This page is part of the FHIR eMedication exchange formats for the implementation effort of CARA within its EPR community (v1.0.0: STU1) 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: PADV Observation

Definition of the observation for the pharmaceutical advice document

Usage:

• Use this Resource Profile: PADV Document
• Refer to this Resource Profile: PADV Composition and PADV Changed MedicationRequest
• Examples for this Resource Profile: Observation/ObservationParacetamolAxapharmPrePadvCancel, Observation/ObservationRamiprilPadv and Observation/ObservationTriatecPadv

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	C	0..*	CHEMEDObservation	CH EMED Observation (PADV) only-one-obs-ref: A single reference (to either a medication treatment plan, prescription or dispense) SHALL be present mtp-entry-only-with-ref: A changed MedicationStatement SHALL only be present with a medication treatment plan reference, in a PADV CHANGE pre-entry-only-with-ref: A changed MedicationRequest SHALL only be present with a medication request reference, in a PADV CHANGE treatment-plan-id-reference-matches-statement-changed-reference: If the observation includes a medication statement changed reference, it SHALL match the treatment plan id reference
meta
extension	D	0..*	Extension	✕ This element is not supported
versionId	D	0..1	id	✕ This element is not supported
lastUpdated	D	0..1	instant	✕ This element is not supported
source	D	0..1	uri	✕ This element is not supported
security	D	0..*	Coding	✕ This element is not supported
tag	D	0..*	Coding	✕ This element is not supported
implicitRules		0..0
extension:medicationStatementChanged		0..1	CHEMEDExtMedicationStatementChanged	CH EMED Extension
value[x]:valueReference		1..1	Reference(PADV Changed MedicationStatement) {r, b}	The changed MedicationStatement
extension:medicationRequestChanged		0..1	CHEMEDExtMedicationRequestChanged	CH EMED Extension
value[x]:valueReference		1..1	Reference(PADV Changed MedicationRequest) {r, b}	The changed MedicationRequest
modifierExtension		0..0
basedOn	D	0..*	Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest)	✕ This element is not supported
partOf	D	0..*	Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy)	✕ This element is not supported
category	D	0..*	CodeableConcept	✕ This element is not supported
subject		0..1	Reference(CH EMED EPR Patient) {r, b}	Patient
focus	D	0..*	Reference(Resource)	✕ This element is not supported
encounter	D	0..1	Reference(Encounter)	✕ This element is not supported
effective[x]	D	0..1	dateTime, Period, Timing, instant	✕ This element is not supported
value[x]	D	0..1	Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period	✕ This element is not supported
dataAbsentReason	D	0..1	CodeableConcept	✕ This element is not supported
interpretation	D	0..*	CodeableConcept	✕ This element is not supported
note
id	D	0..1	string	✕ This element is not supported
extension	D	0..*	Extension	✕ This element is not supported
author[x]	D	0..1	Reference(Practitioner | Patient | RelatedPerson | Organization), string	✕ The note author is ignored, as it cannot be different than the document and/or entry's author
time	D	0..1	dateTime	✕ This element is not supported
text		1..1	markdown	The annotation text content (as raw text, no markdown allowed).
bodySite	D	0..1	CodeableConcept	✕ This element is not supported
method	D	0..1	CodeableConcept	✕ This element is not supported
specimen	D	0..1	Reference(Specimen)	✕ This element is not supported
device	D	0..1	Reference(Device | DeviceMetric)	✕ This element is not supported
referenceRange	D	0..*	BackboneElement	✕ This element is not supported
hasMember	D	0..*	Reference(Observation | QuestionnaireResponse | MolecularSequence)	✕ This element is not supported
derivedFrom	D	0..*	Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | Observation | MolecularSequence)	✕ This element is not supported
component	D	0..*	BackboneElement	✕ This element is not supported
Documentation for this format

Constraints

Id	Grade	Path(s)	Details	Requirements
mtp-entry-only-with-ref	error	Observation	A changed MedicationStatement SHALL only be present with a medication treatment plan reference, in a PADV CHANGE : (extension.where(url='http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-treatmentplan').exists() and extension.where(url='http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-medicationstatement-changed').exists() and code.coding.single().code = 'CHANGE') or extension.where(url='http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-medicationstatement-changed').exists().not()
only-one-obs-ref	error	Observation	A single reference (to either a medication treatment plan, prescription or dispense) SHALL be present : (extension.where(url='http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-treatmentplan').exists() xor extension.where(url='http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-prescription').exists() xor extension.where(url='http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-dispense').exists()) and (extension.where(url='http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-treatmentplan').exists() and extension.where(url='http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-prescription').exists() and extension.where(url='http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-dispense').exists()).not()
pre-entry-only-with-ref	error	Observation	A changed MedicationRequest SHALL only be present with a medication request reference, in a PADV CHANGE : (extension.where(url='http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-prescription').exists() and extension.where(url='http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-medicationrequest-changed').exists() and code.coding.single().code = 'CHANGE') or extension.where(url='http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-medicationrequest-changed').exists().not()
treatment-plan-id-reference-matches-statement-changed-reference	error	Observation	If the observation includes a medication statement changed reference, it SHALL match the treatment plan id reference : extension('http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-medicationstatement-changed').exists() implies (extension('http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-medicationstatement-changed').single().value as Reference).reference = (extension('http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-treatmentplan').extension('id').single().value as Identifier).value

Name	Flags	Card.	Type	Description & Constraints
Observation	C	0..*	CHEMEDObservation	CH EMED Observation (PADV) only-one-obs-ref: A single reference (to either a medication treatment plan, prescription or dispense) SHALL be present mtp-entry-only-with-ref: A changed MedicationStatement SHALL only be present with a medication treatment plan reference, in a PADV CHANGE pre-entry-only-with-ref: A changed MedicationRequest SHALL only be present with a medication request reference, in a PADV CHANGE treatment-plan-id-reference-matches-statement-changed-reference: If the observation includes a medication statement changed reference, it SHALL match the treatment plan id reference
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}	CH EMED Extension URL: http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-medicationstatement-changed
extension		0..0
url		1..1	uri	"http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-medicationstatement-changed"
Slices for value[x]		1..1	Reference()	Value of extension Slice: Unordered, Closed by type:$this
value[x]:valueReference		1..1	Reference(PADV Changed MedicationStatement) {r, b}	The changed MedicationStatement
medicationRequestChanged		0..1	Reference(CH EMED MedicationRequest Changed) {r, b}	CH EMED Extension URL: http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-medicationrequest-changed
extension		0..0
url		1..1	uri	"http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-medicationrequest-changed"
Slices for value[x]		1..1	Reference()	Value of extension Slice: Unordered, Closed by type:$this
value[x]:valueReference		1..1	Reference(PADV Changed MedicationRequest) {r, b}	The changed MedicationRequest
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
basedOn	Σ	0..*	Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest)	✕ This element is not supported
partOf	Σ	0..*	Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy)	✕ This element is not supported
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	✕ This element is not supported 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 EMED EPR Patient) {r, b}	Patient
reference	ΣC	1..1	string	Literal reference, Relative, internal or absolute URL
focus	Σ	0..*	Reference(Resource)	✕ This element is not supported
encounter	Σ	0..1	Reference(Encounter)	✕ This element is not supported
Slices for effective[x]	Σ	0..1		✕ This element is not supported Slice: Unordered, Closed 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
value[x]	ΣC	0..1		✕ This element is not supported
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	✕ This element is not supported Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation		0..*	CodeableConcept	✕ This element is not supported 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.
id		0..1	string	✕ This element is not supported
extension		0..*	Extension	✕ This element is not supported Slice: Unordered, Open by value:url
author[x]	Σ	0..1		✕ The note author is ignored, as it cannot be different than the document and/or entry's author
authorReference			Reference(Practitioner | Patient | RelatedPerson | Organization)
authorString			string
time	Σ	0..1	dateTime	✕ This element is not supported
text	Σ	1..1	markdown	The annotation text content (as raw text, no markdown allowed).
bodySite		0..1	CodeableConcept	✕ This element is not supported Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
method		0..1	CodeableConcept	✕ This element is not supported Binding: ObservationMethods (example): Methods for simple observations.
specimen		0..1	Reference(Specimen)	✕ This element is not supported
device		0..1	Reference(Device | DeviceMetric)	✕ This element is not supported
referenceRange	C	0..*	BackboneElement	✕ This element is not supported
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
hasMember	Σ	0..*	Reference(Observation | QuestionnaireResponse | MolecularSequence)	✕ This element is not supported
derivedFrom	Σ	0..*	Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | Observation | MolecularSequence)	✕ This element is not supported
component	Σ	0..*	BackboneElement	✕ This element is not supported
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.
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.category	preferred	ObservationCategoryCodes http://hl7.org/fhir/ValueSet/observation-category from the FHIR Standard
Observation.code	required	IHEPharmaceuticalAdviceStatusList http://fhir.ch/ig/ch-emed/ValueSet/ihe-pharmaceuticaladvicestatuslist
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.component.code	example	LOINCCodes (a valid code from LOINC) http://hl7.org/fhir/ValueSet/observation-codes 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()
mtp-entry-only-with-ref	error	Observation	A changed MedicationStatement SHALL only be present with a medication treatment plan reference, in a PADV CHANGE : (extension.where(url='http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-treatmentplan').exists() and extension.where(url='http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-medicationstatement-changed').exists() and code.coding.single().code = 'CHANGE') or extension.where(url='http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-medicationstatement-changed').exists().not()
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()
only-one-obs-ref	error	Observation	A single reference (to either a medication treatment plan, prescription or dispense) SHALL be present : (extension.where(url='http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-treatmentplan').exists() xor extension.where(url='http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-prescription').exists() xor extension.where(url='http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-dispense').exists()) and (extension.where(url='http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-treatmentplan').exists() and extension.where(url='http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-prescription').exists() and extension.where(url='http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-dispense').exists()).not()
pre-entry-only-with-ref	error	Observation	A changed MedicationRequest SHALL only be present with a medication request reference, in a PADV CHANGE : (extension.where(url='http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-prescription').exists() and extension.where(url='http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-medicationrequest-changed').exists() and code.coding.single().code = 'CHANGE') or extension.where(url='http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-medicationrequest-changed').exists().not()
treatment-plan-id-reference-matches-statement-changed-reference	error	Observation	If the observation includes a medication statement changed reference, it SHALL match the treatment plan id reference : extension('http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-medicationstatement-changed').exists() implies (extension('http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-medicationstatement-changed').single().value as Reference).reference = (extension('http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-treatmentplan').extension('id').single().value as Identifier).value

Name	Flags	Card.	Type	Description & Constraints
Observation	C	0..*	CHEMEDObservation	CH EMED Observation (PADV) only-one-obs-ref: A single reference (to either a medication treatment plan, prescription or dispense) SHALL be present mtp-entry-only-with-ref: A changed MedicationStatement SHALL only be present with a medication treatment plan reference, in a PADV CHANGE pre-entry-only-with-ref: A changed MedicationRequest SHALL only be present with a medication request reference, in a PADV CHANGE treatment-plan-id-reference-matches-statement-changed-reference: If the observation includes a medication statement changed reference, it SHALL match the treatment plan id reference
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	✕ This element is not supported Slice: Unordered, Open by value:url
versionId	Σ	0..1	id	✕ This element is not supported
lastUpdated	Σ	0..1	instant	✕ This element is not supported
source	Σ	0..1	uri	✕ This element is not supported
profile	Σ	0..*	canonical(StructureDefinition)	Profiles this resource claims to conform to
security	Σ	0..*	Coding	✕ This element is not supported Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
tag	Σ	0..*	Coding	✕ This element is not supported Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".
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}	CH EMED Extension URL: http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-medicationstatement-changed
id		0..1	string	Unique id for inter-element referencing
extension		0..0
url		1..1	uri	"http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-medicationstatement-changed"
Slices for value[x]		1..1	Reference()	Value of extension Slice: Unordered, Closed by type:$this
value[x]:valueReference		1..1	Reference(PADV Changed MedicationStatement) {r, b}	The changed MedicationStatement
medicationRequestChanged		0..1	Reference(CH EMED MedicationRequest Changed) {r, b}	CH EMED Extension URL: http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-medicationrequest-changed
id		0..1	string	Unique id for inter-element referencing
extension		0..0
url		1..1	uri	"http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-medicationrequest-changed"
Slices for value[x]		1..1	Reference()	Value of extension Slice: Unordered, Closed by type:$this
value[x]:valueReference		1..1	Reference(PADV Changed MedicationRequest) {r, b}	The changed MedicationRequest
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)	✕ This element is not supported
partOf	Σ	0..*	Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy)	✕ This element is not supported
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	✕ This element is not supported 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 EMED EPR Patient) {r, b}	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)	✕ This element is not supported
encounter	Σ	0..1	Reference(Encounter)	✕ This element is not supported
Slices for effective[x]	Σ	0..1		✕ This element is not supported Slice: Unordered, Closed 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		✕ This element is not supported
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	✕ This element is not supported Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation		0..*	CodeableConcept	✕ This element is not supported 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.
id		0..1	string	✕ This element is not supported
extension		0..*	Extension	✕ This element is not supported Slice: Unordered, Open by value:url
author[x]	Σ	0..1		✕ The note author is ignored, as it cannot be different than the document and/or entry's author
authorReference			Reference(Practitioner | Patient | RelatedPerson | Organization)
authorString			string
time	Σ	0..1	dateTime	✕ This element is not supported
text	Σ	1..1	markdown	The annotation text content (as raw text, no markdown allowed).
bodySite		0..1	CodeableConcept	✕ This element is not supported Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
method		0..1	CodeableConcept	✕ This element is not supported Binding: ObservationMethods (example): Methods for simple observations.
specimen		0..1	Reference(Specimen)	✕ This element is not supported
device		0..1	Reference(Device | DeviceMetric)	✕ This element is not supported
referenceRange	C	0..*	BackboneElement	✕ This element is not supported
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)	✕ This element is not supported
derivedFrom	Σ	0..*	Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | Observation | MolecularSequence)	✕ This element is not supported
component	Σ	0..*	BackboneElement	✕ This element is not supported
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.meta.security	extensible	All Security Labels http://hl7.org/fhir/ValueSet/security-labels from the FHIR Standard
Observation.meta.tag	example	CommonTags http://hl7.org/fhir/ValueSet/common-tags from the FHIR Standard
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-emed/ValueSet/ihe-pharmaceuticaladvicestatuslist
Observation.subject.type	extensible	ResourceType http://hl7.org/fhir/ValueSet/resource-types
Observation.performer.type	extensible	ResourceType http://hl7.org/fhir/ValueSet/resource-types
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()
mtp-entry-only-with-ref	error	Observation	A changed MedicationStatement SHALL only be present with a medication treatment plan reference, in a PADV CHANGE : (extension.where(url='http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-treatmentplan').exists() and extension.where(url='http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-medicationstatement-changed').exists() and code.coding.single().code = 'CHANGE') or extension.where(url='http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-medicationstatement-changed').exists().not()
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()
only-one-obs-ref	error	Observation	A single reference (to either a medication treatment plan, prescription or dispense) SHALL be present : (extension.where(url='http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-treatmentplan').exists() xor extension.where(url='http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-prescription').exists() xor extension.where(url='http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-dispense').exists()) and (extension.where(url='http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-treatmentplan').exists() and extension.where(url='http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-prescription').exists() and extension.where(url='http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-dispense').exists()).not()
pre-entry-only-with-ref	error	Observation	A changed MedicationRequest SHALL only be present with a medication request reference, in a PADV CHANGE : (extension.where(url='http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-prescription').exists() and extension.where(url='http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-medicationrequest-changed').exists() and code.coding.single().code = 'CHANGE') or extension.where(url='http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-medicationrequest-changed').exists().not()
treatment-plan-id-reference-matches-statement-changed-reference	error	Observation	If the observation includes a medication statement changed reference, it SHALL match the treatment plan id reference : extension('http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-medicationstatement-changed').exists() implies (extension('http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-medicationstatement-changed').single().value as Reference).reference = (extension('http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-treatmentplan').extension('id').single().value as Identifier).value

This structure is derived from CHEMEDObservation

Summary

Prohibited: 2 elements

Structures

This structure refers to these other structures:

• PADV Changed MedicationStatement (http://fhir.ch/ig/ch-emed-epr/StructureDefinition/ch-emed-epr-medicationstatement-changed)
• PADV Changed MedicationRequest (http://fhir.ch/ig/ch-emed-epr/StructureDefinition/ch-emed-epr-medicationrequest-changed)
• CH EMED EPR Patient (http://fhir.ch/ig/ch-emed-epr/StructureDefinition/ch-emed-epr-patient)

Differential View

This structure is derived from CHEMEDObservation

Name	Flags	Card.	Type	Description & Constraints
Observation	C	0..*	CHEMEDObservation	CH EMED Observation (PADV) only-one-obs-ref: A single reference (to either a medication treatment plan, prescription or dispense) SHALL be present mtp-entry-only-with-ref: A changed MedicationStatement SHALL only be present with a medication treatment plan reference, in a PADV CHANGE pre-entry-only-with-ref: A changed MedicationRequest SHALL only be present with a medication request reference, in a PADV CHANGE treatment-plan-id-reference-matches-statement-changed-reference: If the observation includes a medication statement changed reference, it SHALL match the treatment plan id reference
meta
extension	D	0..*	Extension	✕ This element is not supported
versionId	D	0..1	id	✕ This element is not supported
lastUpdated	D	0..1	instant	✕ This element is not supported
source	D	0..1	uri	✕ This element is not supported
security	D	0..*	Coding	✕ This element is not supported
tag	D	0..*	Coding	✕ This element is not supported
implicitRules		0..0
extension:medicationStatementChanged		0..1	CHEMEDExtMedicationStatementChanged	CH EMED Extension
value[x]:valueReference		1..1	Reference(PADV Changed MedicationStatement) {r, b}	The changed MedicationStatement
extension:medicationRequestChanged		0..1	CHEMEDExtMedicationRequestChanged	CH EMED Extension
value[x]:valueReference		1..1	Reference(PADV Changed MedicationRequest) {r, b}	The changed MedicationRequest
modifierExtension		0..0
basedOn	D	0..*	Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest)	✕ This element is not supported
partOf	D	0..*	Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy)	✕ This element is not supported
category	D	0..*	CodeableConcept	✕ This element is not supported
subject		0..1	Reference(CH EMED EPR Patient) {r, b}	Patient
focus	D	0..*	Reference(Resource)	✕ This element is not supported
encounter	D	0..1	Reference(Encounter)	✕ This element is not supported
effective[x]	D	0..1	dateTime, Period, Timing, instant	✕ This element is not supported
value[x]	D	0..1	Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period	✕ This element is not supported
dataAbsentReason	D	0..1	CodeableConcept	✕ This element is not supported
interpretation	D	0..*	CodeableConcept	✕ This element is not supported
note
id	D	0..1	string	✕ This element is not supported
extension	D	0..*	Extension	✕ This element is not supported
author[x]	D	0..1	Reference(Practitioner | Patient | RelatedPerson | Organization), string	✕ The note author is ignored, as it cannot be different than the document and/or entry's author
time	D	0..1	dateTime	✕ This element is not supported
text		1..1	markdown	The annotation text content (as raw text, no markdown allowed).
bodySite	D	0..1	CodeableConcept	✕ This element is not supported
method	D	0..1	CodeableConcept	✕ This element is not supported
specimen	D	0..1	Reference(Specimen)	✕ This element is not supported
device	D	0..1	Reference(Device | DeviceMetric)	✕ This element is not supported
referenceRange	D	0..*	BackboneElement	✕ This element is not supported
hasMember	D	0..*	Reference(Observation | QuestionnaireResponse | MolecularSequence)	✕ This element is not supported
derivedFrom	D	0..*	Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | Observation | MolecularSequence)	✕ This element is not supported
component	D	0..*	BackboneElement	✕ This element is not supported
Documentation for this format

Constraints

Id	Grade	Path(s)	Details	Requirements
mtp-entry-only-with-ref	error	Observation	A changed MedicationStatement SHALL only be present with a medication treatment plan reference, in a PADV CHANGE : (extension.where(url='http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-treatmentplan').exists() and extension.where(url='http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-medicationstatement-changed').exists() and code.coding.single().code = 'CHANGE') or extension.where(url='http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-medicationstatement-changed').exists().not()
only-one-obs-ref	error	Observation	A single reference (to either a medication treatment plan, prescription or dispense) SHALL be present : (extension.where(url='http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-treatmentplan').exists() xor extension.where(url='http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-prescription').exists() xor extension.where(url='http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-dispense').exists()) and (extension.where(url='http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-treatmentplan').exists() and extension.where(url='http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-prescription').exists() and extension.where(url='http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-dispense').exists()).not()
pre-entry-only-with-ref	error	Observation	A changed MedicationRequest SHALL only be present with a medication request reference, in a PADV CHANGE : (extension.where(url='http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-prescription').exists() and extension.where(url='http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-medicationrequest-changed').exists() and code.coding.single().code = 'CHANGE') or extension.where(url='http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-medicationrequest-changed').exists().not()
treatment-plan-id-reference-matches-statement-changed-reference	error	Observation	If the observation includes a medication statement changed reference, it SHALL match the treatment plan id reference : extension('http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-medicationstatement-changed').exists() implies (extension('http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-medicationstatement-changed').single().value as Reference).reference = (extension('http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-treatmentplan').extension('id').single().value as Identifier).value

Key Elements View

Name	Flags	Card.	Type	Description & Constraints
Observation	C	0..*	CHEMEDObservation	CH EMED Observation (PADV) only-one-obs-ref: A single reference (to either a medication treatment plan, prescription or dispense) SHALL be present mtp-entry-only-with-ref: A changed MedicationStatement SHALL only be present with a medication treatment plan reference, in a PADV CHANGE pre-entry-only-with-ref: A changed MedicationRequest SHALL only be present with a medication request reference, in a PADV CHANGE treatment-plan-id-reference-matches-statement-changed-reference: If the observation includes a medication statement changed reference, it SHALL match the treatment plan id reference
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}	CH EMED Extension URL: http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-medicationstatement-changed
extension		0..0
url		1..1	uri	"http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-medicationstatement-changed"
Slices for value[x]		1..1	Reference()	Value of extension Slice: Unordered, Closed by type:$this
value[x]:valueReference		1..1	Reference(PADV Changed MedicationStatement) {r, b}	The changed MedicationStatement
medicationRequestChanged		0..1	Reference(CH EMED MedicationRequest Changed) {r, b}	CH EMED Extension URL: http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-medicationrequest-changed
extension		0..0
url		1..1	uri	"http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-medicationrequest-changed"
Slices for value[x]		1..1	Reference()	Value of extension Slice: Unordered, Closed by type:$this
value[x]:valueReference		1..1	Reference(PADV Changed MedicationRequest) {r, b}	The changed MedicationRequest
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
basedOn	Σ	0..*	Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest)	✕ This element is not supported
partOf	Σ	0..*	Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy)	✕ This element is not supported
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	✕ This element is not supported 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 EMED EPR Patient) {r, b}	Patient
reference	ΣC	1..1	string	Literal reference, Relative, internal or absolute URL
focus	Σ	0..*	Reference(Resource)	✕ This element is not supported
encounter	Σ	0..1	Reference(Encounter)	✕ This element is not supported
Slices for effective[x]	Σ	0..1		✕ This element is not supported Slice: Unordered, Closed 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
value[x]	ΣC	0..1		✕ This element is not supported
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	✕ This element is not supported Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation		0..*	CodeableConcept	✕ This element is not supported 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.
id		0..1	string	✕ This element is not supported
extension		0..*	Extension	✕ This element is not supported Slice: Unordered, Open by value:url
author[x]	Σ	0..1		✕ The note author is ignored, as it cannot be different than the document and/or entry's author
authorReference			Reference(Practitioner | Patient | RelatedPerson | Organization)
authorString			string
time	Σ	0..1	dateTime	✕ This element is not supported
text	Σ	1..1	markdown	The annotation text content (as raw text, no markdown allowed).
bodySite		0..1	CodeableConcept	✕ This element is not supported Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
method		0..1	CodeableConcept	✕ This element is not supported Binding: ObservationMethods (example): Methods for simple observations.
specimen		0..1	Reference(Specimen)	✕ This element is not supported
device		0..1	Reference(Device | DeviceMetric)	✕ This element is not supported
referenceRange	C	0..*	BackboneElement	✕ This element is not supported
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
hasMember	Σ	0..*	Reference(Observation | QuestionnaireResponse | MolecularSequence)	✕ This element is not supported
derivedFrom	Σ	0..*	Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | Observation | MolecularSequence)	✕ This element is not supported
component	Σ	0..*	BackboneElement	✕ This element is not supported
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.
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.category	preferred	ObservationCategoryCodes http://hl7.org/fhir/ValueSet/observation-category from the FHIR Standard
Observation.code	required	IHEPharmaceuticalAdviceStatusList http://fhir.ch/ig/ch-emed/ValueSet/ihe-pharmaceuticaladvicestatuslist
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.component.code	example	LOINCCodes (a valid code from LOINC) http://hl7.org/fhir/ValueSet/observation-codes 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()
mtp-entry-only-with-ref	error	Observation	A changed MedicationStatement SHALL only be present with a medication treatment plan reference, in a PADV CHANGE : (extension.where(url='http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-treatmentplan').exists() and extension.where(url='http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-medicationstatement-changed').exists() and code.coding.single().code = 'CHANGE') or extension.where(url='http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-medicationstatement-changed').exists().not()
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()
only-one-obs-ref	error	Observation	A single reference (to either a medication treatment plan, prescription or dispense) SHALL be present : (extension.where(url='http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-treatmentplan').exists() xor extension.where(url='http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-prescription').exists() xor extension.where(url='http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-dispense').exists()) and (extension.where(url='http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-treatmentplan').exists() and extension.where(url='http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-prescription').exists() and extension.where(url='http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-dispense').exists()).not()
pre-entry-only-with-ref	error	Observation	A changed MedicationRequest SHALL only be present with a medication request reference, in a PADV CHANGE : (extension.where(url='http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-prescription').exists() and extension.where(url='http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-medicationrequest-changed').exists() and code.coding.single().code = 'CHANGE') or extension.where(url='http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-medicationrequest-changed').exists().not()
treatment-plan-id-reference-matches-statement-changed-reference	error	Observation	If the observation includes a medication statement changed reference, it SHALL match the treatment plan id reference : extension('http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-medicationstatement-changed').exists() implies (extension('http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-medicationstatement-changed').single().value as Reference).reference = (extension('http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-treatmentplan').extension('id').single().value as Identifier).value

Snapshot View

Name	Flags	Card.	Type	Description & Constraints
Observation	C	0..*	CHEMEDObservation	CH EMED Observation (PADV) only-one-obs-ref: A single reference (to either a medication treatment plan, prescription or dispense) SHALL be present mtp-entry-only-with-ref: A changed MedicationStatement SHALL only be present with a medication treatment plan reference, in a PADV CHANGE pre-entry-only-with-ref: A changed MedicationRequest SHALL only be present with a medication request reference, in a PADV CHANGE treatment-plan-id-reference-matches-statement-changed-reference: If the observation includes a medication statement changed reference, it SHALL match the treatment plan id reference
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	✕ This element is not supported Slice: Unordered, Open by value:url
versionId	Σ	0..1	id	✕ This element is not supported
lastUpdated	Σ	0..1	instant	✕ This element is not supported
source	Σ	0..1	uri	✕ This element is not supported
profile	Σ	0..*	canonical(StructureDefinition)	Profiles this resource claims to conform to
security	Σ	0..*	Coding	✕ This element is not supported Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
tag	Σ	0..*	Coding	✕ This element is not supported Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".
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}	CH EMED Extension URL: http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-medicationstatement-changed
id		0..1	string	Unique id for inter-element referencing
extension		0..0
url		1..1	uri	"http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-medicationstatement-changed"
Slices for value[x]		1..1	Reference()	Value of extension Slice: Unordered, Closed by type:$this
value[x]:valueReference		1..1	Reference(PADV Changed MedicationStatement) {r, b}	The changed MedicationStatement
medicationRequestChanged		0..1	Reference(CH EMED MedicationRequest Changed) {r, b}	CH EMED Extension URL: http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-medicationrequest-changed
id		0..1	string	Unique id for inter-element referencing
extension		0..0
url		1..1	uri	"http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-medicationrequest-changed"
Slices for value[x]		1..1	Reference()	Value of extension Slice: Unordered, Closed by type:$this
value[x]:valueReference		1..1	Reference(PADV Changed MedicationRequest) {r, b}	The changed MedicationRequest
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)	✕ This element is not supported
partOf	Σ	0..*	Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy)	✕ This element is not supported
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	✕ This element is not supported 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 EMED EPR Patient) {r, b}	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)	✕ This element is not supported
encounter	Σ	0..1	Reference(Encounter)	✕ This element is not supported
Slices for effective[x]	Σ	0..1		✕ This element is not supported Slice: Unordered, Closed 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		✕ This element is not supported
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	✕ This element is not supported Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation		0..*	CodeableConcept	✕ This element is not supported 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.
id		0..1	string	✕ This element is not supported
extension		0..*	Extension	✕ This element is not supported Slice: Unordered, Open by value:url
author[x]	Σ	0..1		✕ The note author is ignored, as it cannot be different than the document and/or entry's author
authorReference			Reference(Practitioner | Patient | RelatedPerson | Organization)
authorString			string
time	Σ	0..1	dateTime	✕ This element is not supported
text	Σ	1..1	markdown	The annotation text content (as raw text, no markdown allowed).
bodySite		0..1	CodeableConcept	✕ This element is not supported Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
method		0..1	CodeableConcept	✕ This element is not supported Binding: ObservationMethods (example): Methods for simple observations.
specimen		0..1	Reference(Specimen)	✕ This element is not supported
device		0..1	Reference(Device | DeviceMetric)	✕ This element is not supported
referenceRange	C	0..*	BackboneElement	✕ This element is not supported
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)	✕ This element is not supported
derivedFrom	Σ	0..*	Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | Observation | MolecularSequence)	✕ This element is not supported
component	Σ	0..*	BackboneElement	✕ This element is not supported
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.meta.security	extensible	All Security Labels http://hl7.org/fhir/ValueSet/security-labels from the FHIR Standard
Observation.meta.tag	example	CommonTags http://hl7.org/fhir/ValueSet/common-tags from the FHIR Standard
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-emed/ValueSet/ihe-pharmaceuticaladvicestatuslist
Observation.subject.type	extensible	ResourceType http://hl7.org/fhir/ValueSet/resource-types
Observation.performer.type	extensible	ResourceType http://hl7.org/fhir/ValueSet/resource-types
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()
mtp-entry-only-with-ref	error	Observation	A changed MedicationStatement SHALL only be present with a medication treatment plan reference, in a PADV CHANGE : (extension.where(url='http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-treatmentplan').exists() and extension.where(url='http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-medicationstatement-changed').exists() and code.coding.single().code = 'CHANGE') or extension.where(url='http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-medicationstatement-changed').exists().not()
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()
only-one-obs-ref	error	Observation	A single reference (to either a medication treatment plan, prescription or dispense) SHALL be present : (extension.where(url='http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-treatmentplan').exists() xor extension.where(url='http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-prescription').exists() xor extension.where(url='http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-dispense').exists()) and (extension.where(url='http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-treatmentplan').exists() and extension.where(url='http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-prescription').exists() and extension.where(url='http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-dispense').exists()).not()
pre-entry-only-with-ref	error	Observation	A changed MedicationRequest SHALL only be present with a medication request reference, in a PADV CHANGE : (extension.where(url='http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-prescription').exists() and extension.where(url='http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-medicationrequest-changed').exists() and code.coding.single().code = 'CHANGE') or extension.where(url='http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-medicationrequest-changed').exists().not()
treatment-plan-id-reference-matches-statement-changed-reference	error	Observation	If the observation includes a medication statement changed reference, it SHALL match the treatment plan id reference : extension('http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-medicationstatement-changed').exists() implies (extension('http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-medicationstatement-changed').single().value as Reference).reference = (extension('http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-treatmentplan').extension('id').single().value as Identifier).value

This structure is derived from CHEMEDObservation

Summary

Prohibited: 2 elements

Structures

This structure refers to these other structures:

• PADV Changed MedicationStatement (http://fhir.ch/ig/ch-emed-epr/StructureDefinition/ch-emed-epr-medicationstatement-changed)
• PADV Changed MedicationRequest (http://fhir.ch/ig/ch-emed-epr/StructureDefinition/ch-emed-epr-medicationrequest-changed)
• CH EMED EPR Patient (http://fhir.ch/ig/ch-emed-epr/StructureDefinition/ch-emed-epr-patient)