Clinical Observation - an observation about the patient, such as a vital sign or a social context finding. The target of the definition of the Vital Signs questionnaire items, so the answers can be extracted as Observations. Codes follow the NHS England Clinical Observations guide where it defines them.

FDP Canonical Data Model

Equivalent FDP Canonical Data Model (CDM) v1.0.0 objects: Observation, Scored Assessment.

Differences:

• observationValue is a string, with a separate UCUM unit; this profile uses valueQuantity (UCUM).
• No components (e.g. blood pressure systolic / diastolic), status, category or performer.
• Codes are SNOMED CT and CTV3 (legacy); no LOINC.
• Good: links to the admission, appointment, virtual ward stay or UEC attendance it was taken in.

The CDM is a downstream persistence model, used here as evidence of what NHS operations record, not as a design source. Mapping by property name - To confirm. See FDP Canonical Data Model Mapping for the full mapping.

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

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Observation	C	0..*	Observation	Measurements and simple assertions Constraints: obs-6, obs-7
Observation.implicitRules	?! This element is a modifier element. Σ This element is included in summaries.	0..1	uri	A set of rules under which this content was created
Observation.modifierExtension	?! This element is a modifier element.	0..*	Extension	Extensions that cannot be ignored
Observation.status	?! This element is a modifier element. S This element must be supported. Σ This element is included in summaries.	1..1	code	registered | preliminary | final | amended + Binding: ObservationStatus (required): Codes providing the status of an observation.
Observation.category	S This element must be supported.	0..*	CodeableConcept	Classification of type of observation Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
Observation.code	S This element must be supported. Σ This element is included in summaries.	1..1	CodeableConcept	What was observed - SNOMED CT (and LOINC for vital signs) Binding: LOINCCodes (example): Codes identifying names of simple observations.
Observation.subject	S This element must be supported. Σ This element is included in summaries.	1..1	Reference(Patient)	Who and/or what the observation is about
Observation.effective[x]	S This element must be supported. Σ This element is included in summaries.	1..1	dateTime	Clinically relevant time/time-period for observation
Observation.performer	S This element must be supported. Σ This element is included in summaries.	0..*	Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson)	Who is responsible for the observation
Observation.Slices for value[x]	S This element must be supported. Σ This element is included in summaries. C	0..1		Actual result Slice: Unordered, Closed by type:$this Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them Other type slices that contain no new information are not shown in this view
Observation.Slices for value[x].valueQuantity			Quantity
Observation.Slices for value[x].valueCodeableConcept			CodeableConcept
Observation.Slices for value[x].valueString			string
Observation.Slices for value[x].valueBoolean			boolean
Observation.Slices for value[x].valueInteger			integer
Observation.Slices for value[x].valueRange			Range
Observation.Slices for value[x].valueRatio			Ratio
Observation.Slices for value[x].valueSampledData			SampledData
Observation.Slices for value[x].valueTime			time
Observation.Slices for value[x].valueDateTime			dateTime
Observation.Slices for value[x].valuePeriod			Period
Observation.Slices for value[x].value[x]:valueQuantity	Σ This element is included in summaries. C	0..1	Quantity	Value with a UCUM unit
Observation.Slices for value[x].value[x]:valueQuantity.comparator	?! This element is a modifier element. Σ This element is included in summaries.	0..1	code	< | <= | >= | > - how to understand the value Binding: QuantityComparator (required): How the Quantity should be understood and represented.
Observation.Slices for value[x].value[x]:valueQuantity.system	Σ This element is included in summaries. C	0..1	uri	System that defines coded unit form Required Pattern: http://unitsofmeasure.org (extensions allowed)
Observation.method	S This element must be supported.	0..1	CodeableConcept	How it was observed - e.g. the oxygen delivery route Binding: ObservationMethods (example): Methods for simple observations.
Observation.component	S This element must be supported. Σ This element is included in summaries.	0..*	BackboneElement	Component results
Observation.component.modifierExtension	?! This element is a modifier element. Σ This element is included in summaries.	0..*	Extension	Extensions that cannot be ignored even if unrecognized
Observation.component.code	S This element must be supported. Σ This element is included in summaries.	1..1	CodeableConcept	Type of component observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations.
Observation.component.value[x]	S This element must be supported. Σ This element is included in summaries.	0..1		Actual component result
Observation.component.value[x].valueQuantity			Quantity
Observation.component.value[x].valueCodeableConcept			CodeableConcept
Observation.component.value[x].valueString			string
Observation.component.value[x].valueBoolean			boolean
Observation.component.value[x].valueInteger			integer
Observation.component.value[x].valueRange			Range
Observation.component.value[x].valueRatio			Ratio
Observation.component.value[x].valueSampledData			SampledData
Observation.component.value[x].valueTime			time
Observation.component.value[x].valueDateTime			dateTime
Observation.component.value[x].valuePeriod			Period
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
Observation.status	Base	required	ObservationStatus	📍4.0.1	FHIR Std.
Observation.category	Base	preferred	Observation Category Codes	📍4.0.1	FHIR Std.
Observation.code	Base	example	LOINC Codes	📍4.0.1	FHIR Std.
Observation.value[x]:valueQuantity.​comparator	Base	required	QuantityComparator	📍4.0.1	FHIR Std.
Observation.method	Base	example	Observation Methods	📍4.0.1	FHIR Std.
Observation.component.​code	Base	example	LOINC Codes	📍4.0.1	FHIR Std.

Constraints

Id	Grade	Path(s)	Description	Expression
dom-2	error	Observation	If the resource is contained in another resource, it SHALL NOT contain nested Resources	contained.contained.empty()
dom-3	error	Observation	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource	contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Observation	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated	contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Observation	If a resource is contained in another resource, it SHALL NOT have a security label	contained.meta.security.empty()
dom-6	best practice	Observation	A resource should have narrative for robust management	text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children	hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both	extension.exists() != value.exists()
obs-6	error	Observation	dataAbsentReason SHALL only be present if Observation.value[x] is not present	dataAbsentReason.empty() or value.empty()
obs-7	error	Observation	If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present	value.empty() or component.code.where(coding.intersect(%resource.code.coding).exists()).empty()

This structure is derived from Observation

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Observation		0..*	Observation	Measurements and simple assertions
Observation.status	S This element must be supported.	1..1	code	registered | preliminary | final | amended +
Observation.category	S This element must be supported.	0..*	CodeableConcept	Classification of type of observation
Observation.code	S This element must be supported.	1..1	CodeableConcept	What was observed - SNOMED CT (and LOINC for vital signs)
Observation.subject	S This element must be supported.	1..1	Reference(Patient)	Who and/or what the observation is about
Observation.effective[x]	S This element must be supported.	1..1	dateTime	Clinically relevant time/time-period for observation
Observation.performer	S This element must be supported.	0..*	Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson)	Who is responsible for the observation
Observation.Slices for value[x]	S This element must be supported.	0..1	Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period	Actual result Slice: Unordered, Open by type:$this Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them Other type slices that contain no new information are not shown in this view
Observation.Slices for value[x].value[x]:valueQuantity		0..1	Quantity	Value with a UCUM unit
Observation.Slices for value[x].value[x]:valueQuantity.system		0..1	uri	System that defines coded unit form Required Pattern: http://unitsofmeasure.org (extensions allowed)
Observation.method	S This element must be supported.	0..1	CodeableConcept	How it was observed - e.g. the oxygen delivery route
Observation.component	S This element must be supported.	0..*	BackboneElement	Component results
Observation.component.code	S This element must be supported.	1..1	CodeableConcept	Type of component observation (code / type)
Observation.component.value[x]	S This element must be supported.	0..1	Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period	Actual component result
Documentation for this format

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Observation	C	0..*	Observation	Measurements and simple assertions Constraints: obs-6, obs-7
Observation.id	Σ This element is included in summaries.	0..1	id	Logical id of this artifact
Observation.meta	Σ This element is included in summaries.	0..1	Meta	Metadata about the resource
Observation.implicitRules	?! This element is a modifier element. Σ This element is included in summaries.	0..1	uri	A set of rules under which this content was created
Observation.language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
Observation.text		0..1	Narrative	Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
Observation.contained		0..*	Resource	Contained, inline Resources
Observation.extension		0..*	Extension	Additional content defined by implementations
Observation.modifierExtension	?! This element is a modifier element.	0..*	Extension	Extensions that cannot be ignored
Observation.identifier	Σ This element is included in summaries.	0..*	Identifier	Business Identifier for observation
Observation.basedOn	Σ This element is included in summaries.	0..*	Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest)	Fulfills plan, proposal or order
Observation.partOf	Σ This element is included in summaries.	0..*	Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy)	Part of referenced event
Observation.status	?! This element is a modifier element. S This element must be supported. Σ This element is included in summaries.	1..1	code	registered | preliminary | final | amended + Binding: ObservationStatus (required): Codes providing the status of an observation.
Observation.category	S This element must be supported.	0..*	CodeableConcept	Classification of type of observation Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
Observation.code	S This element must be supported. Σ This element is included in summaries.	1..1	CodeableConcept	What was observed - SNOMED CT (and LOINC for vital signs) Binding: LOINCCodes (example): Codes identifying names of simple observations.
Observation.subject	S This element must be supported. Σ This element is included in summaries.	1..1	Reference(Patient)	Who and/or what the observation is about
Observation.focus	Σ This element is included in summaries.	0..*	Reference(Resource)	What the observation is about, when it is not about the subject of record
Observation.encounter	Σ This element is included in summaries.	0..1	Reference(Encounter)	Healthcare event during which this observation is made
Observation.effective[x]	S This element must be supported. Σ This element is included in summaries.	1..1	dateTime	Clinically relevant time/time-period for observation
Observation.issued	Σ This element is included in summaries.	0..1	instant	Date/Time this version was made available
Observation.performer	S This element must be supported. Σ This element is included in summaries.	0..*	Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson)	Who is responsible for the observation
Observation.Slices for value[x]	S This element must be supported. Σ This element is included in summaries. C	0..1		Actual result Slice: Unordered, Closed by type:$this Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them Other type slices that contain no new information are not shown in this view
Observation.Slices for value[x].valueQuantity			Quantity
Observation.Slices for value[x].valueCodeableConcept			CodeableConcept
Observation.Slices for value[x].valueString			string
Observation.Slices for value[x].valueBoolean			boolean
Observation.Slices for value[x].valueInteger			integer
Observation.Slices for value[x].valueRange			Range
Observation.Slices for value[x].valueRatio			Ratio
Observation.Slices for value[x].valueSampledData			SampledData
Observation.Slices for value[x].valueTime			time
Observation.Slices for value[x].valueDateTime			dateTime
Observation.Slices for value[x].valuePeriod			Period
Observation.Slices for value[x].value[x]:valueQuantity	Σ This element is included in summaries. C	0..1	Quantity	Value with a UCUM unit
Observation.Slices for value[x].value[x]:valueQuantity.id		0..1	string	Unique id for inter-element referencing
Observation.Slices for value[x].value[x]:valueQuantity.extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
Observation.Slices for value[x].value[x]:valueQuantity.value	Σ This element is included in summaries.	0..1	decimal	Numerical value (with implicit precision)
Observation.Slices for value[x].value[x]:valueQuantity.comparator	?! This element is a modifier element. Σ This element is included in summaries.	0..1	code	< | <= | >= | > - how to understand the value Binding: QuantityComparator (required): How the Quantity should be understood and represented.
Observation.Slices for value[x].value[x]:valueQuantity.unit	Σ This element is included in summaries.	0..1	string	Unit representation
Observation.Slices for value[x].value[x]:valueQuantity.system	Σ This element is included in summaries. C	0..1	uri	System that defines coded unit form Required Pattern: http://unitsofmeasure.org (extensions allowed)
Observation.Slices for value[x].value[x]:valueQuantity.code	Σ This element is included in summaries.	0..1	code	Coded form of the unit
Observation.dataAbsentReason	C	0..1	CodeableConcept	Why the result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
Observation.interpretation		0..*	CodeableConcept	High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
Observation.note		0..*	Annotation	Comments about the observation
Observation.bodySite		0..1	CodeableConcept	Observed body part Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
Observation.method	S This element must be supported.	0..1	CodeableConcept	How it was observed - e.g. the oxygen delivery route Binding: ObservationMethods (example): Methods for simple observations.
Observation.specimen		0..1	Reference(Specimen)	Specimen used for this observation
Observation.device		0..1	Reference(Device | DeviceMetric)	(Measurement) Device
Observation.referenceRange	C	0..*	BackboneElement	Provides guide for interpretation Constraints: obs-3
Observation.referenceRange.id		0..1	string	Unique id for inter-element referencing
Observation.referenceRange.extension		0..*	Extension	Additional content defined by implementations
Observation.referenceRange.modifierExtension	?! This element is a modifier element. Σ This element is included in summaries.	0..*	Extension	Extensions that cannot be ignored even if unrecognized
Observation.referenceRange.low	C	0..1	SimpleQuantity(4.0.1)	Low Range, if relevant Constraints: sqty-1
Observation.referenceRange.high	C	0..1	SimpleQuantity(4.0.1)	High Range, if relevant Constraints: sqty-1
Observation.referenceRange.type		0..1	CodeableConcept	Reference range qualifier Binding: ObservationReferenceRangeMeaningCodes (preferred): Code for the meaning of a reference range.
Observation.referenceRange.appliesTo		0..*	CodeableConcept	Reference range population Binding: ObservationReferenceRangeAppliesToCodes (example): Codes identifying the population the reference range applies to.
Observation.referenceRange.age		0..1	Range	Applicable age range, if relevant
Observation.referenceRange.text		0..1	string	Text based reference range in an observation
Observation.hasMember	Σ This element is included in summaries.	0..*	Reference(Observation | QuestionnaireResponse | MolecularSequence)	Related resource that belongs to the Observation group
Observation.derivedFrom	Σ This element is included in summaries.	0..*	Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | Observation | MolecularSequence)	Related measurements the observation is made from
Observation.component	S This element must be supported. Σ This element is included in summaries.	0..*	BackboneElement	Component results
Observation.component.id		0..1	string	Unique id for inter-element referencing
Observation.component.extension		0..*	Extension	Additional content defined by implementations
Observation.component.modifierExtension	?! This element is a modifier element. Σ This element is included in summaries.	0..*	Extension	Extensions that cannot be ignored even if unrecognized
Observation.component.code	S This element must be supported. Σ This element is included in summaries.	1..1	CodeableConcept	Type of component observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations.
Observation.component.value[x]	S This element must be supported. Σ This element is included in summaries.	0..1		Actual component result
Observation.component.value[x].valueQuantity			Quantity
Observation.component.value[x].valueCodeableConcept			CodeableConcept
Observation.component.value[x].valueString			string
Observation.component.value[x].valueBoolean			boolean
Observation.component.value[x].valueInteger			integer
Observation.component.value[x].valueRange			Range
Observation.component.value[x].valueRatio			Ratio
Observation.component.value[x].valueSampledData			SampledData
Observation.component.value[x].valueTime			time
Observation.component.value[x].valueDateTime			dateTime
Observation.component.value[x].valuePeriod			Period
Observation.component.dataAbsentReason	C	0..1	CodeableConcept	Why the component result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
Observation.component.interpretation		0..*	CodeableConcept	High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
Observation.component.referenceRange		0..*	See referenceRange (Observation)	Provides guide for interpretation of component result
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
Observation.language	Base	preferred	Common Languages	📍4.0.1	FHIR Std.
Observation.status	Base	required	ObservationStatus	📍4.0.1	FHIR Std.
Observation.category	Base	preferred	Observation Category Codes	📍4.0.1	FHIR Std.
Observation.code	Base	example	LOINC Codes	📍4.0.1	FHIR Std.
Observation.value[x]:valueQuantity.​comparator	Base	required	QuantityComparator	📍4.0.1	FHIR Std.
Observation.dataAbsentReason	Base	extensible	DataAbsentReason	📍4.0.1	FHIR Std.
Observation.interpretation	Base	extensible	Observation Interpretation Codes	📍4.0.1	FHIR Std.
Observation.bodySite	Base	example	SNOMED CT Body Structures	📍4.0.1	FHIR Std.
Observation.method	Base	example	Observation Methods	📍4.0.1	FHIR Std.
Observation.referenceRange.​type	Base	preferred	Observation Reference Range Meaning Codes	📍4.0.1	FHIR Std.
Observation.referenceRange.​appliesTo	Base	example	Observation Reference Range Applies To Codes	📍4.0.1	FHIR Std.
Observation.component.​code	Base	example	LOINC Codes	📍4.0.1	FHIR Std.
Observation.component.​dataAbsentReason	Base	extensible	DataAbsentReason	📍4.0.1	FHIR Std.
Observation.component.​interpretation	Base	extensible	Observation Interpretation Codes	📍4.0.1	FHIR Std.

Constraints

Id	Grade	Path(s)	Description	Expression
dom-2	error	Observation	If the resource is contained in another resource, it SHALL NOT contain nested Resources	contained.contained.empty()
dom-3	error	Observation	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource	contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Observation	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated	contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Observation	If a resource is contained in another resource, it SHALL NOT have a security label	contained.meta.security.empty()
dom-6	best practice	Observation	A resource should have narrative for robust management	text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children	hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both	extension.exists() != value.exists()
obs-3	error	Observation.referenceRange	Must have at least a low or a high or text	low.exists() or high.exists() or text.exists()
obs-6	error	Observation	dataAbsentReason SHALL only be present if Observation.value[x] is not present	dataAbsentReason.empty() or value.empty()
obs-7	error	Observation	If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present	value.empty() or component.code.where(coding.intersect(%resource.code.coding).exists()).empty()
sqty-1	error	Observation.referenceRange.low, Observation.referenceRange.high	The comparator is not used on a SimpleQuantity	comparator.empty()

Key Elements View

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Observation	C	0..*	Observation	Measurements and simple assertions Constraints: obs-6, obs-7
Observation.implicitRules	?! This element is a modifier element. Σ This element is included in summaries.	0..1	uri	A set of rules under which this content was created
Observation.modifierExtension	?! This element is a modifier element.	0..*	Extension	Extensions that cannot be ignored
Observation.status	?! This element is a modifier element. S This element must be supported. Σ This element is included in summaries.	1..1	code	registered | preliminary | final | amended + Binding: ObservationStatus (required): Codes providing the status of an observation.
Observation.category	S This element must be supported.	0..*	CodeableConcept	Classification of type of observation Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
Observation.code	S This element must be supported. Σ This element is included in summaries.	1..1	CodeableConcept	What was observed - SNOMED CT (and LOINC for vital signs) Binding: LOINCCodes (example): Codes identifying names of simple observations.
Observation.subject	S This element must be supported. Σ This element is included in summaries.	1..1	Reference(Patient)	Who and/or what the observation is about
Observation.effective[x]	S This element must be supported. Σ This element is included in summaries.	1..1	dateTime	Clinically relevant time/time-period for observation
Observation.performer	S This element must be supported. Σ This element is included in summaries.	0..*	Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson)	Who is responsible for the observation
Observation.Slices for value[x]	S This element must be supported. Σ This element is included in summaries. C	0..1		Actual result Slice: Unordered, Closed by type:$this Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them Other type slices that contain no new information are not shown in this view
Observation.Slices for value[x].valueQuantity			Quantity
Observation.Slices for value[x].valueCodeableConcept			CodeableConcept
Observation.Slices for value[x].valueString			string
Observation.Slices for value[x].valueBoolean			boolean
Observation.Slices for value[x].valueInteger			integer
Observation.Slices for value[x].valueRange			Range
Observation.Slices for value[x].valueRatio			Ratio
Observation.Slices for value[x].valueSampledData			SampledData
Observation.Slices for value[x].valueTime			time
Observation.Slices for value[x].valueDateTime			dateTime
Observation.Slices for value[x].valuePeriod			Period
Observation.Slices for value[x].value[x]:valueQuantity	Σ This element is included in summaries. C	0..1	Quantity	Value with a UCUM unit
Observation.Slices for value[x].value[x]:valueQuantity.comparator	?! This element is a modifier element. Σ This element is included in summaries.	0..1	code	< | <= | >= | > - how to understand the value Binding: QuantityComparator (required): How the Quantity should be understood and represented.
Observation.Slices for value[x].value[x]:valueQuantity.system	Σ This element is included in summaries. C	0..1	uri	System that defines coded unit form Required Pattern: http://unitsofmeasure.org (extensions allowed)
Observation.method	S This element must be supported.	0..1	CodeableConcept	How it was observed - e.g. the oxygen delivery route Binding: ObservationMethods (example): Methods for simple observations.
Observation.component	S This element must be supported. Σ This element is included in summaries.	0..*	BackboneElement	Component results
Observation.component.modifierExtension	?! This element is a modifier element. Σ This element is included in summaries.	0..*	Extension	Extensions that cannot be ignored even if unrecognized
Observation.component.code	S This element must be supported. Σ This element is included in summaries.	1..1	CodeableConcept	Type of component observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations.
Observation.component.value[x]	S This element must be supported. Σ This element is included in summaries.	0..1		Actual component result
Observation.component.value[x].valueQuantity			Quantity
Observation.component.value[x].valueCodeableConcept			CodeableConcept
Observation.component.value[x].valueString			string
Observation.component.value[x].valueBoolean			boolean
Observation.component.value[x].valueInteger			integer
Observation.component.value[x].valueRange			Range
Observation.component.value[x].valueRatio			Ratio
Observation.component.value[x].valueSampledData			SampledData
Observation.component.value[x].valueTime			time
Observation.component.value[x].valueDateTime			dateTime
Observation.component.value[x].valuePeriod			Period
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
Observation.status	Base	required	ObservationStatus	📍4.0.1	FHIR Std.
Observation.category	Base	preferred	Observation Category Codes	📍4.0.1	FHIR Std.
Observation.code	Base	example	LOINC Codes	📍4.0.1	FHIR Std.
Observation.value[x]:valueQuantity.​comparator	Base	required	QuantityComparator	📍4.0.1	FHIR Std.
Observation.method	Base	example	Observation Methods	📍4.0.1	FHIR Std.
Observation.component.​code	Base	example	LOINC Codes	📍4.0.1	FHIR Std.

Constraints

Id	Grade	Path(s)	Description	Expression
dom-2	error	Observation	If the resource is contained in another resource, it SHALL NOT contain nested Resources	contained.contained.empty()
dom-3	error	Observation	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource	contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Observation	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated	contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Observation	If a resource is contained in another resource, it SHALL NOT have a security label	contained.meta.security.empty()
dom-6	best practice	Observation	A resource should have narrative for robust management	text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children	hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both	extension.exists() != value.exists()
obs-6	error	Observation	dataAbsentReason SHALL only be present if Observation.value[x] is not present	dataAbsentReason.empty() or value.empty()
obs-7	error	Observation	If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present	value.empty() or component.code.where(coding.intersect(%resource.code.coding).exists()).empty()

Differential View

This structure is derived from Observation

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Observation		0..*	Observation	Measurements and simple assertions
Observation.status	S This element must be supported.	1..1	code	registered | preliminary | final | amended +
Observation.category	S This element must be supported.	0..*	CodeableConcept	Classification of type of observation
Observation.code	S This element must be supported.	1..1	CodeableConcept	What was observed - SNOMED CT (and LOINC for vital signs)
Observation.subject	S This element must be supported.	1..1	Reference(Patient)	Who and/or what the observation is about
Observation.effective[x]	S This element must be supported.	1..1	dateTime	Clinically relevant time/time-period for observation
Observation.performer	S This element must be supported.	0..*	Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson)	Who is responsible for the observation
Observation.Slices for value[x]	S This element must be supported.	0..1	Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period	Actual result Slice: Unordered, Open by type:$this Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them Other type slices that contain no new information are not shown in this view
Observation.Slices for value[x].value[x]:valueQuantity		0..1	Quantity	Value with a UCUM unit
Observation.Slices for value[x].value[x]:valueQuantity.system		0..1	uri	System that defines coded unit form Required Pattern: http://unitsofmeasure.org (extensions allowed)
Observation.method	S This element must be supported.	0..1	CodeableConcept	How it was observed - e.g. the oxygen delivery route
Observation.component	S This element must be supported.	0..*	BackboneElement	Component results
Observation.component.code	S This element must be supported.	1..1	CodeableConcept	Type of component observation (code / type)
Observation.component.value[x]	S This element must be supported.	0..1	Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period	Actual component result
Documentation for this format

Snapshot ViewView

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Observation	C	0..*	Observation	Measurements and simple assertions Constraints: obs-6, obs-7
Observation.id	Σ This element is included in summaries.	0..1	id	Logical id of this artifact
Observation.meta	Σ This element is included in summaries.	0..1	Meta	Metadata about the resource
Observation.implicitRules	?! This element is a modifier element. Σ This element is included in summaries.	0..1	uri	A set of rules under which this content was created
Observation.language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
Observation.text		0..1	Narrative	Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
Observation.contained		0..*	Resource	Contained, inline Resources
Observation.extension		0..*	Extension	Additional content defined by implementations
Observation.modifierExtension	?! This element is a modifier element.	0..*	Extension	Extensions that cannot be ignored
Observation.identifier	Σ This element is included in summaries.	0..*	Identifier	Business Identifier for observation
Observation.basedOn	Σ This element is included in summaries.	0..*	Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest)	Fulfills plan, proposal or order
Observation.partOf	Σ This element is included in summaries.	0..*	Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy)	Part of referenced event
Observation.status	?! This element is a modifier element. S This element must be supported. Σ This element is included in summaries.	1..1	code	registered | preliminary | final | amended + Binding: ObservationStatus (required): Codes providing the status of an observation.
Observation.category	S This element must be supported.	0..*	CodeableConcept	Classification of type of observation Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
Observation.code	S This element must be supported. Σ This element is included in summaries.	1..1	CodeableConcept	What was observed - SNOMED CT (and LOINC for vital signs) Binding: LOINCCodes (example): Codes identifying names of simple observations.
Observation.subject	S This element must be supported. Σ This element is included in summaries.	1..1	Reference(Patient)	Who and/or what the observation is about
Observation.focus	Σ This element is included in summaries.	0..*	Reference(Resource)	What the observation is about, when it is not about the subject of record
Observation.encounter	Σ This element is included in summaries.	0..1	Reference(Encounter)	Healthcare event during which this observation is made
Observation.effective[x]	S This element must be supported. Σ This element is included in summaries.	1..1	dateTime	Clinically relevant time/time-period for observation
Observation.issued	Σ This element is included in summaries.	0..1	instant	Date/Time this version was made available
Observation.performer	S This element must be supported. Σ This element is included in summaries.	0..*	Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson)	Who is responsible for the observation
Observation.Slices for value[x]	S This element must be supported. Σ This element is included in summaries. C	0..1		Actual result Slice: Unordered, Closed by type:$this Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them Other type slices that contain no new information are not shown in this view
Observation.Slices for value[x].valueQuantity			Quantity
Observation.Slices for value[x].valueCodeableConcept			CodeableConcept
Observation.Slices for value[x].valueString			string
Observation.Slices for value[x].valueBoolean			boolean
Observation.Slices for value[x].valueInteger			integer
Observation.Slices for value[x].valueRange			Range
Observation.Slices for value[x].valueRatio			Ratio
Observation.Slices for value[x].valueSampledData			SampledData
Observation.Slices for value[x].valueTime			time
Observation.Slices for value[x].valueDateTime			dateTime
Observation.Slices for value[x].valuePeriod			Period
Observation.Slices for value[x].value[x]:valueQuantity	Σ This element is included in summaries. C	0..1	Quantity	Value with a UCUM unit
Observation.Slices for value[x].value[x]:valueQuantity.id		0..1	string	Unique id for inter-element referencing
Observation.Slices for value[x].value[x]:valueQuantity.extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
Observation.Slices for value[x].value[x]:valueQuantity.value	Σ This element is included in summaries.	0..1	decimal	Numerical value (with implicit precision)
Observation.Slices for value[x].value[x]:valueQuantity.comparator	?! This element is a modifier element. Σ This element is included in summaries.	0..1	code	< | <= | >= | > - how to understand the value Binding: QuantityComparator (required): How the Quantity should be understood and represented.
Observation.Slices for value[x].value[x]:valueQuantity.unit	Σ This element is included in summaries.	0..1	string	Unit representation
Observation.Slices for value[x].value[x]:valueQuantity.system	Σ This element is included in summaries. C	0..1	uri	System that defines coded unit form Required Pattern: http://unitsofmeasure.org (extensions allowed)
Observation.Slices for value[x].value[x]:valueQuantity.code	Σ This element is included in summaries.	0..1	code	Coded form of the unit
Observation.dataAbsentReason	C	0..1	CodeableConcept	Why the result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
Observation.interpretation		0..*	CodeableConcept	High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
Observation.note		0..*	Annotation	Comments about the observation
Observation.bodySite		0..1	CodeableConcept	Observed body part Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
Observation.method	S This element must be supported.	0..1	CodeableConcept	How it was observed - e.g. the oxygen delivery route Binding: ObservationMethods (example): Methods for simple observations.
Observation.specimen		0..1	Reference(Specimen)	Specimen used for this observation
Observation.device		0..1	Reference(Device | DeviceMetric)	(Measurement) Device
Observation.referenceRange	C	0..*	BackboneElement	Provides guide for interpretation Constraints: obs-3
Observation.referenceRange.id		0..1	string	Unique id for inter-element referencing
Observation.referenceRange.extension		0..*	Extension	Additional content defined by implementations
Observation.referenceRange.modifierExtension	?! This element is a modifier element. Σ This element is included in summaries.	0..*	Extension	Extensions that cannot be ignored even if unrecognized
Observation.referenceRange.low	C	0..1	SimpleQuantity(4.0.1)	Low Range, if relevant Constraints: sqty-1
Observation.referenceRange.high	C	0..1	SimpleQuantity(4.0.1)	High Range, if relevant Constraints: sqty-1
Observation.referenceRange.type		0..1	CodeableConcept	Reference range qualifier Binding: ObservationReferenceRangeMeaningCodes (preferred): Code for the meaning of a reference range.
Observation.referenceRange.appliesTo		0..*	CodeableConcept	Reference range population Binding: ObservationReferenceRangeAppliesToCodes (example): Codes identifying the population the reference range applies to.
Observation.referenceRange.age		0..1	Range	Applicable age range, if relevant
Observation.referenceRange.text		0..1	string	Text based reference range in an observation
Observation.hasMember	Σ This element is included in summaries.	0..*	Reference(Observation | QuestionnaireResponse | MolecularSequence)	Related resource that belongs to the Observation group
Observation.derivedFrom	Σ This element is included in summaries.	0..*	Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | Observation | MolecularSequence)	Related measurements the observation is made from
Observation.component	S This element must be supported. Σ This element is included in summaries.	0..*	BackboneElement	Component results
Observation.component.id		0..1	string	Unique id for inter-element referencing
Observation.component.extension		0..*	Extension	Additional content defined by implementations
Observation.component.modifierExtension	?! This element is a modifier element. Σ This element is included in summaries.	0..*	Extension	Extensions that cannot be ignored even if unrecognized
Observation.component.code	S This element must be supported. Σ This element is included in summaries.	1..1	CodeableConcept	Type of component observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations.
Observation.component.value[x]	S This element must be supported. Σ This element is included in summaries.	0..1		Actual component result
Observation.component.value[x].valueQuantity			Quantity
Observation.component.value[x].valueCodeableConcept			CodeableConcept
Observation.component.value[x].valueString			string
Observation.component.value[x].valueBoolean			boolean
Observation.component.value[x].valueInteger			integer
Observation.component.value[x].valueRange			Range
Observation.component.value[x].valueRatio			Ratio
Observation.component.value[x].valueSampledData			SampledData
Observation.component.value[x].valueTime			time
Observation.component.value[x].valueDateTime			dateTime
Observation.component.value[x].valuePeriod			Period
Observation.component.dataAbsentReason	C	0..1	CodeableConcept	Why the component result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
Observation.component.interpretation		0..*	CodeableConcept	High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
Observation.component.referenceRange		0..*	See referenceRange (Observation)	Provides guide for interpretation of component result
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
Observation.language	Base	preferred	Common Languages	📍4.0.1	FHIR Std.
Observation.status	Base	required	ObservationStatus	📍4.0.1	FHIR Std.
Observation.category	Base	preferred	Observation Category Codes	📍4.0.1	FHIR Std.
Observation.code	Base	example	LOINC Codes	📍4.0.1	FHIR Std.
Observation.value[x]:valueQuantity.​comparator	Base	required	QuantityComparator	📍4.0.1	FHIR Std.
Observation.dataAbsentReason	Base	extensible	DataAbsentReason	📍4.0.1	FHIR Std.
Observation.interpretation	Base	extensible	Observation Interpretation Codes	📍4.0.1	FHIR Std.
Observation.bodySite	Base	example	SNOMED CT Body Structures	📍4.0.1	FHIR Std.
Observation.method	Base	example	Observation Methods	📍4.0.1	FHIR Std.
Observation.referenceRange.​type	Base	preferred	Observation Reference Range Meaning Codes	📍4.0.1	FHIR Std.
Observation.referenceRange.​appliesTo	Base	example	Observation Reference Range Applies To Codes	📍4.0.1	FHIR Std.
Observation.component.​code	Base	example	LOINC Codes	📍4.0.1	FHIR Std.
Observation.component.​dataAbsentReason	Base	extensible	DataAbsentReason	📍4.0.1	FHIR Std.
Observation.component.​interpretation	Base	extensible	Observation Interpretation Codes	📍4.0.1	FHIR Std.

Constraints

Id	Grade	Path(s)	Description	Expression
dom-2	error	Observation	If the resource is contained in another resource, it SHALL NOT contain nested Resources	contained.contained.empty()
dom-3	error	Observation	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource	contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Observation	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated	contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Observation	If a resource is contained in another resource, it SHALL NOT have a security label	contained.meta.security.empty()
dom-6	best practice	Observation	A resource should have narrative for robust management	text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children	hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both	extension.exists() != value.exists()
obs-3	error	Observation.referenceRange	Must have at least a low or a high or text	low.exists() or high.exists() or text.exists()
obs-6	error	Observation	dataAbsentReason SHALL only be present if Observation.value[x] is not present	dataAbsentReason.empty() or value.empty()
obs-7	error	Observation	If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present	value.empty() or component.code.where(coding.intersect(%resource.code.coding).exists()).empty()
sqty-1	error	Observation.referenceRange.low, Observation.referenceRange.high	The comparator is not used on a SimpleQuantity	comparator.empty()

This structure is derived from Observation

Summary

Mandatory: 2 elements
Must-Support: 11 elements

Structures

This structure refers to these other structures:

• Patient (https://fhir.acmeexample.org.uk/PatientCareCoordination/StructureDefinition/Patient)

Slices

This structure defines the following Slices:

• The element 1 is sliced based on the value of Observation.value[x]