PrescribeIT™ Specification and Guide Version 2.0 Revision F

 

3.52 StructureDefinition: PrescribeIT Pharmacy-related Observation

The official URL for this profile is: 

http://prescribeit.ca/fhir/StructureDefinition/profile-observation-rx

3.52.2 Formal Views of Profile Content

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

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This structure is derived from Observation

NameCard.TypeConstraints and Usage
.  Observation 0..*obs-6: dataAbsentReason SHALL only be present if Observation.value[x] is not present
obs-7: Component code SHALL not be same as observation code
Definition:
Measurements and simple assertions made about a patient, device or other subject.


Comments:
At present, only supported observations are height and weight.

Conformance Rule: Observations of height and weight should only be sent when there is an effective date.

..  id 1..1idDefinition:
The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.


Comments:
Usage Note: This will usually be a GUID and is assigned by the sending application. Ideally it should be consistent for all messages referencing this observation measurement.

..  status 1..1codeBinding: ObservationStatus (required)
Fixed Value: final
Definition:
The status of the result value.


Comments:
Fixed value: final

..  category 1..1Shared Health CodeableConcept CodeBinding: Observation Category Codes (example)
Definition:
A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text.


Comments:
codes are from HL7 and system URL is http://hl7.org/fhir/observation-category.

...  coding 1..*CodingSlice: Unordered, Open by value:system
Definition:
A reference to a code 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 labelled as UserSelected = true.

....  system 1..1uriDefinition:
The identification of the code system that defines the meaning of the symbol in the code.


Comments:
....  code 1..1codeDefinition:
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).

...  coding
       (HL7Code) 		1..*CodingDefinition:
A reference to a code defined by a terminology system.


Comments:
See children for fixed value

....  system 1..1uriFixed Value: http://hl7.org/fhir/observation-category
Definition:
The identification of the code system that defines the meaning of the symbol in the code.


Comments:
Fixed value: http://hl7.org/fhir/observation-category

....  code 1..1codeFixed Value: vital-signs
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).


Comments:
Fixed value: vital-signs

..  code 1..1Shared Health CodeableConcept Code​Binding: PrescriptionObservationTypeVitalSign (required)
Definition:
Identification of the type of measurement/observation that was made about the patient. The only two allowable types are height and weight.


Comments:
Conformance Rule: Code set has a binding value set defined.

...  coding 1..*CodingDefinition:
A reference to a code defined by a terminology system.


Comments:
Code and System will be set. For Body height code value = 8302-2 For Body weight code value = 29463-7

....  system 1..1uriDefinition:
The identification of the code system that defines the meaning of the symbol in the code.


Comments:
This must be https://fhir.infoway-inforoute.ca/CodeSystem/pCLOCD

....  code 1..1codeDefinition:
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).

..  subject 1..1Reference(Shared Health Patient) {b}Definition:
A reference from one resource to another.


Comments:
This must point to the patient associated with the message

..  effectiveDateTime 1..1dateTimeDefinition:
When the measurement was made


Comments:
At least a date should be present unless this observation is a historical report.

..  valueQuantity 1..1Shared Health Quantityqty-3: If a code for the unit is present, the system SHALL also be present
Definition:
A measured amount (or an amount that can potentially be measured). Note that measured amounts include amounts that are not precisely quantified, including amounts involving arbitrary units and floating currencies.


Comments:
Conformance Rule: This MUST be expressed in kilograms (weight), and centimeters (height). Value, System and Code will be set. For Body height; value - set to height measurement in centimeters system = http://unitsofmeasure.org code = cm For Body weight: value - set to weight measurement in kilograms system = http://unitsofmeasure.org code = kg

This structure is derived from Observation

Summary

Mandatory: 12 elements
Must-Support: 14 elements
Fixed Value: 3 elements

Structures

This structure refers to these other structures:

Slices

This structure defines the following Slices:

  • The element Observation.category.coding is sliced based on the value of value:system

This structure is derived from Observation

NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation S0..*Prescription-related observations
... id S1..1id
... status S1..1codeFixed Value: final
... category S1..1Shared Health CodeableConcept Code
.... coding SCodingSlice: Unordered, Open by value:system
.... coding S1..*Coding
..... system S1..1uriFixed Value: http://hl7.org/fhir/observation-category
..... code S1..1codeFixed Value: vital-signs
... code S1..1Shared Health CodeableConcept Code​Binding: PrescriptionObservationTypeVitalSign (required)
.... coding S1..*Coding
..... system S1..1uri
..... code S1..1code
... subject S1..1Reference(Shared Health Patient) {b}
... effectiveDateTime S1..1dateTime
... valueQuantity S1..1Shared Health QuantityMeasured value

doco Documentation for this format
NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation SI0..*Prescription-related observations
... id SΣ1..1idLogical id of this artifact
... meta Σ0..1MetaMetadata about the resource
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... language 0..1codeLanguage of the resource content
Binding: http://tools.ietf.org/html/bcp47 (required)
... text I0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... extension 0..*ExtensionAdditional Content defined by implementations
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... identifier 0..*IdentifierUnique Id for this particular observation
... status ?!SΣ1..1coderegistered | preliminary | final | amended +
Binding: ObservationStatus (required)
Fixed Value: final
... category S1..1Shared Health CodeableConcept CodeConcept - reference to a terminology or just text
Binding: Observation Category Codes (example)
.... id 0..1idxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
.... coding SΣCodingCode defined by a terminology system
Slice: Unordered, Open by value:system
..... id 0..1idxml:id (or equivalent in JSON)
..... extension 0..*ExtensionAdditional Content defined by implementations
..... system SΣ1..1uriIdentity of the terminology system
..... version Σ0..1stringVersion of the system - if relevant
..... code SΣ1..1codeSymbol in syntax defined by the system
..... display Σ0..1stringRepresentation defined by the system
..... userSelected Σ0..1booleanIf this coding was chosen directly by the user
.... coding SΣ1..*CodingCode defined by a terminology system
..... id 0..1idxml:id (or equivalent in JSON)
..... extension 0..*ExtensionAdditional Content defined by implementations
..... system SΣ1..1uriIdentity of the terminology system
Fixed Value: http://hl7.org/fhir/observation-category
..... version Σ0..1stringVersion of the system - if relevant
..... code SΣ1..1codeSymbol in syntax defined by the system
Fixed Value: vital-signs
..... display Σ0..1stringRepresentation defined by the system
..... userSelected Σ0..1booleanIf this coding was chosen directly by the user
.... text Σ0..1stringPlain text representation of the concept
... code S1..1Shared Health CodeableConcept Code​Concept - reference to a terminology or just text
Binding: PrescriptionObservationTypeVitalSign (required)
.... id 0..1idxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
.... coding SΣ1..*CodingCode defined by a terminology system
..... id 0..1idxml:id (or equivalent in JSON)
..... extension 0..*ExtensionAdditional Content defined by implementations
..... system SΣ1..1uriIdentity of the terminology system
..... version Σ0..1stringVersion of the system - if relevant
..... code SΣ1..1codeSymbol in syntax defined by the system
..... display Σ0..1stringRepresentation defined by the system
..... userSelected Σ0..1booleanIf this coding was chosen directly by the user
.... text Σ0..1stringPlain text representation of the concept
... subject SΣ1..1Reference(Shared Health Patient) {b}A reference from one resource to another
... encounter 0..1Reference(Encounter)Healthcare event during which this observation is made
... effectiveDateTime SΣ1..1dateTimeClinically relevant time/time-period for observation
... issued Σ0..1instantDate/Time this was made available
... performer Σ0..*Reference(Practitioner | Organization | Patient | RelatedPerson)Who is responsible for the observation
... valueQuantity SI1..1Shared Health QuantityMeasured value
... dataAbsentReason I0..1CodeableConceptWhy the result is missing
Binding: Observation Value Absent Reason (extensible)
... interpretation 0..1CodeableConceptHigh, low, normal, etc.
Binding: Observation Interpretation Codes (extensible)
... comment 0..1stringComments about result
... bodySite 0..1CodeableConceptObserved body part
Binding: SNOMED CT Body Structures (example)
... method 0..1CodeableConceptHow it was done
Binding: Observation Methods (example)
... specimen 0..1Reference(Specimen)Specimen used for this observation
... device 0..1Reference(Device | DeviceMetric)(Measurement) Device
... referenceRange I0..*BackboneElementProvides guide for interpretation
obs-3: Must have at least a low or a high or text
.... id 0..1idxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored
.... low I0..1SimpleQuantityLow Range, if relevant
.... high I0..1SimpleQuantityHigh Range, if relevant
.... meaning 0..1CodeableConceptIndicates the meaning/use of this range of this range
Binding: Observation Reference Range Meaning Codes (example)
.... age 0..1RangeApplicable age range, if relevant
.... text 0..1stringText based reference range in an observation
... related Σ0..*BackboneElementResource related to this observation
.... id 0..1idxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored
.... type 0..1codehas-member | derived-from | sequel-to | replaces | qualified-by | interfered-by
Binding: ObservationRelationshipType (required)
.... target 1..1Reference(Observation | QuestionnaireResponse)Resource that is related to this one
... component Σ0..*BackboneElementComponent results
.... id 0..1idxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored
.... code ΣI1..1CodeableConceptType of component observation (code / type)
Binding: LOINC Codes (example)
.... value[x] Σ0..1Quantity, CodeableConcept, string, Range, Ratio, SampledData, Attachment, time, dateTime, PeriodActual component result
.... dataAbsentReason I0..1CodeableConceptWhy the component result is missing
Binding: Observation Value Absent Reason (extensible)
.... referenceRange 0..*Unknown reference to #Observation.referenceRange
Provides guide for interpretation of component result

doco Documentation for this format

Grid View

This structure is derived from Observation

NameCard.TypeConstraints and Usage
.  Observation 0..*obs-6: dataAbsentReason SHALL only be present if Observation.value[x] is not present
obs-7: Component code SHALL not be same as observation code
Definition:
Measurements and simple assertions made about a patient, device or other subject.


Comments:
At present, only supported observations are height and weight.

Conformance Rule: Observations of height and weight should only be sent when there is an effective date.

..  id 1..1idDefinition:
The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.


Comments:
Usage Note: This will usually be a GUID and is assigned by the sending application. Ideally it should be consistent for all messages referencing this observation measurement.

..  status 1..1codeBinding: ObservationStatus (required)
Fixed Value: final
Definition:
The status of the result value.


Comments:
Fixed value: final

..  category 1..1Shared Health CodeableConcept CodeBinding: Observation Category Codes (example)
Definition:
A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text.


Comments:
codes are from HL7 and system URL is http://hl7.org/fhir/observation-category.

...  coding 1..*CodingSlice: Unordered, Open by value:system
Definition:
A reference to a code 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 labelled as UserSelected = true.

....  system 1..1uriDefinition:
The identification of the code system that defines the meaning of the symbol in the code.


Comments:
....  code 1..1codeDefinition:
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).

...  coding
       (HL7Code) 		1..*CodingDefinition:
A reference to a code defined by a terminology system.


Comments:
See children for fixed value

....  system 1..1uriFixed Value: http://hl7.org/fhir/observation-category
Definition:
The identification of the code system that defines the meaning of the symbol in the code.


Comments:
Fixed value: http://hl7.org/fhir/observation-category

....  code 1..1codeFixed Value: vital-signs
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).


Comments:
Fixed value: vital-signs

..  code 1..1Shared Health CodeableConcept Code​Binding: PrescriptionObservationTypeVitalSign (required)
Definition:
Identification of the type of measurement/observation that was made about the patient. The only two allowable types are height and weight.


Comments:
Conformance Rule: Code set has a binding value set defined.

...  coding 1..*CodingDefinition:
A reference to a code defined by a terminology system.


Comments:
Code and System will be set. For Body height code value = 8302-2 For Body weight code value = 29463-7

....  system 1..1uriDefinition:
The identification of the code system that defines the meaning of the symbol in the code.


Comments:
This must be https://fhir.infoway-inforoute.ca/CodeSystem/pCLOCD

....  code 1..1codeDefinition:
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).

..  subject 1..1Reference(Shared Health Patient) {b}Definition:
A reference from one resource to another.


Comments:
This must point to the patient associated with the message

..  effectiveDateTime 1..1dateTimeDefinition:
When the measurement was made


Comments:
At least a date should be present unless this observation is a historical report.

..  valueQuantity 1..1Shared Health Quantityqty-3: If a code for the unit is present, the system SHALL also be present
Definition:
A measured amount (or an amount that can potentially be measured). Note that measured amounts include amounts that are not precisely quantified, including amounts involving arbitrary units and floating currencies.


Comments:
Conformance Rule: This MUST be expressed in kilograms (weight), and centimeters (height). Value, System and Code will be set. For Body height; value - set to height measurement in centimeters system = http://unitsofmeasure.org code = cm For Body weight: value - set to weight measurement in kilograms system = http://unitsofmeasure.org code = kg

This structure is derived from Observation

Summary

Mandatory: 12 elements
Must-Support: 14 elements
Fixed Value: 3 elements

Structures

This structure refers to these other structures:

Slices

This structure defines the following Slices:

  • The element Observation.category.coding is sliced based on the value of value:system

Differential View

This structure is derived from Observation

NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation S0..*Prescription-related observations
... id S1..1id
... status S1..1codeFixed Value: final
... category S1..1Shared Health CodeableConcept Code
.... coding SCodingSlice: Unordered, Open by value:system
.... coding S1..*Coding
..... system S1..1uriFixed Value: http://hl7.org/fhir/observation-category
..... code S1..1codeFixed Value: vital-signs
... code S1..1Shared Health CodeableConcept Code​Binding: PrescriptionObservationTypeVitalSign (required)
.... coding S1..*Coding
..... system S1..1uri
..... code S1..1code
... subject S1..1Reference(Shared Health Patient) {b}
... effectiveDateTime S1..1dateTime
... valueQuantity S1..1Shared Health QuantityMeasured value

doco Documentation for this format

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation SI0..*Prescription-related observations
... id SΣ1..1idLogical id of this artifact
... meta Σ0..1MetaMetadata about the resource
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... language 0..1codeLanguage of the resource content
Binding: http://tools.ietf.org/html/bcp47 (required)
... text I0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... extension 0..*ExtensionAdditional Content defined by implementations
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... identifier 0..*IdentifierUnique Id for this particular observation
... status ?!SΣ1..1coderegistered | preliminary | final | amended +
Binding: ObservationStatus (required)
Fixed Value: final
... category S1..1Shared Health CodeableConcept CodeConcept - reference to a terminology or just text
Binding: Observation Category Codes (example)
.... id 0..1idxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
.... coding SΣCodingCode defined by a terminology system
Slice: Unordered, Open by value:system
..... id 0..1idxml:id (or equivalent in JSON)
..... extension 0..*ExtensionAdditional Content defined by implementations
..... system SΣ1..1uriIdentity of the terminology system
..... version Σ0..1stringVersion of the system - if relevant
..... code SΣ1..1codeSymbol in syntax defined by the system
..... display Σ0..1stringRepresentation defined by the system
..... userSelected Σ0..1booleanIf this coding was chosen directly by the user
.... coding SΣ1..*CodingCode defined by a terminology system
..... id 0..1idxml:id (or equivalent in JSON)
..... extension 0..*ExtensionAdditional Content defined by implementations
..... system SΣ1..1uriIdentity of the terminology system
Fixed Value: http://hl7.org/fhir/observation-category
..... version Σ0..1stringVersion of the system - if relevant
..... code SΣ1..1codeSymbol in syntax defined by the system
Fixed Value: vital-signs
..... display Σ0..1stringRepresentation defined by the system
..... userSelected Σ0..1booleanIf this coding was chosen directly by the user
.... text Σ0..1stringPlain text representation of the concept
... code S1..1Shared Health CodeableConcept Code​Concept - reference to a terminology or just text
Binding: PrescriptionObservationTypeVitalSign (required)
.... id 0..1idxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
.... coding SΣ1..*CodingCode defined by a terminology system
..... id 0..1idxml:id (or equivalent in JSON)
..... extension 0..*ExtensionAdditional Content defined by implementations
..... system SΣ1..1uriIdentity of the terminology system
..... version Σ0..1stringVersion of the system - if relevant
..... code SΣ1..1codeSymbol in syntax defined by the system
..... display Σ0..1stringRepresentation defined by the system
..... userSelected Σ0..1booleanIf this coding was chosen directly by the user
.... text Σ0..1stringPlain text representation of the concept
... subject SΣ1..1Reference(Shared Health Patient) {b}A reference from one resource to another
... encounter 0..1Reference(Encounter)Healthcare event during which this observation is made
... effectiveDateTime SΣ1..1dateTimeClinically relevant time/time-period for observation
... issued Σ0..1instantDate/Time this was made available
... performer Σ0..*Reference(Practitioner | Organization | Patient | RelatedPerson)Who is responsible for the observation
... valueQuantity SI1..1Shared Health QuantityMeasured value
... dataAbsentReason I0..1CodeableConceptWhy the result is missing
Binding: Observation Value Absent Reason (extensible)
... interpretation 0..1CodeableConceptHigh, low, normal, etc.
Binding: Observation Interpretation Codes (extensible)
... comment 0..1stringComments about result
... bodySite 0..1CodeableConceptObserved body part
Binding: SNOMED CT Body Structures (example)
... method 0..1CodeableConceptHow it was done
Binding: Observation Methods (example)
... specimen 0..1Reference(Specimen)Specimen used for this observation
... device 0..1Reference(Device | DeviceMetric)(Measurement) Device
... referenceRange I0..*BackboneElementProvides guide for interpretation
obs-3: Must have at least a low or a high or text
.... id 0..1idxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored
.... low I0..1SimpleQuantityLow Range, if relevant
.... high I0..1SimpleQuantityHigh Range, if relevant
.... meaning 0..1CodeableConceptIndicates the meaning/use of this range of this range
Binding: Observation Reference Range Meaning Codes (example)
.... age 0..1RangeApplicable age range, if relevant
.... text 0..1stringText based reference range in an observation
... related Σ0..*BackboneElementResource related to this observation
.... id 0..1idxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored
.... type 0..1codehas-member | derived-from | sequel-to | replaces | qualified-by | interfered-by
Binding: ObservationRelationshipType (required)
.... target 1..1Reference(Observation | QuestionnaireResponse)Resource that is related to this one
... component Σ0..*BackboneElementComponent results
.... id 0..1idxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored
.... code ΣI1..1CodeableConceptType of component observation (code / type)
Binding: LOINC Codes (example)
.... value[x] Σ0..1Quantity, CodeableConcept, string, Range, Ratio, SampledData, Attachment, time, dateTime, PeriodActual component result
.... dataAbsentReason I0..1CodeableConceptWhy the component result is missing
Binding: Observation Value Absent Reason (extensible)
.... referenceRange 0..*Unknown reference to #Observation.referenceRange
Provides guide for interpretation of component result

doco Documentation for this format

 

Other representations of profile: Schematron

3.52.3 Terminology Bindings

Terminology Bindings

PathNameConformanceValueSet
Observation.language?extrequiredhttp://tools.ietf.org/html/bcp47
Observation.statusObservationStatusrequiredObservationStatus
Observation.categoryObservation Category CodesexampleObservation Category Codes
Observation.codePrescriptionObservationTypeVitalSignrequired​PrescriptionObservationTypeVitalSign
Observation.dataAbsentReasonObservation Value Absent ReasonextensibleObservation Value Absent Reason
Observation.interpretationObservation Interpretation CodesextensibleObservation Interpretation Codes
Observation.bodySiteSNOMED CT Body StructuresexampleSNOMED CT Body Structures
Observation.methodObservation MethodsexampleObservation Methods
Observation.referenceRange.meaningObservation Reference Range Meaning CodesexampleObservation Reference Range Meaning Codes
Observation.related.typeObservationRelationshipTyperequiredObservationRelationshipType
Observation.component.codeLOINC CodesexampleLOINC Codes
Observation.component.dataAbsentReasonObservation Value Absent ReasonextensibleObservation Value Absent Reason

3.52.4 Constraints

Constraints

IdPathDetailsRequirements
obs-6ObservationdataAbsentReason SHALL only be present if Observation.value[x] is not present
: dataAbsentReason.empty() or value.empty()
obs-7ObservationComponent code SHALL not be same as observation code
: value.empty() or code!=component.code
qty-3Observation.valueQuantityIf a code for the unit is present, the system SHALL also be present
: code.empty() or system.exists()
obs-3Observation.referenceRangeMust have at least a low or a high or text
: low.exists() or high.exists() or text.exists()