Name	Flags	Card.	Type	Description & Constraints
Observation	C	0..*	Observation	CH EMED Observation (PADV) ch-obs-1: In case of a 'CHANGE', reference shall be made to an entry containing the changes.
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
identifier		1..1	Identifier	Observation Identifier
system		1..1	uri	The namespace for the identifier value Fixed Value: urn:ietf:rfc:3986
value		1..1	string	Identifier value as UUID Example CH EMED: urn:uuid:daa8cd41-34a1-4a9c-9a6d-cd3f850142e9
status		1..1	code	registered | preliminary | final | amended + Fixed Value: final
code		1..1	CodeableConcept	Observation code Binding: IHE Pharmaceutical Advice Status List (required)
subject		0..1	Reference(CH Core Patient)	Patient
reference		1..1	string	Literal reference, Relative, internal or absolute URL
Slices for effective[x]		0..1	dateTime, Period, Timing, instant	Clinically relevant time/time-period for observation Slice: Unordered, Open by type:$this
effective[x]:effectiveDateTime		0..1	dateTime	Effective Time
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 (Differential)

Path	Conformance	ValueSet
Observation.code	required	IHEPharmaceuticalAdviceStatusList

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.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()

Name	Flags	Card.	Type	Description & Constraints
Observation	C	0..*	Observation	CH EMED Observation (PADV) 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		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
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)
subject	Σ	0..1	Reference(CH Core Patient)	Patient
reference	ΣC	1..1	string	Literal reference, Relative, internal or absolute URL
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
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
Observation.identifier.use	required	IdentifierUse
Observation.status	required	Fixed Value: final
Observation.code	required	IHEPharmaceuticalAdviceStatusList

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.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..*	Observation	CH EMED Observation (PADV) 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
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	ΣTU	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	0..1	instant	Date/Time this version was made available
performer	Σ	0..*	Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson)	Who is responsible for the observation
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
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
Observation.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding
Observation.identifier.use	required	IdentifierUse
Observation.identifier.type	extensible	Identifier Type Codes
Observation.status	required	Fixed Value: final
Observation.category	preferred	ObservationCategoryCodes
Observation.code	required	IHEPharmaceuticalAdviceStatusList
Observation.subject.type	extensible	ResourceType
Observation.dataAbsentReason	extensible	DataAbsentReason
Observation.interpretation	extensible	ObservationInterpretationCodes
Observation.bodySite	example	SNOMEDCTBodyStructures
Observation.method	example	ObservationMethods
Observation.referenceRange.type	preferred	ObservationReferenceRangeMeaningCodes
Observation.referenceRange.appliesTo	example	ObservationReferenceRangeAppliesToCodes
Observation.component.code	example	LOINCCodes (a valid code from LOINC)
Observation.component.dataAbsentReason	extensible	DataAbsentReason
Observation.component.interpretation	extensible	ObservationInterpretationCodes

Constraints

Id	Grade	Path(s)	Details	Requirements
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()

Summary

Mandatory: 4 elements (1 nested mandatory element)
Fixed Value: 2 elements

Structures

This structure refers to these other structures:

• CH Core Patient (http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-patient)

Extensions

This structure refers to these extensions:

• http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-treatmentplan
• http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-prescription
• http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-dispense
• http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-medicationstatement-changed
• http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-medicationrequest-changed

Slices

This structure defines the following Slices:

• The element Observation.effective[x] is sliced based on the value of type:$this

Name	Flags	Card.	Type	Description & Constraints
Observation	C	0..*	Observation	CH EMED Observation (PADV) ch-obs-1: In case of a 'CHANGE', reference shall be made to an entry containing the changes.
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
identifier		1..1	Identifier	Observation Identifier
system		1..1	uri	The namespace for the identifier value Fixed Value: urn:ietf:rfc:3986
value		1..1	string	Identifier value as UUID Example CH EMED: urn:uuid:daa8cd41-34a1-4a9c-9a6d-cd3f850142e9
status		1..1	code	registered | preliminary | final | amended + Fixed Value: final
code		1..1	CodeableConcept	Observation code Binding: IHE Pharmaceutical Advice Status List (required)
subject		0..1	Reference(CH Core Patient)	Patient
reference		1..1	string	Literal reference, Relative, internal or absolute URL
Slices for effective[x]		0..1	dateTime, Period, Timing, instant	Clinically relevant time/time-period for observation Slice: Unordered, Open by type:$this
effective[x]:effectiveDateTime		0..1	dateTime	Effective Time
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 (Differential)

Path	Conformance	ValueSet
Observation.code	required	IHEPharmaceuticalAdviceStatusList

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.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()

Name	Flags	Card.	Type	Description & Constraints
Observation	C	0..*	Observation	CH EMED Observation (PADV) 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		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
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)
subject	Σ	0..1	Reference(CH Core Patient)	Patient
reference	ΣC	1..1	string	Literal reference, Relative, internal or absolute URL
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
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
Observation.identifier.use	required	IdentifierUse
Observation.status	required	Fixed Value: final
Observation.code	required	IHEPharmaceuticalAdviceStatusList

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.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..*	Observation	CH EMED Observation (PADV) 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
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	ΣTU	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	0..1	instant	Date/Time this version was made available
performer	Σ	0..*	Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson)	Who is responsible for the observation
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
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
Observation.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding
Observation.identifier.use	required	IdentifierUse
Observation.identifier.type	extensible	Identifier Type Codes
Observation.status	required	Fixed Value: final
Observation.category	preferred	ObservationCategoryCodes
Observation.code	required	IHEPharmaceuticalAdviceStatusList
Observation.subject.type	extensible	ResourceType
Observation.dataAbsentReason	extensible	DataAbsentReason
Observation.interpretation	extensible	ObservationInterpretationCodes
Observation.bodySite	example	SNOMEDCTBodyStructures
Observation.method	example	ObservationMethods
Observation.referenceRange.type	preferred	ObservationReferenceRangeMeaningCodes
Observation.referenceRange.appliesTo	example	ObservationReferenceRangeAppliesToCodes
Observation.component.code	example	LOINCCodes (a valid code from LOINC)
Observation.component.dataAbsentReason	extensible	DataAbsentReason
Observation.component.interpretation	extensible	ObservationInterpretationCodes

Constraints

Id	Grade	Path(s)	Details	Requirements
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()

Summary

Mandatory: 4 elements (1 nested mandatory element)
Fixed Value: 2 elements

Structures

This structure refers to these other structures:

• CH Core Patient (http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-patient)

Extensions

This structure refers to these extensions:

• http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-treatmentplan
• http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-prescription
• http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-dispense
• http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-medicationstatement-changed
• http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-medicationrequest-changed

Slices

This structure defines the following Slices:

• The element Observation.effective[x] is sliced based on the value of type:$this