly over age.

                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        124. Observation.referenceRange.text
                                                                        Definition

                                                                        Text based reference range in an observation which may be used when a quantitative range is not appropriate for an observation. An example would be a reference value of "Negative" or a list or table of "normals".

                                                                        ShortText based reference range in an observation
                                                                        Control0..1
                                                                        Typestring
                                                                        Is Modifierfalse
                                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                        Summaryfalse
                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        126. Observation.hasMember
                                                                        Definition

                                                                        This observation is a group observation (e.g. a battery, a panel of tests, a set of vital sign measurements) that includes the target as a member of the group.

                                                                        ShortRelated resource that belongs to the Observation group
                                                                        Comments

                                                                        When using this element, an observation will typically have either a value or a set of related resources, although both may be present in some cases. For a discussion on the ways Observations can assembled in groups together, see Notes below. Note that a system may calculate results from QuestionnaireResponse into a final score and represent the score as an Observation.

                                                                        Control0..*
                                                                        TypeReference(Observation, QuestionnaireResponse, MolecularSequence)
                                                                        Is Modifierfalse
                                                                        Summarytrue
                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        128. Observation.derivedFrom
                                                                        Definition

                                                                        The target resource that represents a measurement from which this observation value is derived. For example, a calculated anion gap or a fetal measurement based on an ultrasound image.

                                                                        ShortRelated measurements the observation is made from
                                                                        Comments

                                                                        All the reference choices that are listed in this element can represent clinical observations and other measurements that may be the source for a derived value. The most common reference will be another Observation. For a discussion on the ways Observations can assembled in groups together, see Notes below.

                                                                        Control0..*
                                                                        TypeReference(DocumentReference, ImagingStudy, Media, QuestionnaireResponse, Observation, MolecularSequence)
                                                                        Is Modifierfalse
                                                                        Summarytrue
                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        130. Observation.component
                                                                        Definition

                                                                        Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.

                                                                        ShortComponent results
                                                                        Comments

                                                                        For a discussion on the ways Observations can be assembled in groups together see Notes below.

                                                                        Control10..*
                                                                        TypeBackboneElement
                                                                        Is Modifierfalse
                                                                        Summarytrue
                                                                        Requirements

                                                                        Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        SlicingThis element introduces a set of slices on Observation.component. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                        • value @ code
                                                                        • 132. Observation.component.id
                                                                          Definition

                                                                          Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                          ShortUnique id for inter-element referencing
                                                                          Control0..1
                                                                          Typestring
                                                                          Is Modifierfalse
                                                                          XML FormatIn the XML format, this property is represented as an attribute.
                                                                          Summaryfalse
                                                                          134. Observation.component.extension
                                                                          Definition

                                                                          May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                          ShortAdditional content defined by implementations
                                                                          Comments

                                                                          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                          Control0..*
                                                                          TypeExtension
                                                                          Is Modifierfalse
                                                                          Summaryfalse
                                                                          Alternate Namesextensions, user content
                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                          136. Observation.component.modifierExtension
                                                                          Definition

                                                                          May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                                                          Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                                          ShortExtensions that cannot be ignored even if unrecognized
                                                                          Comments

                                                                          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                          Control0..*
                                                                          TypeExtension
                                                                          Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                          Summarytrue
                                                                          Requirements

                                                                          Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                                          Alternate Namesextensions, user content, modifiers
                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                          138. Observation.component.code
                                                                          Definition

                                                                          Describes what was observed. Sometimes this is called the observation "code".

                                                                          ShortType of component observation (code / type)
                                                                          Comments

                                                                          All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

                                                                          Control1..1
                                                                          BindingFor example codes, see LOINCCodes
                                                                          (example to http://hl7.org/fhir/ValueSet/observation-codes)

                                                                          Codes identifying names of simple observations.

                                                                          TypeCodeableConcept
                                                                          Is Modifierfalse
                                                                          Summarytrue
                                                                          Requirements

                                                                          Knowing what kind of observation is being made is essential to understanding the observation.

                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                          140. Observation.component.value[x]
                                                                          Definition

                                                                          The information determined as a result of making the observation, if the information has a simple value.

                                                                          ShortActual component result
                                                                          Comments

                                                                          Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

                                                                          Control0..1
                                                                          TypeChoice of: Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period
                                                                          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                          Is Modifierfalse
                                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                          Summarytrue
                                                                          Requirements

                                                                          An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                          142. Observation.component.dataAbsentReason
                                                                          Definition

                                                                          Provides a reason why the expected value in the element Observation.component.value[x] is missing.

                                                                          ShortWhy the component result is missing
                                                                          Comments

                                                                          "Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done".

                                                                          The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

                                                                          Control0..1
                                                                          This element is affected by the following invariants: obs-6
                                                                          BindingUnless not suitable, these codes SHALL be taken from DataAbsentReason
                                                                          (extensible to http://hl7.org/fhir/ValueSet/data-absent-reason)

                                                                          Codes specifying why the result (Observation.value[x]) is missing.

                                                                          TypeCodeableConcept
                                                                          Is Modifierfalse
                                                                          Summaryfalse
                                                                          Requirements

                                                                          For many results it is necessary to handle exceptional values in measurements.

                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                          144. Observation.component.interpretation
                                                                          Definition

                                                                          A categorical assessment of an observation value. For example, high, low, normal.

                                                                          ShortHigh, low, normal, etc.
                                                                          Comments

                                                                          Historically used for laboratory results (known as 'abnormal flag' ), its use extends to other use cases where coded interpretations are relevant. Often reported as one or more simple compact codes this element is often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result.

                                                                          Control0..*
                                                                          BindingUnless not suitable, these codes SHALL be taken from ObservationInterpretationCodes
                                                                          (extensible to http://hl7.org/fhir/ValueSet/observation-interpretation)

                                                                          Codes identifying interpretations of observations.

                                                                          TypeCodeableConcept
                                                                          Is Modifierfalse
                                                                          Summaryfalse
                                                                          Requirements

                                                                          For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.

                                                                          Alternate NamesAbnormal Flag
                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                          146. Observation.component.referenceRange
                                                                          Definition

                                                                          Guidance on how to interpret the value by comparison to a normal or recommended range.

                                                                          ShortProvides guide for interpretation of component result
                                                                          Comments

                                                                          Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this might not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.

                                                                          Control0..*
                                                                          TypeSeettp://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange
                                                                          Is Modifierfalse
                                                                          Summaryfalse
                                                                          Requirements

                                                                          Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.

                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                          148. Observation.component:numberOfExerciseRepetitionsCompleted
                                                                          Slice NamenumberOfExerciseRepetitionsCompleted
                                                                          Definition

                                                                          Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.

                                                                          ShortComponent results
                                                                          Comments

                                                                          For a discussion on the ways Observations can be assembled in groups together see Notes below.

                                                                          Control1..1
                                                                          TypeBackboneElement
                                                                          Is Modifierfalse
                                                                          Summarytrue
                                                                          Requirements

                                                                          Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                          150. Observation.component:numberOfExerciseRepetitionsCompleted.id
                                                                          Definition

                                                                          Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                          ShortUnique id for inter-element referencing
                                                                          Control0..1
                                                                          Typestring
                                                                          Is Modifierfalse
                                                                          XML FormatIn the XML format, this property is represented as an attribute.
                                                                          Summaryfalse
                                                                          152. Observation.component:numberOfExerciseRepetitionsCompleted.extension
                                                                          Definition

                                                                          May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                          ShortAdditional content defined by implementations
                                                                          Comments

                                                                          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                          Control0..*
                                                                          TypeExtension
                                                                          Is Modifierfalse
                                                                          Summaryfalse
                                                                          Alternate Namesextensions, user content
                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                          154. Observation.component:numberOfExerciseRepetitionsCompleted.modifierExtension
                                                                          Definition

                                                                          May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                                                          Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                                          ShortExtensions that cannot be ignored even if unrecognized
                                                                          Comments

                                                                          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                          Control0..*
                                                                          TypeExtension
                                                                          Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                          Summarytrue
                                                                          Requirements

                                                                          Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                                          Alternate Namesextensions, user content, modifiers
                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                          156. Observation.component:numberOfExerciseRepetitionsCompleted.code
                                                                          Definition

                                                                          Describes what was observed. Sometimes this is called the observation "code".

                                                                          ShortType of component observation (code / type)
                                                                          Comments

                                                                          All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

                                                                          Control1..1
                                                                          BindingFor example codes, see LOINCCodes
                                                                          (example to http://hl7.org/fhir/ValueSet/observation-codes)

                                                                          Codes identifying names of simple observations.

                                                                          TypeCodeableConcept
                                                                          Is Modifierfalse
                                                                          Summarytrue
                                                                          Requirements

                                                                          Knowing what kind of observation is being made is essential to understanding the observation.

                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                          158. Observation.component:numberOfExerciseRepetitionsCompleted.code.id
                                                                          Definition

                                                                          Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                          ShortUnique id for inter-element referencing
                                                                          Control0..1
                                                                          Typestring
                                                                          Is Modifierfalse
                                                                          XML FormatIn the XML format, this property is represented as an attribute.
                                                                          Summaryfalse
                                                                          160. Observation.component:numberOfExerciseRepetitionsCompleted.code.extension
                                                                          Definition

                                                                          May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                          ShortAdditional content defined by implementations
                                                                          Comments

                                                                          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                          Control0..*
                                                                          TypeExtension
                                                                          Is Modifierfalse
                                                                          Summaryfalse
                                                                          Alternate Namesextensions, user content
                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                          SlicingThis element introduces a set of slices on Observation.component.code.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                          • value @ url
                                                                          • 162. Observation.component:numberOfExerciseRepetitionsCompleted.code.coding
                                                                            Definition

                                                                            A reference to a code defined by a terminology system.

                                                                            ShortCode defined by a terminology system
                                                                            Comments

                                                                            Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                                                                            Control0..*
                                                                            TypeCoding
                                                                            Is Modifierfalse
                                                                            Summarytrue
                                                                            Requirements

                                                                            Allows for alternative encodings within a code system, and translations to other code systems.

                                                                            Pattern Value{
                                                                              "system" : "http://snomed.info/sct",
                                                                              "code" : "1202026006",
                                                                              "display" : "Number of exercise repetitions completed"
                                                                            }
                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            164. Observation.component:numberOfExerciseRepetitionsCompleted.code.coding.id
                                                                            Definition

                                                                            Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                            ShortUnique id for inter-element referencing
                                                                            Control0..1
                                                                            Typestring
                                                                            Is Modifierfalse
                                                                            XML FormatIn the XML format, this property is represented as an attribute.
                                                                            Summaryfalse
                                                                            166. Observation.component:numberOfExerciseRepetitionsCompleted.code.coding.extension
                                                                            Definition

                                                                            May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                            ShortAdditional content defined by implementations
                                                                            Comments

                                                                            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                            Control0..*
                                                                            TypeExtension
                                                                            Is Modifierfalse
                                                                            Summaryfalse
                                                                            Alternate Namesextensions, user content
                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                            SlicingThis element introduces a set of slices on Observation.component.code.coding.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                            • value @ url
                                                                            • 168. Observation.component:numberOfExerciseRepetitionsCompleted.code.coding.system
                                                                              Definition

                                                                              The identification of the code system that defines the meaning of the symbol in the code.

                                                                              ShortIdentity of the terminology system
                                                                              Comments

                                                                              The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

                                                                              Control0..1
                                                                              Typeuri
                                                                              Is Modifierfalse
                                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                              Summarytrue
                                                                              Requirements

                                                                              Need to be unambiguous about the source of the definition of the symbol.

                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                              170. Observation.component:numberOfExerciseRepetitionsCompleted.code.coding.version
                                                                              Definition

                                                                              The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

                                                                              ShortVersion of the system - if relevant
                                                                              Comments

                                                                              Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

                                                                              NoteThis is a business version Id, not a resource version Id (see discussion)
                                                                              Control0..1
                                                                              Typestring
                                                                              Is Modifierfalse
                                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                              Summarytrue
                                                                              Pattern Valuehttp://snomed.info/sct/900000000000207008/version/20220228
                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                              172. Observation.component:numberOfExerciseRepetitionsCompleted.code.coding.code
                                                                              Definition

                                                                              A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

                                                                              ShortSymbol in syntax defined by the system
                                                                              Control0..1
                                                                              Typecode
                                                                              Is Modifierfalse
                                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                              Summarytrue
                                                                              Requirements

                                                                              Need to refer to a particular code in the system.

                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                              174. Observation.component:numberOfExerciseRepetitionsCompleted.code.coding.display
                                                                              Definition

                                                                              A representation of the meaning of the code in the system, following the rules of the system.

                                                                              ShortRepresentation defined by the system
                                                                              Control0..1
                                                                              Typestring
                                                                              Is Modifierfalse
                                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                              Summarytrue
                                                                              Requirements

                                                                              Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                              176. Observation.component:numberOfExerciseRepetitionsCompleted.code.coding.userSelected
                                                                              Definition

                                                                              Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).

                                                                              ShortIf this coding was chosen directly by the user
                                                                              Comments

                                                                              Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

                                                                              Control0..1
                                                                              Typeboolean
                                                                              Is Modifierfalse
                                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                              Summarytrue
                                                                              Requirements

                                                                              This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                              178. Observation.component:numberOfExerciseRepetitionsCompleted.code.text
                                                                              Definition

                                                                              A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

                                                                              ShortPlain text representation of the concept
                                                                              Comments

                                                                              Very often the text is the same as a displayName of one of the codings.

                                                                              Control0..1
                                                                              Typestring
                                                                              Is Modifierfalse
                                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                              Summarytrue
                                                                              Requirements

                                                                              The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

                                                                              Pattern ValueTotal number of head movements performed
                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                              180. Observation.component:numberOfExerciseRepetitionsCompleted.value[x]
                                                                              Definition

                                                                              The information determined as a result of making the observation, if the information has a simple value.

                                                                              ShortActual component result
                                                                              Comments

                                                                              Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

                                                                              Control0..1
                                                                              TypeChoice of: Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period
                                                                              [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                              Is Modifierfalse
                                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                              Summarytrue
                                                                              Requirements

                                                                              An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                              SlicingThis element introduces a set of slices on Observation.component.value[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                              • type @ $this
                                                                              • 182. Observation.component:numberOfExerciseRepetitionsCompleted.value[x]:valueQuantity
                                                                                Slice NamevalueQuantity
                                                                                Definition

                                                                                The information determined as a result of making the observation, if the information has a simple value.

                                                                                ShortActual component result
                                                                                Comments

                                                                                Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

                                                                                Control0..1
                                                                                TypeQuantity
                                                                                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                Is Modifierfalse
                                                                                Summarytrue
                                                                                Requirements

                                                                                An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                                                                                Pattern Value{
                                                                                  "value" : 0,
                                                                                  "unit" : "Number",
                                                                                  "system" : "http://unitsofmeasure.org",
                                                                                  "code" : "#"
                                                                                }
                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                184. Observation.component:numberOfExerciseRepetitionsCompleted.dataAbsentReason
                                                                                Definition

                                                                                Provides a reason why the expected value in the element Observation.component.value[x] is missing.

                                                                                ShortWhy the component result is missing
                                                                                Comments

                                                                                "Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done".

                                                                                The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

                                                                                Control0..1
                                                                                This element is affected by the following invariants: obs-6
                                                                                BindingUnless not suitable, these codes SHALL be taken from DataAbsentReason
                                                                                (extensible to http://hl7.org/fhir/ValueSet/data-absent-reason)

                                                                                Codes specifying why the result (Observation.value[x]) is missing.

                                                                                TypeCodeableConcept
                                                                                Is Modifierfalse
                                                                                Summaryfalse
                                                                                Requirements

                                                                                For many results it is necessary to handle exceptional values in measurements.

                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                186. Observation.component:numberOfExerciseRepetitionsCompleted.interpretation
                                                                                Definition

                                                                                A categorical assessment of an observation value. For example, high, low, normal.

                                                                                ShortHigh, low, normal, etc.
                                                                                Comments

                                                                                Historically used for laboratory results (known as 'abnormal flag' ), its use extends to other use cases where coded interpretations are relevant. Often reported as one or more simple compact codes this element is often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result.

                                                                                Control0..*
                                                                                BindingUnless not suitable, these codes SHALL be taken from ObservationInterpretationCodes
                                                                                (extensible to http://hl7.org/fhir/ValueSet/observation-interpretation)

                                                                                Codes identifying interpretations of observations.

                                                                                TypeCodeableConcept
                                                                                Is Modifierfalse
                                                                                Summaryfalse
                                                                                Requirements

                                                                                For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.

                                                                                Alternate NamesAbnormal Flag
                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                188. Observation.component:numberOfExerciseRepetitionsCompleted.referenceRange
                                                                                Definition

                                                                                Guidance on how to interpret the value by comparison to a normal or recommended range.

                                                                                ShortProvides guide for interpretation of component result
                                                                                Comments

                                                                                Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this might not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.

                                                                                Control0..*
                                                                                TypeSeettp://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange
                                                                                Is Modifierfalse
                                                                                Summaryfalse
                                                                                Requirements

                                                                                Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.

                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                190. Observation.component:sagittalPlaneBodyPosition
                                                                                Slice NamesagittalPlaneBodyPosition
                                                                                Definition

                                                                                Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.

                                                                                ShortComponent results
                                                                                Comments

                                                                                For a discussion on the ways Observations can be assembled in groups together see Notes below.

                                                                                Control1..1
                                                                                TypeBackboneElement
                                                                                Is Modifierfalse
                                                                                Summarytrue
                                                                                Requirements

                                                                                Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                192. Observation.component:sagittalPlaneBodyPosition.id
                                                                                Definition

                                                                                Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                ShortUnique id for inter-element referencing
                                                                                Control0..1
                                                                                Typestring
                                                                                Is Modifierfalse
                                                                                XML FormatIn the XML format, this property is represented as an attribute.
                                                                                Summaryfalse
                                                                                194. Observation.component:sagittalPlaneBodyPosition.extension
                                                                                Definition

                                                                                May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                                ShortAdditional content defined by implementations
                                                                                Comments

                                                                                There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                Control0..*
                                                                                TypeExtension
                                                                                Is Modifierfalse
                                                                                Summaryfalse
                                                                                Alternate Namesextensions, user content
                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                196. Observation.component:sagittalPlaneBodyPosition.modifierExtension
                                                                                Definition

                                                                                May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                                                                Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                                                ShortExtensions that cannot be ignored even if unrecognized
                                                                                Comments

                                                                                There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                Control0..*
                                                                                TypeExtension
                                                                                Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                                Summarytrue
                                                                                Requirements

                                                                                Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                                                Alternate Namesextensions, user content, modifiers
                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                198. Observation.component:sagittalPlaneBodyPosition.code
                                                                                Definition

                                                                                Describes what was observed. Sometimes this is called the observation "code".

                                                                                ShortType of component observation (code / type)
                                                                                Comments

                                                                                All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

                                                                                Control1..1
                                                                                BindingFor example codes, see LOINCCodes
                                                                                (example to http://hl7.org/fhir/ValueSet/observation-codes)

                                                                                Codes identifying names of simple observations.

                                                                                TypeCodeableConcept
                                                                                Is Modifierfalse
                                                                                Summarytrue
                                                                                Requirements

                                                                                Knowing what kind of observation is being made is essential to understanding the observation.

                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                200. Observation.component:sagittalPlaneBodyPosition.code.id
                                                                                Definition

                                                                                Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                ShortUnique id for inter-element referencing
                                                                                Control0..1
                                                                                Typestring
                                                                                Is Modifierfalse
                                                                                XML FormatIn the XML format, this property is represented as an attribute.
                                                                                Summaryfalse
                                                                                202. Observation.component:sagittalPlaneBodyPosition.code.extension
                                                                                Definition

                                                                                May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                                ShortAdditional content defined by implementations
                                                                                Comments

                                                                                There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                Control0..*
                                                                                TypeExtension
                                                                                Is Modifierfalse
                                                                                Summaryfalse
                                                                                Alternate Namesextensions, user content
                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                SlicingThis element introduces a set of slices on Observation.component.code.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                • value @ url
                                                                                • 204. Observation.component:sagittalPlaneBodyPosition.code.coding
                                                                                  Definition

                                                                                  A reference to a code defined by a terminology system.

                                                                                  ShortCode defined by a terminology system
                                                                                  Comments

                                                                                  Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                                                                                  Control0..*
                                                                                  TypeCoding
                                                                                  Is Modifierfalse
                                                                                  Summarytrue
                                                                                  Requirements

                                                                                  Allows for alternative encodings within a code system, and translations to other code systems.

                                                                                  Pattern Value{
                                                                                    "system" : "http://loinc.org",
                                                                                    "code" : "72282-7",
                                                                                    "display" : "Sagittal plane body position"
                                                                                  }
                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  206. Observation.component:sagittalPlaneBodyPosition.code.coding.id
                                                                                  Definition

                                                                                  Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                  ShortUnique id for inter-element referencing
                                                                                  Control0..1
                                                                                  Typestring
                                                                                  Is Modifierfalse
                                                                                  XML FormatIn the XML format, this property is represented as an attribute.
                                                                                  Summaryfalse
                                                                                  208. Observation.component:sagittalPlaneBodyPosition.code.coding.extension
                                                                                  Definition

                                                                                  May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                                  ShortAdditional content defined by implementations
                                                                                  Comments

                                                                                  There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                  Control0..*
                                                                                  TypeExtension
                                                                                  Is Modifierfalse
                                                                                  Summaryfalse
                                                                                  Alternate Namesextensions, user content
                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                  SlicingThis element introduces a set of slices on Observation.component.code.coding.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                  • value @ url
                                                                                  • 210. Observation.component:sagittalPlaneBodyPosition.code.coding.system
                                                                                    Definition

                                                                                    The identification of the code system that defines the meaning of the symbol in the code.

                                                                                    ShortIdentity of the terminology system
                                                                                    Comments

                                                                                    The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

                                                                                    Control0..1
                                                                                    Typeuri
                                                                                    Is Modifierfalse
                                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                    Summarytrue
                                                                                    Requirements

                                                                                    Need to be unambiguous about the source of the definition of the symbol.

                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                    212. Observation.component:sagittalPlaneBodyPosition.code.coding.version
                                                                                    Definition

                                                                                    The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

                                                                                    ShortVersion of the system - if relevant
                                                                                    Comments

                                                                                    Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

                                                                                    NoteThis is a business version Id, not a resource version Id (see discussion)
                                                                                    Control0..1
                                                                                    Typestring
                                                                                    Is Modifierfalse
                                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                    Summarytrue
                                                                                    Pattern Value2.69
                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                    214. Observation.component:sagittalPlaneBodyPosition.code.coding.code
                                                                                    Definition

                                                                                    A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

                                                                                    ShortSymbol in syntax defined by the system
                                                                                    Control0..1
                                                                                    Typecode
                                                                                    Is Modifierfalse
                                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                    Summarytrue
                                                                                    Requirements

                                                                                    Need to refer to a particular code in the system.

                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                    216. Observation.component:sagittalPlaneBodyPosition.code.coding.display
                                                                                    Definition

                                                                                    A representation of the meaning of the code in the system, following the rules of the system.

                                                                                    ShortRepresentation defined by the system
                                                                                    Control0..1
                                                                                    Typestring
                                                                                    Is Modifierfalse
                                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                    Summarytrue
                                                                                    Requirements

                                                                                    Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                    218. Observation.component:sagittalPlaneBodyPosition.code.coding.userSelected
                                                                                    Definition

                                                                                    Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).

                                                                                    ShortIf this coding was chosen directly by the user
                                                                                    Comments

                                                                                    Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

                                                                                    Control0..1
                                                                                    Typeboolean
                                                                                    Is Modifierfalse
                                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                    Summarytrue
                                                                                    Requirements

                                                                                    This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                    220. Observation.component:sagittalPlaneBodyPosition.code.text
                                                                                    Definition

                                                                                    A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

                                                                                    ShortPlain text representation of the concept
                                                                                    Comments

                                                                                    Very often the text is the same as a displayName of one of the codings.

                                                                                    Control0..1
                                                                                    Typestring
                                                                                    Is Modifierfalse
                                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                    Summarytrue
                                                                                    Requirements

                                                                                    The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                    222. Observation.component:sagittalPlaneBodyPosition.value[x]
                                                                                    Definition

                                                                                    The information determined as a result of making the observation, if the information has a simple value.

                                                                                    ShortActual component result
                                                                                    Comments

                                                                                    Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

                                                                                    Control0..1
                                                                                    TypeChoice of: Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period
                                                                                    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                    Is Modifierfalse
                                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                    Summarytrue
                                                                                    Requirements

                                                                                    An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                    SlicingThis element introduces a set of slices on Observation.component.value[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                    • type @ $this
                                                                                    • 224. Observation.component:sagittalPlaneBodyPosition.value[x]:valueSampledData
                                                                                      Slice NamevalueSampledData
                                                                                      Definition

                                                                                      The information determined as a result of making the observation, if the information has a simple value.

                                                                                      ShortActual component result
                                                                                      Comments

                                                                                      Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

                                                                                      Control0..1
                                                                                      TypeSampledData
                                                                                      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                      Is Modifierfalse
                                                                                      Summarytrue
                                                                                      Requirements

                                                                                      An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                      226. Observation.component:sagittalPlaneBodyPosition.value[x]:valueSampledData.id
                                                                                      Definition

                                                                                      Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                      ShortUnique id for inter-element referencing
                                                                                      Control0..1
                                                                                      Typestring
                                                                                      Is Modifierfalse
                                                                                      XML FormatIn the XML format, this property is represented as an attribute.
                                                                                      Summaryfalse
                                                                                      228. Observation.component:sagittalPlaneBodyPosition.value[x]:valueSampledData.extension
                                                                                      Definition

                                                                                      May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                                      ShortAdditional content defined by implementations
                                                                                      Comments

                                                                                      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                      Control0..*
                                                                                      TypeExtension
                                                                                      Is Modifierfalse
                                                                                      Summaryfalse
                                                                                      Alternate Namesextensions, user content
                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                      SlicingThis element introduces a set of slices on Observation.component.value[x].extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                      • value @ url
                                                                                      • 230. Observation.component:sagittalPlaneBodyPosition.value[x]:valueSampledData.origin
                                                                                        Definition

                                                                                        The base quantity that a measured value of zero represents. In addition, this provides the units of the entire measurement series.

                                                                                        ShortZero value and units
                                                                                        Control1..1
                                                                                        TypeQuantity(SimpleQuantity)
                                                                                        Is Modifierfalse
                                                                                        Summarytrue
                                                                                        Pattern Value{
                                                                                          "unit" : "degree",
                                                                                          "system" : "http://unitsofmeasure.org",
                                                                                          "code" : "deg"
                                                                                        }
                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                        232. Observation.component:sagittalPlaneBodyPosition.value[x]:valueSampledData.period
                                                                                        Definition

                                                                                        The length of time between sampling times, measured in milliseconds.

                                                                                        ShortNumber of milliseconds between samples
                                                                                        Comments

                                                                                        This is usually a whole number.

                                                                                        Control1..1
                                                                                        Typedecimal
                                                                                        Is Modifierfalse
                                                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                        Summarytrue
                                                                                        Pattern Value15000
                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                        234. Observation.component:sagittalPlaneBodyPosition.value[x]:valueSampledData.factor
                                                                                        Definition

                                                                                        A correction factor that is applied to the sampled data points before they are added to the origin.

                                                                                        ShortMultiply data by this before adding to origin
                                                                                        Control0..1
                                                                                        Typedecimal
                                                                                        Is Modifierfalse
                                                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                        Summarytrue
                                                                                        Meaning if MissingIf no factor is assigned, the data is not adjusted before adding to the origin
                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                        236. Observation.component:sagittalPlaneBodyPosition.value[x]:valueSampledData.lowerLimit
                                                                                        Definition

                                                                                        The lower limit of detection of the measured points. This is needed if any of the data points have the value "L" (lower than detection limit).

                                                                                        ShortLower limit of detection
                                                                                        Control0..1
                                                                                        Typedecimal
                                                                                        Is Modifierfalse
                                                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                        Summarytrue
                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                        238. Observation.component:sagittalPlaneBodyPosition.value[x]:valueSampledData.upperLimit
                                                                                        Definition

                                                                                        The upper limit of detection of the measured points. This is needed if any of the data points have the value "U" (higher than detection limit).

                                                                                        ShortUpper limit of detection
                                                                                        Control0..1
                                                                                        Typedecimal
                                                                                        Is Modifierfalse
                                                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                        Summarytrue
                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                        240. Observation.component:sagittalPlaneBodyPosition.value[x]:valueSampledData.dimensions
                                                                                        Definition

                                                                                        The number of sample points at each time point. If this value is greater than one, then the dimensions will be interlaced - all the sample points for a point in time will be recorded at once.

                                                                                        ShortNumber of sample points at each time point
                                                                                        Comments

                                                                                        If there is more than one dimension, the code for the type of data will define the meaning of the dimensions (typically ECG data).

                                                                                        Control1..1
                                                                                        TypepositiveInt
                                                                                        Is Modifierfalse
                                                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                        Summarytrue
                                                                                        Pattern Value1
                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                        242. Observation.component:sagittalPlaneBodyPosition.value[x]:valueSampledData.data
                                                                                        Definition

                                                                                        A series of data points which are decimal values separated by a single space (character u20). The special values "E" (error), "L" (below detection limit) and "U" (above detection limit) can also be used in place of a decimal value.

                                                                                        ShortDecimal values with spaces, or "E" | "U" | "L"
                                                                                        Comments

                                                                                        Data may be missing if it is omitted for summarization purposes. In general, data is required for any actual use of a SampledData.

                                                                                        Control0..1
                                                                                        Typestring
                                                                                        Is Modifierfalse
                                                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                        Summaryfalse
                                                                                        Pattern Value<<posture|FlattenedArrayOddRemoved>>
                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                        244. Observation.component:sagittalPlaneBodyPosition.dataAbsentReason
                                                                                        Definition

                                                                                        Provides a reason why the expected value in the element Observation.component.value[x] is missing.

                                                                                        ShortWhy the component result is missing
                                                                                        Comments

                                                                                        "Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done".

                                                                                        The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

                                                                                        Control0..1
                                                                                        This element is affected by the following invariants: obs-6
                                                                                        BindingUnless not suitable, these codes SHALL be taken from DataAbsentReason
                                                                                        (extensible to http://hl7.org/fhir/ValueSet/data-absent-reason)

                                                                                        Codes specifying why the result (Observation.value[x]) is missing.

                                                                                        TypeCodeableConcept
                                                                                        Is Modifierfalse
                                                                                        Summaryfalse
                                                                                        Requirements

                                                                                        For many results it is necessary to handle exceptional values in measurements.

                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                        246. Observation.component:sagittalPlaneBodyPosition.interpretation
                                                                                        Definition

                                                                                        A categorical assessment of an observation value. For example, high, low, normal.

                                                                                        ShortHigh, low, normal, etc.
                                                                                        Comments

                                                                                        Historically used for laboratory results (known as 'abnormal flag' ), its use extends to other use cases where coded interpretations are relevant. Often reported as one or more simple compact codes this element is often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result.

                                                                                        Control0..*
                                                                                        BindingUnless not suitable, these codes SHALL be taken from ObservationInterpretationCodes
                                                                                        (extensible to http://hl7.org/fhir/ValueSet/observation-interpretation)

                                                                                        Codes identifying interpretations of observations.

                                                                                        TypeCodeableConcept
                                                                                        Is Modifierfalse
                                                                                        Summaryfalse
                                                                                        Requirements

                                                                                        For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.

                                                                                        Alternate NamesAbnormal Flag
                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                        248. Observation.component:sagittalPlaneBodyPosition.referenceRange
                                                                                        Definition

                                                                                        Guidance on how to interpret the value by comparison to a normal or recommended range.

                                                                                        ShortProvides guide for interpretation of component result
                                                                                        Comments

                                                                                        Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this might not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.

                                                                                        Control0..*
                                                                                        TypeSeettp://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange
                                                                                        Is Modifierfalse
                                                                                        Summaryfalse
                                                                                        Requirements

                                                                                        Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.

                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                        250. Observation.component:timeSpentExercising
                                                                                        Slice NametimeSpentExercising
                                                                                        Definition

                                                                                        Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.

                                                                                        ShortComponent results
                                                                                        Comments

                                                                                        For a discussion on the ways Observations can be assembled in groups together see Notes below.

                                                                                        Control1..1
                                                                                        TypeBackboneElement
                                                                                        Is Modifierfalse
                                                                                        Summarytrue
                                                                                        Requirements

                                                                                        Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                        252. Observation.component:timeSpentExercising.id
                                                                                        Definition

                                                                                        Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                        ShortUnique id for inter-element referencing
                                                                                        Control0..1
                                                                                        Typestring
                                                                                        Is Modifierfalse
                                                                                        XML FormatIn the XML format, this property is represented as an attribute.
                                                                                        Summaryfalse
                                                                                        254. Observation.component:timeSpentExercising.extension
                                                                                        Definition

                                                                                        May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                                        ShortAdditional content defined by implementations
                                                                                        Comments

                                                                                        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                        Control0..*
                                                                                        TypeExtension
                                                                                        Is Modifierfalse
                                                                                        Summaryfalse
                                                                                        Alternate Namesextensions, user content
                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                        256. Observation.component:timeSpentExercising.modifierExtension
                                                                                        Definition

                                                                                        May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                                                                        Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                                                        ShortExtensions that cannot be ignored even if unrecognized
                                                                                        Comments

                                                                                        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                        Control0..*
                                                                                        TypeExtension
                                                                                        Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                                        Summarytrue
                                                                                        Requirements

                                                                                        Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                                                        Alternate Namesextensions, user content, modifiers
                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                        258. Observation.component:timeSpentExercising.code
                                                                                        Definition

                                                                                        Describes what was observed. Sometimes this is called the observation "code".

                                                                                        ShortType of component observation (code / type)
                                                                                        Comments

                                                                                        All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

                                                                                        Control1..1
                                                                                        BindingFor example codes, see LOINCCodes
                                                                                        (example to http://hl7.org/fhir/ValueSet/observation-codes)

                                                                                        Codes identifying names of simple observations.

                                                                                        TypeCodeableConcept
                                                                                        Is Modifierfalse
                                                                                        Summarytrue
                                                                                        Requirements

                                                                                        Knowing what kind of observation is being made is essential to understanding the observation.

                                                                                        Pattern Value{
                                                                                          "coding" : [{
                                                                                            "system" : "http://snomed.info/sct",
                                                                                            "code" : "228450008",
                                                                                            "display" : "Time spent exercising"
                                                                                          }]
                                                                                        }
                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                        260. Observation.component:timeSpentExercising.value[x]
                                                                                        Definition

                                                                                        The information determined as a result of making the observation, if the information has a simple value.

                                                                                        ShortActual component result
                                                                                        Comments

                                                                                        Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

                                                                                        Control0..1
                                                                                        TypeChoice of: Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period
                                                                                        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                        Is Modifierfalse
                                                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                        Summarytrue
                                                                                        Requirements

                                                                                        An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                        SlicingThis element introduces a set of slices on Observation.component.value[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                        • type @ $this
                                                                                        • 262. Observation.component:timeSpentExercising.value[x]:valueQuantity
                                                                                          Slice NamevalueQuantity
                                                                                          Definition

                                                                                          The information determined as a result of making the observation, if the information has a simple value.

                                                                                          ShortActual component result
                                                                                          Comments

                                                                                          Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

                                                                                          Control0..1
                                                                                          TypeQuantity
                                                                                          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                          Is Modifierfalse
                                                                                          Summarytrue
                                                                                          Requirements

                                                                                          An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                                                                                          Pattern Value{
                                                                                            "value" : 0,
                                                                                            "unit" : "second",
                                                                                            "system" : "http://unitsofmeasure.org",
                                                                                            "code" : "s"
                                                                                          }
                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                          264. Observation.component:timeSpentExercising.dataAbsentReason
                                                                                          Definition

                                                                                          Provides a reason why the expected value in the element Observation.component.value[x] is missing.

                                                                                          ShortWhy the component result is missing
                                                                                          Comments

                                                                                          "Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done".

                                                                                          The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

                                                                                          Control0..1
                                                                                          This element is affected by the following invariants: obs-6
                                                                                          BindingUnless not suitable, these codes SHALL be taken from DataAbsentReason
                                                                                          (extensible to http://hl7.org/fhir/ValueSet/data-absent-reason)

                                                                                          Codes specifying why the result (Observation.value[x]) is missing.

                                                                                          TypeCodeableConcept
                                                                                          Is Modifierfalse
                                                                                          Summaryfalse
                                                                                          Requirements

                                                                                          For many results it is necessary to handle exceptional values in measurements.

                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                          266. Observation.component:timeSpentExercising.interpretation
                                                                                          Definition

                                                                                          A categorical assessment of an observation value. For example, high, low, normal.

                                                                                          ShortHigh, low, normal, etc.
                                                                                          Comments

                                                                                          Historically used for laboratory results (known as 'abnormal flag' ), its use extends to other use cases where coded interpretations are relevant. Often reported as one or more simple compact codes this element is often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result.

                                                                                          Control0..*
                                                                                          BindingUnless not suitable, these codes SHALL be taken from ObservationInterpretationCodes
                                                                                          (extensible to http://hl7.org/fhir/ValueSet/observation-interpretation)

                                                                                          Codes identifying interpretations of observations.

                                                                                          TypeCodeableConcept
                                                                                          Is Modifierfalse
                                                                                          Summaryfalse
                                                                                          Requirements

                                                                                          For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.

                                                                                          Alternate NamesAbnormal Flag
                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                          268. Observation.component:timeSpentExercising.referenceRange
                                                                                          Definition

                                                                                          Guidance on how to interpret the value by comparison to a normal or recommended range.

                                                                                          ShortProvides guide for interpretation of component result
                                                                                          Comments

                                                                                          Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this might not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.

                                                                                          Control0..*
                                                                                          TypeSeettp://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange
                                                                                          Is Modifierfalse
                                                                                          Summaryfalse
                                                                                          Requirements

                                                                                          Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.

                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                          270. Observation.component:performanceBasedMeasureScore
                                                                                          Slice NameperformanceBasedMeasureScore
                                                                                          Definition

                                                                                          Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.

                                                                                          ShortComponent results
                                                                                          Comments

                                                                                          For a discussion on the ways Observations can be assembled in groups together see Notes below.

                                                                                          Control1..1
                                                                                          TypeBackboneElement
                                                                                          Is Modifierfalse
                                                                                          Summarytrue
                                                                                          Requirements

                                                                                          Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                          272. Observation.component:performanceBasedMeasureScore.id
                                                                                          Definition

                                                                                          Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                          ShortUnique id for inter-element referencing
                                                                                          Control0..1
                                                                                          Typestring
                                                                                          Is Modifierfalse
                                                                                          XML FormatIn the XML format, this property is represented as an attribute.
                                                                                          Summaryfalse
                                                                                          274. Observation.component:performanceBasedMeasureScore.extension
                                                                                          Definition

                                                                                          May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                                          ShortAdditional content defined by implementations
                                                                                          Comments

                                                                                          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                          Control0..*
                                                                                          TypeExtension
                                                                                          Is Modifierfalse
                                                                                          Summaryfalse
                                                                                          Alternate Namesextensions, user content
                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                          276. Observation.component:performanceBasedMeasureScore.modifierExtension
                                                                                          Definition

                                                                                          May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                                                                          Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                                                          ShortExtensions that cannot be ignored even if unrecognized
                                                                                          Comments

                                                                                          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                          Control0..*
                                                                                          TypeExtension
                                                                                          Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                                          Summarytrue
                                                                                          Requirements

                                                                                          Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                                                          Alternate Namesextensions, user content, modifiers
                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                          278. Observation.component:performanceBasedMeasureScore.code
                                                                                          Definition

                                                                                          Describes what was observed. Sometimes this is called the observation "code".

                                                                                          ShortType of component observation (code / type)
                                                                                          Comments

                                                                                          All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

                                                                                          Control1..1
                                                                                          BindingFor example codes, see LOINCCodes
                                                                                          (example to http://hl7.org/fhir/ValueSet/observation-codes)

                                                                                          Codes identifying names of simple observations.

                                                                                          TypeCodeableConcept
                                                                                          Is Modifierfalse
                                                                                          Summarytrue
                                                                                          Requirements

                                                                                          Knowing what kind of observation is being made is essential to understanding the observation.

                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                          280. Observation.component:performanceBasedMeasureScore.code.id
                                                                                          Definition

                                                                                          Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                          ShortUnique id for inter-element referencing
                                                                                          Control0..1
                                                                                          Typestring
                                                                                          Is Modifierfalse
                                                                                          XML FormatIn the XML format, this property is represented as an attribute.
                                                                                          Summaryfalse
                                                                                          282. Observation.component:performanceBasedMeasureScore.code.extension
                                                                                          Definition

                                                                                          May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                                          ShortAdditional content defined by implementations
                                                                                          Comments

                                                                                          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                          Control0..*
                                                                                          TypeExtension
                                                                                          Is Modifierfalse
                                                                                          Summaryfalse
                                                                                          Alternate Namesextensions, user content
                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                          SlicingThis element introduces a set of slices on Observation.component.code.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                          • value @ url
                                                                                          • 284. Observation.component:performanceBasedMeasureScore.code.coding
                                                                                            Definition

                                                                                            A reference to a code defined by a terminology system.

                                                                                            ShortCode defined by a terminology system
                                                                                            Comments

                                                                                            Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                                                                                            Control0..*
                                                                                            TypeCoding
                                                                                            Is Modifierfalse
                                                                                            Summarytrue
                                                                                            Requirements

                                                                                            Allows for alternative encodings within a code system, and translations to other code systems.

                                                                                            Pattern Value{
                                                                                              "system" : "http://loinc.org",
                                                                                              "code" : "89191-1",
                                                                                              "display" : "Performance-based measure score"
                                                                                            }
                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                            286. Observation.component:performanceBasedMeasureScore.code.coding.id
                                                                                            Definition

                                                                                            Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                            ShortUnique id for inter-element referencing
                                                                                            Control0..1
                                                                                            Typestring
                                                                                            Is Modifierfalse
                                                                                            XML FormatIn the XML format, this property is represented as an attribute.
                                                                                            Summaryfalse
                                                                                            288. Observation.component:performanceBasedMeasureScore.code.coding.extension
                                                                                            Definition

                                                                                            May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                                            ShortAdditional content defined by implementations
                                                                                            Comments

                                                                                            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                            Control0..*
                                                                                            TypeExtension
                                                                                            Is Modifierfalse
                                                                                            Summaryfalse
                                                                                            Alternate Namesextensions, user content
                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                            SlicingThis element introduces a set of slices on Observation.component.code.coding.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                            • value @ url
                                                                                            • 290. Observation.component:performanceBasedMeasureScore.code.coding.system
                                                                                              Definition

                                                                                              The identification of the code system that defines the meaning of the symbol in the code.

                                                                                              ShortIdentity of the terminology system
                                                                                              Comments

                                                                                              The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

                                                                                              Control0..1
                                                                                              Typeuri
                                                                                              Is Modifierfalse
                                                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                              Summarytrue
                                                                                              Requirements

                                                                                              Need to be unambiguous about the source of the definition of the symbol.

                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                              292. Observation.component:performanceBasedMeasureScore.code.coding.version
                                                                                              Definition

                                                                                              The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

                                                                                              ShortVersion of the system - if relevant
                                                                                              Comments

                                                                                              Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

                                                                                              NoteThis is a business version Id, not a resource version Id (see discussion)
                                                                                              Control0..1
                                                                                              Typestring
                                                                                              Is Modifierfalse
                                                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                              Summarytrue
                                                                                              Pattern Value2.69
                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                              294. Observation.component:performanceBasedMeasureScore.code.coding.code
                                                                                              Definition

                                                                                              A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

                                                                                              ShortSymbol in syntax defined by the system
                                                                                              Control0..1
                                                                                              Typecode
                                                                                              Is Modifierfalse
                                                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                              Summarytrue
                                                                                              Requirements

                                                                                              Need to refer to a particular code in the system.

                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                              296. Observation.component:performanceBasedMeasureScore.code.coding.display
                                                                                              Definition

                                                                                              A representation of the meaning of the code in the system, following the rules of the system.

                                                                                              ShortRepresentation defined by the system
                                                                                              Control0..1
                                                                                              Typestring
                                                                                              Is Modifierfalse
                                                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                              Summarytrue
                                                                                              Requirements

                                                                                              Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                              298. Observation.component:performanceBasedMeasureScore.code.coding.userSelected
                                                                                              Definition

                                                                                              Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).

                                                                                              ShortIf this coding was chosen directly by the user
                                                                                              Comments

                                                                                              Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

                                                                                              Control0..1
                                                                                              Typeboolean
                                                                                              Is Modifierfalse
                                                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                              Summarytrue
                                                                                              Requirements

                                                                                              This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                              300. Observation.component:performanceBasedMeasureScore.code.text
                                                                                              Definition

                                                                                              A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

                                                                                              ShortPlain text representation of the concept
                                                                                              Comments

                                                                                              Very often the text is the same as a displayName of one of the codings.

                                                                                              Control0..1
                                                                                              Typestring
                                                                                              Is Modifierfalse
                                                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                              Summarytrue
                                                                                              Requirements

                                                                                              The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                              302. Observation.component:performanceBasedMeasureScore.value[x]
                                                                                              Definition

                                                                                              The information determined as a result of making the observation, if the information has a simple value.

                                                                                              ShortActual component result
                                                                                              Comments

                                                                                              Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

                                                                                              Control0..1
                                                                                              TypeChoice of: Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period
                                                                                              [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                              Is Modifierfalse
                                                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                              Summarytrue
                                                                                              Requirements

                                                                                              An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                              SlicingThis element introduces a set of slices on Observation.component.value[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                              • type @ $this
                                                                                              • 304. Observation.component:performanceBasedMeasureScore.value[x]:valueQuantity
                                                                                                Slice NamevalueQuantity
                                                                                                Definition

                                                                                                The information determined as a result of making the observation, if the information has a simple value.

                                                                                                ShortActual component result
                                                                                                Comments

                                                                                                Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

                                                                                                Control0..1
                                                                                                TypeQuantity
                                                                                                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                                Is Modifierfalse
                                                                                                Summarytrue
                                                                                                Requirements

                                                                                                An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                                                                                                Pattern Value{
                                                                                                  "value" : 0,
                                                                                                  "unit" : "score",
                                                                                                  "system" : "http://unitsofmeasure.org",
                                                                                                  "code" : "{score}"
                                                                                                }
                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                306. Observation.component:performanceBasedMeasureScore.dataAbsentReason
                                                                                                Definition

                                                                                                Provides a reason why the expected value in the element Observation.component.value[x] is missing.

                                                                                                ShortWhy the component result is missing
                                                                                                Comments

                                                                                                "Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done".

                                                                                                The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

                                                                                                Control0..1
                                                                                                This element is affected by the following invariants: obs-6
                                                                                                BindingUnless not suitable, these codes SHALL be taken from DataAbsentReason
                                                                                                (extensible to http://hl7.org/fhir/ValueSet/data-absent-reason)

                                                                                                Codes specifying why the result (Observation.value[x]) is missing.

                                                                                                TypeCodeableConcept
                                                                                                Is Modifierfalse
                                                                                                Summaryfalse
                                                                                                Requirements

                                                                                                For many results it is necessary to handle exceptional values in measurements.

                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                308. Observation.component:performanceBasedMeasureScore.interpretation
                                                                                                Definition

                                                                                                A categorical assessment of an observation value. For example, high, low, normal.

                                                                                                ShortHigh, low, normal, etc.
                                                                                                Comments

                                                                                                Historically used for laboratory results (known as 'abnormal flag' ), its use extends to other use cases where coded interpretations are relevant. Often reported as one or more simple compact codes this element is often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result.

                                                                                                Control0..*
                                                                                                BindingUnless not suitable, these codes SHALL be taken from ObservationInterpretationCodes
                                                                                                (extensible to http://hl7.org/fhir/ValueSet/observation-interpretation)

                                                                                                Codes identifying interpretations of observations.

                                                                                                TypeCodeableConcept
                                                                                                Is Modifierfalse
                                                                                                Summaryfalse
                                                                                                Requirements

                                                                                                For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.

                                                                                                Alternate NamesAbnormal Flag
                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                310. Observation.component:performanceBasedMeasureScore.referenceRange
                                                                                                Definition

                                                                                                Guidance on how to interpret the value by comparison to a normal or recommended range.

                                                                                                ShortProvides guide for interpretation of component result
                                                                                                Comments

                                                                                                Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this might not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.

                                                                                                Control0..*
                                                                                                TypeSeettp://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange
                                                                                                Is Modifierfalse
                                                                                                Summaryfalse
                                                                                                Requirements

                                                                                                Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.

                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                312. Observation.component:disorientated
                                                                                                Slice Namedisorientated
                                                                                                Definition

                                                                                                Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.

                                                                                                ShortComponent results
                                                                                                Comments

                                                                                                For a discussion on the ways Observations can be assembled in groups together see Notes below.

                                                                                                Control1..1
                                                                                                TypeBackboneElement
                                                                                                Is Modifierfalse
                                                                                                Summarytrue
                                                                                                Requirements

                                                                                                Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                314. Observation.component:disorientated.id
                                                                                                Definition

                                                                                                Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                                ShortUnique id for inter-element referencing
                                                                                                Control0..1
                                                                                                Typestring
                                                                                                Is Modifierfalse
                                                                                                XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                Summaryfalse
                                                                                                316. Observation.component:disorientated.extension
                                                                                                Definition

                                                                                                May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                                                ShortAdditional content defined by implementations
                                                                                                Comments

                                                                                                There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                                Control0..*
                                                                                                TypeExtension
                                                                                                Is Modifierfalse
                                                                                                Summaryfalse
                                                                                                Alternate Namesextensions, user content
                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                318. Observation.component:disorientated.modifierExtension
                                                                                                Definition

                                                                                                May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                                                                                Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                                                                ShortExtensions that cannot be ignored even if unrecognized
                                                                                                Comments

                                                                                                There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                                Control0..*
                                                                                                TypeExtension
                                                                                                Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                                                Summarytrue
                                                                                                Requirements

                                                                                                Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                                                                Alternate Namesextensions, user content, modifiers
                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                320. Observation.component:disorientated.code
                                                                                                Definition

                                                                                                Describes what was observed. Sometimes this is called the observation "code".

                                                                                                ShortType of component observation (code / type)
                                                                                                Comments

                                                                                                All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

                                                                                                Control1..1
                                                                                                BindingFor example codes, see LOINCCodes
                                                                                                (example to http://hl7.org/fhir/ValueSet/observation-codes)

                                                                                                Codes identifying names of simple observations.

                                                                                                TypeCodeableConcept
                                                                                                Is Modifierfalse
                                                                                                Summarytrue
                                                                                                Requirements

                                                                                                Knowing what kind of observation is being made is essential to understanding the observation.

                                                                                                Pattern Value{
                                                                                                  "coding" : [{
                                                                                                    "system" : "http://snomed.info/sct",
                                                                                                    "code" : "62476001",
                                                                                                    "display" : "Disorientated"
                                                                                                  }]
                                                                                                }
                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                322. Observation.component:disorientated.value[x]
                                                                                                Definition

                                                                                                The information determined as a result of making the observation, if the information has a simple value.

                                                                                                ShortActual component result
                                                                                                Comments

                                                                                                Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

                                                                                                Control0..1
                                                                                                TypeChoice of: Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period
                                                                                                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                                Is Modifierfalse
                                                                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                Summarytrue
                                                                                                Requirements

                                                                                                An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                SlicingThis element introduces a set of slices on Observation.component.value[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                • type @ $this
                                                                                                • 324. Observation.component:disorientated.value[x]:valueBoolean
                                                                                                  Slice NamevalueBoolean
                                                                                                  Definition

                                                                                                  The information determined as a result of making the observation, if the information has a simple value.

                                                                                                  ShortActual component result
                                                                                                  Comments

                                                                                                  Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

                                                                                                  Control0..1
                                                                                                  Typeboolean
                                                                                                  [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                                  Is Modifierfalse
                                                                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                  Summarytrue
                                                                                                  Requirements

                                                                                                  An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                                                                                                  Pattern Valuetrue
                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                  326. Observation.component:disorientated.value[x]:valueCodeableConcept
                                                                                                  Slice NamevalueCodeableConcept
                                                                                                  Definition

                                                                                                  The information determined as a result of making the observation, if the information has a simple value.

                                                                                                  ShortActual component result
                                                                                                  Comments

                                                                                                  Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

                                                                                                  Control0..1
                                                                                                  TypeCodeableConcept
                                                                                                  [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                                  Is Modifierfalse
                                                                                                  Summarytrue
                                                                                                  Requirements

                                                                                                  An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                                                                                                  Pattern Value{
                                                                                                    "coding" : [{
                                                                                                      "system" : "http://snomed.info/sct",
                                                                                                      "code" : "<<disoriented|SeverityCode>>",
                                                                                                      "display" : "<<disoriented|SeverityCodeDisplay>>"
                                                                                                    }]
                                                                                                  }
                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                  328. Observation.component:disorientated.dataAbsentReason
                                                                                                  Definition

                                                                                                  Provides a reason why the expected value in the element Observation.component.value[x] is missing.

                                                                                                  ShortWhy the component result is missing
                                                                                                  Comments

                                                                                                  "Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done".

                                                                                                  The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

                                                                                                  Control0..1
                                                                                                  This element is affected by the following invariants: obs-6
                                                                                                  BindingUnless not suitable, these codes SHALL be taken from DataAbsentReason
                                                                                                  (extensible to http://hl7.org/fhir/ValueSet/data-absent-reason)

                                                                                                  Codes specifying why the result (Observation.value[x]) is missing.

                                                                                                  TypeCodeableConcept
                                                                                                  Is Modifierfalse
                                                                                                  Summaryfalse
                                                                                                  Requirements

                                                                                                  For many results it is necessary to handle exceptional values in measurements.

                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                  330. Observation.component:disorientated.interpretation
                                                                                                  Definition

                                                                                                  A categorical assessment of an observation value. For example, high, low, normal.

                                                                                                  ShortHigh, low, normal, etc.
                                                                                                  Comments

                                                                                                  Historically used for laboratory results (known as 'abnormal flag' ), its use extends to other use cases where coded interpretations are relevant. Often reported as one or more simple compact codes this element is often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result.

                                                                                                  Control0..*
                                                                                                  BindingUnless not suitable, these codes SHALL be taken from ObservationInterpretationCodes
                                                                                                  (extensible to http://hl7.org/fhir/ValueSet/observation-interpretation)

                                                                                                  Codes identifying interpretations of observations.

                                                                                                  TypeCodeableConcept
                                                                                                  Is Modifierfalse
                                                                                                  Summaryfalse
                                                                                                  Requirements

                                                                                                  For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.

                                                                                                  Alternate NamesAbnormal Flag
                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                  332. Observation.component:disorientated.referenceRange
                                                                                                  Definition

                                                                                                  Guidance on how to interpret the value by comparison to a normal or recommended range.

                                                                                                  ShortProvides guide for interpretation of component result
                                                                                                  Comments

                                                                                                  Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this might not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.

                                                                                                  Control0..*
                                                                                                  TypeSeettp://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange
                                                                                                  Is Modifierfalse
                                                                                                  Summaryfalse
                                                                                                  Requirements

                                                                                                  Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.

                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                  334. Observation.component:abnormalVision
                                                                                                  Slice NameabnormalVision
                                                                                                  Definition

                                                                                                  Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.

                                                                                                  ShortComponent results
                                                                                                  Comments

                                                                                                  For a discussion on the ways Observations can be assembled in groups together see Notes below.

                                                                                                  Control1..1
                                                                                                  TypeBackboneElement
                                                                                                  Is Modifierfalse
                                                                                                  Summarytrue
                                                                                                  Requirements

                                                                                                  Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                  336. Observation.component:abnormalVision.id
                                                                                                  Definition

                                                                                                  Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                                  ShortUnique id for inter-element referencing
                                                                                                  Control0..1
                                                                                                  Typestring
                                                                                                  Is Modifierfalse
                                                                                                  XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                  Summaryfalse
                                                                                                  338. Observation.component:abnormalVision.extension
                                                                                                  Definition

                                                                                                  May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                                                  ShortAdditional content defined by implementations
                                                                                                  Comments

                                                                                                  There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                                  Control0..*
                                                                                                  TypeExtension
                                                                                                  Is Modifierfalse
                                                                                                  Summaryfalse
                                                                                                  Alternate Namesextensions, user content
                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                  340. Observation.component:abnormalVision.modifierExtension
                                                                                                  Definition

                                                                                                  May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                                                                                  Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                                                                  ShortExtensions that cannot be ignored even if unrecognized
                                                                                                  Comments

                                                                                                  There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                                  Control0..*
                                                                                                  TypeExtension
                                                                                                  Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                                                  Summarytrue
                                                                                                  Requirements

                                                                                                  Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                                                                  Alternate Namesextensions, user content, modifiers
                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                  342. Observation.component:abnormalVision.code
                                                                                                  Definition

                                                                                                  Describes what was observed. Sometimes this is called the observation "code".

                                                                                                  ShortType of component observation (code / type)
                                                                                                  Comments

                                                                                                  All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

                                                                                                  Control1..1
                                                                                                  BindingFor example codes, see LOINCCodes
                                                                                                  (example to http://hl7.org/fhir/ValueSet/observation-codes)

                                                                                                  Codes identifying names of simple observations.

                                                                                                  TypeCodeableConcept
                                                                                                  Is Modifierfalse
                                                                                                  Summarytrue
                                                                                                  Requirements

                                                                                                  Knowing what kind of observation is being made is essential to understanding the observation.

                                                                                                  Pattern Value{
                                                                                                    "coding" : [{
                                                                                                      "system" : "http://snomed.info/sct",
                                                                                                      "code" : "7973008",
                                                                                                      "display" : "Abnormal vision"
                                                                                                    }]
                                                                                                  }
                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                  344. Observation.component:abnormalVision.value[x]
                                                                                                  Definition

                                                                                                  The information determined as a result of making the observation, if the information has a simple value.

                                                                                                  ShortActual component result
                                                                                                  Comments

                                                                                                  Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

                                                                                                  Control0..1
                                                                                                  TypeChoice of: Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period
                                                                                                  [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                                  Is Modifierfalse
                                                                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                  Summarytrue
                                                                                                  Requirements

                                                                                                  An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                  SlicingThis element introduces a set of slices on Observation.component.value[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                  • type @ $this
                                                                                                  • 346. Observation.component:abnormalVision.value[x]:valueBoolean
                                                                                                    Slice NamevalueBoolean
                                                                                                    Definition

                                                                                                    The information determined as a result of making the observation, if the information has a simple value.

                                                                                                    ShortActual component result
                                                                                                    Comments

                                                                                                    Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

                                                                                                    Control0..1
                                                                                                    Typeboolean
                                                                                                    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                                    Is Modifierfalse
                                                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                    Summarytrue
                                                                                                    Requirements

                                                                                                    An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                                                                                                    Pattern Valuetrue
                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                    348. Observation.component:abnormalVision.value[x]:valueCodeableConcept
                                                                                                    Slice NamevalueCodeableConcept
                                                                                                    Definition

                                                                                                    The information determined as a result of making the observation, if the information has a simple value.

                                                                                                    ShortActual component result
                                                                                                    Comments

                                                                                                    Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

                                                                                                    Control0..1
                                                                                                    TypeCodeableConcept
                                                                                                    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                                    Is Modifierfalse
                                                                                                    Summarytrue
                                                                                                    Requirements

                                                                                                    An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                                                                                                    Pattern Value{
                                                                                                      "coding" : [{
                                                                                                        "system" : "http://snomed.info/sct",
                                                                                                        "code" : "<<blurryvision|SeverityCode>>",
                                                                                                        "display" : "<<blurryvision|SeverityCodeDisplay>>"
                                                                                                      }]
                                                                                                    }
                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                    350. Observation.component:abnormalVision.dataAbsentReason
                                                                                                    Definition

                                                                                                    Provides a reason why the expected value in the element Observation.component.value[x] is missing.

                                                                                                    ShortWhy the component result is missing
                                                                                                    Comments

                                                                                                    "Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done".

                                                                                                    The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

                                                                                                    Control0..1
                                                                                                    This element is affected by the following invariants: obs-6
                                                                                                    BindingUnless not suitable, these codes SHALL be taken from DataAbsentReason
                                                                                                    (extensible to http://hl7.org/fhir/ValueSet/data-absent-reason)

                                                                                                    Codes specifying why the result (Observation.value[x]) is missing.

                                                                                                    TypeCodeableConcept
                                                                                                    Is Modifierfalse
                                                                                                    Summaryfalse
                                                                                                    Requirements

                                                                                                    For many results it is necessary to handle exceptional values in measurements.

                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                    352. Observation.component:abnormalVision.interpretation
                                                                                                    Definition

                                                                                                    A categorical assessment of an observation value. For example, high, low, normal.

                                                                                                    ShortHigh, low, normal, etc.
                                                                                                    Comments

                                                                                                    Historically used for laboratory results (known as 'abnormal flag' ), its use extends to other use cases where coded interpretations are relevant. Often reported as one or more simple compact codes this element is often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result.

                                                                                                    Control0..*
                                                                                                    BindingUnless not suitable, these codes SHALL be taken from ObservationInterpretationCodes
                                                                                                    (extensible to http://hl7.org/fhir/ValueSet/observation-interpretation)

                                                                                                    Codes identifying interpretations of observations.

                                                                                                    TypeCodeableConcept
                                                                                                    Is Modifierfalse
                                                                                                    Summaryfalse
                                                                                                    Requirements

                                                                                                    For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.

                                                                                                    Alternate NamesAbnormal Flag
                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                    354. Observation.component:abnormalVision.referenceRange
                                                                                                    Definition

                                                                                                    Guidance on how to interpret the value by comparison to a normal or recommended range.

                                                                                                    ShortProvides guide for interpretation of component result
                                                                                                    Comments

                                                                                                    Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this might not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.

                                                                                                    Control0..*
                                                                                                    TypeSeettp://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange
                                                                                                    Is Modifierfalse
                                                                                                    Summaryfalse
                                                                                                    Requirements

                                                                                                    Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.

                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                    356. Observation.component:dizziness
                                                                                                    Slice Namedizziness
                                                                                                    Definition

                                                                                                    Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.

                                                                                                    ShortComponent results
                                                                                                    Comments

                                                                                                    For a discussion on the ways Observations can be assembled in groups together see Notes below.

                                                                                                    Control1..1
                                                                                                    TypeBackboneElement
                                                                                                    Is Modifierfalse
                                                                                                    Summarytrue
                                                                                                    Requirements

                                                                                                    Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                    358. Observation.component:dizziness.id
                                                                                                    Definition

                                                                                                    Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                                    ShortUnique id for inter-element referencing
                                                                                                    Control0..1
                                                                                                    Typestring
                                                                                                    Is Modifierfalse
                                                                                                    XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                    Summaryfalse
                                                                                                    360. Observation.component:dizziness.extension
                                                                                                    Definition

                                                                                                    May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                                                    ShortAdditional content defined by implementations
                                                                                                    Comments

                                                                                                    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                                    Control0..*
                                                                                                    TypeExtension
                                                                                                    Is Modifierfalse
                                                                                                    Summaryfalse
                                                                                                    Alternate Namesextensions, user content
                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                    362. Observation.component:dizziness.modifierExtension
                                                                                                    Definition

                                                                                                    May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                                                                                    Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                                                                    ShortExtensions that cannot be ignored even if unrecognized
                                                                                                    Comments

                                                                                                    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                                    Control0..*
                                                                                                    TypeExtension
                                                                                                    Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                                                    Summarytrue
                                                                                                    Requirements

                                                                                                    Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                                                                    Alternate Namesextensions, user content, modifiers
                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                    364. Observation.component:dizziness.code
                                                                                                    Definition

                                                                                                    Describes what was observed. Sometimes this is called the observation "code".

                                                                                                    ShortType of component observation (code / type)
                                                                                                    Comments

                                                                                                    All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

                                                                                                    Control1..1
                                                                                                    BindingFor example codes, see LOINCCodes
                                                                                                    (example to http://hl7.org/fhir/ValueSet/observation-codes)

                                                                                                    Codes identifying names of simple observations.

                                                                                                    TypeCodeableConcept
                                                                                                    Is Modifierfalse
                                                                                                    Summarytrue
                                                                                                    Requirements

                                                                                                    Knowing what kind of observation is being made is essential to understanding the observation.

                                                                                                    Pattern Value{
                                                                                                      "coding" : [{
                                                                                                        "system" : "http://snomed.info/sct",
                                                                                                        "code" : "404640003",
                                                                                                        "display" : "Dizziness"
                                                                                                      }]
                                                                                                    }
                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                    366. Observation.component:dizziness.value[x]
                                                                                                    Definition

                                                                                                    The information determined as a result of making the observation, if the information has a simple value.

                                                                                                    ShortActual component result
                                                                                                    Comments

                                                                                                    Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

                                                                                                    Control0..1
                                                                                                    TypeChoice of: Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period
                                                                                                    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                                    Is Modifierfalse
                                                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                    Summarytrue
                                                                                                    Requirements

                                                                                                    An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                    SlicingThis element introduces a set of slices on Observation.component.value[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                    • type @ $this
                                                                                                    • 368. Observation.component:dizziness.value[x]:valueBoolean
                                                                                                      Slice NamevalueBoolean
                                                                                                      Definition

                                                                                                      The information determined as a result of making the observation, if the information has a simple value.

                                                                                                      ShortActual component result
                                                                                                      Comments

                                                                                                      Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

                                                                                                      Control0..1
                                                                                                      Typeboolean
                                                                                                      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                                      Is Modifierfalse
                                                                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                      Summarytrue
                                                                                                      Requirements

                                                                                                      An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                                                                                                      Pattern Valuetrue
                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                      370. Observation.component:dizziness.value[x]:valueCodeableConcept
                                                                                                      Slice NamevalueCodeableConcept
                                                                                                      Definition

                                                                                                      The information determined as a result of making the observation, if the information has a simple value.

                                                                                                      ShortActual component result
                                                                                                      Comments

                                                                                                      Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

                                                                                                      Control0..1
                                                                                                      TypeCodeableConcept
                                                                                                      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                                      Is Modifierfalse
                                                                                                      Summarytrue
                                                                                                      Requirements

                                                                                                      An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                                                                                                      Pattern Value{
                                                                                                        "coding" : [{
                                                                                                          "system" : "http://snomed.info/sct",
                                                                                                          "code" : "<<dizzy|SeverityCode>>",
                                                                                                          "display" : "<<dizzy|SeverityCodeDisplay>>"
                                                                                                        }]
                                                                                                      }
                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                      372. Observation.component:dizziness.dataAbsentReason
                                                                                                      Definition

                                                                                                      Provides a reason why the expected value in the element Observation.component.value[x] is missing.

                                                                                                      ShortWhy the component result is missing
                                                                                                      Comments

                                                                                                      "Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done".

                                                                                                      The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

                                                                                                      Control0..1
                                                                                                      This element is affected by the following invariants: obs-6
                                                                                                      BindingUnless not suitable, these codes SHALL be taken from DataAbsentReason
                                                                                                      (extensible to http://hl7.org/fhir/ValueSet/data-absent-reason)

                                                                                                      Codes specifying why the result (Observation.value[x]) is missing.

                                                                                                      TypeCodeableConcept
                                                                                                      Is Modifierfalse
                                                                                                      Summaryfalse
                                                                                                      Requirements

                                                                                                      For many results it is necessary to handle exceptional values in measurements.

                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                      374. Observation.component:dizziness.interpretation
                                                                                                      Definition

                                                                                                      A categorical assessment of an observation value. For example, high, low, normal.

                                                                                                      ShortHigh, low, normal, etc.
                                                                                                      Comments

                                                                                                      Historically used for laboratory results (known as 'abnormal flag' ), its use extends to other use cases where coded interpretations are relevant. Often reported as one or more simple compact codes this element is often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result.

                                                                                                      Control0..*
                                                                                                      BindingUnless not suitable, these codes SHALL be taken from ObservationInterpretationCodes
                                                                                                      (extensible to http://hl7.org/fhir/ValueSet/observation-interpretation)

                                                                                                      Codes identifying interpretations of observations.

                                                                                                      TypeCodeableConcept
                                                                                                      Is Modifierfalse
                                                                                                      Summaryfalse
                                                                                                      Requirements

                                                                                                      For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.

                                                                                                      Alternate NamesAbnormal Flag
                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                      376. Observation.component:dizziness.referenceRange
                                                                                                      Definition

                                                                                                      Guidance on how to interpret the value by comparison to a normal or recommended range.

                                                                                                      ShortProvides guide for interpretation of component result
                                                                                                      Comments

                                                                                                      Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this might not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.

                                                                                                      Control0..*
                                                                                                      TypeSeettp://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange
                                                                                                      Is Modifierfalse
                                                                                                      Summaryfalse
                                                                                                      Requirements

                                                                                                      Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.

                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                      378. Observation.component:headache
                                                                                                      Slice Nameheadache
                                                                                                      Definition

                                                                                                      Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.

                                                                                                      ShortComponent results
                                                                                                      Comments

                                                                                                      For a discussion on the ways Observations can be assembled in groups together see Notes below.

                                                                                                      Control1..1
                                                                                                      TypeBackboneElement
                                                                                                      Is Modifierfalse
                                                                                                      Summarytrue
                                                                                                      Requirements

                                                                                                      Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                      380. Observation.component:headache.id
                                                                                                      Definition

                                                                                                      Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                                      ShortUnique id for inter-element referencing
                                                                                                      Control0..1
                                                                                                      Typestring
                                                                                                      Is Modifierfalse
                                                                                                      XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                      Summaryfalse
                                                                                                      382. Observation.component:headache.extension
                                                                                                      Definition

                                                                                                      May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                                                      ShortAdditional content defined by implementations
                                                                                                      Comments

                                                                                                      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                                      Control0..*
                                                                                                      TypeExtension
                                                                                                      Is Modifierfalse
                                                                                                      Summaryfalse
                                                                                                      Alternate Namesextensions, user content
                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                      384. Observation.component:headache.modifierExtension
                                                                                                      Definition

                                                                                                      May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                                                                                      Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                                                                      ShortExtensions that cannot be ignored even if unrecognized
                                                                                                      Comments

                                                                                                      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                                      Control0..*
                                                                                                      TypeExtension
                                                                                                      Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                                                      Summarytrue
                                                                                                      Requirements

                                                                                                      Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                                                                      Alternate Namesextensions, user content, modifiers
                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                      386. Observation.component:headache.code
                                                                                                      Definition

                                                                                                      Describes what was observed. Sometimes this is called the observation "code".

                                                                                                      ShortType of component observation (code / type)
                                                                                                      Comments

                                                                                                      All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

                                                                                                      Control1..1
                                                                                                      BindingFor example codes, see LOINCCodes
                                                                                                      (example to http://hl7.org/fhir/ValueSet/observation-codes)

                                                                                                      Codes identifying names of simple observations.

                                                                                                      TypeCodeableConcept
                                                                                                      Is Modifierfalse
                                                                                                      Summarytrue
                                                                                                      Requirements

                                                                                                      Knowing what kind of observation is being made is essential to understanding the observation.

                                                                                                      Pattern Value{
                                                                                                        "coding" : [{
                                                                                                          "system" : "http://snomed.info/sct",
                                                                                                          "code" : "25064002",
                                                                                                          "display" : "Headache"
                                                                                                        }]
                                                                                                      }
                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                      388. Observation.component:headache.value[x]
                                                                                                      Definition

                                                                                                      The information determined as a result of making the observation, if the information has a simple value.

                                                                                                      ShortActual component result
                                                                                                      Comments

                                                                                                      Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

                                                                                                      Control0..1
                                                                                                      TypeChoice of: Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period
                                                                                                      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                                      Is Modifierfalse
                                                                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                      Summarytrue
                                                                                                      Requirements

                                                                                                      An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                      SlicingThis element introduces a set of slices on Observation.component.value[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                      • type @ $this
                                                                                                      • 390. Observation.component:headache.value[x]:valueBoolean
                                                                                                        Slice NamevalueBoolean
                                                                                                        Definition

                                                                                                        The information determined as a result of making the observation, if the information has a simple value.

                                                                                                        ShortActual component result
                                                                                                        Comments

                                                                                                        Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

                                                                                                        Control0..1
                                                                                                        Typeboolean
                                                                                                        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                                        Is Modifierfalse
                                                                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                        Summarytrue
                                                                                                        Requirements

                                                                                                        An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                                                                                                        Pattern Valuetrue
                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                        392. Observation.component:headache.value[x]:valueCodeableConcept
                                                                                                        Slice NamevalueCodeableConcept
                                                                                                        Definition

                                                                                                        The information determined as a result of making the observation, if the information has a simple value.

                                                                                                        ShortActual component result
                                                                                                        Comments

                                                                                                        Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

                                                                                                        Control0..1
                                                                                                        TypeCodeableConcept
                                                                                                        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                                        Is Modifierfalse
                                                                                                        Summarytrue
                                                                                                        Requirements

                                                                                                        An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                                                                                                        Pattern Value{
                                                                                                          "coding" : [{
                                                                                                            "system" : "http://snomed.info/sct",
                                                                                                            "code" : "<<headache|SeverityCode>>",
                                                                                                            "display" : "<<headache|SeverityCodeDisplay>>"
                                                                                                          }]
                                                                                                        }
                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                        394. Observation.component:headache.dataAbsentReason
                                                                                                        Definition

                                                                                                        Provides a reason why the expected value in the element Observation.component.value[x] is missing.

                                                                                                        ShortWhy the component result is missing
                                                                                                        Comments

                                                                                                        "Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done".

                                                                                                        The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

                                                                                                        Control0..1
                                                                                                        This element is affected by the following invariants: obs-6
                                                                                                        BindingUnless not suitable, these codes SHALL be taken from DataAbsentReason
                                                                                                        (extensible to http://hl7.org/fhir/ValueSet/data-absent-reason)

                                                                                                        Codes specifying why the result (Observation.value[x]) is missing.

                                                                                                        TypeCodeableConcept
                                                                                                        Is Modifierfalse
                                                                                                        Summaryfalse
                                                                                                        Requirements

                                                                                                        For many results it is necessary to handle exceptional values in measurements.

                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                        396. Observation.component:headache.interpretation
                                                                                                        Definition

                                                                                                        A categorical assessment of an observation value. For example, high, low, normal.

                                                                                                        ShortHigh, low, normal, etc.
                                                                                                        Comments

                                                                                                        Historically used for laboratory results (known as 'abnormal flag' ), its use extends to other use cases where coded interpretations are relevant. Often reported as one or more simple compact codes this element is often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result.

                                                                                                        Control0..*
                                                                                                        BindingUnless not suitable, these codes SHALL be taken from ObservationInterpretationCodes
                                                                                                        (extensible to http://hl7.org/fhir/ValueSet/observation-interpretation)

                                                                                                        Codes identifying interpretations of observations.

                                                                                                        TypeCodeableConcept
                                                                                                        Is Modifierfalse
                                                                                                        Summaryfalse
                                                                                                        Requirements

                                                                                                        For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.

                                                                                                        Alternate NamesAbnormal Flag
                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                        398. Observation.component:headache.referenceRange
                                                                                                        Definition

                                                                                                        Guidance on how to interpret the value by comparison to a normal or recommended range.

                                                                                                        ShortProvides guide for interpretation of component result
                                                                                                        Comments

                                                                                                        Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this might not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.

                                                                                                        Control0..*
                                                                                                        TypeSeettp://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange
                                                                                                        Is Modifierfalse
                                                                                                        Summaryfalse
                                                                                                        Requirements

                                                                                                        Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.

                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                        400. Observation.component:neckJointRangeOfMovement
                                                                                                        Slice NameneckJointRangeOfMovement
                                                                                                        Definition

                                                                                                        Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.

                                                                                                        ShortComponent results
                                                                                                        Comments

                                                                                                        For a discussion on the ways Observations can be assembled in groups together see Notes below.

                                                                                                        Control1..1
                                                                                                        TypeBackboneElement
                                                                                                        Is Modifierfalse
                                                                                                        Summarytrue
                                                                                                        Requirements

                                                                                                        Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                        402. Observation.component:neckJointRangeOfMovement.id
                                                                                                        Definition

                                                                                                        Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                                        ShortUnique id for inter-element referencing
                                                                                                        Control0..1
                                                                                                        Typestring
                                                                                                        Is Modifierfalse
                                                                                                        XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                        Summaryfalse
                                                                                                        404. Observation.component:neckJointRangeOfMovement.extension
                                                                                                        Definition

                                                                                                        May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                                                        ShortAdditional content defined by implementations
                                                                                                        Comments

                                                                                                        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                                        Control0..*
                                                                                                        TypeExtension
                                                                                                        Is Modifierfalse
                                                                                                        Summaryfalse
                                                                                                        Alternate Namesextensions, user content
                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                        406. Observation.component:neckJointRangeOfMovement.modifierExtension
                                                                                                        Definition

                                                                                                        May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                                                                                        Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                                                                        ShortExtensions that cannot be ignored even if unrecognized
                                                                                                        Comments

                                                                                                        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                                        Control0..*
                                                                                                        TypeExtension
                                                                                                        Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                                                        Summarytrue
                                                                                                        Requirements

                                                                                                        Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                                                                        Alternate Namesextensions, user content, modifiers
                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                        408. Observation.component:neckJointRangeOfMovement.code
                                                                                                        Definition

                                                                                                        Describes what was observed. Sometimes this is called the observation "code".

                                                                                                        ShortType of component observation (code / type)
                                                                                                        Comments

                                                                                                        All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

                                                                                                        Control1..1
                                                                                                        BindingFor example codes, see LOINCCodes
                                                                                                        (example to http://hl7.org/fhir/ValueSet/observation-codes)

                                                                                                        Codes identifying names of simple observations.

                                                                                                        TypeCodeableConcept
                                                                                                        Is Modifierfalse
                                                                                                        Summarytrue
                                                                                                        Requirements

                                                                                                        Knowing what kind of observation is being made is essential to understanding the observation.

                                                                                                        Pattern Value{
                                                                                                          "coding" : [{
                                                                                                            "system" : "http://snomed.info/sct",
                                                                                                            "code" : "404979006",
                                                                                                            "display" : "Neck joint - range of movement"
                                                                                                          }]
                                                                                                        }
                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                        410. Observation.component:neckJointRangeOfMovement.code.id
                                                                                                        Definition

                                                                                                        Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                                        ShortUnique id for inter-element referencing
                                                                                                        Control0..1
                                                                                                        Typestring
                                                                                                        Is Modifierfalse
                                                                                                        XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                        Summaryfalse
                                                                                                        412. Observation.component:neckJointRangeOfMovement.code.extension
                                                                                                        Definition

                                                                                                        May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                                                        ShortAdditional content defined by implementations
                                                                                                        Comments

                                                                                                        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                                        Control0..*
                                                                                                        TypeExtension
                                                                                                        Is Modifierfalse
                                                                                                        Summaryfalse
                                                                                                        Alternate Namesextensions, user content
                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                        SlicingThis element introduces a set of slices on Observation.component.code.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                        • value @ url
                                                                                                        • 414. Observation.component:neckJointRangeOfMovement.code.coding
                                                                                                          Definition

                                                                                                          A reference to a code defined by a terminology system.

                                                                                                          ShortCode defined by a terminology system
                                                                                                          Comments

                                                                                                          Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                                                                                                          Control0..*
                                                                                                          TypeCoding
                                                                                                          Is Modifierfalse
                                                                                                          Summarytrue
                                                                                                          Requirements

                                                                                                          Allows for alternative encodings within a code system, and translations to other code systems.

                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                          416. Observation.component:neckJointRangeOfMovement.code.text
                                                                                                          Definition

                                                                                                          A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

                                                                                                          ShortPlain text representation of the concept
                                                                                                          Comments

                                                                                                          Very often the text is the same as a displayName of one of the codings.

                                                                                                          Control0..1
                                                                                                          Typestring
                                                                                                          Is Modifierfalse
                                                                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                          Summarytrue
                                                                                                          Requirements

                                                                                                          The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

                                                                                                          Pattern ValueRange of head turns in pitch plane (Up-Down)
                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                          418. Observation.component:neckJointRangeOfMovement.value[x]
                                                                                                          Definition

                                                                                                          The information determined as a result of making the observation, if the information has a simple value.

                                                                                                          ShortActual component result
                                                                                                          Comments

                                                                                                          Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

                                                                                                          Control0..1
                                                                                                          TypeChoice of: Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period
                                                                                                          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                                          Is Modifierfalse
                                                                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                          Summarytrue
                                                                                                          Requirements

                                                                                                          An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                          SlicingThis element introduces a set of slices on Observation.component.value[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                          • type @ $this
                                                                                                          • 420. Observation.component:neckJointRangeOfMovement.value[x]:valueSampledData
                                                                                                            Slice NamevalueSampledData
                                                                                                            Definition

                                                                                                            The information determined as a result of making the observation, if the information has a simple value.

                                                                                                            ShortActual component result
                                                                                                            Comments

                                                                                                            Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

                                                                                                            Control0..1
                                                                                                            TypeSampledData
                                                                                                            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                                            Is Modifierfalse
                                                                                                            Summarytrue
                                                                                                            Requirements

                                                                                                            An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                            422. Observation.component:neckJointRangeOfMovement.value[x]:valueSampledData.id
                                                                                                            Definition

                                                                                                            Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                                            ShortUnique id for inter-element referencing
                                                                                                            Control0..1
                                                                                                            Typestring
                                                                                                            Is Modifierfalse
                                                                                                            XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                            Summaryfalse
                                                                                                            424. Observation.component:neckJointRangeOfMovement.value[x]:valueSampledData.extension
                                                                                                            Definition

                                                                                                            May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                                                            ShortAdditional content defined by implementations
                                                                                                            Comments

                                                                                                            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                                            Control0..*
                                                                                                            TypeExtension
                                                                                                            Is Modifierfalse
                                                                                                            Summaryfalse
                                                                                                            Alternate Namesextensions, user content
                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                            SlicingThis element introduces a set of slices on Observation.component.value[x].extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                            • value @ url
                                                                                                            • 426. Observation.component:neckJointRangeOfMovement.value[x]:valueSampledData.origin
                                                                                                              Definition

                                                                                                              The base quantity that a measured value of zero represents. In addition, this provides the units of the entire measurement series.

                                                                                                              ShortZero value and units
                                                                                                              Control1..1
                                                                                                              TypeQuantity(SimpleQuantity)
                                                                                                              Is Modifierfalse
                                                                                                              Summarytrue
                                                                                                              Pattern Value{
                                                                                                                "unit" : "degree",
                                                                                                                "system" : "http://unitsofmeasure.org",
                                                                                                                "code" : "deg"
                                                                                                              }
                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                              428. Observation.component:neckJointRangeOfMovement.value[x]:valueSampledData.period
                                                                                                              Definition

                                                                                                              The length of time between sampling times, measured in milliseconds.

                                                                                                              ShortNumber of milliseconds between samples
                                                                                                              Comments

                                                                                                              This is usually a whole number.

                                                                                                              Control1..1
                                                                                                              Typedecimal
                                                                                                              Is Modifierfalse
                                                                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                              Summarytrue
                                                                                                              Pattern Value1000
                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                              430. Observation.component:neckJointRangeOfMovement.value[x]:valueSampledData.factor
                                                                                                              Definition

                                                                                                              A correction factor that is applied to the sampled data points before they are added to the origin.

                                                                                                              ShortMultiply data by this before adding to origin
                                                                                                              Control0..1
                                                                                                              Typedecimal
                                                                                                              Is Modifierfalse
                                                                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                              Summarytrue
                                                                                                              Meaning if MissingIf no factor is assigned, the data is not adjusted before adding to the origin
                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                              432. Observation.component:neckJointRangeOfMovement.value[x]:valueSampledData.lowerLimit
                                                                                                              Definition

                                                                                                              The lower limit of detection of the measured points. This is needed if any of the data points have the value "L" (lower than detection limit).

                                                                                                              ShortLower limit of detection
                                                                                                              Control0..1
                                                                                                              Typedecimal
                                                                                                              Is Modifierfalse
                                                                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                              Summarytrue
                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                              434. Observation.component:neckJointRangeOfMovement.value[x]:valueSampledData.upperLimit
                                                                                                              Definition

                                                                                                              The upper limit of detection of the measured points. This is needed if any of the data points have the value "U" (higher than detection limit).

                                                                                                              ShortUpper limit of detection
                                                                                                              Control0..1
                                                                                                              Typedecimal
                                                                                                              Is Modifierfalse
                                                                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                              Summarytrue
                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                              436. Observation.component:neckJointRangeOfMovement.value[x]:valueSampledData.dimensions
                                                                                                              Definition

                                                                                                              The number of sample points at each time point. If this value is greater than one, then the dimensions will be interlaced - all the sample points for a point in time will be recorded at once.

                                                                                                              ShortNumber of sample points at each time point
                                                                                                              Comments

                                                                                                              If there is more than one dimension, the code for the type of data will define the meaning of the dimensions (typically ECG data).

                                                                                                              Control1..1
                                                                                                              TypepositiveInt
                                                                                                              Is Modifierfalse
                                                                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                              Summarytrue
                                                                                                              Pattern Value1
                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                              438. Observation.component:neckJointRangeOfMovement.value[x]:valueSampledData.data
                                                                                                              Definition

                                                                                                              A series of data points which are decimal values separated by a single space (character u20). The special values "E" (error), "L" (below detection limit) and "U" (above detection limit) can also be used in place of a decimal value.

                                                                                                              ShortDecimal values with spaces, or "E" | "U" | "L"
                                                                                                              Comments

                                                                                                              Data may be missing if it is omitted for summarization purposes. In general, data is required for any actual use of a SampledData.

                                                                                                              Control0..1
                                                                                                              Typestring
                                                                                                              Is Modifierfalse
                                                                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                              Summaryfalse
                                                                                                              Pattern Value<<range|FlattenedArray>>
                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                              440. Observation.component:neckJointRangeOfMovement.dataAbsentReason
                                                                                                              Definition

                                                                                                              Provides a reason why the expected value in the element Observation.component.value[x] is missing.

                                                                                                              ShortWhy the component result is missing
                                                                                                              Comments

                                                                                                              "Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done".

                                                                                                              The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

                                                                                                              Control0..1
                                                                                                              This element is affected by the following invariants: obs-6
                                                                                                              BindingUnless not suitable, these codes SHALL be taken from DataAbsentReason
                                                                                                              (extensible to http://hl7.org/fhir/ValueSet/data-absent-reason)

                                                                                                              Codes specifying why the result (Observation.value[x]) is missing.

                                                                                                              TypeCodeableConcept
                                                                                                              Is Modifierfalse
                                                                                                              Summaryfalse
                                                                                                              Requirements

                                                                                                              For many results it is necessary to handle exceptional values in measurements.

                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                              442. Observation.component:neckJointRangeOfMovement.interpretation
                                                                                                              Definition

                                                                                                              A categorical assessment of an observation value. For example, high, low, normal.

                                                                                                              ShortHigh, low, normal, etc.
                                                                                                              Comments

                                                                                                              Historically used for laboratory results (known as 'abnormal flag' ), its use extends to other use cases where coded interpretations are relevant. Often reported as one or more simple compact codes this element is often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result.

                                                                                                              Control0..*
                                                                                                              BindingUnless not suitable, these codes SHALL be taken from ObservationInterpretationCodes
                                                                                                              (extensible to http://hl7.org/fhir/ValueSet/observation-interpretation)

                                                                                                              Codes identifying interpretations of observations.

                                                                                                              TypeCodeableConcept
                                                                                                              Is Modifierfalse
                                                                                                              Summaryfalse
                                                                                                              Requirements

                                                                                                              For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.

                                                                                                              Alternate NamesAbnormal Flag
                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                              444. Observation.component:neckJointRangeOfMovement.referenceRange
                                                                                                              Definition

                                                                                                              Guidance on how to interpret the value by comparison to a normal or recommended range.

                                                                                                              ShortProvides guide for interpretation of component result
                                                                                                              Comments

                                                                                                              Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this might not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.

                                                                                                              Control0..*
                                                                                                              TypeSeettp://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange
                                                                                                              Is Modifierfalse
                                                                                                              Summaryfalse
                                                                                                              Requirements

                                                                                                              Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.

                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                              446. Observation.component:countsPerSecond
                                                                                                              Slice NamecountsPerSecond
                                                                                                              Definition

                                                                                                              Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.

                                                                                                              ShortComponent results
                                                                                                              Comments

                                                                                                              For a discussion on the ways Observations can be assembled in groups together see Notes below.

                                                                                                              Control1..1
                                                                                                              TypeBackboneElement
                                                                                                              Is Modifierfalse
                                                                                                              Summarytrue
                                                                                                              Requirements

                                                                                                              Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                              448. Observation.component:countsPerSecond.id
                                                                                                              Definition

                                                                                                              Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                                              ShortUnique id for inter-element referencing
                                                                                                              Control0..1
                                                                                                              Typestring
                                                                                                              Is Modifierfalse
                                                                                                              XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                              Summaryfalse
                                                                                                              450. Observation.component:countsPerSecond.extension
                                                                                                              Definition

                                                                                                              May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                                                              ShortAdditional content defined by implementations
                                                                                                              Comments

                                                                                                              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                                              Control0..*
                                                                                                              TypeExtension
                                                                                                              Is Modifierfalse
                                                                                                              Summaryfalse
                                                                                                              Alternate Namesextensions, user content
                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                              452. Observation.component:countsPerSecond.modifierExtension
                                                                                                              Definition

                                                                                                              May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                                                                                              Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                                                                              ShortExtensions that cannot be ignored even if unrecognized
                                                                                                              Comments

                                                                                                              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                                              Control0..*
                                                                                                              TypeExtension
                                                                                                              Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                                                              Summarytrue
                                                                                                              Requirements

                                                                                                              Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                                                                              Alternate Namesextensions, user content, modifiers
                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                              454. Observation.component:countsPerSecond.code
                                                                                                              Definition

                                                                                                              Describes what was observed. Sometimes this is called the observation "code".

                                                                                                              ShortType of component observation (code / type)
                                                                                                              Comments

                                                                                                              All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

                                                                                                              Control1..1
                                                                                                              BindingFor example codes, see LOINCCodes
                                                                                                              (example to http://hl7.org/fhir/ValueSet/observation-codes)

                                                                                                              Codes identifying names of simple observations.

                                                                                                              TypeCodeableConcept
                                                                                                              Is Modifierfalse
                                                                                                              Summarytrue
                                                                                                              Requirements

                                                                                                              Knowing what kind of observation is being made is essential to understanding the observation.

                                                                                                              Pattern Value{
                                                                                                                "coding" : [{
                                                                                                                  "system" : "http://snomed.info/sct",
                                                                                                                  "code" : "282108002",
                                                                                                                  "display" : "Counts per second"
                                                                                                                }]
                                                                                                              }
                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                              456. Observation.component:countsPerSecond.code.id
                                                                                                              Definition

                                                                                                              Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                                              ShortUnique id for inter-element referencing
                                                                                                              Control0..1
                                                                                                              Typestring
                                                                                                              Is Modifierfalse
                                                                                                              XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                              Summaryfalse
                                                                                                              458. Observation.component:countsPerSecond.code.extension
                                                                                                              Definition

                                                                                                              May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                                                              ShortAdditional content defined by implementations
                                                                                                              Comments

                                                                                                              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                                              Control0..*
                                                                                                              TypeExtension
                                                                                                              Is Modifierfalse
                                                                                                              Summaryfalse
                                                                                                              Alternate Namesextensions, user content
                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                              SlicingThis element introduces a set of slices on Observation.component.code.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                              • value @ url
                                                                                                              • 460. Observation.component:countsPerSecond.code.coding
                                                                                                                Definition

                                                                                                                A reference to a code defined by a terminology system.

                                                                                                                ShortCode defined by a terminology system
                                                                                                                Comments

                                                                                                                Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                                                                                                                Control0..*
                                                                                                                TypeCoding
                                                                                                                Is Modifierfalse
                                                                                                                Summarytrue
                                                                                                                Requirements

                                                                                                                Allows for alternative encodings within a code system, and translations to other code systems.

                                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                462. Observation.component:countsPerSecond.code.text
                                                                                                                Definition

                                                                                                                A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

                                                                                                                ShortPlain text representation of the concept
                                                                                                                Comments

                                                                                                                Very often the text is the same as a displayName of one of the codings.

                                                                                                                Control0..1
                                                                                                                Typestring
                                                                                                                Is Modifierfalse
                                                                                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                Summarytrue
                                                                                                                Requirements

                                                                                                                The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

                                                                                                                Pattern ValueHead turns per second
                                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                464. Observation.component:countsPerSecond.value[x]
                                                                                                                Definition

                                                                                                                The information determined as a result of making the observation, if the information has a simple value.

                                                                                                                ShortActual component result
                                                                                                                Comments

                                                                                                                Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

                                                                                                                Control0..1
                                                                                                                TypeChoice of: Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period
                                                                                                                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                                                Is Modifierfalse
                                                                                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                Summarytrue
                                                                                                                Requirements

                                                                                                                An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                SlicingThis element introduces a set of slices on Observation.component.value[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                                • type @ $this
                                                                                                                • 466. Observation.component:countsPerSecond.value[x]:valueSampledData
                                                                                                                  Slice NamevalueSampledData
                                                                                                                  Definition

                                                                                                                  The information determined as a result of making the observation, if the information has a simple value.

                                                                                                                  ShortActual component result
                                                                                                                  Comments

                                                                                                                  Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

                                                                                                                  Control0..1
                                                                                                                  TypeSampledData
                                                                                                                  [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                                                  Is Modifierfalse
                                                                                                                  Summarytrue
                                                                                                                  Requirements

                                                                                                                  An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                  468. Observation.component:countsPerSecond.value[x]:valueSampledData.id
                                                                                                                  Definition

                                                                                                                  Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                                                  ShortUnique id for inter-element referencing
                                                                                                                  Control0..1
                                                                                                                  Typestring
                                                                                                                  Is Modifierfalse
                                                                                                                  XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                                  Summaryfalse
                                                                                                                  470. Observation.component:countsPerSecond.value[x]:valueSampledData.extension
                                                                                                                  Definition

                                                                                                                  May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                                                                  ShortAdditional content defined by implementations
                                                                                                                  Comments

                                                                                                                  There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                                                  Control0..*
                                                                                                                  TypeExtension
                                                                                                                  Is Modifierfalse
                                                                                                                  Summaryfalse
                                                                                                                  Alternate Namesextensions, user content
                                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                  SlicingThis element introduces a set of slices on Observation.component.value[x].extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                                  • value @ url
                                                                                                                  • 472. Observation.component:countsPerSecond.value[x]:valueSampledData.origin
                                                                                                                    Definition

                                                                                                                    The base quantity that a measured value of zero represents. In addition, this provides the units of the entire measurement series.

                                                                                                                    ShortZero value and units
                                                                                                                    Control1..1
                                                                                                                    TypeQuantity(SimpleQuantity)
                                                                                                                    Is Modifierfalse
                                                                                                                    Summarytrue
                                                                                                                    Pattern Value{
                                                                                                                      "unit" : "per second",
                                                                                                                      "system" : "http://unitsofmeasure.org",
                                                                                                                      "code" : "/s"
                                                                                                                    }
                                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                    474. Observation.component:countsPerSecond.value[x]:valueSampledData.period
                                                                                                                    Definition

                                                                                                                    The length of time between sampling times, measured in milliseconds.

                                                                                                                    ShortNumber of milliseconds between samples
                                                                                                                    Comments

                                                                                                                    This is usually a whole number.

                                                                                                                    Control1..1
                                                                                                                    Typedecimal
                                                                                                                    Is Modifierfalse
                                                                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                    Summarytrue
                                                                                                                    Pattern Value1000
                                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                    476. Observation.component:countsPerSecond.value[x]:valueSampledData.factor
                                                                                                                    Definition

                                                                                                                    A correction factor that is applied to the sampled data points before they are added to the origin.

                                                                                                                    ShortMultiply data by this before adding to origin
                                                                                                                    Control0..1
                                                                                                                    Typedecimal
                                                                                                                    Is Modifierfalse
                                                                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                    Summarytrue
                                                                                                                    Meaning if MissingIf no factor is assigned, the data is not adjusted before adding to the origin
                                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                    478. Observation.component:countsPerSecond.value[x]:valueSampledData.lowerLimit
                                                                                                                    Definition

                                                                                                                    The lower limit of detection of the measured points. This is needed if any of the data points have the value "L" (lower than detection limit).

                                                                                                                    ShortLower limit of detection
                                                                                                                    Control0..1
                                                                                                                    Typedecimal
                                                                                                                    Is Modifierfalse
                                                                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                    Summarytrue
                                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                    480. Observation.component:countsPerSecond.value[x]:valueSampledData.upperLimit
                                                                                                                    Definition

                                                                                                                    The upper limit of detection of the measured points. This is needed if any of the data points have the value "U" (higher than detection limit).

                                                                                                                    ShortUpper limit of detection
                                                                                                                    Control0..1
                                                                                                                    Typedecimal
                                                                                                                    Is Modifierfalse
                                                                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                    Summarytrue
                                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                    482. Observation.component:countsPerSecond.value[x]:valueSampledData.dimensions
                                                                                                                    Definition

                                                                                                                    The number of sample points at each time point. If this value is greater than one, then the dimensions will be interlaced - all the sample points for a point in time will be recorded at once.

                                                                                                                    ShortNumber of sample points at each time point
                                                                                                                    Comments

                                                                                                                    If there is more than one dimension, the code for the type of data will define the meaning of the dimensions (typically ECG data).

                                                                                                                    Control1..1
                                                                                                                    TypepositiveInt
                                                                                                                    Is Modifierfalse
                                                                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                    Summarytrue
                                                                                                                    Pattern Value1
                                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                    484. Observation.component:countsPerSecond.value[x]:valueSampledData.data
                                                                                                                    Definition

                                                                                                                    A series of data points which are decimal values separated by a single space (character u20). The special values "E" (error), "L" (below detection limit) and "U" (above detection limit) can also be used in place of a decimal value.

                                                                                                                    ShortDecimal values with spaces, or "E" | "U" | "L"
                                                                                                                    Comments

                                                                                                                    Data may be missing if it is omitted for summarization purposes. In general, data is required for any actual use of a SampledData.

                                                                                                                    Control0..1
                                                                                                                    Typestring
                                                                                                                    Is Modifierfalse
                                                                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                    Summaryfalse
                                                                                                                    Pattern Value<<speed|FlattenedArray>>
                                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                    486. Observation.component:countsPerSecond.dataAbsentReason
                                                                                                                    Definition

                                                                                                                    Provides a reason why the expected value in the element Observation.component.value[x] is missing.

                                                                                                                    ShortWhy the component result is missing
                                                                                                                    Comments

                                                                                                                    "Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done".

                                                                                                                    The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

                                                                                                                    Control0..1
                                                                                                                    This element is affected by the following invariants: obs-6
                                                                                                                    BindingUnless not suitable, these codes SHALL be taken from DataAbsentReason
                                                                                                                    (extensible to http://hl7.org/fhir/ValueSet/data-absent-reason)

                                                                                                                    Codes specifying why the result (Observation.value[x]) is missing.

                                                                                                                    TypeCodeableConcept
                                                                                                                    Is Modifierfalse
                                                                                                                    Summaryfalse
                                                                                                                    Requirements

                                                                                                                    For many results it is necessary to handle exceptional values in measurements.

                                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                    488. Observation.component:countsPerSecond.interpretation
                                                                                                                    Definition

                                                                                                                    A categorical assessment of an observation value. For example, high, low, normal.

                                                                                                                    ShortHigh, low, normal, etc.
                                                                                                                    Comments

                                                                                                                    Historically used for laboratory results (known as 'abnormal flag' ), its use extends to other use cases where coded interpretations are relevant. Often reported as one or more simple compact codes this element is often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result.

                                                                                                                    Control0..*
                                                                                                                    BindingUnless not suitable, these codes SHALL be taken from ObservationInterpretationCodes
                                                                                                                    (extensible to http://hl7.org/fhir/ValueSet/observation-interpretation)

                                                                                                                    Codes identifying interpretations of observations.

                                                                                                                    TypeCodeableConcept
                                                                                                                    Is Modifierfalse
                                                                                                                    Summaryfalse
                                                                                                                    Requirements

                                                                                                                    For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.

                                                                                                                    Alternate NamesAbnormal Flag
                                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                    490. Observation.component:countsPerSecond.referenceRange
                                                                                                                    Definition

                                                                                                                    Guidance on how to interpret the value by comparison to a normal or recommended range.

                                                                                                                    ShortProvides guide for interpretation of component result
                                                                                                                    Comments

                                                                                                                    Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this might not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.

                                                                                                                    Control0..*
                                                                                                                    TypeSeettp://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange
                                                                                                                    Is Modifierfalse
                                                                                                                    Summaryfalse
                                                                                                                    Requirements

                                                                                                                    Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.

                                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))