This page is part of the SDOH Clinical Care for Multiple Domains (v2.3.0: STU 2.3) based on FHIR (HL7® FHIR® Standard) R4. This is the current published version. For a full list of available versions, see the Directory of published versions

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Resource Profile: SDOHCC Observation Sexual Orientation

Profile for observations about the sexual orientation of an individual. This profile is intended for draft use only. For further details on this profile see Draft Specifications for Personal Characteristics.

Usage:

• Examples for this Resource Profile: Observation/SDOHCC-ObservationSexualOrientationExample
• CapabilityStatements using this Resource Profile: SDOHCC Coordination Platform, SDOHCC Referral Recipient, SDOHCC Referral Recipient - Light and SDOHCC Referral Source

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
Observation	C	0..*	SDOHCCObservationPersonalCharacteristic	Observation about an individual's sexual orientation dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated dom-5: If a resource is contained in another resource, it SHALL NOT have a security label dom-6: A resource should have narrative for robust management obs-6: dataAbsentReason SHALL only be present if Observation.value[x] is not present obs-7: If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present SDOH-Obs-1: Either subject or extension-Observation.subject must exist but not both SDOH-Obs-2: Focus is only allowed if subject is present SDOH-Obs-3: Must have either performer or derivedFrom
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created ele-1: All FHIR elements must have a @value or children
Slices for extension				Content/Rules for all slices
extension:OtherSubject	SC	0..1	(Complex)	Optional Extensions Element URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.subject ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
extension		0..0
url		1..1	uri	"http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.subject"
value[x]		1..1	Reference(US Core Practitioner Profile(7.0.0))	Value of extension ele-1: All FHIR elements must have a @value or children
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
status	?!SΣ	1..1	code	final | corrected | entered-in-error | unknown Binding: SDOHCC ValueSet Observation Status (required) ele-1: All FHIR elements must have a @value or children
Slices for category	S	1..*	CodeableConcept	Classification of type of observation Slice: Unordered, Open by pattern:$this Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories. ele-1: All FHIR elements must have a @value or children
category:us-core	S	0..*	CodeableConcept	Classification of type of observation Binding: USCoreSimpleObservationCategory (7.0.0) (required): Note that other codes are permitted, see Required Bindings When Slicing by Value Sets ele-1: All FHIR elements must have a @value or children
category:PersonalCharacteristic	S	1..1	CodeableConcept	Classification of type of observation Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories. ele-1: All FHIR elements must have a @value or children Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://hl7.org/fhir/us/sdoh-clinicalcare/CodeSystem/SDOHCC-CodeSystemTemporaryCodes
code		1..1	code	Symbol in syntax defined by the system Fixed Value: personal-characteristic
code	SΣ	1..1	CodeableConcept	Type of observation (code / type) Binding: LOINCCodes (preferred): Codes identifying names of simple observations. ele-1: All FHIR elements must have a @value or children Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 76690-7
subject	SΣC	1..1	Reference(US Core Patient Profile(7.0.0))	Who and/or what the observation is about ele-1: All FHIR elements must have a @value or children
focus	ΣC	0..1	Reference(RelatedPerson)	What the observation is about, when it is not about the subject of record ele-1: All FHIR elements must have a @value or children
effective[x]	SΣ	0..1		Clinically relevant time/time-period for observation ele-1: All FHIR elements must have a @value or children
effectiveDateTime			dateTime
performer	SΣC	0..*	Reference(US Core Practitioner Profile(7.0.0) | US Core Organization Profile(7.0.0) | US Core Patient Profile(7.0.0) | PractitionerRole | US Core CareTeam Profile(7.0.0) | US Core RelatedPerson Profile(7.0.0))	Who is responsible for the observation ele-1: All FHIR elements must have a @value or children
value[x]	SΣC	1..1	CodeableConcept	Actual result Binding: LOINC Answer List LL3323-4 (preferred): Codes for sexual orientation ele-1: All FHIR elements must have a @value or children
Slices for extension				Content/Rules for all slices
extension:DataAbsentReasonMasked		0..1	(Complex)	unknown | asked | temp | notasked | masked | unsupported | astext | error URL: http://hl7.org/fhir/StructureDefinition/data-absent-reason ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
extension		0..0
url		1..1	uri	"http://hl7.org/fhir/StructureDefinition/data-absent-reason"
value[x]	S	1..1	code	Value of extension Binding: DataAbsentReason (required): Used to specify why the normally expected content of the data element is missing. ele-1: All FHIR elements must have a @value or children Fixed Value: masked
coding	SΣ	0..*	Coding	Code defined by a terminology system ele-1: All FHIR elements must have a @value or children
method	S	1..1	CodeableConcept	How it was done Binding: SDOHCC ValueSet Observation Method (extensible): Methods for personal characteristic observations. ele-1: All FHIR elements must have a @value or children
derivedFrom	SΣC	0..*	Reference(US Core DocumentReference Profile(7.0.0) | US Core QuestionnaireResponse Profile(7.0.0) | Observation)	𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: US Core Profiles or other resource the observation is made from ele-1: All FHIR elements must have a @value or children
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
Observation.status	required	SDOHCCValueSetObservationStatus http://hl7.org/fhir/us/sdoh-clinicalcare/ValueSet/SDOHCC-ValueSetObservationStatus from this IG
Observation.category	preferred	ObservationCategoryCodes http://hl7.org/fhir/ValueSet/observation-category from the FHIR Standard
Observation.category:us-core	required	USCoreSimpleObservationCategory http://hl7.org/fhir/us/core/ValueSet/us-core-simple-observation-category|7.0.0
Observation.category:PersonalCharacteristic	preferred	Pattern: personal-characteristic http://hl7.org/fhir/ValueSet/observation-category from the FHIR Standard
Observation.code	preferred	Pattern: LOINC Code 76690-7 http://hl7.org/fhir/ValueSet/observation-codes from the FHIR Standard
Observation.value[x]	preferred	LOINC LL3323-4 http://loinc.org/vs/LL3323-4
Observation.value[x].extension:DataAbsentReasonMasked.value[x]	required	Fixed Value: masked http://hl7.org/fhir/ValueSet/data-absent-reason|4.0.1 from the FHIR Standard
Observation.method	extensible	SDOHCCValueSetObservationMethod http://hl7.org/fhir/us/sdoh-clinicalcare/ValueSet/SDOHCC-ValueSetObservationMethod from this IG

Constraints

Id	Grade	Path(s)	Details	Requirements
SDOH-Obs-1	error	Observation	Either subject or extension-Observation.subject must exist but not both : subject.exists() xor extension('http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.subject').exists()
SDOH-Obs-2	error	Observation	Focus is only allowed if subject is present : focus.exists() implies subject.exists()
SDOH-Obs-3	error	Observation	Must have either performer or derivedFrom : performer.exists() or derivedFrom.exists()
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()

This structure is derived from SDOHCCObservationPersonalCharacteristic

Name	Flags	Card.	Type	Description & Constraints
Observation		0..*	SDOHCCObservationPersonalCharacteristic	Observation about an individual's sexual orientation
code		1..1	CodeableConcept	Type of observation (code / type) Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 76690-7
value[x]		1..1	CodeableConcept	Actual result Binding: LOINC Answer List LL3323-4 (preferred): Codes for sexual orientation
Slices for extension				Content/Rules for all slices
extension:DataAbsentReasonMasked		0..1	(Complex)	unknown | asked | temp | notasked | masked | unsupported | astext | error URL: http://hl7.org/fhir/StructureDefinition/data-absent-reason
value[x]	S	1..1	code	Value of extension Fixed Value: masked
coding	S	0..*	Coding	Code defined by a terminology system
dataAbsentReason		0..0
method	S	1..1	CodeableConcept	How it was done Binding: SDOHCC ValueSet Observation Method (extensible): Methods for personal characteristic observations.
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
Observation.value[x]	preferred	LOINC LL3323-4 http://loinc.org/vs/LL3323-4
Observation.method	extensible	SDOHCCValueSetObservationMethod http://hl7.org/fhir/us/sdoh-clinicalcare/ValueSet/SDOHCC-ValueSetObservationMethod from this IG

Name	Flags	Card.	Type	Description & Constraints
Observation	C	0..*	SDOHCCObservationPersonalCharacteristic	Observation about an individual's sexual orientation obs-6: dataAbsentReason SHALL only be present if Observation.value[x] is not present obs-7: If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present SDOH-Obs-1: Either subject or extension-Observation.subject must exist but not both SDOH-Obs-2: Focus is only allowed if subject is present SDOH-Obs-3: Must have either performer or derivedFrom
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:OtherSubject	SC	0..1	(Complex)	Optional Extensions Element URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.subject
id		0..1	string	Unique id for inter-element referencing
extension		0..0
url		1..1	uri	"http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.subject"
value[x]		1..1	Reference(US Core Practitioner Profile(7.0.0))	Value of extension
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	0..*	Identifier	Business Identifier for observation
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	?!SΣ	1..1	code	final | corrected | entered-in-error | unknown Binding: SDOHCC ValueSet Observation Status (required)
Slices for category	S	1..*	CodeableConcept	Classification of type of observation Slice: Unordered, Open by pattern:$this Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
category:us-core	S	0..*	CodeableConcept	Classification of type of observation Binding: USCoreSimpleObservationCategory (7.0.0) (required): Note that other codes are permitted, see Required Bindings When Slicing by Value Sets
category:PersonalCharacteristic	S	1..1	CodeableConcept	Classification of type of observation Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://hl7.org/fhir/us/sdoh-clinicalcare/CodeSystem/SDOHCC-CodeSystemTemporaryCodes
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: personal-characteristic
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
code	SΣ	1..1	CodeableConcept	Type of observation (code / type) Binding: LOINCCodes (preferred): Codes identifying names of simple observations. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 76690-7
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
subject	SΣC	1..1	Reference(US Core Patient Profile(7.0.0))	Who and/or what the observation is about
focus	ΣC	0..1	Reference(RelatedPerson)	What the observation is about, when it is not about the subject of record
encounter	Σ	0..1	Reference(Encounter)	Healthcare event during which this observation is made
effective[x]	SΣ	0..1		Clinically relevant time/time-period for observation
effectiveDateTime			dateTime S
effectivePeriod			Period
issued	Σ	0..1	instant	Date/Time this version was made available
performer	SΣC	0..*	Reference(US Core Practitioner Profile(7.0.0) | US Core Organization Profile(7.0.0) | US Core Patient Profile(7.0.0) | PractitionerRole | US Core CareTeam Profile(7.0.0) | US Core RelatedPerson Profile(7.0.0))	Who is responsible for the observation
value[x]	SΣC	1..1	CodeableConcept S	Actual result Binding: LOINC Answer List LL3323-4 (preferred): Codes for sexual orientation
id		0..1	string	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
extension:DataAbsentReasonMasked		0..1	(Complex)	unknown | asked | temp | notasked | masked | unsupported | astext | error URL: http://hl7.org/fhir/StructureDefinition/data-absent-reason
id		0..1	string	Unique id for inter-element referencing
extension		0..0
url		1..1	uri	"http://hl7.org/fhir/StructureDefinition/data-absent-reason"
value[x]	S	1..1	code	Value of extension Binding: DataAbsentReason (required): Used to specify why the normally expected content of the data element is missing. Fixed Value: masked
coding	SΣ	0..*	Coding	Code defined by a terminology system
text	Σ	0..1	string	Plain text representation of the concept
note		0..*	Annotation	Comments about the observation
method	S	1..1	CodeableConcept	How it was done Binding: SDOHCC ValueSet Observation Method (extensible): Methods for personal characteristic observations.
device		0..1	Reference(Device | DeviceMetric)	(Measurement) Device
hasMember	Σ	0..*	Reference(Observation | QuestionnaireResponse | MolecularSequence)	Related resource that belongs to the Observation group
derivedFrom	SΣC	0..*	Reference(US Core DocumentReference Profile(7.0.0) | US Core QuestionnaireResponse Profile(7.0.0) | Observation)	𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: US Core Profiles or other resource the observation is made from
component	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	Σ	1..1	CodeableConcept	Type of component observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations.
value[x]	Σ	0..1		Actual component result
valueQuantity			Quantity
valueCodeableConcept			CodeableConcept
valueString			string
valueBoolean			boolean
valueInteger			integer
valueRange			Range
valueRatio			Ratio
valueSampledData			SampledData
valueTime			time
valueDateTime			dateTime
valuePeriod			Period
dataAbsentReason	C	0..1	CodeableConcept	Why the component result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation		0..*	CodeableConcept	High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
referenceRange		0..*	See referenceRange (Observation)	Provides guide for interpretation of component result
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
Observation.language	preferred	CommonLanguages http://hl7.org/fhir/ValueSet/languages from the FHIR Standard Additional Bindings Purpose AllLanguages Max Binding
Observation.status	required	SDOHCCValueSetObservationStatus http://hl7.org/fhir/us/sdoh-clinicalcare/ValueSet/SDOHCC-ValueSetObservationStatus from this IG
Observation.category	preferred	ObservationCategoryCodes http://hl7.org/fhir/ValueSet/observation-category from the FHIR Standard
Observation.category:us-core	required	USCoreSimpleObservationCategory http://hl7.org/fhir/us/core/ValueSet/us-core-simple-observation-category|7.0.0
Observation.category:PersonalCharacteristic	preferred	Pattern: personal-characteristic http://hl7.org/fhir/ValueSet/observation-category from the FHIR Standard
Observation.code	preferred	Pattern: LOINC Code 76690-7 http://hl7.org/fhir/ValueSet/observation-codes from the FHIR Standard
Observation.value[x]	preferred	LOINC LL3323-4 http://loinc.org/vs/LL3323-4
Observation.value[x].extension:DataAbsentReasonMasked.value[x]	required	Fixed Value: masked http://hl7.org/fhir/ValueSet/data-absent-reason|4.0.1 from the FHIR Standard
Observation.method	extensible	SDOHCCValueSetObservationMethod http://hl7.org/fhir/us/sdoh-clinicalcare/ValueSet/SDOHCC-ValueSetObservationMethod from this IG
Observation.referenceRange.type	preferred	ObservationReferenceRangeMeaningCodes http://hl7.org/fhir/ValueSet/referencerange-meaning from the FHIR Standard
Observation.referenceRange.appliesTo	example	ObservationReferenceRangeAppliesToCodes http://hl7.org/fhir/ValueSet/referencerange-appliesto from the FHIR Standard
Observation.component.code	example	LOINCCodes (a valid code from LOINC) http://hl7.org/fhir/ValueSet/observation-codes from the FHIR Standard
Observation.component.dataAbsentReason	extensible	DataAbsentReason http://hl7.org/fhir/ValueSet/data-absent-reason from the FHIR Standard
Observation.component.interpretation	extensible	ObservationInterpretationCodes http://hl7.org/fhir/ValueSet/observation-interpretation from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
SDOH-Obs-1	error	Observation	Either subject or extension-Observation.subject must exist but not both : subject.exists() xor extension('http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.subject').exists()
SDOH-Obs-2	error	Observation	Focus is only allowed if subject is present : focus.exists() implies subject.exists()
SDOH-Obs-3	error	Observation	Must have either performer or derivedFrom : performer.exists() or derivedFrom.exists()
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()

This structure is derived from SDOHCCObservationPersonalCharacteristic

Summary

Mandatory: 2 elements
Must-Support: 3 elements
Fixed: 1 element
Prohibited: 1 element

Extensions

This structure refers to these extensions:

• http://hl7.org/fhir/StructureDefinition/data-absent-reason|4.0.1

Maturity: 2

Key Elements View

Name	Flags	Card.	Type	Description & Constraints
Observation	C	0..*	SDOHCCObservationPersonalCharacteristic	Observation about an individual's sexual orientation dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated dom-5: If a resource is contained in another resource, it SHALL NOT have a security label dom-6: A resource should have narrative for robust management obs-6: dataAbsentReason SHALL only be present if Observation.value[x] is not present obs-7: If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present SDOH-Obs-1: Either subject or extension-Observation.subject must exist but not both SDOH-Obs-2: Focus is only allowed if subject is present SDOH-Obs-3: Must have either performer or derivedFrom
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created ele-1: All FHIR elements must have a @value or children
Slices for extension				Content/Rules for all slices
extension:OtherSubject	SC	0..1	(Complex)	Optional Extensions Element URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.subject ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
extension		0..0
url		1..1	uri	"http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.subject"
value[x]		1..1	Reference(US Core Practitioner Profile(7.0.0))	Value of extension ele-1: All FHIR elements must have a @value or children
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
status	?!SΣ	1..1	code	final | corrected | entered-in-error | unknown Binding: SDOHCC ValueSet Observation Status (required) ele-1: All FHIR elements must have a @value or children
Slices for category	S	1..*	CodeableConcept	Classification of type of observation Slice: Unordered, Open by pattern:$this Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories. ele-1: All FHIR elements must have a @value or children
category:us-core	S	0..*	CodeableConcept	Classification of type of observation Binding: USCoreSimpleObservationCategory (7.0.0) (required): Note that other codes are permitted, see Required Bindings When Slicing by Value Sets ele-1: All FHIR elements must have a @value or children
category:PersonalCharacteristic	S	1..1	CodeableConcept	Classification of type of observation Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories. ele-1: All FHIR elements must have a @value or children Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://hl7.org/fhir/us/sdoh-clinicalcare/CodeSystem/SDOHCC-CodeSystemTemporaryCodes
code		1..1	code	Symbol in syntax defined by the system Fixed Value: personal-characteristic
code	SΣ	1..1	CodeableConcept	Type of observation (code / type) Binding: LOINCCodes (preferred): Codes identifying names of simple observations. ele-1: All FHIR elements must have a @value or children Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 76690-7
subject	SΣC	1..1	Reference(US Core Patient Profile(7.0.0))	Who and/or what the observation is about ele-1: All FHIR elements must have a @value or children
focus	ΣC	0..1	Reference(RelatedPerson)	What the observation is about, when it is not about the subject of record ele-1: All FHIR elements must have a @value or children
effective[x]	SΣ	0..1		Clinically relevant time/time-period for observation ele-1: All FHIR elements must have a @value or children
effectiveDateTime			dateTime
performer	SΣC	0..*	Reference(US Core Practitioner Profile(7.0.0) | US Core Organization Profile(7.0.0) | US Core Patient Profile(7.0.0) | PractitionerRole | US Core CareTeam Profile(7.0.0) | US Core RelatedPerson Profile(7.0.0))	Who is responsible for the observation ele-1: All FHIR elements must have a @value or children
value[x]	SΣC	1..1	CodeableConcept	Actual result Binding: LOINC Answer List LL3323-4 (preferred): Codes for sexual orientation ele-1: All FHIR elements must have a @value or children
Slices for extension				Content/Rules for all slices
extension:DataAbsentReasonMasked		0..1	(Complex)	unknown | asked | temp | notasked | masked | unsupported | astext | error URL: http://hl7.org/fhir/StructureDefinition/data-absent-reason ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
extension		0..0
url		1..1	uri	"http://hl7.org/fhir/StructureDefinition/data-absent-reason"
value[x]	S	1..1	code	Value of extension Binding: DataAbsentReason (required): Used to specify why the normally expected content of the data element is missing. ele-1: All FHIR elements must have a @value or children Fixed Value: masked
coding	SΣ	0..*	Coding	Code defined by a terminology system ele-1: All FHIR elements must have a @value or children
method	S	1..1	CodeableConcept	How it was done Binding: SDOHCC ValueSet Observation Method (extensible): Methods for personal characteristic observations. ele-1: All FHIR elements must have a @value or children
derivedFrom	SΣC	0..*	Reference(US Core DocumentReference Profile(7.0.0) | US Core QuestionnaireResponse Profile(7.0.0) | Observation)	𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: US Core Profiles or other resource the observation is made from ele-1: All FHIR elements must have a @value or children
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
Observation.status	required	SDOHCCValueSetObservationStatus http://hl7.org/fhir/us/sdoh-clinicalcare/ValueSet/SDOHCC-ValueSetObservationStatus from this IG
Observation.category	preferred	ObservationCategoryCodes http://hl7.org/fhir/ValueSet/observation-category from the FHIR Standard
Observation.category:us-core	required	USCoreSimpleObservationCategory http://hl7.org/fhir/us/core/ValueSet/us-core-simple-observation-category|7.0.0
Observation.category:PersonalCharacteristic	preferred	Pattern: personal-characteristic http://hl7.org/fhir/ValueSet/observation-category from the FHIR Standard
Observation.code	preferred	Pattern: LOINC Code 76690-7 http://hl7.org/fhir/ValueSet/observation-codes from the FHIR Standard
Observation.value[x]	preferred	LOINC LL3323-4 http://loinc.org/vs/LL3323-4
Observation.value[x].extension:DataAbsentReasonMasked.value[x]	required	Fixed Value: masked http://hl7.org/fhir/ValueSet/data-absent-reason|4.0.1 from the FHIR Standard
Observation.method	extensible	SDOHCCValueSetObservationMethod http://hl7.org/fhir/us/sdoh-clinicalcare/ValueSet/SDOHCC-ValueSetObservationMethod from this IG

Constraints

Id	Grade	Path(s)	Details	Requirements
SDOH-Obs-1	error	Observation	Either subject or extension-Observation.subject must exist but not both : subject.exists() xor extension('http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.subject').exists()
SDOH-Obs-2	error	Observation	Focus is only allowed if subject is present : focus.exists() implies subject.exists()
SDOH-Obs-3	error	Observation	Must have either performer or derivedFrom : performer.exists() or derivedFrom.exists()
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()

Differential View

This structure is derived from SDOHCCObservationPersonalCharacteristic

Name	Flags	Card.	Type	Description & Constraints
Observation		0..*	SDOHCCObservationPersonalCharacteristic	Observation about an individual's sexual orientation
code		1..1	CodeableConcept	Type of observation (code / type) Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 76690-7
value[x]		1..1	CodeableConcept	Actual result Binding: LOINC Answer List LL3323-4 (preferred): Codes for sexual orientation
Slices for extension				Content/Rules for all slices
extension:DataAbsentReasonMasked		0..1	(Complex)	unknown | asked | temp | notasked | masked | unsupported | astext | error URL: http://hl7.org/fhir/StructureDefinition/data-absent-reason
value[x]	S	1..1	code	Value of extension Fixed Value: masked
coding	S	0..*	Coding	Code defined by a terminology system
dataAbsentReason		0..0
method	S	1..1	CodeableConcept	How it was done Binding: SDOHCC ValueSet Observation Method (extensible): Methods for personal characteristic observations.
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
Observation.value[x]	preferred	LOINC LL3323-4 http://loinc.org/vs/LL3323-4
Observation.method	extensible	SDOHCCValueSetObservationMethod http://hl7.org/fhir/us/sdoh-clinicalcare/ValueSet/SDOHCC-ValueSetObservationMethod from this IG

Snapshot View

Name	Flags	Card.	Type	Description & Constraints
Observation	C	0..*	SDOHCCObservationPersonalCharacteristic	Observation about an individual's sexual orientation obs-6: dataAbsentReason SHALL only be present if Observation.value[x] is not present obs-7: If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present SDOH-Obs-1: Either subject or extension-Observation.subject must exist but not both SDOH-Obs-2: Focus is only allowed if subject is present SDOH-Obs-3: Must have either performer or derivedFrom
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:OtherSubject	SC	0..1	(Complex)	Optional Extensions Element URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.subject
id		0..1	string	Unique id for inter-element referencing
extension		0..0
url		1..1	uri	"http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.subject"
value[x]		1..1	Reference(US Core Practitioner Profile(7.0.0))	Value of extension
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	0..*	Identifier	Business Identifier for observation
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	?!SΣ	1..1	code	final | corrected | entered-in-error | unknown Binding: SDOHCC ValueSet Observation Status (required)
Slices for category	S	1..*	CodeableConcept	Classification of type of observation Slice: Unordered, Open by pattern:$this Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
category:us-core	S	0..*	CodeableConcept	Classification of type of observation Binding: USCoreSimpleObservationCategory (7.0.0) (required): Note that other codes are permitted, see Required Bindings When Slicing by Value Sets
category:PersonalCharacteristic	S	1..1	CodeableConcept	Classification of type of observation Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://hl7.org/fhir/us/sdoh-clinicalcare/CodeSystem/SDOHCC-CodeSystemTemporaryCodes
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: personal-characteristic
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
code	SΣ	1..1	CodeableConcept	Type of observation (code / type) Binding: LOINCCodes (preferred): Codes identifying names of simple observations. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 76690-7
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
subject	SΣC	1..1	Reference(US Core Patient Profile(7.0.0))	Who and/or what the observation is about
focus	ΣC	0..1	Reference(RelatedPerson)	What the observation is about, when it is not about the subject of record
encounter	Σ	0..1	Reference(Encounter)	Healthcare event during which this observation is made
effective[x]	SΣ	0..1		Clinically relevant time/time-period for observation
effectiveDateTime			dateTime S
effectivePeriod			Period
issued	Σ	0..1	instant	Date/Time this version was made available
performer	SΣC	0..*	Reference(US Core Practitioner Profile(7.0.0) | US Core Organization Profile(7.0.0) | US Core Patient Profile(7.0.0) | PractitionerRole | US Core CareTeam Profile(7.0.0) | US Core RelatedPerson Profile(7.0.0))	Who is responsible for the observation
value[x]	SΣC	1..1	CodeableConcept S	Actual result Binding: LOINC Answer List LL3323-4 (preferred): Codes for sexual orientation
id		0..1	string	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
extension:DataAbsentReasonMasked		0..1	(Complex)	unknown | asked | temp | notasked | masked | unsupported | astext | error URL: http://hl7.org/fhir/StructureDefinition/data-absent-reason
id		0..1	string	Unique id for inter-element referencing
extension		0..0
url		1..1	uri	"http://hl7.org/fhir/StructureDefinition/data-absent-reason"
value[x]	S	1..1	code	Value of extension Binding: DataAbsentReason (required): Used to specify why the normally expected content of the data element is missing. Fixed Value: masked
coding	SΣ	0..*	Coding	Code defined by a terminology system
text	Σ	0..1	string	Plain text representation of the concept
note		0..*	Annotation	Comments about the observation
method	S	1..1	CodeableConcept	How it was done Binding: SDOHCC ValueSet Observation Method (extensible): Methods for personal characteristic observations.
device		0..1	Reference(Device | DeviceMetric)	(Measurement) Device
hasMember	Σ	0..*	Reference(Observation | QuestionnaireResponse | MolecularSequence)	Related resource that belongs to the Observation group
derivedFrom	SΣC	0..*	Reference(US Core DocumentReference Profile(7.0.0) | US Core QuestionnaireResponse Profile(7.0.0) | Observation)	𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: US Core Profiles or other resource the observation is made from
component	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	Σ	1..1	CodeableConcept	Type of component observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations.
value[x]	Σ	0..1		Actual component result
valueQuantity			Quantity
valueCodeableConcept			CodeableConcept
valueString			string
valueBoolean			boolean
valueInteger			integer
valueRange			Range
valueRatio			Ratio
valueSampledData			SampledData
valueTime			time
valueDateTime			dateTime
valuePeriod			Period
dataAbsentReason	C	0..1	CodeableConcept	Why the component result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation		0..*	CodeableConcept	High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
referenceRange		0..*	See referenceRange (Observation)	Provides guide for interpretation of component result
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
Observation.language	preferred	CommonLanguages http://hl7.org/fhir/ValueSet/languages from the FHIR Standard Additional Bindings Purpose AllLanguages Max Binding
Observation.status	required	SDOHCCValueSetObservationStatus http://hl7.org/fhir/us/sdoh-clinicalcare/ValueSet/SDOHCC-ValueSetObservationStatus from this IG
Observation.category	preferred	ObservationCategoryCodes http://hl7.org/fhir/ValueSet/observation-category from the FHIR Standard
Observation.category:us-core	required	USCoreSimpleObservationCategory http://hl7.org/fhir/us/core/ValueSet/us-core-simple-observation-category|7.0.0
Observation.category:PersonalCharacteristic	preferred	Pattern: personal-characteristic http://hl7.org/fhir/ValueSet/observation-category from the FHIR Standard
Observation.code	preferred	Pattern: LOINC Code 76690-7 http://hl7.org/fhir/ValueSet/observation-codes from the FHIR Standard
Observation.value[x]	preferred	LOINC LL3323-4 http://loinc.org/vs/LL3323-4
Observation.value[x].extension:DataAbsentReasonMasked.value[x]	required	Fixed Value: masked http://hl7.org/fhir/ValueSet/data-absent-reason|4.0.1 from the FHIR Standard
Observation.method	extensible	SDOHCCValueSetObservationMethod http://hl7.org/fhir/us/sdoh-clinicalcare/ValueSet/SDOHCC-ValueSetObservationMethod from this IG
Observation.referenceRange.type	preferred	ObservationReferenceRangeMeaningCodes http://hl7.org/fhir/ValueSet/referencerange-meaning from the FHIR Standard
Observation.referenceRange.appliesTo	example	ObservationReferenceRangeAppliesToCodes http://hl7.org/fhir/ValueSet/referencerange-appliesto from the FHIR Standard
Observation.component.code	example	LOINCCodes (a valid code from LOINC) http://hl7.org/fhir/ValueSet/observation-codes from the FHIR Standard
Observation.component.dataAbsentReason	extensible	DataAbsentReason http://hl7.org/fhir/ValueSet/data-absent-reason from the FHIR Standard
Observation.component.interpretation	extensible	ObservationInterpretationCodes http://hl7.org/fhir/ValueSet/observation-interpretation from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
SDOH-Obs-1	error	Observation	Either subject or extension-Observation.subject must exist but not both : subject.exists() xor extension('http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.subject').exists()
SDOH-Obs-2	error	Observation	Focus is only allowed if subject is present : focus.exists() implies subject.exists()
SDOH-Obs-3	error	Observation	Must have either performer or derivedFrom : performer.exists() or derivedFrom.exists()
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()

This structure is derived from SDOHCCObservationPersonalCharacteristic

Summary

Mandatory: 2 elements
Must-Support: 3 elements
Fixed: 1 element
Prohibited: 1 element

Extensions

This structure refers to these extensions:

• http://hl7.org/fhir/StructureDefinition/data-absent-reason|4.0.1

Maturity: 2

Other representations of profile: CSV, Excel, Schematron