Medtech ALEX® AU Implementation Guide
1.0.0 - Trial Use

Medtech ALEX® AU Implementation Guide - Local Development build (v1.0.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

## Resource Profile: Observation

Official URL: https://alexapi.medtechglobal.com.au/fhir/StructureDefinition/alex-observation | Version: 1.0.0
Active as of 2026-01-12 | Computable Name: AlexObservation

The observation exposed by ALEX.

Usages:

- Derived from this Profile: Observation IPS Profile
- Use this Profile: Observation Bundle
- Examples for this Profile: Observation/observation-full-example and Observation/observation-min-example

You can also check for usages in the FHIR IG Statistics

### Formal Views of Profile Content

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

- Key Elements Table
- Differential Table
- Snapshot Table
- Statistics/References
- All

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Observation | C | 0..* | Observation | Measurements and simple assertions Constraints: obs-6, obs-7, observation-code-text-length, observation-note-text-length
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
status | ?!Σ | 1..1 | code | registered | preliminary | final | amended + Binding: ObservationStatus (required): Codes providing the status of an observation. Required Pattern: final
code | S Σ | 1..1 | CodeableConcept | Type of observation (code / type) Binding: Screening Term Value Set for observation result (extensible)
text | S Σ | 1..1 | string | Plain text representation of the concept
subject | S Σ | 1..1 | Reference(Patient | Group | Device | Location) | Who and/or what the observation is about
reference | S Σ C | 1..1 | string | Reference to Patient resource
display | Σ | 0..1 | string | External Name of Patient
Slices for effective[x] | Σ | 1..1 | instant | Clinically relevant time/time-period for observation Slice: Unordered, Closed by type:$this
effective[x]:effectiveInstant | S Σ | 1..1 | instant | Clinically relevant time/time-period for observation
performer | S Σ | 1..1 | Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson) | Who is responsible for the observation
reference | S Σ C | 1..1 | string | Reference to Practitioner resource
display | Σ | 0..1 | string | External Name of Practitioner
Slices for value[x] | Σ C | 0..1 |  | Actual result Slice: Unordered, Closed by type:$this
valueQuantity |  |  | Quantity |
valueString |  |  | string |
valueDateTime |  |  | dateTime |
value[x]:valueString | S Σ C | 0..1 | string | Actual result
value[x]:valueQuantity | Σ C | 0..1 | Quantity | Actual result
value | S Σ | 1..1 | decimal | Numerical value (with implicit precision)
comparator | ?!Σ | 0..1 | code | < | <= | >= | > - how to understand the value Binding: QuantityComparator (required): How the Quantity should be understood and represented.
system | Σ C | 0..1 | uri | System that defines coded unit form Required Pattern: https://alexapi.medtechglobal.com.au/fhir/CodeSystem/value-quantity-unit
code | Σ | 0..1 | code | Coded form of the unit Binding: Unit Value Set for Observation Component (extensible)
value[x]:valueDateTime | S Σ C | 0..1 | dateTime | Actual result
interpretation | S | 0..* | CodeableConcept | High, low, normal, etc. Binding: Interpretation Value Set for Observation (extensible)
coding | Σ | 1..* | Coding | Code defined by a terminology system
system | S Σ | 1..1 | uri | Identity of the terminology system Required Pattern: https://alexapi.medtechglobal.com.au/fhir/CodeSystem/observation-interpretation
code | S Σ | 1..1 | code | Symbol in syntax defined by the system
text | S Σ | 0..1 | string | Plain text representation of the concept
note | S | 0..* | Annotation | Comments about the observation
text | S Σ | 1..1 | markdown | The annotation - text content (as markdown)
component | S Σ | 0..* | BackboneElement | Component results
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
code | S Σ | 1..1 | CodeableConcept | Type of component observation (code / type) Binding: Prompt Value Set for Measurement (preferred)
Slices for value[x] | Σ | 0..1 |  | Actual component result Slice: Unordered, Closed by type:$this
valueQuantity |  |  | Quantity |
valueString |  |  | string |
valueDateTime |  |  | dateTime |
value[x]:valueString | S Σ | 0..1 | string | Actual component result
value[x]:valueQuantity | Σ | 0..1 | Quantity | Actual component result
value | S Σ | 1..1 | decimal | Numerical value (with implicit precision)
comparator | ?!Σ | 0..1 | code | < | <= | >= | > - how to understand the value Binding: QuantityComparator (required): How the Quantity should be understood and represented.
system | Σ C | 0..1 | uri | System that defines coded unit form Required Pattern: https://alexapi.medtechglobal.com.au/fhir/CodeSystem/value-quantity-unit
code | Σ | 0..1 | code | Coded form of the unit Binding: Unit Value Set for Observation Component (extensible)
value[x]:valueDateTime | S Σ | 0..1 | dateTime | Actual component result
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
Observation.status | Base | required | ObservationStatus | 📍4.0.1 | FHIR Std.
Observation.code | Base | extensible | Screening Term Value Set for observation result | 📦1.0.0 | This IG
Observation.value[x]:valueQuantity.​comparator | Base | required | QuantityComparator | 📍4.0.1 | FHIR Std.
Observation.value[x]:valueQuantity.​code | Base | extensible | Unit Value Set for Observation Component | 📦1.0.0 | This IG
Observation.interpretation | Base | extensible | Interpretation Value Set for Observation | 📦1.0.0 | This IG
Observation.component.​code | Base | preferred | Prompt Value Set for Measurement | 📦1.0.0 | This IG
Observation.component.​value[x]:valueQuantity.​comparator | Base | required | QuantityComparator | 📍4.0.1 | FHIR Std.
Observation.component.​value[x]:valueQuantity.​code | Base | extensible | Unit Value Set for Observation Component | 📦1.0.0 | This IG

#### Constraints

Id | Grade | Path(s) | Description | Expression
dom-2 | error | Observation | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | Observation | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource | `contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()`
dom-4 | error | Observation | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated | `contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()`
dom-5 | error | Observation | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | Observation | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`
obs-6 | error | Observation | dataAbsentReason SHALL only be present if Observation.value[x] is not present | `dataAbsentReason.empty() or value.empty()`
obs-7 | error | Observation | If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present | `value.empty() or component.code.where(coding.intersect(%resource.code.coding).exists()).empty()`
observation-code-text-length | error | Observation | Code.text cannot be more than 30 characters | `code.text.empty() or code.text.length() <= 30`
observation-note-text-length | error | Observation | Note - text size validation | `note.text.empty() or note.text.length() <= 4096`

This structure is derived from Observation

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Observation | C | 0..* | Observation | Measurements and simple assertions Constraints: observation-code-text-length, observation-note-text-length
meta |  |  |  |
security |  | 0..* | Coding | Security Labels applied to this resource Binding: Definition of Confidentiality Value Set (required)
implicitRules |  | 0..0 |  | A set of rules under which this content was created
language |  | 0..0 |  | Language of the resource content
contained |  | 0..0 |  | Contained, inline Resources
identifier |  | 0..0 |  | Business Identifier for observation
status |  | 1..1 | code | registered | preliminary | final | amended + Required Pattern: final
category |  | 0..0 |  | Classification of type of observation
code | S | 1..1 | CodeableConcept | Type of observation (code / type) Binding: Screening Term Value Set for observation result (extensible)
coding |  |  |  |
system |  | 0..1 | uri | Identity of the terminology system Required Pattern: https://alexapi.medtechglobal.com.au/fhir/CodeSystem/screening-term
text | S | 1..1 | string | Plain text representation of the concept
subject | S | 1..1 | Reference(Patient | Group | Device | Location) | Who and/or what the observation is about
reference | S | 1..1 | string | Reference to Patient resource
display |  | 0..1 | string | External Name of Patient
encounter |  | 0..0 |  | Healthcare event during which this observation is made
Slices for effective[x] |  | 1..1 | instant | Clinically relevant time/time-period for observation Slice: Unordered, Open by type:$this
effective[x]:effectiveInstant | S | 1..1 | instant | Clinically relevant time/time-period for observation
performer | S | 1..1 | Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson) | Who is responsible for the observation
reference | S | 1..1 | string | Reference to Practitioner resource
display |  | 0..1 | string | External Name of Practitioner
Slices for value[x] |  | 0..1 |  | Actual result Slice: Unordered, Open by type:$this
valueQuantity |  |  | Quantity |
valueString |  |  | string |
valueDateTime |  |  | dateTime |
value[x]:valueString | S | 0..1 | string | Actual result
value[x]:valueQuantity |  | 0..1 | Quantity | Actual result
value | S | 1..1 | decimal | Numerical value (with implicit precision)
system |  | 0..1 | uri | System that defines coded unit form Required Pattern: https://alexapi.medtechglobal.com.au/fhir/CodeSystem/value-quantity-unit
code |  | 0..1 | code | Coded form of the unit Binding: Unit Value Set for Observation Component (extensible)
value[x]:valueDateTime | S | 0..1 | dateTime | Actual result
interpretation | S | 0..* | CodeableConcept | High, low, normal, etc. Binding: Interpretation Value Set for Observation (extensible)
coding |  | 1..* | Coding | Code defined by a terminology system
system | S | 1..1 | uri | Identity of the terminology system Required Pattern: https://alexapi.medtechglobal.com.au/fhir/CodeSystem/observation-interpretation
code | S | 1..1 | code | Symbol in syntax defined by the system
text | S | 0..1 | string | Plain text representation of the concept
note | S | 0..* | Annotation | Comments about the observation
text | S | 1..1 | markdown | The annotation - text content (as markdown)
bodySite |  | 0..0 |  | Observed body part
component | S | 0..* | BackboneElement | Component results
code | S | 1..1 | CodeableConcept | Type of component observation (code / type) Binding: Prompt Value Set for Measurement (preferred)
coding |  |  |  |
system |  | 0..1 | uri | Identity of the terminology system Required Pattern: https://alexapi.medtechglobal.com.au/fhir/CodeSystem/measurement-prompt
Slices for value[x] |  | 0..1 |  | Actual component result Slice: Unordered, Open by type:$this
valueQuantity |  |  | Quantity |
valueString |  |  | string |
valueDateTime |  |  | dateTime |
value[x]:valueString | S | 0..1 | string | Actual component result
value[x]:valueQuantity |  | 0..1 | Quantity | Actual component result
value | S | 1..1 | decimal | Numerical value (with implicit precision)
system |  | 0..1 | uri | System that defines coded unit form Required Pattern: https://alexapi.medtechglobal.com.au/fhir/CodeSystem/value-quantity-unit
code |  | 0..1 | code | Coded form of the unit Binding: Unit Value Set for Observation Component (extensible)
value[x]:valueDateTime | S | 0..1 | dateTime | Actual component result
Documentation for this format

#### Terminology Bindings (Differential)

Path | Status | Usage | ValueSet | Version | Source
Observation.meta.security | Base | required | Definition of Confidentiality Value Set | 📦1.0.0 | This IG
Observation.code | Base | extensible | Screening Term Value Set for observation result | 📦1.0.0 | This IG
Observation.value[x]:valueQuantity.​code | Base | extensible | Unit Value Set for Observation Component | 📦1.0.0 | This IG
Observation.interpretation | Base | extensible | Interpretation Value Set for Observation | 📦1.0.0 | This IG
Observation.component.​code | Base | preferred | Prompt Value Set for Measurement | 📦1.0.0 | This IG
Observation.component.​value[x]:valueQuantity.​code | Base | extensible | Unit Value Set for Observation Component | 📦1.0.0 | This IG

#### Constraints

Id | Grade | Path(s) | Description | Expression
observation-code-text-length | error | Observation | Code.text cannot be more than 30 characters | `code.text.empty() or code.text.length() <= 30`
observation-note-text-length | error | Observation | Note - text size validation | `note.text.empty() or note.text.length() <= 4096`

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Observation | C | 0..* | Observation | Measurements and simple assertions Constraints: obs-6, obs-7, observation-code-text-length, observation-note-text-length
id | Σ | 0..1 | id | Logical id of this artifact
meta | Σ | 0..1 | Meta | Metadata about the resource
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
versionId | Σ | 0..1 | id | Version specific identifier
lastUpdated | Σ | 0..1 | instant | When the resource version last changed
source | Σ | 0..1 | uri | Identifies where the resource comes from
profile | Σ | 0..* | canonical(StructureDefinition) | Profiles this resource claims to conform to
security | Σ | 0..* | Coding | Security Labels applied to this resource Binding: Definition of Confidentiality Value Set (required)
tag | Σ | 0..* | Coding | Tags applied to this resource Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".
text |  | 0..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
basedOn | Σ | 0..* | Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest) | Fulfills plan, proposal or order
partOf | Σ | 0..* | Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy) | Part of referenced event
status | ?!Σ | 1..1 | code | registered | preliminary | final | amended + Binding: ObservationStatus (required): Codes providing the status of an observation. Required Pattern: final
code | S Σ | 1..1 | CodeableConcept | Type of observation (code / type) Binding: Screening Term Value Set for observation result (extensible)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
coding | Σ | 0..* | Coding | Code defined by a terminology system
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
system | Σ | 0..1 | uri | Identity of the terminology system Required Pattern: https://alexapi.medtechglobal.com.au/fhir/CodeSystem/screening-term
version | Σ | 0..1 | string | Version of the system - if relevant
code | Σ | 0..1 | code | Symbol in syntax defined by the system
display | Σ | 0..1 | string | Representation defined by the system
userSelected | Σ | 0..1 | boolean | If this coding was chosen directly by the user
text | S Σ | 1..1 | string | Plain text representation of the concept
subject | S Σ | 1..1 | Reference(Patient | Group | Device | Location) | Who and/or what the observation is about
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
reference | S Σ C | 1..1 | string | Reference to Patient resource
type | Σ | 0..1 | uri | Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier | Σ | 0..1 | Identifier | Logical reference, when literal reference is not known
display | Σ | 0..1 | string | External Name of Patient
focus | Σ | 0..* | Reference(Resource) | What the observation is about, when it is not about the subject of record
Slices for effective[x] | Σ | 1..1 | instant | Clinically relevant time/time-period for observation Slice: Unordered, Closed by type:$this
effective[x]:effectiveInstant | S Σ | 1..1 | instant | Clinically relevant time/time-period for observation
issued | Σ | 0..1 | instant | Date/Time this version was made available
performer | S Σ | 1..1 | Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson) | Who is responsible for the observation
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
reference | S Σ C | 1..1 | string | Reference to Practitioner resource
type | Σ | 0..1 | uri | Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier | Σ | 0..1 | Identifier | Logical reference, when literal reference is not known
display | Σ | 0..1 | string | External Name of Practitioner
Slices for value[x] | Σ C | 0..1 |  | Actual result Slice: Unordered, Closed by type:$this
valueQuantity |  |  | Quantity |
valueString |  |  | string |
valueDateTime |  |  | dateTime |
value[x]:valueString | S Σ C | 0..1 | string | Actual result
value[x]:valueQuantity | Σ C | 0..1 | Quantity | Actual result
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
value | S Σ | 1..1 | decimal | Numerical value (with implicit precision)
comparator | ?!Σ | 0..1 | code | < | <= | >= | > - how to understand the value Binding: QuantityComparator (required): How the Quantity should be understood and represented.
unit | Σ | 0..1 | string | Unit representation
system | Σ C | 0..1 | uri | System that defines coded unit form Required Pattern: https://alexapi.medtechglobal.com.au/fhir/CodeSystem/value-quantity-unit
code | Σ | 0..1 | code | Coded form of the unit Binding: Unit Value Set for Observation Component (extensible)
value[x]:valueDateTime | S Σ C | 0..1 | dateTime | Actual result
dataAbsentReason | C | 0..1 | CodeableConcept | Why the result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation | S | 0..* | CodeableConcept | High, low, normal, etc. Binding: Interpretation Value Set for Observation (extensible)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
coding | Σ | 1..* | Coding | Code defined by a terminology system
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
system | S Σ | 1..1 | uri | Identity of the terminology system Required Pattern: https://alexapi.medtechglobal.com.au/fhir/CodeSystem/observation-interpretation
version | Σ | 0..1 | string | Version of the system - if relevant
code | S Σ | 1..1 | code | Symbol in syntax defined by the system
display | Σ | 0..1 | string | Representation defined by the system
userSelected | Σ | 0..1 | boolean | If this coding was chosen directly by the user
text | S Σ | 0..1 | string | Plain text representation of the concept
note | S | 0..* | Annotation | Comments about the observation
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
author[x] | Σ | 0..1 |  | Individual responsible for the annotation
authorReference |  |  | Reference(Practitioner | Patient | RelatedPerson | Organization) |
authorString |  |  | string |
time | Σ | 0..1 | dateTime | When the annotation was made
text | S Σ | 1..1 | markdown | The annotation - text content (as markdown)
method |  | 0..1 | CodeableConcept | How it was done Binding: ObservationMethods (example): Methods for simple observations.
specimen |  | 0..1 | Reference(Specimen) | Specimen used for this observation
device |  | 0..1 | Reference(Device | DeviceMetric) | (Measurement) Device
referenceRange | C | 0..* | BackboneElement | Provides guide for interpretation Constraints: obs-3
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
low | C | 0..1 | SimpleQuantity(4.0.1) | Low Range, if relevant
high | C | 0..1 | SimpleQuantity(4.0.1) | High Range, if relevant
type |  | 0..1 | CodeableConcept | Reference range qualifier Binding: ObservationReferenceRangeMeaningCodes (preferred): Code for the meaning of a reference range.
appliesTo |  | 0..* | CodeableConcept | Reference range population Binding: ObservationReferenceRangeAppliesToCodes (example): Codes identifying the population the reference range applies to.
age |  | 0..1 | Range | Applicable age range, if relevant
text |  | 0..1 | string | Text based reference range in an observation
hasMember | Σ | 0..* | Reference(Observation | QuestionnaireResponse | MolecularSequence) | Related resource that belongs to the Observation group
derivedFrom | Σ | 0..* | Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | Observation | MolecularSequence) | Related measurements the observation is made from
component | S Σ | 0..* | BackboneElement | Component results
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
code | S Σ | 1..1 | CodeableConcept | Type of component observation (code / type) Binding: Prompt Value Set for Measurement (preferred)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
coding | Σ | 0..* | Coding | Code defined by a terminology system
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
system | Σ | 0..1 | uri | Identity of the terminology system Required Pattern: https://alexapi.medtechglobal.com.au/fhir/CodeSystem/measurement-prompt
version | Σ | 0..1 | string | Version of the system - if relevant
code | Σ | 0..1 | code | Symbol in syntax defined by the system
display | Σ | 0..1 | string | Representation defined by the system
userSelected | Σ | 0..1 | boolean | If this coding was chosen directly by the user
text | Σ | 0..1 | string | Plain text representation of the concept
Slices for value[x] | Σ | 0..1 |  | Actual component result Slice: Unordered, Closed by type:$this
valueQuantity |  |  | Quantity |
valueString |  |  | string |
valueDateTime |  |  | dateTime |
value[x]:valueString | S Σ | 0..1 | string | Actual component result
value[x]:valueQuantity | Σ | 0..1 | Quantity | Actual component result
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
value | S Σ | 1..1 | decimal | Numerical value (with implicit precision)
comparator | ?!Σ | 0..1 | code | < | <= | >= | > - how to understand the value Binding: QuantityComparator (required): How the Quantity should be understood and represented.
unit | Σ | 0..1 | string | Unit representation
system | Σ C | 0..1 | uri | System that defines coded unit form Required Pattern: https://alexapi.medtechglobal.com.au/fhir/CodeSystem/value-quantity-unit
code | Σ | 0..1 | code | Coded form of the unit Binding: Unit Value Set for Observation Component (extensible)
value[x]:valueDateTime | S Σ | 0..1 | dateTime | Actual component result
dataAbsentReason | C | 0..1 | CodeableConcept | Why the component result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation |  | 0..* | CodeableConcept | High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
referenceRange |  | 0..* | See referenceRange (Observation) | Provides guide for interpretation of component result
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
Observation.meta.security | Base | required | Definition of Confidentiality Value Set | 📦1.0.0 | This IG
Observation.meta.tag | Base | example | Common Tags | 📍4.0.1 | FHIR Std.
Observation.status | Base | required | ObservationStatus | 📍4.0.1 | FHIR Std.
Observation.code | Base | extensible | Screening Term Value Set for observation result | 📦1.0.0 | This IG
Observation.subject.​type | Base | extensible | ResourceType | 📍4.0.1 | FHIR Std.
Observation.performer.​type | Base | extensible | ResourceType | 📍4.0.1 | FHIR Std.
Observation.value[x]:valueQuantity.​comparator | Base | required | QuantityComparator | 📍4.0.1 | FHIR Std.
Observation.value[x]:valueQuantity.​code | Base | extensible | Unit Value Set for Observation Component | 📦1.0.0 | This IG
Observation.dataAbsentReason | Base | extensible | DataAbsentReason | 📍4.0.1 | FHIR Std.
Observation.interpretation | Base | extensible | Interpretation Value Set for Observation | 📦1.0.0 | This IG
Observation.method | Base | example | Observation Methods | 📍4.0.1 | FHIR Std.
Observation.referenceRange.​type | Base | preferred | Observation Reference Range Meaning Codes | 📍4.0.1 | FHIR Std.
Observation.referenceRange.​appliesTo | Base | example | Observation Reference Range Applies To Codes | 📍4.0.1 | FHIR Std.
Observation.component.​code | Base | preferred | Prompt Value Set for Measurement | 📦1.0.0 | This IG
Observation.component.​value[x]:valueQuantity.​comparator | Base | required | QuantityComparator | 📍4.0.1 | FHIR Std.
Observation.component.​value[x]:valueQuantity.​code | Base | extensible | Unit Value Set for Observation Component | 📦1.0.0 | This IG
Observation.component.​dataAbsentReason | Base | extensible | DataAbsentReason | 📍4.0.1 | FHIR Std.
Observation.component.​interpretation | Base | extensible | Observation Interpretation Codes | 📍4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
dom-2 | error | Observation | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | Observation | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource | `contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()`
dom-4 | error | Observation | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated | `contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()`
dom-5 | error | Observation | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | Observation | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`
obs-3 | error | Observation.referenceRange | Must have at least a low or a high or text | `low.exists() or high.exists() or text.exists()`
obs-6 | error | Observation | dataAbsentReason SHALL only be present if Observation.value[x] is not present | `dataAbsentReason.empty() or value.empty()`
obs-7 | error | Observation | If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present | `value.empty() or component.code.where(coding.intersect(%resource.code.coding).exists()).empty()`
observation-code-text-length | error | Observation | Code.text cannot be more than 30 characters | `code.text.empty() or code.text.length() <= 30`
observation-note-text-length | error | Observation | Note - text size validation | `note.text.empty() or note.text.length() <= 4096`

This structure is derived from Observation

Summary

Mandatory: 7 elements(5 nested mandatory elements)
Must-Support: 21 elements
Prohibited: 7 elements

Slices

This structure defines the following Slices:

- The element 1 is sliced based on the value of Observation.effective[x]
- The element 1 is sliced based on the value of Observation.value[x]
- The element 1 is sliced based on the value of Observation.component.value[x]

Key Elements View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Observation | C | 0..* | Observation | Measurements and simple assertions Constraints: obs-6, obs-7, observation-code-text-length, observation-note-text-length
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
status | ?!Σ | 1..1 | code | registered | preliminary | final | amended + Binding: ObservationStatus (required): Codes providing the status of an observation. Required Pattern: final
code | S Σ | 1..1 | CodeableConcept | Type of observation (code / type) Binding: Screening Term Value Set for observation result (extensible)
text | S Σ | 1..1 | string | Plain text representation of the concept
subject | S Σ | 1..1 | Reference(Patient | Group | Device | Location) | Who and/or what the observation is about
reference | S Σ C | 1..1 | string | Reference to Patient resource
display | Σ | 0..1 | string | External Name of Patient
Slices for effective[x] | Σ | 1..1 | instant | Clinically relevant time/time-period for observation Slice: Unordered, Closed by type:$this
effective[x]:effectiveInstant | S Σ | 1..1 | instant | Clinically relevant time/time-period for observation
performer | S Σ | 1..1 | Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson) | Who is responsible for the observation
reference | S Σ C | 1..1 | string | Reference to Practitioner resource
display | Σ | 0..1 | string | External Name of Practitioner
Slices for value[x] | Σ C | 0..1 |  | Actual result Slice: Unordered, Closed by type:$this
valueQuantity |  |  | Quantity |
valueString |  |  | string |
valueDateTime |  |  | dateTime |
value[x]:valueString | S Σ C | 0..1 | string | Actual result
value[x]:valueQuantity | Σ C | 0..1 | Quantity | Actual result
value | S Σ | 1..1 | decimal | Numerical value (with implicit precision)
comparator | ?!Σ | 0..1 | code | < | <= | >= | > - how to understand the value Binding: QuantityComparator (required): How the Quantity should be understood and represented.
system | Σ C | 0..1 | uri | System that defines coded unit form Required Pattern: https://alexapi.medtechglobal.com.au/fhir/CodeSystem/value-quantity-unit
code | Σ | 0..1 | code | Coded form of the unit Binding: Unit Value Set for Observation Component (extensible)
value[x]:valueDateTime | S Σ C | 0..1 | dateTime | Actual result
interpretation | S | 0..* | CodeableConcept | High, low, normal, etc. Binding: Interpretation Value Set for Observation (extensible)
coding | Σ | 1..* | Coding | Code defined by a terminology system
system | S Σ | 1..1 | uri | Identity of the terminology system Required Pattern: https://alexapi.medtechglobal.com.au/fhir/CodeSystem/observation-interpretation
code | S Σ | 1..1 | code | Symbol in syntax defined by the system
text | S Σ | 0..1 | string | Plain text representation of the concept
note | S | 0..* | Annotation | Comments about the observation
text | S Σ | 1..1 | markdown | The annotation - text content (as markdown)
component | S Σ | 0..* | BackboneElement | Component results
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
code | S Σ | 1..1 | CodeableConcept | Type of component observation (code / type) Binding: Prompt Value Set for Measurement (preferred)
Slices for value[x] | Σ | 0..1 |  | Actual component result Slice: Unordered, Closed by type:$this
valueQuantity |  |  | Quantity |
valueString |  |  | string |
valueDateTime |  |  | dateTime |
value[x]:valueString | S Σ | 0..1 | string | Actual component result
value[x]:valueQuantity | Σ | 0..1 | Quantity | Actual component result
value | S Σ | 1..1 | decimal | Numerical value (with implicit precision)
comparator | ?!Σ | 0..1 | code | < | <= | >= | > - how to understand the value Binding: QuantityComparator (required): How the Quantity should be understood and represented.
system | Σ C | 0..1 | uri | System that defines coded unit form Required Pattern: https://alexapi.medtechglobal.com.au/fhir/CodeSystem/value-quantity-unit
code | Σ | 0..1 | code | Coded form of the unit Binding: Unit Value Set for Observation Component (extensible)
value[x]:valueDateTime | S Σ | 0..1 | dateTime | Actual component result
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
Observation.status | Base | required | ObservationStatus | 📍4.0.1 | FHIR Std.
Observation.code | Base | extensible | Screening Term Value Set for observation result | 📦1.0.0 | This IG
Observation.value[x]:valueQuantity.​comparator | Base | required | QuantityComparator | 📍4.0.1 | FHIR Std.
Observation.value[x]:valueQuantity.​code | Base | extensible | Unit Value Set for Observation Component | 📦1.0.0 | This IG
Observation.interpretation | Base | extensible | Interpretation Value Set for Observation | 📦1.0.0 | This IG
Observation.component.​code | Base | preferred | Prompt Value Set for Measurement | 📦1.0.0 | This IG
Observation.component.​value[x]:valueQuantity.​comparator | Base | required | QuantityComparator | 📍4.0.1 | FHIR Std.
Observation.component.​value[x]:valueQuantity.​code | Base | extensible | Unit Value Set for Observation Component | 📦1.0.0 | This IG

#### Constraints

Id | Grade | Path(s) | Description | Expression
dom-2 | error | Observation | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | Observation | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource | `contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()`
dom-4 | error | Observation | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated | `contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()`
dom-5 | error | Observation | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | Observation | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`
obs-6 | error | Observation | dataAbsentReason SHALL only be present if Observation.value[x] is not present | `dataAbsentReason.empty() or value.empty()`
obs-7 | error | Observation | If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present | `value.empty() or component.code.where(coding.intersect(%resource.code.coding).exists()).empty()`
observation-code-text-length | error | Observation | Code.text cannot be more than 30 characters | `code.text.empty() or code.text.length() <= 30`
observation-note-text-length | error | Observation | Note - text size validation | `note.text.empty() or note.text.length() <= 4096`

Differential View

This structure is derived from Observation

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Observation | C | 0..* | Observation | Measurements and simple assertions Constraints: observation-code-text-length, observation-note-text-length
meta |  |  |  |
security |  | 0..* | Coding | Security Labels applied to this resource Binding: Definition of Confidentiality Value Set (required)
implicitRules |  | 0..0 |  | A set of rules under which this content was created
language |  | 0..0 |  | Language of the resource content
contained |  | 0..0 |  | Contained, inline Resources
identifier |  | 0..0 |  | Business Identifier for observation
status |  | 1..1 | code | registered | preliminary | final | amended + Required Pattern: final
category |  | 0..0 |  | Classification of type of observation
code | S | 1..1 | CodeableConcept | Type of observation (code / type) Binding: Screening Term Value Set for observation result (extensible)
coding |  |  |  |
system |  | 0..1 | uri | Identity of the terminology system Required Pattern: https://alexapi.medtechglobal.com.au/fhir/CodeSystem/screening-term
text | S | 1..1 | string | Plain text representation of the concept
subject | S | 1..1 | Reference(Patient | Group | Device | Location) | Who and/or what the observation is about
reference | S | 1..1 | string | Reference to Patient resource
display |  | 0..1 | string | External Name of Patient
encounter |  | 0..0 |  | Healthcare event during which this observation is made
Slices for effective[x] |  | 1..1 | instant | Clinically relevant time/time-period for observation Slice: Unordered, Open by type:$this
effective[x]:effectiveInstant | S | 1..1 | instant | Clinically relevant time/time-period for observation
performer | S | 1..1 | Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson) | Who is responsible for the observation
reference | S | 1..1 | string | Reference to Practitioner resource
display |  | 0..1 | string | External Name of Practitioner
Slices for value[x] |  | 0..1 |  | Actual result Slice: Unordered, Open by type:$this
valueQuantity |  |  | Quantity |
valueString |  |  | string |
valueDateTime |  |  | dateTime |
value[x]:valueString | S | 0..1 | string | Actual result
value[x]:valueQuantity |  | 0..1 | Quantity | Actual result
value | S | 1..1 | decimal | Numerical value (with implicit precision)
system |  | 0..1 | uri | System that defines coded unit form Required Pattern: https://alexapi.medtechglobal.com.au/fhir/CodeSystem/value-quantity-unit
code |  | 0..1 | code | Coded form of the unit Binding: Unit Value Set for Observation Component (extensible)
value[x]:valueDateTime | S | 0..1 | dateTime | Actual result
interpretation | S | 0..* | CodeableConcept | High, low, normal, etc. Binding: Interpretation Value Set for Observation (extensible)
coding |  | 1..* | Coding | Code defined by a terminology system
system | S | 1..1 | uri | Identity of the terminology system Required Pattern: https://alexapi.medtechglobal.com.au/fhir/CodeSystem/observation-interpretation
code | S | 1..1 | code | Symbol in syntax defined by the system
text | S | 0..1 | string | Plain text representation of the concept
note | S | 0..* | Annotation | Comments about the observation
text | S | 1..1 | markdown | The annotation - text content (as markdown)
bodySite |  | 0..0 |  | Observed body part
component | S | 0..* | BackboneElement | Component results
code | S | 1..1 | CodeableConcept | Type of component observation (code / type) Binding: Prompt Value Set for Measurement (preferred)
coding |  |  |  |
system |  | 0..1 | uri | Identity of the terminology system Required Pattern: https://alexapi.medtechglobal.com.au/fhir/CodeSystem/measurement-prompt
Slices for value[x] |  | 0..1 |  | Actual component result Slice: Unordered, Open by type:$this
valueQuantity |  |  | Quantity |
valueString |  |  | string |
valueDateTime |  |  | dateTime |
value[x]:valueString | S | 0..1 | string | Actual component result
value[x]:valueQuantity |  | 0..1 | Quantity | Actual component result
value | S | 1..1 | decimal | Numerical value (with implicit precision)
system |  | 0..1 | uri | System that defines coded unit form Required Pattern: https://alexapi.medtechglobal.com.au/fhir/CodeSystem/value-quantity-unit
code |  | 0..1 | code | Coded form of the unit Binding: Unit Value Set for Observation Component (extensible)
value[x]:valueDateTime | S | 0..1 | dateTime | Actual component result
Documentation for this format

#### Terminology Bindings (Differential)

Path | Status | Usage | ValueSet | Version | Source
Observation.meta.security | Base | required | Definition of Confidentiality Value Set | 📦1.0.0 | This IG
Observation.code | Base | extensible | Screening Term Value Set for observation result | 📦1.0.0 | This IG
Observation.value[x]:valueQuantity.​code | Base | extensible | Unit Value Set for Observation Component | 📦1.0.0 | This IG
Observation.interpretation | Base | extensible | Interpretation Value Set for Observation | 📦1.0.0 | This IG
Observation.component.​code | Base | preferred | Prompt Value Set for Measurement | 📦1.0.0 | This IG
Observation.component.​value[x]:valueQuantity.​code | Base | extensible | Unit Value Set for Observation Component | 📦1.0.0 | This IG

#### Constraints

Id | Grade | Path(s) | Description | Expression
observation-code-text-length | error | Observation | Code.text cannot be more than 30 characters | `code.text.empty() or code.text.length() <= 30`
observation-note-text-length | error | Observation | Note - text size validation | `note.text.empty() or note.text.length() <= 4096`

Snapshot View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Observation | C | 0..* | Observation | Measurements and simple assertions Constraints: obs-6, obs-7, observation-code-text-length, observation-note-text-length
id | Σ | 0..1 | id | Logical id of this artifact
meta | Σ | 0..1 | Meta | Metadata about the resource
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
versionId | Σ | 0..1 | id | Version specific identifier
lastUpdated | Σ | 0..1 | instant | When the resource version last changed
source | Σ | 0..1 | uri | Identifies where the resource comes from
profile | Σ | 0..* | canonical(StructureDefinition) | Profiles this resource claims to conform to
security | Σ | 0..* | Coding | Security Labels applied to this resource Binding: Definition of Confidentiality Value Set (required)
tag | Σ | 0..* | Coding | Tags applied to this resource Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".
text |  | 0..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
basedOn | Σ | 0..* | Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest) | Fulfills plan, proposal or order
partOf | Σ | 0..* | Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy) | Part of referenced event
status | ?!Σ | 1..1 | code | registered | preliminary | final | amended + Binding: ObservationStatus (required): Codes providing the status of an observation. Required Pattern: final
code | S Σ | 1..1 | CodeableConcept | Type of observation (code / type) Binding: Screening Term Value Set for observation result (extensible)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
coding | Σ | 0..* | Coding | Code defined by a terminology system
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
system | Σ | 0..1 | uri | Identity of the terminology system Required Pattern: https://alexapi.medtechglobal.com.au/fhir/CodeSystem/screening-term
version | Σ | 0..1 | string | Version of the system - if relevant
code | Σ | 0..1 | code | Symbol in syntax defined by the system
display | Σ | 0..1 | string | Representation defined by the system
userSelected | Σ | 0..1 | boolean | If this coding was chosen directly by the user
text | S Σ | 1..1 | string | Plain text representation of the concept
subject | S Σ | 1..1 | Reference(Patient | Group | Device | Location) | Who and/or what the observation is about
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
reference | S Σ C | 1..1 | string | Reference to Patient resource
type | Σ | 0..1 | uri | Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier | Σ | 0..1 | Identifier | Logical reference, when literal reference is not known
display | Σ | 0..1 | string | External Name of Patient
focus | Σ | 0..* | Reference(Resource) | What the observation is about, when it is not about the subject of record
Slices for effective[x] | Σ | 1..1 | instant | Clinically relevant time/time-period for observation Slice: Unordered, Closed by type:$this
effective[x]:effectiveInstant | S Σ | 1..1 | instant | Clinically relevant time/time-period for observation
issued | Σ | 0..1 | instant | Date/Time this version was made available
performer | S Σ | 1..1 | Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson) | Who is responsible for the observation
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
reference | S Σ C | 1..1 | string | Reference to Practitioner resource
type | Σ | 0..1 | uri | Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier | Σ | 0..1 | Identifier | Logical reference, when literal reference is not known
display | Σ | 0..1 | string | External Name of Practitioner
Slices for value[x] | Σ C | 0..1 |  | Actual result Slice: Unordered, Closed by type:$this
valueQuantity |  |  | Quantity |
valueString |  |  | string |
valueDateTime |  |  | dateTime |
value[x]:valueString | S Σ C | 0..1 | string | Actual result
value[x]:valueQuantity | Σ C | 0..1 | Quantity | Actual result
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
value | S Σ | 1..1 | decimal | Numerical value (with implicit precision)
comparator | ?!Σ | 0..1 | code | < | <= | >= | > - how to understand the value Binding: QuantityComparator (required): How the Quantity should be understood and represented.
unit | Σ | 0..1 | string | Unit representation
system | Σ C | 0..1 | uri | System that defines coded unit form Required Pattern: https://alexapi.medtechglobal.com.au/fhir/CodeSystem/value-quantity-unit
code | Σ | 0..1 | code | Coded form of the unit Binding: Unit Value Set for Observation Component (extensible)
value[x]:valueDateTime | S Σ C | 0..1 | dateTime | Actual result
dataAbsentReason | C | 0..1 | CodeableConcept | Why the result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation | S | 0..* | CodeableConcept | High, low, normal, etc. Binding: Interpretation Value Set for Observation (extensible)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
coding | Σ | 1..* | Coding | Code defined by a terminology system
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
system | S Σ | 1..1 | uri | Identity of the terminology system Required Pattern: https://alexapi.medtechglobal.com.au/fhir/CodeSystem/observation-interpretation
version | Σ | 0..1 | string | Version of the system - if relevant
code | S Σ | 1..1 | code | Symbol in syntax defined by the system
display | Σ | 0..1 | string | Representation defined by the system
userSelected | Σ | 0..1 | boolean | If this coding was chosen directly by the user
text | S Σ | 0..1 | string | Plain text representation of the concept
note | S | 0..* | Annotation | Comments about the observation
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
author[x] | Σ | 0..1 |  | Individual responsible for the annotation
authorReference |  |  | Reference(Practitioner | Patient | RelatedPerson | Organization) |
authorString |  |  | string |
time | Σ | 0..1 | dateTime | When the annotation was made
text | S Σ | 1..1 | markdown | The annotation - text content (as markdown)
method |  | 0..1 | CodeableConcept | How it was done Binding: ObservationMethods (example): Methods for simple observations.
specimen |  | 0..1 | Reference(Specimen) | Specimen used for this observation
device |  | 0..1 | Reference(Device | DeviceMetric) | (Measurement) Device
referenceRange | C | 0..* | BackboneElement | Provides guide for interpretation Constraints: obs-3
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
low | C | 0..1 | SimpleQuantity(4.0.1) | Low Range, if relevant
high | C | 0..1 | SimpleQuantity(4.0.1) | High Range, if relevant
type |  | 0..1 | CodeableConcept | Reference range qualifier Binding: ObservationReferenceRangeMeaningCodes (preferred): Code for the meaning of a reference range.
appliesTo |  | 0..* | CodeableConcept | Reference range population Binding: ObservationReferenceRangeAppliesToCodes (example): Codes identifying the population the reference range applies to.
age |  | 0..1 | Range | Applicable age range, if relevant
text |  | 0..1 | string | Text based reference range in an observation
hasMember | Σ | 0..* | Reference(Observation | QuestionnaireResponse | MolecularSequence) | Related resource that belongs to the Observation group
derivedFrom | Σ | 0..* | Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | Observation | MolecularSequence) | Related measurements the observation is made from
component | S Σ | 0..* | BackboneElement | Component results
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
code | S Σ | 1..1 | CodeableConcept | Type of component observation (code / type) Binding: Prompt Value Set for Measurement (preferred)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
coding | Σ | 0..* | Coding | Code defined by a terminology system
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
system | Σ | 0..1 | uri | Identity of the terminology system Required Pattern: https://alexapi.medtechglobal.com.au/fhir/CodeSystem/measurement-prompt
version | Σ | 0..1 | string | Version of the system - if relevant
code | Σ | 0..1 | code | Symbol in syntax defined by the system
display | Σ | 0..1 | string | Representation defined by the system
userSelected | Σ | 0..1 | boolean | If this coding was chosen directly by the user
text | Σ | 0..1 | string | Plain text representation of the concept
Slices for value[x] | Σ | 0..1 |  | Actual component result Slice: Unordered, Closed by type:$this
valueQuantity |  |  | Quantity |
valueString |  |  | string |
valueDateTime |  |  | dateTime |
value[x]:valueString | S Σ | 0..1 | string | Actual component result
value[x]:valueQuantity | Σ | 0..1 | Quantity | Actual component result
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
value | S Σ | 1..1 | decimal | Numerical value (with implicit precision)
comparator | ?!Σ | 0..1 | code | < | <= | >= | > - how to understand the value Binding: QuantityComparator (required): How the Quantity should be understood and represented.
unit | Σ | 0..1 | string | Unit representation
system | Σ C | 0..1 | uri | System that defines coded unit form Required Pattern: https://alexapi.medtechglobal.com.au/fhir/CodeSystem/value-quantity-unit
code | Σ | 0..1 | code | Coded form of the unit Binding: Unit Value Set for Observation Component (extensible)
value[x]:valueDateTime | S Σ | 0..1 | dateTime | Actual component result
dataAbsentReason | C | 0..1 | CodeableConcept | Why the component result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation |  | 0..* | CodeableConcept | High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
referenceRange |  | 0..* | See referenceRange (Observation) | Provides guide for interpretation of component result
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
Observation.meta.security | Base | required | Definition of Confidentiality Value Set | 📦1.0.0 | This IG
Observation.meta.tag | Base | example | Common Tags | 📍4.0.1 | FHIR Std.
Observation.status | Base | required | ObservationStatus | 📍4.0.1 | FHIR Std.
Observation.code | Base | extensible | Screening Term Value Set for observation result | 📦1.0.0 | This IG
Observation.subject.​type | Base | extensible | ResourceType | 📍4.0.1 | FHIR Std.
Observation.performer.​type | Base | extensible | ResourceType | 📍4.0.1 | FHIR Std.
Observation.value[x]:valueQuantity.​comparator | Base | required | QuantityComparator | 📍4.0.1 | FHIR Std.
Observation.value[x]:valueQuantity.​code | Base | extensible | Unit Value Set for Observation Component | 📦1.0.0 | This IG
Observation.dataAbsentReason | Base | extensible | DataAbsentReason | 📍4.0.1 | FHIR Std.
Observation.interpretation | Base | extensible | Interpretation Value Set for Observation | 📦1.0.0 | This IG
Observation.method | Base | example | Observation Methods | 📍4.0.1 | FHIR Std.
Observation.referenceRange.​type | Base | preferred | Observation Reference Range Meaning Codes | 📍4.0.1 | FHIR Std.
Observation.referenceRange.​appliesTo | Base | example | Observation Reference Range Applies To Codes | 📍4.0.1 | FHIR Std.
Observation.component.​code | Base | preferred | Prompt Value Set for Measurement | 📦1.0.0 | This IG
Observation.component.​value[x]:valueQuantity.​comparator | Base | required | QuantityComparator | 📍4.0.1 | FHIR Std.
Observation.component.​value[x]:valueQuantity.​code | Base | extensible | Unit Value Set for Observation Component | 📦1.0.0 | This IG
Observation.component.​dataAbsentReason | Base | extensible | DataAbsentReason | 📍4.0.1 | FHIR Std.
Observation.component.​interpretation | Base | extensible | Observation Interpretation Codes | 📍4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
dom-2 | error | Observation | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | Observation | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource | `contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()`
dom-4 | error | Observation | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated | `contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()`
dom-5 | error | Observation | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | Observation | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`
obs-3 | error | Observation.referenceRange | Must have at least a low or a high or text | `low.exists() or high.exists() or text.exists()`
obs-6 | error | Observation | dataAbsentReason SHALL only be present if Observation.value[x] is not present | `dataAbsentReason.empty() or value.empty()`
obs-7 | error | Observation | If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present | `value.empty() or component.code.where(coding.intersect(%resource.code.coding).exists()).empty()`
observation-code-text-length | error | Observation | Code.text cannot be more than 30 characters | `code.text.empty() or code.text.length() <= 30`
observation-note-text-length | error | Observation | Note - text size validation | `note.text.empty() or note.text.length() <= 4096`

This structure is derived from Observation

Summary

Mandatory: 7 elements(5 nested mandatory elements)
Must-Support: 21 elements
Prohibited: 7 elements

Slices

This structure defines the following Slices:

- The element 1 is sliced based on the value of Observation.effective[x]
- The element 1 is sliced based on the value of Observation.value[x]
- The element 1 is sliced based on the value of Observation.component.value[x]

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