Case Based Surveillance Implementation Guide
0.2.1 - ci-build

Case Based Surveillance Implementation Guide - Local Development build (v0.2.1). See the Directory of published versions

Resource Profile: US Case Based Surveillance Lab Observation

Official URL: http://cbsig.chai.gatech.edu/StructureDefinition/us-cbs-lab-observation Version: 0.2.1
Active as of 2021-01-01 Computable Name: USCaseBasedSurveillanceLabObservation

This profile sets minimum expectations for the Observation resource to represent data requested as part of the U.S. Public Health Case Based Surveillance messaging guides. It identifies which core elements, extensions, vocabularies and value sets SHALL be present in the resource when using this profile. This profile is built on top of the [US Core Laboratory Result Observation] profile.

Example Usage Scenarios:

The following are example usage scenarios for the US CBS Lab Observation profile:

  • Provide case surveillance interpretive repeating group results.
  • Provide a generic observation for capturing lab template groups.

Relationship to CDC Message Mapping Guides

The Center for Disease Control’s (CDC) Message Mapping Guides (MMGs) provide guidance on the transmission of records from jurisdictions to case based surveillance programs. MMG documents are publicly available through the CDC’s website. Lab data is typically captured in one of two ways:

  1. as an “interpretive group”, which is set of elements focused on providing summary data explicitly requested by surveillance programs, tied to a condition specific MMG.
  2. as part of the lab repeating group/lab template, an additional MMG document which provides an appendix of standard lab results as per electronic lab reporting standards.

Mandatory and Must Support Data Elements

The following data-elements must always be present (Mandatory definition]) or must be supported if the data is present in the sending system (Must Support definition). They are presented below in a simple human-readable explanation. Profile specific guidance and examples are provided as well. The Formal Profile Definition below provides the formal summary, definitions, and terminology requirements.

Each Observation must have:

  1. a status
  2. a category with a fixed value
  3. a code
  4. a subject reference

Each Observation must support:

  1. an effective time
  2. a performer reference
  3. a value
  4. a data absent reason
  5. an interpretation
  6. a method
  7. a specimen reference

Profile specific implementation guidance:

  • If additional epi data is to be included about a lab or diagnostic report, relevant resources and profiles from ECR, US Core, or base FHIR should be used. If additional epi related Observations are included which are directly tied to a lab result, the Observation.focus in those other resource may provide a reference to the related US CBS Lab Observation or US CBS Lab Diagnostic Report.

Formal Views of Profile Content

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

This structure is derived from USCoreLaboratoryResultObservationProfile

NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation 0..*USCoreLaboratoryResultObservationProfileMeasurements and simple assertions
... status 1..1coderegistered | preliminary | final | amended +
Required Pattern: final
... code 1..1CodeableConceptLaboratory Test Name
Binding: Lab Test Result Name (extensible)
... subject 1..1Reference(US Case Based Surveillance Patient Profile)Who and/or what the observation is about
... value[x] 0..1Result Value
.... valueQuantityQuantity
.... valueCodeableConceptCodeableConcept
.... valueStringstring
.... valueRatioRatio
... interpretation S0..1CodeableConceptHigh, low, normal, etc.
... method S0..1CodeableConceptHow it was done
... specimen S0..1Reference(Case Based Surveillance Specimen Profile)Specimen used for this observation

doco Documentation for this format
NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation I0..*USCoreLaboratoryResultObservationProfileMeasurements and simple assertions
... id Σ0..1stringLogical id of this artifact
... meta Σ0..1MetaMetadata about the resource
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... language 0..1codeLanguage of the resource content
Binding: CommonLanguages (preferred)
Max Binding: AllLanguages: A human language.

... text 0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... extension 0..*ExtensionAdditional content defined by implementations
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... identifier Σ0..*IdentifierBusiness Identifier for observation
... basedOn Σ0..*Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest)Fulfills plan, proposal or order
... partOf Σ0..*Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy)Part of referenced event
... status ?!SΣ1..1coderegistered | preliminary | final | amended +
Binding: ObservationStatus (required)
Required Pattern: final
... Slices for category S1..*CodeableConceptClassification of type of observation
Slice: Unordered, Open by pattern:$this
Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.


.... category:Laboratory S1..1CodeableConceptClassification of type of observation
Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.



Required Pattern: At least the following
..... id0..1stringUnique id for inter-element referencing
..... extension0..*ExtensionAdditional content defined by implementations
..... coding1..*CodingCode defined by a terminology system
Fixed Value: (complex)
...... id0..1stringUnique id for inter-element referencing
...... extension0..*ExtensionAdditional content defined by implementations
...... system1..1uriIdentity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category
...... version0..1stringVersion of the system - if relevant
...... code1..1codeSymbol in syntax defined by the system
Fixed Value: laboratory
...... display0..1stringRepresentation defined by the system
...... userSelected0..1booleanIf this coding was chosen directly by the user
..... text0..1stringPlain text representation of the concept
... code SΣ1..1CodeableConceptLaboratory Test Name
Binding: Lab Test Result Name (extensible)
... subject SΣ1..1Reference(US Case Based Surveillance Patient Profile)Who and/or what the observation is about
... focus Σ0..*Reference(Resource)What the observation is about, when it is not about the subject of record
... encounter Σ0..1Reference(Encounter)Healthcare event during which this observation is made
... effective[x] SΣI0..1Clinically relevant time/time-period for observation
us-core-1: Datetime must be at least to day.
.... effectiveDateTimedateTime S
.... effectivePeriodPeriod
.... effectiveTimingTiming
.... effectiveInstantinstant
... issued Σ0..1instantDate/Time this version was made available
... performer SΣ0..1Reference(US Case Based Surveillance Performing Laboratory Profile)Who is responsible for the observation
... value[x] SΣI0..1Result Value
.... valueQuantityQuantity S
.... valueCodeableConceptCodeableConcept S
.... valueStringstring S
.... valueRatioRatio
... dataAbsentReason SI0..1CodeableConceptWhy the result is missing
Binding: DataAbsentReason (extensible)
... interpretation S0..1CodeableConceptHigh, low, normal, etc.
Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.


... note 0..*AnnotationComments about the observation
... bodySite 0..1CodeableConceptObserved body part
Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.

... method S0..1CodeableConceptHow it was done
Binding: ObservationMethods (example): Methods for simple observations.

... specimen S0..1Reference(Case Based Surveillance Specimen Profile)Specimen used for this observation
... device 0..1Reference(Device | DeviceMetric)(Measurement) Device
... referenceRange I0..*BackboneElementProvides guide for interpretation
obs-3: Must have at least a low or a high or text
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... low I0..1SimpleQuantityLow Range, if relevant
.... high I0..1SimpleQuantityHigh Range, if relevant
.... type 0..1CodeableConceptReference range qualifier
Binding: ObservationReferenceRangeMeaningCodes (preferred): Code for the meaning of a reference range.

.... appliesTo 0..*CodeableConceptReference range population
Binding: ObservationReferenceRangeAppliesToCodes (example): Codes identifying the population the reference range applies to.


.... age 0..1RangeApplicable age range, if relevant
.... text 0..1stringText based reference range in an observation
... hasMember Σ0..*Reference(Observation | QuestionnaireResponse | MolecularSequence)Related resource that belongs to the Observation group
... derivedFrom Σ0..*Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | Observation | MolecularSequence)Related measurements the observation is made from
... component Σ0..*BackboneElementComponent results
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... code Σ1..1CodeableConceptType of component observation (code / type)
Binding: LOINCCodes (example): Codes identifying names of simple observations.

.... value[x] Σ0..1Actual component result
..... valueQuantityQuantity
..... valueCodeableConceptCodeableConcept
..... valueStringstring
..... valueBooleanboolean
..... valueIntegerinteger
..... valueRangeRange
..... valueRatioRatio
..... valueSampledDataSampledData
..... valueTimetime
..... valueDateTimedateTime
..... valuePeriodPeriod
.... dataAbsentReason I0..1CodeableConceptWhy the component result is missing
Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.

.... interpretation 0..*CodeableConceptHigh, low, normal, etc.
Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.


.... referenceRange 0..*See referenceRange (Observation)Provides guide for interpretation of component result

doco Documentation for this format
NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation I0..*USCoreLaboratoryResultObservationProfileMeasurements and simple assertions
... status ?!Σ1..1coderegistered | preliminary | final | amended +
Binding: ObservationStatus (required)
Required Pattern: final
... Slices for category 1..*CodeableConceptClassification of type of observation
Slice: Unordered, Open by pattern:$this
Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.


.... category:Laboratory 1..1CodeableConceptClassification of type of observation
Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.



Required Pattern: At least the following
..... coding1..*CodingCode defined by a terminology system
Fixed Value: (complex)
...... system1..1uriIdentity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category
...... code1..1codeSymbol in syntax defined by the system
Fixed Value: laboratory
... code Σ1..1CodeableConceptLaboratory Test Name
Binding: Lab Test Result Name (extensible)
... effective[x] ΣI0..1Clinically relevant time/time-period for observation
us-core-1: Datetime must be at least to day.
.... effectiveDateTimedateTime
... performer Σ0..1Reference(US Case Based Surveillance Performing Laboratory Profile)Who is responsible for the observation
... value[x] ΣI0..1Result Value
.... valueQuantityQuantity
.... valueCodeableConceptCodeableConcept
.... valueStringstring
... dataAbsentReason I0..1CodeableConceptWhy the result is missing
Binding: DataAbsentReason (extensible)
... interpretation 0..1CodeableConceptHigh, low, normal, etc.
Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.


... method 0..1CodeableConceptHow it was done
Binding: ObservationMethods (example): Methods for simple observations.

... specimen 0..1Reference(Case Based Surveillance Specimen Profile)Specimen used for this observation

doco Documentation for this format

Differential View

This structure is derived from USCoreLaboratoryResultObservationProfile

NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation 0..*USCoreLaboratoryResultObservationProfileMeasurements and simple assertions
... status 1..1coderegistered | preliminary | final | amended +
Required Pattern: final
... code 1..1CodeableConceptLaboratory Test Name
Binding: Lab Test Result Name (extensible)
... subject 1..1Reference(US Case Based Surveillance Patient Profile)Who and/or what the observation is about
... value[x] 0..1Result Value
.... valueQuantityQuantity
.... valueCodeableConceptCodeableConcept
.... valueStringstring
.... valueRatioRatio
... interpretation S0..1CodeableConceptHigh, low, normal, etc.
... method S0..1CodeableConceptHow it was done
... specimen S0..1Reference(Case Based Surveillance Specimen Profile)Specimen used for this observation

doco Documentation for this format

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation I0..*USCoreLaboratoryResultObservationProfileMeasurements and simple assertions
... id Σ0..1stringLogical id of this artifact
... meta Σ0..1MetaMetadata about the resource
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... language 0..1codeLanguage of the resource content
Binding: CommonLanguages (preferred)
Max Binding: AllLanguages: A human language.

... text 0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... extension 0..*ExtensionAdditional content defined by implementations
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... identifier Σ0..*IdentifierBusiness Identifier for observation
... basedOn Σ0..*Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest)Fulfills plan, proposal or order
... partOf Σ0..*Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy)Part of referenced event
... status ?!SΣ1..1coderegistered | preliminary | final | amended +
Binding: ObservationStatus (required)
Required Pattern: final
... Slices for category S1..*CodeableConceptClassification of type of observation
Slice: Unordered, Open by pattern:$this
Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.


.... category:Laboratory S1..1CodeableConceptClassification of type of observation
Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.



Required Pattern: At least the following
..... id0..1stringUnique id for inter-element referencing
..... extension0..*ExtensionAdditional content defined by implementations
..... coding1..*CodingCode defined by a terminology system
Fixed Value: (complex)
...... id0..1stringUnique id for inter-element referencing
...... extension0..*ExtensionAdditional content defined by implementations
...... system1..1uriIdentity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category
...... version0..1stringVersion of the system - if relevant
...... code1..1codeSymbol in syntax defined by the system
Fixed Value: laboratory
...... display0..1stringRepresentation defined by the system
...... userSelected0..1booleanIf this coding was chosen directly by the user
..... text0..1stringPlain text representation of the concept
... code SΣ1..1CodeableConceptLaboratory Test Name
Binding: Lab Test Result Name (extensible)
... subject SΣ1..1Reference(US Case Based Surveillance Patient Profile)Who and/or what the observation is about
... focus Σ0..*Reference(Resource)What the observation is about, when it is not about the subject of record
... encounter Σ0..1Reference(Encounter)Healthcare event during which this observation is made
... effective[x] SΣI0..1Clinically relevant time/time-period for observation
us-core-1: Datetime must be at least to day.
.... effectiveDateTimedateTime S
.... effectivePeriodPeriod
.... effectiveTimingTiming
.... effectiveInstantinstant
... issued Σ0..1instantDate/Time this version was made available
... performer SΣ0..1Reference(US Case Based Surveillance Performing Laboratory Profile)Who is responsible for the observation
... value[x] SΣI0..1Result Value
.... valueQuantityQuantity S
.... valueCodeableConceptCodeableConcept S
.... valueStringstring S
.... valueRatioRatio
... dataAbsentReason SI0..1CodeableConceptWhy the result is missing
Binding: DataAbsentReason (extensible)
... interpretation S0..1CodeableConceptHigh, low, normal, etc.
Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.


... note 0..*AnnotationComments about the observation
... bodySite 0..1CodeableConceptObserved body part
Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.

... method S0..1CodeableConceptHow it was done
Binding: ObservationMethods (example): Methods for simple observations.

... specimen S0..1Reference(Case Based Surveillance Specimen Profile)Specimen used for this observation
... device 0..1Reference(Device | DeviceMetric)(Measurement) Device
... referenceRange I0..*BackboneElementProvides guide for interpretation
obs-3: Must have at least a low or a high or text
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... low I0..1SimpleQuantityLow Range, if relevant
.... high I0..1SimpleQuantityHigh Range, if relevant
.... type 0..1CodeableConceptReference range qualifier
Binding: ObservationReferenceRangeMeaningCodes (preferred): Code for the meaning of a reference range.

.... appliesTo 0..*CodeableConceptReference range population
Binding: ObservationReferenceRangeAppliesToCodes (example): Codes identifying the population the reference range applies to.


.... age 0..1RangeApplicable age range, if relevant
.... text 0..1stringText based reference range in an observation
... hasMember Σ0..*Reference(Observation | QuestionnaireResponse | MolecularSequence)Related resource that belongs to the Observation group
... derivedFrom Σ0..*Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | Observation | MolecularSequence)Related measurements the observation is made from
... component Σ0..*BackboneElementComponent results
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... code Σ1..1CodeableConceptType of component observation (code / type)
Binding: LOINCCodes (example): Codes identifying names of simple observations.

.... value[x] Σ0..1Actual component result
..... valueQuantityQuantity
..... valueCodeableConceptCodeableConcept
..... valueStringstring
..... valueBooleanboolean
..... valueIntegerinteger
..... valueRangeRange
..... valueRatioRatio
..... valueSampledDataSampledData
..... valueTimetime
..... valueDateTimedateTime
..... valuePeriodPeriod
.... dataAbsentReason I0..1CodeableConceptWhy the component result is missing
Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.

.... interpretation 0..*CodeableConceptHigh, low, normal, etc.
Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.


.... referenceRange 0..*See referenceRange (Observation)Provides guide for interpretation of component result

doco Documentation for this format

 

Other representations of profile: CSV, Excel, Schematron

Terminology Bindings

PathConformanceValueSet / Code
Observation.languagepreferredCommonLanguages
Max Binding: AllLanguages
Observation.statusrequiredPattern: final
Observation.categorypreferredObservationCategoryCodes
Observation.category:LaboratorypreferredPattern: laboratory
Observation.codeextensiblePHVS_LabTestName_CDC
Observation.dataAbsentReasonextensibleDataAbsentReason
Observation.interpretationextensibleObservationInterpretationCodes
Observation.bodySiteexampleSNOMEDCTBodyStructures
Observation.methodexampleObservationMethods
Observation.referenceRange.typepreferredObservationReferenceRangeMeaningCodes
Observation.referenceRange.appliesToexampleObservationReferenceRangeAppliesToCodes
Observation.component.codeexampleLOINCCodes
Observation.component.dataAbsentReasonextensibleDataAbsentReason
Observation.component.interpretationextensibleObservationInterpretationCodes

Constraints

IdGradePathDetailsRequirements
dom-2errorObservationIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorObservationIf 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-4errorObservationIf 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-5errorObservationIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6Best PracticeObservationA resource should have narrative for robust management
: text.`div`.exists()
obs-6errorObservationdataAbsentReason SHALL only be present if Observation.value[x] is not present
: dataAbsentReason.empty() or value.empty()
obs-7errorObservationIf 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()
us-core-2errorObservationIf there is no component or hasMember element then either a value[x] or a data absent reason must be present
: (component.empty() and hasMember.empty()) implies (dataAbsentReason.exists() or value.exists())
ele-1errorObservation.metaAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorObservation.implicitRulesAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorObservation.languageAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorObservation.textAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorObservation.extensionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1errorObservation.extensionMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1errorObservation.modifierExtensionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1errorObservation.modifierExtensionMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1errorObservation.identifierAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorObservation.basedOnAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorObservation.partOfAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorObservation.statusAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorObservation.categoryAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorObservation.category:LaboratoryAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorObservation.codeAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorObservation.subjectAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorObservation.focusAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorObservation.encounterAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorObservation.effective[x]All FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
us-core-1errorObservation.effective[x]Datetime must be at least to day.
: Observation.effectiveDateTime.exists() implies Observation.effectiveDateTime.toString().length() >= 8
ele-1errorObservation.issuedAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorObservation.performerAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorObservation.value[x]All FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
us-core-4Best PracticeObservation.value[x]SHOULD use Snomed CT for coded Results
: valueCodeableConcept.coding.system.empty() or valueCodeableConcept.coding.system = 'http://snomed.info/sct'
us-core-3errorObservation.value[x]SHALL use UCUM for coded quantity units.
: valueQuantity.system.empty() or valueQuantity.system = 'http://unitsofmeasure.org'
ele-1errorObservation.dataAbsentReasonAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorObservation.interpretationAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorObservation.noteAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorObservation.bodySiteAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorObservation.methodAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorObservation.specimenAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorObservation.deviceAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorObservation.referenceRangeAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
obs-3errorObservation.referenceRangeMust have at least a low or a high or text
: low.exists() or high.exists() or text.exists()
ele-1errorObservation.referenceRange.extensionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1errorObservation.referenceRange.extensionMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1errorObservation.referenceRange.modifierExtensionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1errorObservation.referenceRange.modifierExtensionMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1errorObservation.referenceRange.lowAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorObservation.referenceRange.highAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorObservation.referenceRange.typeAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorObservation.referenceRange.appliesToAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorObservation.referenceRange.ageAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorObservation.referenceRange.textAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorObservation.hasMemberAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorObservation.derivedFromAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorObservation.componentAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorObservation.component.extensionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1errorObservation.component.extensionMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1errorObservation.component.modifierExtensionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1errorObservation.component.modifierExtensionMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1errorObservation.component.codeAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorObservation.component.value[x]All FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorObservation.component.dataAbsentReasonAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorObservation.component.interpretationAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorObservation.component.referenceRangeAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())