This page is part of the CH EMED (R4) (v5.0.0-ballot: STU 5 Ballot 1) based on FHIR (HL7® FHIR® Standard) R4. This is the current published version in its permanent home (it will always be available at this URL). For a full list of available versions, see the Directory of published versions

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Resource Profile: CH EMED Observation (LIST)

Definition of the observation for the medication list document

Usage:

• Use this Resource Profile: CH EMED Medication List Document
• Refer to this Resource Profile: CH EMED Medication List Composition

Formal Views of Profile Content

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

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

This structure is derived from CHEMEDObservation

Name	Flags	Card.	Type	Description & Constraints
Observation		0..*	CHEMEDObservation	CH EMED Observation (LIST)
Slices for extension				Content/Rules for all slices
parentDocument		0..1	(Complex)	Reference to the parent document URL: http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-pharmaceuticaladvice
authorDocument		0..1	Reference(CH Core Patient | CH Core PractitionerRole | RelatedPerson)	Author of the original document if different from the author of the medical decision (Observation.performer), see also 'Guidance - Authorship' URL: http://fhir.ch/ig/ch-core/StructureDefinition/ch-ext-author
Documentation for this format

Name	Flags	Card.	Type	Description & Constraints
Observation	C	0..*	CHEMEDObservation	CH EMED Observation (LIST) 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 ch-obs-1: In case of a 'CHANGE', reference shall be made to an entry containing the changes.
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
Slices for extension				Content/Rules for all slices
treatmentPlan		0..1	(Complex)	Reference to the medication treatment plan URL: http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-treatmentplan
prescription		0..1	(Complex)	Reference to the medication prescription URL: http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-prescription
dispense		0..1	(Complex)	Reference to the medication dispense URL: http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-dispense
medicationStatementChanged		0..1	Reference(CH EMED MedicationStatement Changed) {r, b}	Reference to the changed medication statement (it shall have the same identifier as the entry it replaces) URL: http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-medicationstatement-changed
medicationRequestChanged		0..1	Reference(CH EMED MedicationRequest Changed) {r, b}	Reference to the changed medication request (it shall have the same identifier as the entry it replaces) URL: http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-medicationrequest-changed
parentDocument		0..1	(Complex)	Reference to the parent document URL: http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-pharmaceuticaladvice
authorDocument		0..1	Reference(CH Core Patient | CH Core PractitionerRole | RelatedPerson)	Author of the original document if different from the author of the medical decision (Observation.performer), see also 'Guidance - Authorship' URL: http://fhir.ch/ig/ch-core/StructureDefinition/ch-ext-author
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	1..1	Identifier	Observation Identifier
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
system	Σ	1..1	uri	The namespace for the identifier value Fixed Value: urn:ietf:rfc:3986
value	Σ	1..1	string	Identifier value as UUID Example General: 123456 Example CH EMED: urn:uuid:daa8cd41-34a1-4a9c-9a6d-cd3f850142e9
status	?!Σ	1..1	code	registered | preliminary | final | amended + Binding: ObservationStatus (required): Codes providing the status of an observation. Fixed Value: final
code	Σ	1..1	CodeableConcept	Observation code Binding: IHE Pharmaceutical Advice Status List (required)
Slices for effective[x]	Σ	0..1		Clinically relevant time/time-period for observation Slice: Unordered, Open by type:$this
effectiveDateTime			dateTime
effectivePeriod			Period
effectiveTiming			Timing
effectiveInstant			instant
effective[x]:effectiveDateTime	Σ	0..1	dateTime	Effective Time
issued	Σ	1..1	instant	Date/Time this version was made available
performer	Σ	1..1	Reference(CH EMED PractitionerRole | CH Core Patient EPR | RelatedPerson)	The author of the medical decision, see also 'Guidance - Authorship'
reference	ΣC	1..1	string	Literal reference, Relative, internal or absolute URL
note		1..1	Annotation	COMMENT: the actual comment. OK/CHANGE/REFUSE/CANCEL/SUSPEND: the reason why the action was done.
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
Observation.identifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 from the FHIR Standard
Observation.status	required	Fixed Value: final http://hl7.org/fhir/ValueSet/observation-status|4.0.1 from the FHIR Standard
Observation.code	required	IHEPharmaceuticalAdviceStatusList http://fhir.ch/ig/ch-term/ValueSet/ihe-pharmaceuticaladvicestatuslist

Constraints

Id	Grade	Path(s)	Details	Requirements
ch-obs-1	error	Observation	In case of a 'CHANGE', reference shall be made to an entry containing the changes. : code.coding.exists(system='urn:oid:1.3.6.1.4.1.19376.1.9.2.1' and code='CHANGE') implies extension.where(url='http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-medicationstatement-changed' or url='http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-medicationrequest-changed').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()

Name	Flags	Card.	Type	Description & Constraints
Observation	C	0..*	CHEMEDObservation	CH EMED Observation (LIST) 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 ch-obs-1: In case of a 'CHANGE', reference shall be made to an entry containing the changes.
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
treatmentPlan		0..1	(Complex)	Reference to the medication treatment plan URL: http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-treatmentplan
prescription		0..1	(Complex)	Reference to the medication prescription URL: http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-prescription
dispense		0..1	(Complex)	Reference to the medication dispense URL: http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-dispense
medicationStatementChanged		0..1	Reference(CH EMED MedicationStatement Changed) {r, b}	Reference to the changed medication statement (it shall have the same identifier as the entry it replaces) URL: http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-medicationstatement-changed
medicationRequestChanged		0..1	Reference(CH EMED MedicationRequest Changed) {r, b}	Reference to the changed medication request (it shall have the same identifier as the entry it replaces) URL: http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-medicationrequest-changed
parentDocument		0..1	(Complex)	Reference to the parent document URL: http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-pharmaceuticaladvice
authorDocument		0..1	Reference(CH Core Patient | CH Core PractitionerRole | RelatedPerson)	Author of the original document if different from the author of the medical decision (Observation.performer), see also 'Guidance - Authorship' URL: http://fhir.ch/ig/ch-core/StructureDefinition/ch-ext-author
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	1..1	Identifier	Observation Identifier
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type	Σ	0..1	CodeableConcept	Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
system	Σ	1..1	uri	The namespace for the identifier value Fixed Value: urn:ietf:rfc:3986
value	Σ	1..1	string	Identifier value as UUID Example General: 123456 Example CH EMED: urn:uuid:daa8cd41-34a1-4a9c-9a6d-cd3f850142e9
period	Σ	0..1	Period	Time period when id is/was valid for use
assigner	Σ	0..1	Reference(Organization)	Organization that issued id (may be just text)
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. Fixed Value: final
category		0..*	CodeableConcept	Classification of type of observation Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
code	Σ	1..1	CodeableConcept	Observation code Binding: IHE Pharmaceutical Advice Status List (required)
subject	Σ	0..1	Reference(CH Core Patient)	Patient
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	ΣC	1..1	string	Literal reference, Relative, internal or absolute URL
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	Text alternative for the resource
focus	Σ	0..*	Reference(Resource)	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
Slices for effective[x]	Σ	0..1		Clinically relevant time/time-period for observation Slice: Unordered, Open by type:$this
effectiveDateTime			dateTime
effectivePeriod			Period
effectiveTiming			Timing
effectiveInstant			instant
effective[x]:effectiveDateTime	Σ	0..1	dateTime	Effective Time
issued	Σ	1..1	instant	Date/Time this version was made available
performer	Σ	1..1	Reference(CH EMED PractitionerRole | CH Core Patient EPR | RelatedPerson)	The author of the medical decision, see also 'Guidance - Authorship'
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	ΣC	1..1	string	Literal reference, Relative, internal or absolute URL
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	Text alternative for the resource
value[x]	ΣC	0..1		Actual 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 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.
note		1..1	Annotation	COMMENT: the actual comment. OK/CHANGE/REFUSE/CANCEL/SUSPEND: the reason why the action was done.
bodySite		0..1	CodeableConcept	Observed body part Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
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 obs-3: Must have at least a low or a high or text
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	Low Range, if relevant
high	C	0..1	SimpleQuantity	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	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 Additional Bindings Purpose AllLanguages Max Binding http://hl7.org/fhir/ValueSet/languages from the FHIR Standard
Observation.identifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 from the FHIR Standard
Observation.identifier.type	extensible	Identifier Type Codes http://hl7.org/fhir/ValueSet/identifier-type from the FHIR Standard
Observation.status	required	Fixed Value: final http://hl7.org/fhir/ValueSet/observation-status|4.0.1 from the FHIR Standard
Observation.category	preferred	ObservationCategoryCodes http://hl7.org/fhir/ValueSet/observation-category from the FHIR Standard
Observation.code	required	IHEPharmaceuticalAdviceStatusList http://fhir.ch/ig/ch-term/ValueSet/ihe-pharmaceuticaladvicestatuslist
Observation.subject.type	extensible	ResourceType http://hl7.org/fhir/ValueSet/resource-types from the FHIR Standard
Observation.performer.type	extensible	ResourceType http://hl7.org/fhir/ValueSet/resource-types from the FHIR Standard
Observation.dataAbsentReason	extensible	DataAbsentReason http://hl7.org/fhir/ValueSet/data-absent-reason from the FHIR Standard
Observation.interpretation	extensible	ObservationInterpretationCodes http://hl7.org/fhir/ValueSet/observation-interpretation from the FHIR Standard
Observation.bodySite	example	SNOMEDCTBodyStructures http://hl7.org/fhir/ValueSet/body-site from the FHIR Standard
Observation.method	example	ObservationMethods http://hl7.org/fhir/ValueSet/observation-methods from the FHIR Standard
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
ch-obs-1	error	Observation	In case of a 'CHANGE', reference shall be made to an entry containing the changes. : code.coding.exists(system='urn:oid:1.3.6.1.4.1.19376.1.9.2.1' and code='CHANGE') implies extension.where(url='http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-medicationstatement-changed' or url='http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-medicationrequest-changed').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-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()

This structure is derived from CHEMEDObservation

Summary

Extensions

This structure refers to these extensions:

• http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-pharmaceuticaladvice
• http://fhir.ch/ig/ch-core/StructureDefinition/ch-ext-author

Differential View

This structure is derived from CHEMEDObservation

Name	Flags	Card.	Type	Description & Constraints
Observation		0..*	CHEMEDObservation	CH EMED Observation (LIST)
Slices for extension				Content/Rules for all slices
parentDocument		0..1	(Complex)	Reference to the parent document URL: http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-pharmaceuticaladvice
authorDocument		0..1	Reference(CH Core Patient | CH Core PractitionerRole | RelatedPerson)	Author of the original document if different from the author of the medical decision (Observation.performer), see also 'Guidance - Authorship' URL: http://fhir.ch/ig/ch-core/StructureDefinition/ch-ext-author
Documentation for this format

Key Elements View

Name	Flags	Card.	Type	Description & Constraints
Observation	C	0..*	CHEMEDObservation	CH EMED Observation (LIST) 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 ch-obs-1: In case of a 'CHANGE', reference shall be made to an entry containing the changes.
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
Slices for extension				Content/Rules for all slices
treatmentPlan		0..1	(Complex)	Reference to the medication treatment plan URL: http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-treatmentplan
prescription		0..1	(Complex)	Reference to the medication prescription URL: http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-prescription
dispense		0..1	(Complex)	Reference to the medication dispense URL: http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-dispense
medicationStatementChanged		0..1	Reference(CH EMED MedicationStatement Changed) {r, b}	Reference to the changed medication statement (it shall have the same identifier as the entry it replaces) URL: http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-medicationstatement-changed
medicationRequestChanged		0..1	Reference(CH EMED MedicationRequest Changed) {r, b}	Reference to the changed medication request (it shall have the same identifier as the entry it replaces) URL: http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-medicationrequest-changed
parentDocument		0..1	(Complex)	Reference to the parent document URL: http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-pharmaceuticaladvice
authorDocument		0..1	Reference(CH Core Patient | CH Core PractitionerRole | RelatedPerson)	Author of the original document if different from the author of the medical decision (Observation.performer), see also 'Guidance - Authorship' URL: http://fhir.ch/ig/ch-core/StructureDefinition/ch-ext-author
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	1..1	Identifier	Observation Identifier
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
system	Σ	1..1	uri	The namespace for the identifier value Fixed Value: urn:ietf:rfc:3986
value	Σ	1..1	string	Identifier value as UUID Example General: 123456 Example CH EMED: urn:uuid:daa8cd41-34a1-4a9c-9a6d-cd3f850142e9
status	?!Σ	1..1	code	registered | preliminary | final | amended + Binding: ObservationStatus (required): Codes providing the status of an observation. Fixed Value: final
code	Σ	1..1	CodeableConcept	Observation code Binding: IHE Pharmaceutical Advice Status List (required)
Slices for effective[x]	Σ	0..1		Clinically relevant time/time-period for observation Slice: Unordered, Open by type:$this
effectiveDateTime			dateTime
effectivePeriod			Period
effectiveTiming			Timing
effectiveInstant			instant
effective[x]:effectiveDateTime	Σ	0..1	dateTime	Effective Time
issued	Σ	1..1	instant	Date/Time this version was made available
performer	Σ	1..1	Reference(CH EMED PractitionerRole | CH Core Patient EPR | RelatedPerson)	The author of the medical decision, see also 'Guidance - Authorship'
reference	ΣC	1..1	string	Literal reference, Relative, internal or absolute URL
note		1..1	Annotation	COMMENT: the actual comment. OK/CHANGE/REFUSE/CANCEL/SUSPEND: the reason why the action was done.
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
Observation.identifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 from the FHIR Standard
Observation.status	required	Fixed Value: final http://hl7.org/fhir/ValueSet/observation-status|4.0.1 from the FHIR Standard
Observation.code	required	IHEPharmaceuticalAdviceStatusList http://fhir.ch/ig/ch-term/ValueSet/ihe-pharmaceuticaladvicestatuslist

Constraints

Id	Grade	Path(s)	Details	Requirements
ch-obs-1	error	Observation	In case of a 'CHANGE', reference shall be made to an entry containing the changes. : code.coding.exists(system='urn:oid:1.3.6.1.4.1.19376.1.9.2.1' and code='CHANGE') implies extension.where(url='http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-medicationstatement-changed' or url='http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-medicationrequest-changed').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()

Snapshot View

Name	Flags	Card.	Type	Description & Constraints
Observation	C	0..*	CHEMEDObservation	CH EMED Observation (LIST) 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 ch-obs-1: In case of a 'CHANGE', reference shall be made to an entry containing the changes.
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
treatmentPlan		0..1	(Complex)	Reference to the medication treatment plan URL: http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-treatmentplan
prescription		0..1	(Complex)	Reference to the medication prescription URL: http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-prescription
dispense		0..1	(Complex)	Reference to the medication dispense URL: http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-dispense
medicationStatementChanged		0..1	Reference(CH EMED MedicationStatement Changed) {r, b}	Reference to the changed medication statement (it shall have the same identifier as the entry it replaces) URL: http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-medicationstatement-changed
medicationRequestChanged		0..1	Reference(CH EMED MedicationRequest Changed) {r, b}	Reference to the changed medication request (it shall have the same identifier as the entry it replaces) URL: http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-medicationrequest-changed
parentDocument		0..1	(Complex)	Reference to the parent document URL: http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-pharmaceuticaladvice
authorDocument		0..1	Reference(CH Core Patient | CH Core PractitionerRole | RelatedPerson)	Author of the original document if different from the author of the medical decision (Observation.performer), see also 'Guidance - Authorship' URL: http://fhir.ch/ig/ch-core/StructureDefinition/ch-ext-author
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	1..1	Identifier	Observation Identifier
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type	Σ	0..1	CodeableConcept	Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
system	Σ	1..1	uri	The namespace for the identifier value Fixed Value: urn:ietf:rfc:3986
value	Σ	1..1	string	Identifier value as UUID Example General: 123456 Example CH EMED: urn:uuid:daa8cd41-34a1-4a9c-9a6d-cd3f850142e9
period	Σ	0..1	Period	Time period when id is/was valid for use
assigner	Σ	0..1	Reference(Organization)	Organization that issued id (may be just text)
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. Fixed Value: final
category		0..*	CodeableConcept	Classification of type of observation Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
code	Σ	1..1	CodeableConcept	Observation code Binding: IHE Pharmaceutical Advice Status List (required)
subject	Σ	0..1	Reference(CH Core Patient)	Patient
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	ΣC	1..1	string	Literal reference, Relative, internal or absolute URL
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	Text alternative for the resource
focus	Σ	0..*	Reference(Resource)	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
Slices for effective[x]	Σ	0..1		Clinically relevant time/time-period for observation Slice: Unordered, Open by type:$this
effectiveDateTime			dateTime
effectivePeriod			Period
effectiveTiming			Timing
effectiveInstant			instant
effective[x]:effectiveDateTime	Σ	0..1	dateTime	Effective Time
issued	Σ	1..1	instant	Date/Time this version was made available
performer	Σ	1..1	Reference(CH EMED PractitionerRole | CH Core Patient EPR | RelatedPerson)	The author of the medical decision, see also 'Guidance - Authorship'
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	ΣC	1..1	string	Literal reference, Relative, internal or absolute URL
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	Text alternative for the resource
value[x]	ΣC	0..1		Actual 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 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.
note		1..1	Annotation	COMMENT: the actual comment. OK/CHANGE/REFUSE/CANCEL/SUSPEND: the reason why the action was done.
bodySite		0..1	CodeableConcept	Observed body part Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
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 obs-3: Must have at least a low or a high or text
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	Low Range, if relevant
high	C	0..1	SimpleQuantity	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	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 Additional Bindings Purpose AllLanguages Max Binding http://hl7.org/fhir/ValueSet/languages from the FHIR Standard
Observation.identifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 from the FHIR Standard
Observation.identifier.type	extensible	Identifier Type Codes http://hl7.org/fhir/ValueSet/identifier-type from the FHIR Standard
Observation.status	required	Fixed Value: final http://hl7.org/fhir/ValueSet/observation-status|4.0.1 from the FHIR Standard
Observation.category	preferred	ObservationCategoryCodes http://hl7.org/fhir/ValueSet/observation-category from the FHIR Standard
Observation.code	required	IHEPharmaceuticalAdviceStatusList http://fhir.ch/ig/ch-term/ValueSet/ihe-pharmaceuticaladvicestatuslist
Observation.subject.type	extensible	ResourceType http://hl7.org/fhir/ValueSet/resource-types from the FHIR Standard
Observation.performer.type	extensible	ResourceType http://hl7.org/fhir/ValueSet/resource-types from the FHIR Standard
Observation.dataAbsentReason	extensible	DataAbsentReason http://hl7.org/fhir/ValueSet/data-absent-reason from the FHIR Standard
Observation.interpretation	extensible	ObservationInterpretationCodes http://hl7.org/fhir/ValueSet/observation-interpretation from the FHIR Standard
Observation.bodySite	example	SNOMEDCTBodyStructures http://hl7.org/fhir/ValueSet/body-site from the FHIR Standard
Observation.method	example	ObservationMethods http://hl7.org/fhir/ValueSet/observation-methods from the FHIR Standard
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
ch-obs-1	error	Observation	In case of a 'CHANGE', reference shall be made to an entry containing the changes. : code.coding.exists(system='urn:oid:1.3.6.1.4.1.19376.1.9.2.1' and code='CHANGE') implies extension.where(url='http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-medicationstatement-changed' or url='http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-medicationrequest-changed').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-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()

This structure is derived from CHEMEDObservation

Summary

Extensions

This structure refers to these extensions:

• http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-pharmaceuticaladvice
• http://fhir.ch/ig/ch-core/StructureDefinition/ch-ext-author

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