Release 4

This page is part of the FHIR Specification (v4.0.1: R4 - Mixed Normative and STU) in it's permanent home (it will always be available at this URL). The current version which supercedes this version is 5.0.0. For a full list of available versions, see the Directory of published versions . Page versions: R5 R4B R4 R3

Orders and Observations Work Group Maturity Level: 5Trial Use Use Context: Any

The official URL for this profile is:

http://hl7.org/fhir/StructureDefinition/headcircum

FHIR Head Circumference Profile

This profile was published on Sat, Aug 11, 2018 00:00+1000 as a draft by Health Level Seven International (Orders and Observations Workgroup).

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

This structure is derived from observation-vitalsigns.

Summary

  1. One code in Observation.code which must have
    • a fixed Observation.code.coding.system='http ://loinc.org'
    • a fixed Observation.code.coding.code= '9843-4'
    • Other additional Codings are allowed in Observation.code- e.g. more specific LOINC Codes, SNOMED CT concepts, system specific codes. All codes SHALL have an system value
  2. Either one Observation.valueQuantity or, if there is no value, one code in Observation.DataAbsentReason
    • Each Observation.valueQuantity must have:
      • One numeric value in Observation.valueQuantity.value
      • a fixed Observation.valueQuantity.system="http://unitsofmeasure.org"
      • a UCUM unit code in Observation.valueQuantity.code = 'cm', or '[in_i]'

Mandatory: 3 elements (+4 nested mandatory elements)
Must-Support: 4 elements
Fixed Value: 3 elements

Slices

This structure defines the following Slices:

  • The element Observation.code.coding is sliced based on the values of value:code, value:system

This structure is derived from observation-vitalsigns.

NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation 0..*FHIR Head Circumference Profile
... code 1..1CodeableConceptHead Circumference
.... coding (Slice Definition)Slice: Unordered, Open by value:code, value:system
..... coding:HeadCircumCode 1..1Coding
...... system 1..1uriFixed Value: http://loinc.org
...... code 1..1codeFixed Value: 9843-4
... valueQuantity 0..1Quantity
.... value S1..1decimal
.... unit S1..1string
.... system S1..1uriFixed Value: http://unitsofmeasure.org
.... code S1..1codeCoded responses from the common UCUM units for vital signs value set.
Binding: Body Length Units (required)

doco Documentation for this format
NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation I0..*FHIR Head Circumference Profile
... id Σ0..1stringLogical id of this artifact
... meta ΣI0..1MetaMetadata about the resource
... implicitRules ?!ΣI0..1uriA set of rules under which this content was created
... language I0..1codeLanguage of the resource content
Binding: Common Languages (preferred)
Max Binding: All Languages
... text I0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... extension I0..*ExtensionAdditional content defined by implementations
... modifierExtension ?!I0..*ExtensionExtensions that cannot be ignored
... identifier ΣI0..*IdentifierBusiness Identifier for observation
... basedOn ΣI0..*Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest)Fulfills plan, proposal or order
... partOf ΣI0..*Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy)Part of referenced event
... status ?!SΣI1..1coderegistered | preliminary | final | amended +
Binding: ObservationStatus (required)
... category SI(Slice Definition)Classification of type of observation
Slice: Unordered, Open by value:coding.code, value:coding.system
Binding: Observation Category Codes (preferred)
.... category:VSCat SI1..1CodeableConceptClassification of type of observation
Binding: Observation Category Codes (preferred)
..... id 0..1stringUnique id for inter-element referencing
..... extension I0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
..... coding SΣI1..*CodingCode defined by a terminology system
...... id 0..1stringUnique id for inter-element referencing
...... extension I0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
...... system SΣI1..1uriIdentity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category
...... version ΣI0..1stringVersion of the system - if relevant
...... code SΣI1..1codeSymbol in syntax defined by the system
Fixed Value: vital-signs
...... display ΣI0..1stringRepresentation defined by the system
...... userSelected ΣI0..1booleanIf this coding was chosen directly by the user
..... text ΣI0..1stringPlain text representation of the concept
... code SΣI1..1CodeableConceptHead Circumference
Binding: Vital Signs (extensible)
.... id 0..1stringUnique id for inter-element referencing
.... extension I0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
.... coding ΣI(Slice Definition)Code defined by a terminology system
Slice: Unordered, Open by value:code, value:system
..... coding:HeadCircumCode ΣI1..1CodingCode defined by a terminology system
...... id 0..1stringUnique id for inter-element referencing
...... extension I0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
...... system ΣI1..1uriIdentity of the terminology system
Fixed Value: http://loinc.org
...... version ΣI0..1stringVersion of the system - if relevant
...... code ΣI1..1codeSymbol in syntax defined by the system
Fixed Value: 9843-4
...... display ΣI0..1stringRepresentation defined by the system
...... userSelected ΣI0..1booleanIf this coding was chosen directly by the user
.... text ΣI0..1stringPlain text representation of the concept
... subject SΣI1..1Reference(Patient)Who and/or what the observation is about
... focus ΣI0..*Reference(Resource)What the observation is about, when it is not about the subject of record
... encounter ΣI0..1Reference(Encounter)Healthcare event during which this observation is made
... effective[x] SΣI1..1Often just a dateTime for Vital Signs
vs-1: if Observation.effective[x] is dateTime and has a value then that value shall be precise to the day
.... effectiveDateTimedateTime
.... effectivePeriodPeriod
... issued ΣI0..1instantDate/Time this version was made available
... performer ΣI0..*Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson)Who is responsible for the observation
... value[x] SΣI(Slice Definition)Vital Signs value are recorded using the Quantity data type. For supporting observations such as Cuff size could use other datatypes such as CodeableConcept.
Slice: Unordered, Closed by type:$this
.... value[x]:valueQuantity SΣI0..1QuantityVital Signs value are recorded using the Quantity data type. For supporting observations such as Cuff size could use other datatypes such as CodeableConcept.
..... id 0..1stringUnique id for inter-element referencing
..... extension I0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
..... value SΣI1..1decimalNumerical value (with implicit precision)
..... comparator ?!ΣI0..1code< | <= | >= | > - how to understand the value
Binding: QuantityComparator (required)
..... unit SΣI1..1stringUnit representation
..... system SΣI1..1uriSystem that defines coded unit form
Fixed Value: http://unitsofmeasure.org
..... code SΣI1..1codeCoded responses from the common UCUM units for vital signs value set.
Binding: Body Length Units (required)
... dataAbsentReason SI0..1CodeableConceptWhy the result is missing
Binding: DataAbsentReason (extensible)
... interpretation I0..*CodeableConceptHigh, low, normal, etc.
Binding: Observation Interpretation Codes (extensible)
... note I0..*AnnotationComments about the observation
... bodySite I0..1CodeableConceptObserved body part
Binding: SNOMED CT Body Structures (example)
... method I0..1CodeableConceptHow it was done
Binding: Observation Methods (example)
... specimen I0..1Reference(Specimen)Specimen used for this observation
... device I0..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..1stringUnique id for inter-element referencing
.... extension I0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!ΣI0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... low I0..1SimpleQuantityLow Range, if relevant
.... high I0..1SimpleQuantityHigh Range, if relevant
.... type I0..1CodeableConceptReference range qualifier
Binding: Observation Reference Range Meaning Codes (preferred)
.... appliesTo I0..*CodeableConceptReference range population
Binding: Observation Reference Range Applies To Codes (example)
.... age I0..1RangeApplicable age range, if relevant
.... text I0..1stringText based reference range in an observation
... hasMember ΣI0..*Reference(QuestionnaireResponse | MolecularSequence | Vital Signs Profile)Used when reporting vital signs panel components
... derivedFrom ΣI0..*Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | MolecularSequence | Vital Signs Profile)Related measurements the observation is made from
... component SΣI0..*BackboneElementUsed when reporting systolic and diastolic blood pressure.
vs-3: If there is no a value a data absent reason must be present
.... id 0..1stringUnique id for inter-element referencing
.... extension I0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!ΣI0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... code SΣI1..1CodeableConceptType of component observation (code / type)
Binding: Vital Signs (extensible)
.... value[x] SΣI0..1Vital Sign Value recorded with UCUM
Binding: Vital Signs Units (required)
..... valueQuantityQuantity
..... valueCodeableConceptCodeableConcept
..... valueStringstring
..... valueBooleanboolean
..... valueIntegerinteger
..... valueRangeRange
..... valueRatioRatio
..... valueSampledDataSampledData
..... valueTimetime
..... valueDateTimedateTime
..... valuePeriodPeriod
.... dataAbsentReason SI0..1CodeableConceptWhy the component result is missing
Binding: DataAbsentReason (extensible)
.... interpretation I0..*CodeableConceptHigh, low, normal, etc.
Binding: Observation Interpretation Codes (extensible)
.... referenceRange I0..*Unknown reference to #Observation.referenceRange
Provides guide for interpretation of component result

doco Documentation for this format
<!-- observation-headcircum -->doco

<Observation xmlns="http://hl7.org/fhir"
>
  <!-- from Element: extension -->
 <id><!-- 0..1 string Logical id of this artifact --></id>
 <meta><!-- ?? 0..1 Meta Metadata about the resource --></meta>
 <implicitRules value="[uri]"/><!-- ?? 0..1 A set of rules under which this content was created -->
 <language value="[code]"/><!-- ?? 0..1 Language of the resource content   -->
 <text><!-- ?? 0..1 Narrative 
     Text summary of the resource, for human interpretation --></text>
 <contained><!-- 0..* Resource Contained, inline Resources --></contained>
 <modifierExtension><!-- ?? 0..* Extension  Extensions that cannot be ignored  --></modifierExtension>
 <identifier><!-- ?? 0..* Identifier 
     Business Identifier for observation --></identifier>
 <basedOn><!-- ?? 0..* Reference(CarePlan) Fulfills plan, proposal or order --></basedOn>
 <partOf><!-- ?? 0..* Reference(MedicationAdministration) Part of referenced event --></partOf>
 <status value="[code]"/><!-- ?? 1..1 registered | preliminary | final | amended +   -->
 <-- category sliced by value:coding.code, value:coding.system  in the specified orderOpen-->
 <category> ?? 1..1 CodeableConcept  <!-- ?? 1..1 Classification of  type of observation -->
  <coding> ?? 1..* Coding  <!-- ?? 1..* Code defined by a terminology system -->
   <system value="[uri]"/><!-- ?? 1..1 Identity of the terminology system -->
   <version value="[string]"/><!-- ?? 0..1 Version of the system - if relevant -->
   <code value="[code]"/><!-- ?? 1..1 Symbol in syntax defined by the system -->
   <display value="[string]"/><!-- ?? 0..1 Representation defined by the system -->
   <userSelected value="[boolean]"/><!-- ?? 0..1 If this coding was chosen directly by the user -->
  </coding>
  <text value="[string]"/><!-- ?? 0..1 Plain text representation of the concept -->
 </category>
 <code> ?? 1..1 CodeableConcept  <!-- ?? 1..1 Head Circumference -->
  <-- coding sliced by value:code, value:system  in the specified orderOpen-->
  <coding> ?? 1..1 Coding  <!-- ?? 1..1 Code defined by a terminology system -->
   <system value="[uri]"/><!-- ?? 1..1 Identity of the terminology system -->
   <version value="[string]"/><!-- ?? 0..1 Version of the system - if relevant -->
   <code value="[code]"/><!-- ?? 1..1 Symbol in syntax defined by the system -->
   <display value="[string]"/><!-- ?? 0..1 Representation defined by the system -->
   <userSelected value="[boolean]"/><!-- ?? 0..1 If this coding was chosen directly by the user -->
  </coding>
  <text value="[string]"/><!-- ?? 0..1 Plain text representation of the concept -->
 </code>
 <subject><!-- ?? 1..1 Reference(Patient) 
     Who and/or what the observation is about --></subject>
 <focus><!-- ?? 0..* Reference(Resource) 
     What the observation is about, when it is not about the subject of record --></focus>
 <encounter><!-- ?? 0..1 Reference(Encounter) 
     Healthcare event during which this observation is made --></encounter>
 <effective[x]><!-- ?? 1..1 dateTime|Period 
     Often just a dateTime for Vital Signs --></effective[x]>
 <issued value="[instant]"/><!-- ?? 0..1 Date/Time this version was made available -->
 <performer><!-- ?? 0..* Reference(Practitioner) 
     Who is responsible for the observation --></performer>
 <-- valueQuantity sliced by type:$this  in the specified orderClosed-->
 <valueQuantity> ?? 0..1 Quantity  <!-- ?? 0..1 Vital Signs value are recorded using the Quantity data type. For supporting observations such as Cuff size could use other datatypes such as CodeableConcept. -->
  <value value="[decimal]"/><!-- ?? 1..1 Numerical value (with implicit precision) -->
  <comparator value="[code]"/><!-- ?? 0..1 < | <= | >= | > - how to understand the value   -->
  <unit value="[string]"/><!-- ?? 1..1 Unit representation -->
  <system value="[uri]"/><!-- ?? 1..1 System that defines coded unit form -->
  <code value="[code]"/><!-- ?? 1..1 Coded responses from the common UCUM units for vital signs value set.   -->
 </valueQuantity>
 <dataAbsentReason><!-- ?? 0..1 CodeableConcept Why the result is missing   --></dataAbsentReason>
 <interpretation><!-- ?? 0..* CodeableConcept High, low, normal, etc.   --></interpretation>
 <note><!-- ?? 0..* Annotation Comments about the observation --></note>
 <bodySite><!-- ?? 0..1 CodeableConcept Observed body part   --></bodySite>
 <method><!-- ?? 0..1 CodeableConcept How it was done   --></method>
 <specimen><!-- ?? 0..1 Reference(Specimen) Specimen used for this observation --></specimen>
 <device><!-- ?? 0..1 Reference(Device) (Measurement) Device --></device>
 <referenceRange> ?? 0..* BackboneElement  <!-- ?? 0..* Provides guide for interpretation -->
  <modifierExtension><!-- ?? 0..* Extension  Extensions that cannot be ignored even if unrecognized  --></modifierExtension>
  <low><!-- ?? 0..1 Quantity 
      Low Range, if relevant --></low>
  <high><!-- ?? 0..1 Quantity 
      High Range, if relevant --></high>
  <type><!-- ?? 0..1 CodeableConcept Reference range qualifier   --></type>
  <appliesTo><!-- ?? 0..* CodeableConcept Reference range population   --></appliesTo>
  <age><!-- ?? 0..1 Range 
      Applicable age range, if relevant --></age>
  <text value="[string]"/><!-- ?? 0..1 Text based reference range in an observation -->
 </referenceRange>
 <hasMember><!-- ?? 0..* Reference(QuestionnaireResponse) 
     Used when reporting vital signs panel components --></hasMember>
 <derivedFrom><!-- ?? 0..* Reference(DocumentReference) 
     Related measurements the observation is made from --></derivedFrom>
 <component> ?? 0..* BackboneElement  <!-- ?? 0..* Used when reporting systolic and diastolic blood pressure. -->
  <modifierExtension><!-- ?? 0..* Extension  Extensions that cannot be ignored even if unrecognized  --></modifierExtension>
  <code><!-- ?? 1..1 CodeableConcept Type of component observation (code / type)   --></code>
  <value[x]><!-- ?? 0..1 Quantity|CodeableConcept|string|
    boolean|integer|Range|Ratio|SampledData|time|dateTime|Period Vital Sign Value recorded with UCUM   --></value[x]>
  <dataAbsentReason><!-- ?? 0..1 CodeableConcept Why the component result is missing   --></dataAbsentReason>
  <interpretation><!-- ?? 0..* CodeableConcept High, low, normal, etc.   --></interpretation>
  <referenceRange><!-- See #Observation.referenceRange  Provides guide for interpretation of component result --></referenceRange>
 </component>
</Observation>
{ // observation-headcircum
  // from Element: extension
    "meta" : { Meta }, // C?Metadata about the resource
    "implicitRules" : "<uri>", // C?A set of rules under which this content was created
    "language" : "<code>", // C?Language of the resource content
    "text" : { Narrative }, // C?Text summary of the resource, for human interpretation
    "contained" : [{ Resource }], //Contained, inline Resources
    "modifierExtension" : [{ Extension }], // C?Extensions that cannot be ignored
    "identifier" : [{ Identifier }], // C?Business Identifier for observation
    "basedOn" : [{ Reference(CarePlan) }], // C?Fulfills plan, proposal or order
    "partOf" : [{ Reference(MedicationAdministration) }], // C?Part of referenced event
    "status" : "<code>", // C? R! registered | preliminary | final | amended +
    "category" : [ //  sliced by value:coding.code, value:coding.system  in the specified order, Open 
      { // Classification of  type of observation // C? R! 
        // from Element: extension
        "extension" : [ //  sliced by value:url  in the specified order, Open ]
        "coding" : [{ Coding }], // C? R! Code defined by a terminology system
        "text" : "<string>" // C?Plain text representation of the concept
      }
    ],
    "code" : { CodeableConcept }, // C? R! Head Circumference
    "subject" : { Reference(Patient) }, // C? R! Who and/or what the observation is about
    "focus" : [{ Reference(Resource) }], // C?What the observation is about, when it is not about the subject of record
    "encounter" : { Reference(Encounter) }, // C?Healthcare event during which this observation is made
// value[x]: Often just a dateTime for Vital Signs. One of these 2:
    "effectiveDateTime" : "<dateTime>", // C? R! Often just a dateTime for Vital Signs
    "effectivePeriod" : { Period }, // C? R! Often just a dateTime for Vital Signs
    "issued" : "<instant>", // C?Date/Time this version was made available
    "performer" : [{ Reference(Practitioner) }], // C?Who is responsible for the observation
    "valueQuantity" : [ //  sliced by type:$this  in the specified order, Closed 
      { // Vital Signs value are recorded using the Quantity data type. For supporting observations such as Cuff size could use other datatypes such as CodeableConcept. // C?
        // from Element: extension
        "extension" : [ //  sliced by value:url  in the specified order, Open ]
        "value" : <decimal>, // C? R! Numerical value (with implicit precision)
        "comparator" : "<code>", // C?< | <= | >= | > - how to understand the value
        "unit" : "<string>", // C? R! Unit representation
        "system" : "http://unitsofmeasure.org", // C? R! 
        "code" : "<code>" // C? R! Coded responses from the common UCUM units for vital signs value set.
      }
    ],
    "dataAbsentReason" : { CodeableConcept }, // C?Why the result is missing
    "interpretation" : [{ CodeableConcept }], // C?High, low, normal, etc.
    "note" : [{ Annotation }], // C?Comments about the observation
    "bodySite" : { CodeableConcept }, // C?Observed body part
    "method" : { CodeableConcept }, // C?How it was done
    "specimen" : { Reference(Specimen) }, // C?Specimen used for this observation
    "device" : { Reference(Device) }, // C?(Measurement) Device
    "referenceRange" : [{ BackboneElement }], // C?Provides guide for interpretation
    "hasMember" : [{ Reference(QuestionnaireResponse) }], // C?Used when reporting vital signs panel components
    "derivedFrom" : [{ Reference(DocumentReference) }], // C?Related measurements the observation is made from
    "component" : [{ BackboneElement }], // C?Used when reporting systolic and diastolic blood pressure.
  }

This structure is derived from observation-vitalsigns.

Summary

  1. One code in Observation.code which must have
    • a fixed Observation.code.coding.system='http ://loinc.org'
    • a fixed Observation.code.coding.code= '9843-4'
    • Other additional Codings are allowed in Observation.code- e.g. more specific LOINC Codes, SNOMED CT concepts, system specific codes. All codes SHALL have an system value
  2. Either one Observation.valueQuantity or, if there is no value, one code in Observation.DataAbsentReason
    • Each Observation.valueQuantity must have:
      • One numeric value in Observation.valueQuantity.value
      • a fixed Observation.valueQuantity.system="http://unitsofmeasure.org"
      • a UCUM unit code in Observation.valueQuantity.code = 'cm', or '[in_i]'

Mandatory: 3 elements (+4 nested mandatory elements)
Must-Support: 4 elements
Fixed Value: 3 elements

Slices

This structure defines the following Slices:

  • The element Observation.code.coding is sliced based on the values of value:code, value:system

Differential View

This structure is derived from observation-vitalsigns.

NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation 0..*FHIR Head Circumference Profile
... code 1..1CodeableConceptHead Circumference
.... coding (Slice Definition)Slice: Unordered, Open by value:code, value:system
..... coding:HeadCircumCode 1..1Coding
...... system 1..1uriFixed Value: http://loinc.org
...... code 1..1codeFixed Value: 9843-4
... valueQuantity 0..1Quantity
.... value S1..1decimal
.... unit S1..1string
.... system S1..1uriFixed Value: http://unitsofmeasure.org
.... code S1..1codeCoded responses from the common UCUM units for vital signs value set.
Binding: Body Length Units (required)

doco Documentation for this format

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation I0..*FHIR Head Circumference Profile
... id Σ0..1stringLogical id of this artifact
... meta ΣI0..1MetaMetadata about the resource
... implicitRules ?!ΣI0..1uriA set of rules under which this content was created
... language I0..1codeLanguage of the resource content
Binding: Common Languages (preferred)
Max Binding: All Languages
... text I0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... extension I0..*ExtensionAdditional content defined by implementations
... modifierExtension ?!I0..*ExtensionExtensions that cannot be ignored
... identifier ΣI0..*IdentifierBusiness Identifier for observation
... basedOn ΣI0..*Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest)Fulfills plan, proposal or order
... partOf ΣI0..*Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy)Part of referenced event
... status ?!SΣI1..1coderegistered | preliminary | final | amended +
Binding: ObservationStatus (required)
... category SI(Slice Definition)Classification of type of observation
Slice: Unordered, Open by value:coding.code, value:coding.system
Binding: Observation Category Codes (preferred)
.... category:VSCat SI1..1CodeableConceptClassification of type of observation
Binding: Observation Category Codes (preferred)
..... id 0..1stringUnique id for inter-element referencing
..... extension I0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
..... coding SΣI1..*CodingCode defined by a terminology system
...... id 0..1stringUnique id for inter-element referencing
...... extension I0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
...... system SΣI1..1uriIdentity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category
...... version ΣI0..1stringVersion of the system - if relevant
...... code SΣI1..1codeSymbol in syntax defined by the system
Fixed Value: vital-signs
...... display ΣI0..1stringRepresentation defined by the system
...... userSelected ΣI0..1booleanIf this coding was chosen directly by the user
..... text ΣI0..1stringPlain text representation of the concept
... code SΣI1..1CodeableConceptHead Circumference
Binding: Vital Signs (extensible)
.... id 0..1stringUnique id for inter-element referencing
.... extension I0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
.... coding ΣI(Slice Definition)Code defined by a terminology system
Slice: Unordered, Open by value:code, value:system
..... coding:HeadCircumCode ΣI1..1CodingCode defined by a terminology system
...... id 0..1stringUnique id for inter-element referencing
...... extension I0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
...... system ΣI1..1uriIdentity of the terminology system
Fixed Value: http://loinc.org
...... version ΣI0..1stringVersion of the system - if relevant
...... code ΣI1..1codeSymbol in syntax defined by the system
Fixed Value: 9843-4
...... display ΣI0..1stringRepresentation defined by the system
...... userSelected ΣI0..1booleanIf this coding was chosen directly by the user
.... text ΣI0..1stringPlain text representation of the concept
... subject SΣI1..1Reference(Patient)Who and/or what the observation is about
... focus ΣI0..*Reference(Resource)What the observation is about, when it is not about the subject of record
... encounter ΣI0..1Reference(Encounter)Healthcare event during which this observation is made
... effective[x] SΣI1..1Often just a dateTime for Vital Signs
vs-1: if Observation.effective[x] is dateTime and has a value then that value shall be precise to the day
.... effectiveDateTimedateTime
.... effectivePeriodPeriod
... issued ΣI0..1instantDate/Time this version was made available
... performer ΣI0..*Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson)Who is responsible for the observation
... value[x] SΣI(Slice Definition)Vital Signs value are recorded using the Quantity data type. For supporting observations such as Cuff size could use other datatypes such as CodeableConcept.
Slice: Unordered, Closed by type:$this
.... value[x]:valueQuantity SΣI0..1QuantityVital Signs value are recorded using the Quantity data type. For supporting observations such as Cuff size could use other datatypes such as CodeableConcept.
..... id 0..1stringUnique id for inter-element referencing
..... extension I0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
..... value SΣI1..1decimalNumerical value (with implicit precision)
..... comparator ?!ΣI0..1code< | <= | >= | > - how to understand the value
Binding: QuantityComparator (required)
..... unit SΣI1..1stringUnit representation
..... system SΣI1..1uriSystem that defines coded unit form
Fixed Value: http://unitsofmeasure.org
..... code SΣI1..1codeCoded responses from the common UCUM units for vital signs value set.
Binding: Body Length Units (required)
... dataAbsentReason SI0..1CodeableConceptWhy the result is missing
Binding: DataAbsentReason (extensible)
... interpretation I0..*CodeableConceptHigh, low, normal, etc.
Binding: Observation Interpretation Codes (extensible)
... note I0..*AnnotationComments about the observation
... bodySite I0..1CodeableConceptObserved body part
Binding: SNOMED CT Body Structures (example)
... method I0..1CodeableConceptHow it was done
Binding: Observation Methods (example)
... specimen I0..1Reference(Specimen)Specimen used for this observation
... device I0..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..1stringUnique id for inter-element referencing
.... extension I0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!ΣI0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... low I0..1SimpleQuantityLow Range, if relevant
.... high I0..1SimpleQuantityHigh Range, if relevant
.... type I0..1CodeableConceptReference range qualifier
Binding: Observation Reference Range Meaning Codes (preferred)
.... appliesTo I0..*CodeableConceptReference range population
Binding: Observation Reference Range Applies To Codes (example)
.... age I0..1RangeApplicable age range, if relevant
.... text I0..1stringText based reference range in an observation
... hasMember ΣI0..*Reference(QuestionnaireResponse | MolecularSequence | Vital Signs Profile)Used when reporting vital signs panel components
... derivedFrom ΣI0..*Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | MolecularSequence | Vital Signs Profile)Related measurements the observation is made from
... component SΣI0..*BackboneElementUsed when reporting systolic and diastolic blood pressure.
vs-3: If there is no a value a data absent reason must be present
.... id 0..1stringUnique id for inter-element referencing
.... extension I0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!ΣI0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... code SΣI1..1CodeableConceptType of component observation (code / type)
Binding: Vital Signs (extensible)
.... value[x] SΣI0..1Vital Sign Value recorded with UCUM
Binding: Vital Signs Units (required)
..... valueQuantityQuantity
..... valueCodeableConceptCodeableConcept
..... valueStringstring
..... valueBooleanboolean
..... valueIntegerinteger
..... valueRangeRange
..... valueRatioRatio
..... valueSampledDataSampledData
..... valueTimetime
..... valueDateTimedateTime
..... valuePeriodPeriod
.... dataAbsentReason SI0..1CodeableConceptWhy the component result is missing
Binding: DataAbsentReason (extensible)
.... interpretation I0..*CodeableConceptHigh, low, normal, etc.
Binding: Observation Interpretation Codes (extensible)
.... referenceRange I0..*Unknown reference to #Observation.referenceRange
Provides guide for interpretation of component result

doco Documentation for this format

XML Template

<!-- observation-headcircum -->doco

<Observation xmlns="http://hl7.org/fhir"
>
  <!-- from Element: extension -->
 <id><!-- 0..1 string Logical id of this artifact --></id>
 <meta><!-- ?? 0..1 Meta Metadata about the resource --></meta>
 <implicitRules value="[uri]"/><!-- ?? 0..1 A set of rules under which this content was created -->
 <language value="[code]"/><!-- ?? 0..1 Language of the resource content   -->
 <text><!-- ?? 0..1 Narrative 
     Text summary of the resource, for human interpretation --></text>
 <contained><!-- 0..* Resource Contained, inline Resources --></contained>
 <modifierExtension><!-- ?? 0..* Extension  Extensions that cannot be ignored  --></modifierExtension>
 <identifier><!-- ?? 0..* Identifier 
     Business Identifier for observation --></identifier>
 <basedOn><!-- ?? 0..* Reference(CarePlan) Fulfills plan, proposal or order --></basedOn>
 <partOf><!-- ?? 0..* Reference(MedicationAdministration) Part of referenced event --></partOf>
 <status value="[code]"/><!-- ?? 1..1 registered | preliminary | final | amended +   -->
 <-- category sliced by value:coding.code, value:coding.system  in the specified orderOpen-->
 <category> ?? 1..1 CodeableConcept  <!-- ?? 1..1 Classification of  type of observation -->
  <coding> ?? 1..* Coding  <!-- ?? 1..* Code defined by a terminology system -->
   <system value="[uri]"/><!-- ?? 1..1 Identity of the terminology system -->
   <version value="[string]"/><!-- ?? 0..1 Version of the system - if relevant -->
   <code value="[code]"/><!-- ?? 1..1 Symbol in syntax defined by the system -->
   <display value="[string]"/><!-- ?? 0..1 Representation defined by the system -->
   <userSelected value="[boolean]"/><!-- ?? 0..1 If this coding was chosen directly by the user -->
  </coding>
  <text value="[string]"/><!-- ?? 0..1 Plain text representation of the concept -->
 </category>
 <code> ?? 1..1 CodeableConcept  <!-- ?? 1..1 Head Circumference -->
  <-- coding sliced by value:code, value:system  in the specified orderOpen-->
  <coding> ?? 1..1 Coding  <!-- ?? 1..1 Code defined by a terminology system -->
   <system value="[uri]"/><!-- ?? 1..1 Identity of the terminology system -->
   <version value="[string]"/><!-- ?? 0..1 Version of the system - if relevant -->
   <code value="[code]"/><!-- ?? 1..1 Symbol in syntax defined by the system -->
   <display value="[string]"/><!-- ?? 0..1 Representation defined by the system -->
   <userSelected value="[boolean]"/><!-- ?? 0..1 If this coding was chosen directly by the user -->
  </coding>
  <text value="[string]"/><!-- ?? 0..1 Plain text representation of the concept -->
 </code>
 <subject><!-- ?? 1..1 Reference(Patient) 
     Who and/or what the observation is about --></subject>
 <focus><!-- ?? 0..* Reference(Resource) 
     What the observation is about, when it is not about the subject of record --></focus>
 <encounter><!-- ?? 0..1 Reference(Encounter) 
     Healthcare event during which this observation is made --></encounter>
 <effective[x]><!-- ?? 1..1 dateTime|Period 
     Often just a dateTime for Vital Signs --></effective[x]>
 <issued value="[instant]"/><!-- ?? 0..1 Date/Time this version was made available -->
 <performer><!-- ?? 0..* Reference(Practitioner) 
     Who is responsible for the observation --></performer>
 <-- valueQuantity sliced by type:$this  in the specified orderClosed-->
 <valueQuantity> ?? 0..1 Quantity  <!-- ?? 0..1 Vital Signs value are recorded using the Quantity data type. For supporting observations such as Cuff size could use other datatypes such as CodeableConcept. -->
  <value value="[decimal]"/><!-- ?? 1..1 Numerical value (with implicit precision) -->
  <comparator value="[code]"/><!-- ?? 0..1 < | <= | >= | > - how to understand the value   -->
  <unit value="[string]"/><!-- ?? 1..1 Unit representation -->
  <system value="[uri]"/><!-- ?? 1..1 System that defines coded unit form -->
  <code value="[code]"/><!-- ?? 1..1 Coded responses from the common UCUM units for vital signs value set.   -->
 </valueQuantity>
 <dataAbsentReason><!-- ?? 0..1 CodeableConcept Why the result is missing   --></dataAbsentReason>
 <interpretation><!-- ?? 0..* CodeableConcept High, low, normal, etc.   --></interpretation>
 <note><!-- ?? 0..* Annotation Comments about the observation --></note>
 <bodySite><!-- ?? 0..1 CodeableConcept Observed body part   --></bodySite>
 <method><!-- ?? 0..1 CodeableConcept How it was done   --></method>
 <specimen><!-- ?? 0..1 Reference(Specimen) Specimen used for this observation --></specimen>
 <device><!-- ?? 0..1 Reference(Device) (Measurement) Device --></device>
 <referenceRange> ?? 0..* BackboneElement  <!-- ?? 0..* Provides guide for interpretation -->
  <modifierExtension><!-- ?? 0..* Extension  Extensions that cannot be ignored even if unrecognized  --></modifierExtension>
  <low><!-- ?? 0..1 Quantity 
      Low Range, if relevant --></low>
  <high><!-- ?? 0..1 Quantity 
      High Range, if relevant --></high>
  <type><!-- ?? 0..1 CodeableConcept Reference range qualifier   --></type>
  <appliesTo><!-- ?? 0..* CodeableConcept Reference range population   --></appliesTo>
  <age><!-- ?? 0..1 Range 
      Applicable age range, if relevant --></age>
  <text value="[string]"/><!-- ?? 0..1 Text based reference range in an observation -->
 </referenceRange>
 <hasMember><!-- ?? 0..* Reference(QuestionnaireResponse) 
     Used when reporting vital signs panel components --></hasMember>
 <derivedFrom><!-- ?? 0..* Reference(DocumentReference) 
     Related measurements the observation is made from --></derivedFrom>
 <component> ?? 0..* BackboneElement  <!-- ?? 0..* Used when reporting systolic and diastolic blood pressure. -->
  <modifierExtension><!-- ?? 0..* Extension  Extensions that cannot be ignored even if unrecognized  --></modifierExtension>
  <code><!-- ?? 1..1 CodeableConcept Type of component observation (code / type)   --></code>
  <value[x]><!-- ?? 0..1 Quantity|CodeableConcept|string|
    boolean|integer|Range|Ratio|SampledData|time|dateTime|Period Vital Sign Value recorded with UCUM   --></value[x]>
  <dataAbsentReason><!-- ?? 0..1 CodeableConcept Why the component result is missing   --></dataAbsentReason>
  <interpretation><!-- ?? 0..* CodeableConcept High, low, normal, etc.   --></interpretation>
  <referenceRange><!-- See #Observation.referenceRange  Provides guide for interpretation of component result --></referenceRange>
 </component>
</Observation>

JSON Template

{ // observation-headcircum
  // from Element: extension
    "meta" : { Meta }, // C?Metadata about the resource
    "implicitRules" : "<uri>", // C?A set of rules under which this content was created
    "language" : "<code>", // C?Language of the resource content
    "text" : { Narrative }, // C?Text summary of the resource, for human interpretation
    "contained" : [{ Resource }], //Contained, inline Resources
    "modifierExtension" : [{ Extension }], // C?Extensions that cannot be ignored
    "identifier" : [{ Identifier }], // C?Business Identifier for observation
    "basedOn" : [{ Reference(CarePlan) }], // C?Fulfills plan, proposal or order
    "partOf" : [{ Reference(MedicationAdministration) }], // C?Part of referenced event
    "status" : "<code>", // C? R! registered | preliminary | final | amended +
    "category" : [ //  sliced by value:coding.code, value:coding.system  in the specified order, Open 
      { // Classification of  type of observation // C? R! 
        // from Element: extension
        "extension" : [ //  sliced by value:url  in the specified order, Open ]
        "coding" : [{ Coding }], // C? R! Code defined by a terminology system
        "text" : "<string>" // C?Plain text representation of the concept
      }
    ],
    "code" : { CodeableConcept }, // C? R! Head Circumference
    "subject" : { Reference(Patient) }, // C? R! Who and/or what the observation is about
    "focus" : [{ Reference(Resource) }], // C?What the observation is about, when it is not about the subject of record
    "encounter" : { Reference(Encounter) }, // C?Healthcare event during which this observation is made
// value[x]: Often just a dateTime for Vital Signs. One of these 2:
    "effectiveDateTime" : "<dateTime>", // C? R! Often just a dateTime for Vital Signs
    "effectivePeriod" : { Period }, // C? R! Often just a dateTime for Vital Signs
    "issued" : "<instant>", // C?Date/Time this version was made available
    "performer" : [{ Reference(Practitioner) }], // C?Who is responsible for the observation
    "valueQuantity" : [ //  sliced by type:$this  in the specified order, Closed 
      { // Vital Signs value are recorded using the Quantity data type. For supporting observations such as Cuff size could use other datatypes such as CodeableConcept. // C?
        // from Element: extension
        "extension" : [ //  sliced by value:url  in the specified order, Open ]
        "value" : <decimal>, // C? R! Numerical value (with implicit precision)
        "comparator" : "<code>", // C?< | <= | >= | > - how to understand the value
        "unit" : "<string>", // C? R! Unit representation
        "system" : "http://unitsofmeasure.org", // C? R! 
        "code" : "<code>" // C? R! Coded responses from the common UCUM units for vital signs value set.
      }
    ],
    "dataAbsentReason" : { CodeableConcept }, // C?Why the result is missing
    "interpretation" : [{ CodeableConcept }], // C?High, low, normal, etc.
    "note" : [{ Annotation }], // C?Comments about the observation
    "bodySite" : { CodeableConcept }, // C?Observed body part
    "method" : { CodeableConcept }, // C?How it was done
    "specimen" : { Reference(Specimen) }, // C?Specimen used for this observation
    "device" : { Reference(Device) }, // C?(Measurement) Device
    "referenceRange" : [{ BackboneElement }], // C?Provides guide for interpretation
    "hasMember" : [{ Reference(QuestionnaireResponse) }], // C?Used when reporting vital signs panel components
    "derivedFrom" : [{ Reference(DocumentReference) }], // C?Related measurements the observation is made from
    "component" : [{ BackboneElement }], // C?Used when reporting systolic and diastolic blood pressure.
  }

 

Alternate definitions: Master Definition (XML, JSON), Schematron

PathNameConformanceValueSet
Observation.languageCommon LanguagespreferredCommon Languages
Observation.statusObservationStatusrequiredObservationStatus
Observation.categoryObservation Category CodespreferredObservation Category Codes
Observation.categoryObservation Category CodespreferredObservation Category Codes
Observation.codeVital SignsextensibleVital Signs
Observation.value[x].comparatorQuantityComparatorrequiredQuantityComparator
Observation.value[x].codeBody Length UnitsrequiredBody Length Units
Observation.dataAbsentReasonDataAbsentReasonextensibleDataAbsentReason
Observation.interpretationObservation Interpretation CodesextensibleObservation Interpretation Codes
Observation.bodySiteSNOMED CT Body StructuresexampleSNOMED CT Body Structures
Observation.methodObservation MethodsexampleObservation Methods
Observation.referenceRange.typeObservation Reference Range Meaning CodespreferredObservation Reference Range Meaning Codes
Observation.referenceRange.appliesToObservation Reference Range Applies To CodesexampleObservation Reference Range Applies To Codes
Observation.component.codeVital SignsextensibleVital Signs
Observation.component.value[x]Vital Signs UnitsrequiredVital Signs Units
Observation.component.dataAbsentReasonDataAbsentReasonextensibleDataAbsentReason
Observation.component.interpretationObservation Interpretation CodesextensibleObservation Interpretation Codes
RuleRuleRule
IdPathDetailsRequirements
vs-1Observation.effective[x]if Observation.effective[x] is dateTime and has a value then that value shall be precise to the day
Expression : ($this as dateTime).toString().length() >= 8
obs-3Observation.referenceRangeMust have at least a low or a high or text
Expression : low.exists() or high.exists() or text.exists()
vs-3Observation.componentIf there is no a value a data absent reason must be present
Expression : value.exists() or dataAbsentReason.exists()
.