HRSA 2024 Uniform Data System (UDS) Patient Level Submission (PLS) (UDS+) FHIR IG
2.0.0 - STU2 Release 1 - Standard for Trial-Use

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## Resource Profile: De-Identified UDS Plus Observation

Official URL: http://fhir.org/guides/hrsa/uds-plus/StructureDefinition/uds-plus-observation | Version: 2.0.0
Standards status: Trial-use | Maturity Level: 2 | Computable Name: UDSPlusObservation

The UDS+ profile is based on the Observation resource and establishes the core elements, extensions, vocabularies and value sets for representing assessments, vitals and other social history observations for UDS+ program.

### Introduction

This profile is used to represent de-identified Observation for Assessments, Physical Exams, Assessment and Social History information. The de-identification process has to remove all data elements not explicitly identified as "SUPPORTED" in the profile.

The HHS De-identification Guidance is to be followed to ensure appropriate level of de-identification is performed.

According to the HHS guidance, dates should not have a precision of more than the year. This means month and day cannot be included. This includes Observation for Lab Result.period.

In FHIR Resources, text elements and reference.display elements which provide human readable information to the providers may be generated using programs and tools from the data present within the resource. For e.g a Observation for Lab Result resource text element may contain information such as the Observation for Lab Result date, patient information. This type of information will enable identification of the individuals. In order to avoid inadvertent revealing of PII/PHI, text elements cannot be included in the De-identified FHIR resource and the submission will be rejected when text elements are present by the validation process.

Ids and References

The original Observation for Lab Result resource id should not be included in the De-identified Observation for Lab Result instance. Instead a new id should be created and provided as part of the FHIR resource. The Data Submitter should be capable of using the generated id to relink the data to the original Observation for Lab Result. All resource references to the Observation for Lab Result submitted as part of the UDS+ report should refer to newly generated id.

Resource references cannot contain text element as it may contain PHI/PII. The text element for following references are not allowed

- subject
- encounter

Date Truncation

The Data Submitter has to truncate the following dates to only have a precision of year

- effective[x]

Usage:

- Examples for this Resource Profile: Observation/generic-observation-de-identified-example

### Formal Views of Profile Content

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

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

Name | Flags | Card. | Type | Description & Constraints
--- | --- | --- | --- | ---
Observation | C | 0..* | Observation | De-Identified UDS Plus Observation dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources dom-3: 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 dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated dom-5: If a resource is contained in another resource, it SHALL NOT have a security label dom-6: A resource should have narrative for robust management obs-6: dataAbsentReason SHALL only be present if Observation.value[x] is not present obs-7: If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present
id | S Σ | 0..1 | id | The de-identified Observation identifier created by the health center to send data to UDS+ Data Receiver
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created ele-1: All FHIR elements must have a @value or children
Slices for extension |  |  |  | Content/Rules for all slices
extension:deidentifiedIssuedTime |  | 0..1 | dateTime | Indicates the time with a precision of only Year. URL: http://fhir.org/guides/hrsa/uds-plus/StructureDefinition/uds-plus-deidentified-instant-extension ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
status | ?!S Σ | 1..1 | code | registered | preliminary | final | amended + Binding: ObservationStatus (required): Codes providing the status of an observation. ele-1: All FHIR elements must have a @value or children
category | S | 1..* | CodeableConcept | Classification of type of observation Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories. ele-1: All FHIR elements must have a @value or children
code | S Σ | 1..1 | CodeableConcept | Type of observation (code / type) Binding: LOINCCodes (preferred): The set of codes indicating the Observations ele-1: All FHIR elements must have a @value or children
subject | S Σ | 1..1 | Reference(De-Identified UDS Plus Patient) | Who and/or what the observation is about ele-1: All FHIR elements must have a @value or children
encounter | S Σ | 0..1 | Reference(De-Identified UDS Plus Encounter) | Healthcare event during which this observation is made ele-1: All FHIR elements must have a @value or children
effective[x] | S Σ C | 0..1 |  | Clinically relevant time/time-period for observation ele-1: All FHIR elements must have a @value or children uds-plus-obs-1: All dateTime data elements should be truncated to a year only for de-identified resources. uds-plus-obs-1a: All dateTime data elements should have valid year > 1900 uds-plus-obs-1b: All dateTime data elements should have valid year < 2030 uds-plus-obs-2: All Period.start data elements should be truncated to a year only for de-identified resources. uds-plus-obs-2a: All Period.start data elements should have valid year > 1900 uds-plus-obs-2b: All Period.start data elements should have valid year < 2030 uds-plus-obs-3: All Period.emd data elements should be truncated to a year only for de-identified resources. uds-plus-obs-3a: All Period.end data elements should have valid year > 1900 uds-plus-obs-3b: All Period.end data elements should have valid year < 2030 uds-plus-obs-4: All Timing.event data elements should be truncated to a year only for de-identified resources. uds-plus-obs-5: All Timing.event data elements should be truncated to a year only for de-identified resources. uds-plus-obs-5a: All Timing data elements should have valid year > 1900 uds-plus-obs-5b: All Timing data elements should have valid year < 2030
effectiveDateTime |  |  | dateTime |
performer | S Σ | 0..* | Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson) | Who is responsible for the observation ele-1: All FHIR elements must have a @value or children
value[x] | S Σ C | 0..1 |  | Actual result ele-1: All FHIR elements must have a @value or children uds-plus-obs-6: All dateTime data elements should be truncated to a year only for de-identified resources. uds-plus-obs-6a: All Period.start data elements should have valid year > 1900 uds-plus-obs-6b: All Period.start data elements should have valid year < 2030 uds-plus-obs-7: All Period.start data elements should be truncated to a year only for de-identified resources. uds-plus-obs-7a: All Period.start data elements should have valid year > 1900 uds-plus-obs-7b: All Period.start data elements should have valid year < 2030 uds-plus-obs-8: All Period.end data elements should be truncated to a year only for de-identified resources. uds-plus-obs-8a: All Period.end data elements should have valid year > 1900 uds-plus-obs-8b: All Period.end data elements should have valid year < 2030
valueQuantity |  |  | Quantity |
valueCodeableConcept |  |  | CodeableConcept |
valueString |  |  | string |
bodySite | S | 0..1 | CodeableConcept | Observed body part Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality. ele-1: All FHIR elements must have a @value or children
component | S Σ | 0..* | BackboneElement | Component results ele-1: All FHIR elements must have a @value or children
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
code | S Σ | 1..1 | CodeableConcept | Type of component observation (code / type) Binding: LOINCCodes (preferred): The set of codes indicating the Observations ele-1: All FHIR elements must have a @value or children
value[x] | S Σ C | 0..1 |  | Actual component result ele-1: All FHIR elements must have a @value or children uds-plus-obs-9: All dateTime data elements should be truncated to a year only for de-identified resources. uds-plus-obs-9a: All dateTime data elements should have valid year > 1900 uds-plus-obs-9b: All dateTime data elements should have valid year < 2030 uds-plus-obs-10: All Period.start data elements should be truncated to a year only for de-identified resources. uds-plus-obs-10a: All Period.start data elements should have valid year > 1900 uds-plus-obs-10b: All Period.start data elements should have valid year < 2030 uds-plus-obs-11: All Period.end data elements should be truncated to a year only for de-identified resources. uds-plus-obs-11a: All Period.end data elements should have valid year > 1900 uds-plus-obs-11b: All Period.end data elements should have valid year < 2030
valueQuantity |  |  | Quantity |
valueCodeableConcept |  |  | CodeableConcept |
valueString |  |  | string |
Documentation for this format

#### Terminology Bindings

Path | Conformance | ValueSet | URI
Observation.status | required | ObservationStatus `http://hl7.org/fhir/ValueSet/observation-status|4.0.1` from the FHIR Standard
Observation.category | preferred | ObservationCategoryCodes `http://hl7.org/fhir/ValueSet/observation-category` from the FHIR Standard
Observation.code | preferred | LOINCCodes (a valid code from LOINC) `http://hl7.org/fhir/ValueSet/observation-codes` from the FHIR Standard
Observation.bodySite | example | SNOMEDCTBodyStructures `http://hl7.org/fhir/ValueSet/body-site` from the FHIR Standard
Observation.component.code | preferred | LOINCCodes (a valid code from LOINC) `http://hl7.org/fhir/ValueSet/observation-codes` from the FHIR Standard

#### Constraints

Id | Grade | Path(s) | Details | Requirements
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() |
uds-plus-obs-1 | error | Observation.effective[x] | All dateTime data elements should be truncated to a year only for de-identified resources. : $this is DateTime implies $this.toString().length() = 4 |
uds-plus-obs-10a | error | Observation.component.value[x] | All Period.start data elements should have valid year > 1900 : $this is Period and Period.start.exists() implies $this.start.toString() >= '1900' |
uds-plus-obs-10b | error | Observation.component.value[x] | All Period.start data elements should have valid year < 2030 : $this is Period and Period.start.exists() implies $this.start.toString() <= '2030' |
uds-plus-obs-11a | error | Observation.component.value[x] | All Period.end data elements should have valid year > 1900 : $this is Period and Period.end.exists() implies $this.end.toString() >= '1900' |
uds-plus-obs-11b | error | Observation.component.value[x] | All Period.end data elements should have valid year < 2030 : $this is Period and Period.end.exists() implies $this.end.toString() <= '2030' |
uds-plus-obs-1a | error | Observation.effective[x] | All dateTime data elements should have valid year > 1900 : $this is DateTime implies $this.toString() >= '1900' |
uds-plus-obs-1b | error | Observation.effective[x] | All dateTime data elements should have valid year < 2030 : $this is DateTime implies $this.toString() <= '2030' |
uds-plus-obs-2 | error | Observation.effective[x] | All Period.start data elements should be truncated to a year only for de-identified resources. : $this is Period and Period.start.exists() implies $this.start.toString().length() = 4 |
uds-plus-obs-2a | error | Observation.effective[x] | All Period.start data elements should have valid year > 1900 : $this is Period and Period.start.exists() implies $this.start.toString() >= '1900' |
uds-plus-obs-2b | error | Observation.effective[x] | All Period.start data elements should have valid year < 2030 : $this is Period and Period.start.exists() implies $this.start.toString() <= '2030' |
uds-plus-obs-3 | error | Observation.effective[x] | All Period.emd data elements should be truncated to a year only for de-identified resources. : $this is Period and Period.end.exists() implies $this.end.toString().length() = 4 |
uds-plus-obs-3a | error | Observation.effective[x] | All Period.end data elements should have valid year > 1900 : $this is Period and Period.end.exists() implies $this.end.toString() >= '1900' |
uds-plus-obs-3b | error | Observation.effective[x] | All Period.end data elements should have valid year < 2030 : $this is Period and Period.end.exists() implies $this.end.toString() <= '2030' |
uds-plus-obs-4 | error | Observation.effective[x] | All Timing.event data elements should be truncated to a year only for de-identified resources. : $this is Timing and Timing.event.exists() implies $this.event.count() = 1 |
uds-plus-obs-5 | error | Observation.effective[x] | All Timing.event data elements should be truncated to a year only for de-identified resources. : $this is Timing and Timing.event.exists() implies $this.event.first().toString().length() = 4 |
uds-plus-obs-6 | error | Observation.value[x] | All dateTime data elements should be truncated to a year only for de-identified resources. : $this is dateTime implies $this.toString().length() = 4 |
uds-plus-obs-10 | error | Observation.component.value[x] | All Period.start data elements should be truncated to a year only for de-identified resources. : $this is Period and Period.start.exists() implies $this.start.toString().length() = 4 |
uds-plus-obs-11 | error | Observation.component.value[x] | All Period.end data elements should be truncated to a year only for de-identified resources. : $this is Period and Period.end.exists() implies $this.end.toString().length() = 4 |
uds-plus-obs-5a | error | Observation.effective[x] | All Timing data elements should have valid year > 1900 : $this is Timing and Timing.event.exists() implies $this.event.first().toString() >= '1900' |
uds-plus-obs-5b | error | Observation.effective[x] | All Timing data elements should have valid year < 2030 : $this is Timing and Timing.event.exists() implies $this.event.first().toString() <= '2030' |
uds-plus-obs-6a | error | Observation.value[x] | All Period.start data elements should have valid year > 1900 : $this is Period and Period.start.exists() implies $this.start.toString() >= '1900' |
uds-plus-obs-6b | error | Observation.value[x] | All Period.start data elements should have valid year < 2030 : $this is Period and Period.start.exists() implies $this.start.toString() <= '2030' |
uds-plus-obs-7 | error | Observation.value[x] | All Period.start data elements should be truncated to a year only for de-identified resources. : $this is Period and Period.start.exists() implies $this.start.toString().length() = 4 |
uds-plus-obs-7a | error | Observation.value[x] | All Period.start data elements should have valid year > 1900 : $this is Period and Period.start.exists() implies $this.start.toString() >= '1900' |
uds-plus-obs-7b | error | Observation.value[x] | All Period.start data elements should have valid year < 2030 : $this is Period and Period.start.exists() implies $this.start.toString() <= '2030' |
uds-plus-obs-8 | error | Observation.value[x] | All Period.end data elements should be truncated to a year only for de-identified resources. : $this is Period and Period.end.exists() implies $this.end.toString().length() = 4 |
uds-plus-obs-8a | error | Observation.value[x] | All Period.end data elements should have valid year > 1900 : $this is Period and Period.end.exists() implies $this.end.toString() >= '1900' |
uds-plus-obs-8b | error | Observation.value[x] | All Period.end data elements should have valid year < 2030 : $this is Period and Period.end.exists() implies $this.end.toString() <= '2030' |
uds-plus-obs-9 | error | Observation.component.value[x] | All dateTime data elements should be truncated to a year only for de-identified resources. : $this is dateTime implies $this.toString().length() = 4 |
uds-plus-obs-9a | error | Observation.component.value[x] | All dateTime data elements should have valid year > 1900 : $this is DateTime implies $this.toString() >= '1900' |
uds-plus-obs-9b | error | Observation.component.value[x] | All dateTime data elements should have valid year < 2030 : $this is DateTime implies $this.toString() <= '2030' |

This structure is derived from Observation

Name | Flags | Card. | Type | Description & Constraints
--- | --- | --- | --- | ---
Observation |  | 0..* | Observation | De-Identified UDS Plus Observation
id | S | 0..1 | id | The de-identified Observation identifier created by the health center to send data to UDS+ Data Receiver
text |  | 0..0 |  |
contained |  | 0..0 |  |
Slices for extension |  |  |  | Content/Rules for all slices
extension:deidentifiedIssuedTime |  | 0..1 | dateTime | Indicates the time with a precision of only Year. URL: http://fhir.org/guides/hrsa/uds-plus/StructureDefinition/uds-plus-deidentified-instant-extension
status | S | 1..1 | code | registered | preliminary | final | amended +
category | S | 1..* | CodeableConcept | Classification of type of observation
code | S | 1..1 | CodeableConcept | Type of observation (code / type) Binding: LOINCCodes (preferred): The set of codes indicating the Observations
subject | S | 1..1 | Reference(De-Identified UDS Plus Patient) | Who and/or what the observation is about
display |  | 0..0 |  |
encounter | S | 0..1 | Reference(De-Identified UDS Plus Encounter) | Healthcare event during which this observation is made
display |  | 0..0 |  |
effective[x] | S C | 0..1 |  | Clinically relevant time/time-period for observation uds-plus-obs-1: All dateTime data elements should be truncated to a year only for de-identified resources. uds-plus-obs-1a: All dateTime data elements should have valid year > 1900 uds-plus-obs-1b: All dateTime data elements should have valid year < 2030 uds-plus-obs-2: All Period.start data elements should be truncated to a year only for de-identified resources. uds-plus-obs-2a: All Period.start data elements should have valid year > 1900 uds-plus-obs-2b: All Period.start data elements should have valid year < 2030 uds-plus-obs-3: All Period.emd data elements should be truncated to a year only for de-identified resources. uds-plus-obs-3a: All Period.end data elements should have valid year > 1900 uds-plus-obs-3b: All Period.end data elements should have valid year < 2030 uds-plus-obs-4: All Timing.event data elements should be truncated to a year only for de-identified resources. uds-plus-obs-5: All Timing.event data elements should be truncated to a year only for de-identified resources. uds-plus-obs-5a: All Timing data elements should have valid year > 1900 uds-plus-obs-5b: All Timing data elements should have valid year < 2030
effectiveDateTime |  |  | dateTime S |
effectivePeriod |  |  | Period |
effectiveTiming |  |  | Timing |
issued |  | 0..0 |  |
performer | S | 0..* | Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson) | Who is responsible for the observation
display |  | 0..0 |  |
value[x] | S C | 0..1 |  | Actual result uds-plus-obs-6: All dateTime data elements should be truncated to a year only for de-identified resources. uds-plus-obs-6a: All Period.start data elements should have valid year > 1900 uds-plus-obs-6b: All Period.start data elements should have valid year < 2030 uds-plus-obs-7: All Period.start data elements should be truncated to a year only for de-identified resources. uds-plus-obs-7a: All Period.start data elements should have valid year > 1900 uds-plus-obs-7b: All Period.start data elements should have valid year < 2030 uds-plus-obs-8: All Period.end data elements should be truncated to a year only for de-identified resources. uds-plus-obs-8a: All Period.end data elements should have valid year > 1900 uds-plus-obs-8b: All Period.end data elements should have valid year < 2030
valueQuantity |  |  | Quantity S |
valueCodeableConcept |  |  | CodeableConcept S |
valueString |  |  | string S |
valueBoolean |  |  | boolean |
valueInteger |  |  | integer |
valueRange |  |  | Range |
valueRatio |  |  | Ratio |
valueSampledData |  |  | SampledData |
valueDateTime |  |  | dateTime |
valuePeriod |  |  | Period |
note |  | 0..0 |  |
bodySite | S | 0..1 | CodeableConcept | Observed body part
component | S | 0..* | BackboneElement | Component results
code | S | 1..1 | CodeableConcept | Type of component observation (code / type) Binding: LOINCCodes (preferred): The set of codes indicating the Observations
value[x] | S C | 0..1 |  | Actual component result uds-plus-obs-9: All dateTime data elements should be truncated to a year only for de-identified resources. uds-plus-obs-9a: All dateTime data elements should have valid year > 1900 uds-plus-obs-9b: All dateTime data elements should have valid year < 2030 uds-plus-obs-10: All Period.start data elements should be truncated to a year only for de-identified resources. uds-plus-obs-10a: All Period.start data elements should have valid year > 1900 uds-plus-obs-10b: All Period.start data elements should have valid year < 2030 uds-plus-obs-11: All Period.end data elements should be truncated to a year only for de-identified resources. uds-plus-obs-11a: All Period.end data elements should have valid year > 1900 uds-plus-obs-11b: All Period.end data elements should have valid year < 2030
valueQuantity |  |  | Quantity S |
valueCodeableConcept |  |  | CodeableConcept S |
valueString |  |  | string S |
valueBoolean |  |  | boolean |
valueInteger |  |  | integer |
valueRange |  |  | Range |
valueRatio |  |  | Ratio |
valueSampledData |  |  | SampledData |
valueDateTime |  |  | dateTime |
valuePeriod |  |  | Period |
Documentation for this format

#### Terminology Bindings (Differential)

Path | Conformance | ValueSet | URI
Observation.code | preferred | LOINCCodes (a valid code from LOINC) `http://hl7.org/fhir/ValueSet/observation-codes` from the FHIR Standard
Observation.component.code | preferred | LOINCCodes (a valid code from LOINC) `http://hl7.org/fhir/ValueSet/observation-codes` from the FHIR Standard

#### Constraints

Id | Grade | Path(s) | Details | Requirements
uds-plus-obs-1 | error | Observation.effective[x] | All dateTime data elements should be truncated to a year only for de-identified resources. : $this is DateTime implies $this.toString().length() = 4 |
uds-plus-obs-10a | error | Observation.component.value[x] | All Period.start data elements should have valid year > 1900 : $this is Period and Period.start.exists() implies $this.start.toString() >= '1900' |
uds-plus-obs-10b | error | Observation.component.value[x] | All Period.start data elements should have valid year < 2030 : $this is Period and Period.start.exists() implies $this.start.toString() <= '2030' |
uds-plus-obs-11a | error | Observation.component.value[x] | All Period.end data elements should have valid year > 1900 : $this is Period and Period.end.exists() implies $this.end.toString() >= '1900' |
uds-plus-obs-11b | error | Observation.component.value[x] | All Period.end data elements should have valid year < 2030 : $this is Period and Period.end.exists() implies $this.end.toString() <= '2030' |
uds-plus-obs-1a | error | Observation.effective[x] | All dateTime data elements should have valid year > 1900 : $this is DateTime implies $this.toString() >= '1900' |
uds-plus-obs-1b | error | Observation.effective[x] | All dateTime data elements should have valid year < 2030 : $this is DateTime implies $this.toString() <= '2030' |
uds-plus-obs-2 | error | Observation.effective[x] | All Period.start data elements should be truncated to a year only for de-identified resources. : $this is Period and Period.start.exists() implies $this.start.toString().length() = 4 |
uds-plus-obs-2a | error | Observation.effective[x] | All Period.start data elements should have valid year > 1900 : $this is Period and Period.start.exists() implies $this.start.toString() >= '1900' |
uds-plus-obs-2b | error | Observation.effective[x] | All Period.start data elements should have valid year < 2030 : $this is Period and Period.start.exists() implies $this.start.toString() <= '2030' |
uds-plus-obs-3 | error | Observation.effective[x] | All Period.emd data elements should be truncated to a year only for de-identified resources. : $this is Period and Period.end.exists() implies $this.end.toString().length() = 4 |
uds-plus-obs-3a | error | Observation.effective[x] | All Period.end data elements should have valid year > 1900 : $this is Period and Period.end.exists() implies $this.end.toString() >= '1900' |
uds-plus-obs-3b | error | Observation.effective[x] | All Period.end data elements should have valid year < 2030 : $this is Period and Period.end.exists() implies $this.end.toString() <= '2030' |
uds-plus-obs-4 | error | Observation.effective[x] | All Timing.event data elements should be truncated to a year only for de-identified resources. : $this is Timing and Timing.event.exists() implies $this.event.count() = 1 |
uds-plus-obs-5 | error | Observation.effective[x] | All Timing.event data elements should be truncated to a year only for de-identified resources. : $this is Timing and Timing.event.exists() implies $this.event.first().toString().length() = 4 |
uds-plus-obs-5a | error | Observation.effective[x] | All Timing data elements should have valid year > 1900 : $this is Timing and Timing.event.exists() implies $this.event.first().toString() >= '1900' |
uds-plus-obs-5b | error | Observation.effective[x] | All Timing data elements should have valid year < 2030 : $this is Timing and Timing.event.exists() implies $this.event.first().toString() <= '2030' |
uds-plus-obs-6 | error | Observation.value[x] | All dateTime data elements should be truncated to a year only for de-identified resources. : $this is dateTime implies $this.toString().length() = 4 |
uds-plus-obs-6a | error | Observation.value[x] | All Period.start data elements should have valid year > 1900 : $this is Period and Period.start.exists() implies $this.start.toString() >= '1900' |
uds-plus-obs-6b | error | Observation.value[x] | All Period.start data elements should have valid year < 2030 : $this is Period and Period.start.exists() implies $this.start.toString() <= '2030' |
uds-plus-obs-7 | error | Observation.value[x] | All Period.start data elements should be truncated to a year only for de-identified resources. : $this is Period and Period.start.exists() implies $this.start.toString().length() = 4 |
uds-plus-obs-8 | error | Observation.value[x] | All Period.end data elements should be truncated to a year only for de-identified resources. : $this is Period and Period.end.exists() implies $this.end.toString().length() = 4 |
uds-plus-obs-10 | error | Observation.component.value[x] | All Period.start data elements should be truncated to a year only for de-identified resources. : $this is Period and Period.start.exists() implies $this.start.toString().length() = 4 |
uds-plus-obs-11 | error | Observation.component.value[x] | All Period.end data elements should be truncated to a year only for de-identified resources. : $this is Period and Period.end.exists() implies $this.end.toString().length() = 4 |
uds-plus-obs-7a | error | Observation.value[x] | All Period.start data elements should have valid year > 1900 : $this is Period and Period.start.exists() implies $this.start.toString() >= '1900' |
uds-plus-obs-7b | error | Observation.value[x] | All Period.start data elements should have valid year < 2030 : $this is Period and Period.start.exists() implies $this.start.toString() <= '2030' |
uds-plus-obs-8a | error | Observation.value[x] | All Period.end data elements should have valid year > 1900 : $this is Period and Period.end.exists() implies $this.end.toString() >= '1900' |
uds-plus-obs-8b | error | Observation.value[x] | All Period.end data elements should have valid year < 2030 : $this is Period and Period.end.exists() implies $this.end.toString() <= '2030' |
uds-plus-obs-9 | error | Observation.component.value[x] | All dateTime data elements should be truncated to a year only for de-identified resources. : $this is dateTime implies $this.toString().length() = 4 |
uds-plus-obs-9a | error | Observation.component.value[x] | All dateTime data elements should have valid year > 1900 : $this is DateTime implies $this.toString() >= '1900' |
uds-plus-obs-9b | error | Observation.component.value[x] | All dateTime data elements should have valid year < 2030 : $this is DateTime implies $this.toString() <= '2030' |

Name | Flags | Card. | Type | Description & Constraints
--- | --- | --- | --- | ---
Observation | C | 0..* | Observation | De-Identified UDS Plus Observation obs-6: dataAbsentReason SHALL only be present if Observation.value[x] is not present obs-7: If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present
id | S Σ | 0..1 | id | The de-identified Observation identifier created by the health center to send data to UDS+ Data Receiver
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
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:deidentifiedIssuedTime |  | 0..1 | dateTime | Indicates the time with a precision of only Year. URL: http://fhir.org/guides/hrsa/uds-plus/StructureDefinition/uds-plus-deidentified-instant-extension
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
identifier | Σ | 0..* | Identifier | Business Identifier for observation
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 | ?!S Σ | 1..1 | code | registered | preliminary | final | amended + Binding: ObservationStatus (required): Codes providing the status of an observation.
category | S | 1..* | CodeableConcept | Classification of type of observation Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
code | S Σ | 1..1 | CodeableConcept | Type of observation (code / type) Binding: LOINCCodes (preferred): The set of codes indicating the Observations
subject | S Σ | 1..1 | Reference(De-Identified UDS Plus Patient) | Who and/or what the observation is about
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 | Σ C | 0..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
focus | Σ | 0..* | Reference(Resource) | What the observation is about, when it is not about the subject of record
encounter | S Σ | 0..1 | Reference(De-Identified UDS Plus Encounter) | Healthcare event during which this observation is made
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 | Σ C | 0..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
effective[x] | S Σ C | 0..1 |  | Clinically relevant time/time-period for observation uds-plus-obs-1: All dateTime data elements should be truncated to a year only for de-identified resources. uds-plus-obs-1a: All dateTime data elements should have valid year > 1900 uds-plus-obs-1b: All dateTime data elements should have valid year < 2030 uds-plus-obs-2: All Period.start data elements should be truncated to a year only for de-identified resources. uds-plus-obs-2a: All Period.start data elements should have valid year > 1900 uds-plus-obs-2b: All Period.start data elements should have valid year < 2030 uds-plus-obs-3: All Period.emd data elements should be truncated to a year only for de-identified resources. uds-plus-obs-3a: All Period.end data elements should have valid year > 1900 uds-plus-obs-3b: All Period.end data elements should have valid year < 2030 uds-plus-obs-4: All Timing.event data elements should be truncated to a year only for de-identified resources. uds-plus-obs-5: All Timing.event data elements should be truncated to a year only for de-identified resources. uds-plus-obs-5a: All Timing data elements should have valid year > 1900 uds-plus-obs-5b: All Timing data elements should have valid year < 2030
effectiveDateTime |  |  | dateTime S |
effectivePeriod |  |  | Period |
effectiveTiming |  |  | Timing |
performer | S Σ | 0..* | Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson) | Who is responsible for the observation
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 | Σ C | 0..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
value[x] | S Σ C | 0..1 |  | Actual result uds-plus-obs-6: All dateTime data elements should be truncated to a year only for de-identified resources. uds-plus-obs-6a: All Period.start data elements should have valid year > 1900 uds-plus-obs-6b: All Period.start data elements should have valid year < 2030 uds-plus-obs-7: All Period.start data elements should be truncated to a year only for de-identified resources. uds-plus-obs-7a: All Period.start data elements should have valid year > 1900 uds-plus-obs-7b: All Period.start data elements should have valid year < 2030 uds-plus-obs-8: All Period.end data elements should be truncated to a year only for de-identified resources. uds-plus-obs-8a: All Period.end data elements should have valid year > 1900 uds-plus-obs-8b: All Period.end data elements should have valid year < 2030
valueQuantity |  |  | Quantity S |
valueCodeableConcept |  |  | CodeableConcept S |
valueString |  |  | string S |
valueBoolean |  |  | boolean |
valueInteger |  |  | integer |
valueRange |  |  | Range |
valueRatio |  |  | Ratio |
valueSampledData |  |  | SampledData |
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.
bodySite | S | 0..1 | CodeableConcept | Observed body part Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
method |  | 0..1 | CodeableConcept | How it was done Binding: ObservationMethods (example): Methods for simple observations.
specimen |  | 0..1 | Reference(Specimen) | Specimen used for this observation
device |  | 0..1 | Reference(Device | DeviceMetric) | (Measurement) Device
referenceRange | C | 0..* | BackboneElement | Provides guide for interpretation obs-3: Must have at least a low or a high or text
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
low | C | 0..1 | SimpleQuantity | Low Range, if relevant
high | C | 0..1 | SimpleQuantity | High Range, if relevant
type |  | 0..1 | CodeableConcept | Reference range qualifier Binding: ObservationReferenceRangeMeaningCodes (preferred): Code for the meaning of a reference range.
appliesTo |  | 0..* | CodeableConcept | Reference range population Binding: ObservationReferenceRangeAppliesToCodes (example): Codes identifying the population the reference range applies to.
age |  | 0..1 | Range | Applicable age range, if relevant
text |  | 0..1 | string | Text based reference range in an observation
hasMember | Σ | 0..* | Reference(Observation | QuestionnaireResponse | MolecularSequence) | Related resource that belongs to the Observation group
derivedFrom | Σ | 0..* | Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | Observation | MolecularSequence) | Related measurements the observation is made from
component | S 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 | S Σ | 1..1 | CodeableConcept | Type of component observation (code / type) Binding: LOINCCodes (preferred): The set of codes indicating the Observations
value[x] | S Σ C | 0..1 |  | Actual component result uds-plus-obs-9: All dateTime data elements should be truncated to a year only for de-identified resources. uds-plus-obs-9a: All dateTime data elements should have valid year > 1900 uds-plus-obs-9b: All dateTime data elements should have valid year < 2030 uds-plus-obs-10: All Period.start data elements should be truncated to a year only for de-identified resources. uds-plus-obs-10a: All Period.start data elements should have valid year > 1900 uds-plus-obs-10b: All Period.start data elements should have valid year < 2030 uds-plus-obs-11: All Period.end data elements should be truncated to a year only for de-identified resources. uds-plus-obs-11a: All Period.end data elements should have valid year > 1900 uds-plus-obs-11b: All Period.end data elements should have valid year < 2030
valueQuantity |  |  | Quantity S |
valueCodeableConcept |  |  | CodeableConcept S |
valueString |  |  | string S |
valueBoolean |  |  | boolean |
valueInteger |  |  | integer |
valueRange |  |  | Range |
valueRatio |  |  | Ratio |
valueSampledData |  |  | SampledData |
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 | URI
Observation.language | preferred | CommonLanguages `http://hl7.org/fhir/ValueSet/languages` from the FHIR Standard
Additional Bindings | Purpose
AllLanguages | Max Binding
Observation.status | required | ObservationStatus `http://hl7.org/fhir/ValueSet/observation-status|4.0.1` from the FHIR Standard
Observation.category | preferred | ObservationCategoryCodes `http://hl7.org/fhir/ValueSet/observation-category` from the FHIR Standard
Observation.code | preferred | LOINCCodes (a valid code from LOINC) `http://hl7.org/fhir/ValueSet/observation-codes` from the FHIR Standard
Observation.subject.type | extensible | ResourceType `http://hl7.org/fhir/ValueSet/resource-types` from the FHIR Standard
Observation.encounter.type | extensible | ResourceType `http://hl7.org/fhir/ValueSet/resource-types` from the FHIR Standard
Observation.performer.type | extensible | ResourceType `http://hl7.org/fhir/ValueSet/resource-types` from the FHIR Standard
Observation.dataAbsentReason | extensible | DataAbsentReason `http://hl7.org/fhir/ValueSet/data-absent-reason` from the FHIR Standard
Observation.interpretation | extensible | ObservationInterpretationCodes `http://hl7.org/fhir/ValueSet/observation-interpretation` from the FHIR Standard
Observation.bodySite | example | SNOMEDCTBodyStructures `http://hl7.org/fhir/ValueSet/body-site` from the FHIR Standard
Observation.method | example | ObservationMethods `http://hl7.org/fhir/ValueSet/observation-methods` from the FHIR Standard
Observation.referenceRange.type | preferred | ObservationReferenceRangeMeaningCodes `http://hl7.org/fhir/ValueSet/referencerange-meaning` from the FHIR Standard
Observation.referenceRange.appliesTo | example | ObservationReferenceRangeAppliesToCodes `http://hl7.org/fhir/ValueSet/referencerange-appliesto` from the FHIR Standard
Observation.component.code | preferred | LOINCCodes (a valid code from LOINC) `http://hl7.org/fhir/ValueSet/observation-codes` from the FHIR Standard
Observation.component.dataAbsentReason | extensible | DataAbsentReason `http://hl7.org/fhir/ValueSet/data-absent-reason` from the FHIR Standard
Observation.component.interpretation | extensible | ObservationInterpretationCodes `http://hl7.org/fhir/ValueSet/observation-interpretation` from the FHIR Standard

#### Constraints

Id | Grade | Path(s) | Details | Requirements
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() |
uds-plus-obs-1 | error | Observation.effective[x] | All dateTime data elements should be truncated to a year only for de-identified resources. : $this is DateTime implies $this.toString().length() = 4 |
uds-plus-obs-10 | error | Observation.component.value[x] | All Period.start data elements should be truncated to a year only for de-identified resources. : $this is Period and Period.start.exists() implies $this.start.toString().length() = 4 |
uds-plus-obs-10a | error | Observation.component.value[x] | All Period.start data elements should have valid year > 1900 : $this is Period and Period.start.exists() implies $this.start.toString() >= '1900' |
uds-plus-obs-10b | error | Observation.component.value[x] | All Period.start data elements should have valid year < 2030 : $this is Period and Period.start.exists() implies $this.start.toString() <= '2030' |
uds-plus-obs-11a | error | Observation.component.value[x] | All Period.end data elements should have valid year > 1900 : $this is Period and Period.end.exists() implies $this.end.toString() >= '1900' |
uds-plus-obs-11b | error | Observation.component.value[x] | All Period.end data elements should have valid year < 2030 : $this is Period and Period.end.exists() implies $this.end.toString() <= '2030' |
uds-plus-obs-1a | error | Observation.effective[x] | All dateTime data elements should have valid year > 1900 : $this is DateTime implies $this.toString() >= '1900' |
uds-plus-obs-1b | error | Observation.effective[x] | All dateTime data elements should have valid year < 2030 : $this is DateTime implies $this.toString() <= '2030' |
uds-plus-obs-2 | error | Observation.effective[x] | All Period.start data elements should be truncated to a year only for de-identified resources. : $this is Period and Period.start.exists() implies $this.start.toString().length() = 4 |
uds-plus-obs-2a | error | Observation.effective[x] | All Period.start data elements should have valid year > 1900 : $this is Period and Period.start.exists() implies $this.start.toString() >= '1900' |
uds-plus-obs-2b | error | Observation.effective[x] | All Period.start data elements should have valid year < 2030 : $this is Period and Period.start.exists() implies $this.start.toString() <= '2030' |
uds-plus-obs-3 | error | Observation.effective[x] | All Period.emd data elements should be truncated to a year only for de-identified resources. : $this is Period and Period.end.exists() implies $this.end.toString().length() = 4 |
uds-plus-obs-3a | error | Observation.effective[x] | All Period.end data elements should have valid year > 1900 : $this is Period and Period.end.exists() implies $this.end.toString() >= '1900' |
uds-plus-obs-3b | error | Observation.effective[x] | All Period.end data elements should have valid year < 2030 : $this is Period and Period.end.exists() implies $this.end.toString() <= '2030' |
uds-plus-obs-4 | error | Observation.effective[x] | All Timing.event data elements should be truncated to a year only for de-identified resources. : $this is Timing and Timing.event.exists() implies $this.event.count() = 1 |
uds-plus-obs-5 | error | Observation.effective[x] | All Timing.event data elements should be truncated to a year only for de-identified resources. : $this is Timing and Timing.event.exists() implies $this.event.first().toString().length() = 4 |
uds-plus-obs-5b | error | Observation.effective[x] | All Timing data elements should have valid year < 2030 : $this is Timing and Timing.event.exists() implies $this.event.first().toString() <= '2030' |
uds-plus-obs-6 | error | Observation.value[x] | All dateTime data elements should be truncated to a year only for de-identified resources. : $this is dateTime implies $this.toString().length() = 4 |
uds-plus-obs-11 | error | Observation.component.value[x] | All Period.end data elements should be truncated to a year only for de-identified resources. : $this is Period and Period.end.exists() implies $this.end.toString().length() = 4 |
uds-plus-obs-5a | error | Observation.effective[x] | All Timing data elements should have valid year > 1900 : $this is Timing and Timing.event.exists() implies $this.event.first().toString() >= '1900' |
uds-plus-obs-6a | error | Observation.value[x] | All Period.start data elements should have valid year > 1900 : $this is Period and Period.start.exists() implies $this.start.toString() >= '1900' |
uds-plus-obs-6b | error | Observation.value[x] | All Period.start data elements should have valid year < 2030 : $this is Period and Period.start.exists() implies $this.start.toString() <= '2030' |
uds-plus-obs-7 | error | Observation.value[x] | All Period.start data elements should be truncated to a year only for de-identified resources. : $this is Period and Period.start.exists() implies $this.start.toString().length() = 4 |
uds-plus-obs-7a | error | Observation.value[x] | All Period.start data elements should have valid year > 1900 : $this is Period and Period.start.exists() implies $this.start.toString() >= '1900' |
uds-plus-obs-7b | error | Observation.value[x] | All Period.start data elements should have valid year < 2030 : $this is Period and Period.start.exists() implies $this.start.toString() <= '2030' |
uds-plus-obs-8 | error | Observation.value[x] | All Period.end data elements should be truncated to a year only for de-identified resources. : $this is Period and Period.end.exists() implies $this.end.toString().length() = 4 |
uds-plus-obs-8a | error | Observation.value[x] | All Period.end data elements should have valid year > 1900 : $this is Period and Period.end.exists() implies $this.end.toString() >= '1900' |
uds-plus-obs-8b | error | Observation.value[x] | All Period.end data elements should have valid year < 2030 : $this is Period and Period.end.exists() implies $this.end.toString() <= '2030' |
uds-plus-obs-9 | error | Observation.component.value[x] | All dateTime data elements should be truncated to a year only for de-identified resources. : $this is dateTime implies $this.toString().length() = 4 |
uds-plus-obs-9a | error | Observation.component.value[x] | All dateTime data elements should have valid year > 1900 : $this is DateTime implies $this.toString() >= '1900' |
uds-plus-obs-9b | error | Observation.component.value[x] | All dateTime data elements should have valid year < 2030 : $this is DateTime implies $this.toString() <= '2030' |

This structure is derived from Observation

Summary

Mandatory: 4 elements(1 nested mandatory element)
Must-Support: 13 elements
Prohibited: 7 elements

Structures

This structure refers to these other structures:

- De-Identified UDS Plus Patient (http://fhir.org/guides/hrsa/uds-plus/StructureDefinition/de-identified-uds-plus-patient)
- De-Identified UDS Plus Encounter (http://fhir.org/guides/hrsa/uds-plus/StructureDefinition/uds-plus-encounter)

Extensions

This structure refers to these extensions:

- http://fhir.org/guides/hrsa/uds-plus/StructureDefinition/uds-plus-deidentified-instant-extension

Maturity: 2

Key Elements View

Name | Flags | Card. | Type | Description & Constraints
--- | --- | --- | --- | ---
Observation | C | 0..* | Observation | De-Identified UDS Plus Observation dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources dom-3: 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 dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated dom-5: If a resource is contained in another resource, it SHALL NOT have a security label dom-6: A resource should have narrative for robust management obs-6: dataAbsentReason SHALL only be present if Observation.value[x] is not present obs-7: If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present
id | S Σ | 0..1 | id | The de-identified Observation identifier created by the health center to send data to UDS+ Data Receiver
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created ele-1: All FHIR elements must have a @value or children
Slices for extension |  |  |  | Content/Rules for all slices
extension:deidentifiedIssuedTime |  | 0..1 | dateTime | Indicates the time with a precision of only Year. URL: http://fhir.org/guides/hrsa/uds-plus/StructureDefinition/uds-plus-deidentified-instant-extension ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
status | ?!S Σ | 1..1 | code | registered | preliminary | final | amended + Binding: ObservationStatus (required): Codes providing the status of an observation. ele-1: All FHIR elements must have a @value or children
category | S | 1..* | CodeableConcept | Classification of type of observation Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories. ele-1: All FHIR elements must have a @value or children
code | S Σ | 1..1 | CodeableConcept | Type of observation (code / type) Binding: LOINCCodes (preferred): The set of codes indicating the Observations ele-1: All FHIR elements must have a @value or children
subject | S Σ | 1..1 | Reference(De-Identified UDS Plus Patient) | Who and/or what the observation is about ele-1: All FHIR elements must have a @value or children
encounter | S Σ | 0..1 | Reference(De-Identified UDS Plus Encounter) | Healthcare event during which this observation is made ele-1: All FHIR elements must have a @value or children
effective[x] | S Σ C | 0..1 |  | Clinically relevant time/time-period for observation ele-1: All FHIR elements must have a @value or children uds-plus-obs-1: All dateTime data elements should be truncated to a year only for de-identified resources. uds-plus-obs-1a: All dateTime data elements should have valid year > 1900 uds-plus-obs-1b: All dateTime data elements should have valid year < 2030 uds-plus-obs-2: All Period.start data elements should be truncated to a year only for de-identified resources. uds-plus-obs-2a: All Period.start data elements should have valid year > 1900 uds-plus-obs-2b: All Period.start data elements should have valid year < 2030 uds-plus-obs-3: All Period.emd data elements should be truncated to a year only for de-identified resources. uds-plus-obs-3a: All Period.end data elements should have valid year > 1900 uds-plus-obs-3b: All Period.end data elements should have valid year < 2030 uds-plus-obs-4: All Timing.event data elements should be truncated to a year only for de-identified resources. uds-plus-obs-5: All Timing.event data elements should be truncated to a year only for de-identified resources. uds-plus-obs-5a: All Timing data elements should have valid year > 1900 uds-plus-obs-5b: All Timing data elements should have valid year < 2030
effectiveDateTime |  |  | dateTime |
performer | S Σ | 0..* | Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson) | Who is responsible for the observation ele-1: All FHIR elements must have a @value or children
value[x] | S Σ C | 0..1 |  | Actual result ele-1: All FHIR elements must have a @value or children uds-plus-obs-6: All dateTime data elements should be truncated to a year only for de-identified resources. uds-plus-obs-6a: All Period.start data elements should have valid year > 1900 uds-plus-obs-6b: All Period.start data elements should have valid year < 2030 uds-plus-obs-7: All Period.start data elements should be truncated to a year only for de-identified resources. uds-plus-obs-7a: All Period.start data elements should have valid year > 1900 uds-plus-obs-7b: All Period.start data elements should have valid year < 2030 uds-plus-obs-8: All Period.end data elements should be truncated to a year only for de-identified resources. uds-plus-obs-8a: All Period.end data elements should have valid year > 1900 uds-plus-obs-8b: All Period.end data elements should have valid year < 2030
valueQuantity |  |  | Quantity |
valueCodeableConcept |  |  | CodeableConcept |
valueString |  |  | string |
bodySite | S | 0..1 | CodeableConcept | Observed body part Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality. ele-1: All FHIR elements must have a @value or children
component | S Σ | 0..* | BackboneElement | Component results ele-1: All FHIR elements must have a @value or children
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
code | S Σ | 1..1 | CodeableConcept | Type of component observation (code / type) Binding: LOINCCodes (preferred): The set of codes indicating the Observations ele-1: All FHIR elements must have a @value or children
value[x] | S Σ C | 0..1 |  | Actual component result ele-1: All FHIR elements must have a @value or children uds-plus-obs-9: All dateTime data elements should be truncated to a year only for de-identified resources. uds-plus-obs-9a: All dateTime data elements should have valid year > 1900 uds-plus-obs-9b: All dateTime data elements should have valid year < 2030 uds-plus-obs-10: All Period.start data elements should be truncated to a year only for de-identified resources. uds-plus-obs-10a: All Period.start data elements should have valid year > 1900 uds-plus-obs-10b: All Period.start data elements should have valid year < 2030 uds-plus-obs-11: All Period.end data elements should be truncated to a year only for de-identified resources. uds-plus-obs-11a: All Period.end data elements should have valid year > 1900 uds-plus-obs-11b: All Period.end data elements should have valid year < 2030
valueQuantity |  |  | Quantity |
valueCodeableConcept |  |  | CodeableConcept |
valueString |  |  | string |
Documentation for this format

#### Terminology Bindings

Path | Conformance | ValueSet | URI
Observation.status | required | ObservationStatus `http://hl7.org/fhir/ValueSet/observation-status|4.0.1` from the FHIR Standard
Observation.category | preferred | ObservationCategoryCodes `http://hl7.org/fhir/ValueSet/observation-category` from the FHIR Standard
Observation.code | preferred | LOINCCodes (a valid code from LOINC) `http://hl7.org/fhir/ValueSet/observation-codes` from the FHIR Standard
Observation.bodySite | example | SNOMEDCTBodyStructures `http://hl7.org/fhir/ValueSet/body-site` from the FHIR Standard
Observation.component.code | preferred | LOINCCodes (a valid code from LOINC) `http://hl7.org/fhir/ValueSet/observation-codes` from the FHIR Standard

#### Constraints

Id | Grade | Path(s) | Details | Requirements
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() |
uds-plus-obs-1 | error | Observation.effective[x] | All dateTime data elements should be truncated to a year only for de-identified resources. : $this is DateTime implies $this.toString().length() = 4 |
uds-plus-obs-10a | error | Observation.component.value[x] | All Period.start data elements should have valid year > 1900 : $this is Period and Period.start.exists() implies $this.start.toString() >= '1900' |
uds-plus-obs-10b | error | Observation.component.value[x] | All Period.start data elements should have valid year < 2030 : $this is Period and Period.start.exists() implies $this.start.toString() <= '2030' |
uds-plus-obs-11a | error | Observation.component.value[x] | All Period.end data elements should have valid year > 1900 : $this is Period and Period.end.exists() implies $this.end.toString() >= '1900' |
uds-plus-obs-11b | error | Observation.component.value[x] | All Period.end data elements should have valid year < 2030 : $this is Period and Period.end.exists() implies $this.end.toString() <= '2030' |
uds-plus-obs-1a | error | Observation.effective[x] | All dateTime data elements should have valid year > 1900 : $this is DateTime implies $this.toString() >= '1900' |
uds-plus-obs-1b | error | Observation.effective[x] | All dateTime data elements should have valid year < 2030 : $this is DateTime implies $this.toString() <= '2030' |
uds-plus-obs-2 | error | Observation.effective[x] | All Period.start data elements should be truncated to a year only for de-identified resources. : $this is Period and Period.start.exists() implies $this.start.toString().length() = 4 |
uds-plus-obs-2a | error | Observation.effective[x] | All Period.start data elements should have valid year > 1900 : $this is Period and Period.start.exists() implies $this.start.toString() >= '1900' |
uds-plus-obs-2b | error | Observation.effective[x] | All Period.start data elements should have valid year < 2030 : $this is Period and Period.start.exists() implies $this.start.toString() <= '2030' |
uds-plus-obs-3 | error | Observation.effective[x] | All Period.emd data elements should be truncated to a year only for de-identified resources. : $this is Period and Period.end.exists() implies $this.end.toString().length() = 4 |
uds-plus-obs-3a | error | Observation.effective[x] | All Period.end data elements should have valid year > 1900 : $this is Period and Period.end.exists() implies $this.end.toString() >= '1900' |
uds-plus-obs-3b | error | Observation.effective[x] | All Period.end data elements should have valid year < 2030 : $this is Period and Period.end.exists() implies $this.end.toString() <= '2030' |
uds-plus-obs-4 | error | Observation.effective[x] | All Timing.event data elements should be truncated to a year only for de-identified resources. : $this is Timing and Timing.event.exists() implies $this.event.count() = 1 |
uds-plus-obs-5 | error | Observation.effective[x] | All Timing.event data elements should be truncated to a year only for de-identified resources. : $this is Timing and Timing.event.exists() implies $this.event.first().toString().length() = 4 |
uds-plus-obs-6 | error | Observation.value[x] | All dateTime data elements should be truncated to a year only for de-identified resources. : $this is dateTime implies $this.toString().length() = 4 |
uds-plus-obs-10 | error | Observation.component.value[x] | All Period.start data elements should be truncated to a year only for de-identified resources. : $this is Period and Period.start.exists() implies $this.start.toString().length() = 4 |
uds-plus-obs-11 | error | Observation.component.value[x] | All Period.end data elements should be truncated to a year only for de-identified resources. : $this is Period and Period.end.exists() implies $this.end.toString().length() = 4 |
uds-plus-obs-5a | error | Observation.effective[x] | All Timing data elements should have valid year > 1900 : $this is Timing and Timing.event.exists() implies $this.event.first().toString() >= '1900' |
uds-plus-obs-5b | error | Observation.effective[x] | All Timing data elements should have valid year < 2030 : $this is Timing and Timing.event.exists() implies $this.event.first().toString() <= '2030' |
uds-plus-obs-6a | error | Observation.value[x] | All Period.start data elements should have valid year > 1900 : $this is Period and Period.start.exists() implies $this.start.toString() >= '1900' |
uds-plus-obs-6b | error | Observation.value[x] | All Period.start data elements should have valid year < 2030 : $this is Period and Period.start.exists() implies $this.start.toString() <= '2030' |
uds-plus-obs-7 | error | Observation.value[x] | All Period.start data elements should be truncated to a year only for de-identified resources. : $this is Period and Period.start.exists() implies $this.start.toString().length() = 4 |
uds-plus-obs-7a | error | Observation.value[x] | All Period.start data elements should have valid year > 1900 : $this is Period and Period.start.exists() implies $this.start.toString() >= '1900' |
uds-plus-obs-7b | error | Observation.value[x] | All Period.start data elements should have valid year < 2030 : $this is Period and Period.start.exists() implies $this.start.toString() <= '2030' |
uds-plus-obs-8 | error | Observation.value[x] | All Period.end data elements should be truncated to a year only for de-identified resources. : $this is Period and Period.end.exists() implies $this.end.toString().length() = 4 |
uds-plus-obs-8a | error | Observation.value[x] | All Period.end data elements should have valid year > 1900 : $this is Period and Period.end.exists() implies $this.end.toString() >= '1900' |
uds-plus-obs-8b | error | Observation.value[x] | All Period.end data elements should have valid year < 2030 : $this is Period and Period.end.exists() implies $this.end.toString() <= '2030' |
uds-plus-obs-9 | error | Observation.component.value[x] | All dateTime data elements should be truncated to a year only for de-identified resources. : $this is dateTime implies $this.toString().length() = 4 |
uds-plus-obs-9a | error | Observation.component.value[x] | All dateTime data elements should have valid year > 1900 : $this is DateTime implies $this.toString() >= '1900' |
uds-plus-obs-9b | error | Observation.component.value[x] | All dateTime data elements should have valid year < 2030 : $this is DateTime implies $this.toString() <= '2030' |

Differential View

This structure is derived from Observation

Name | Flags | Card. | Type | Description & Constraints
--- | --- | --- | --- | ---
Observation |  | 0..* | Observation | De-Identified UDS Plus Observation
id | S | 0..1 | id | The de-identified Observation identifier created by the health center to send data to UDS+ Data Receiver
text |  | 0..0 |  |
contained |  | 0..0 |  |
Slices for extension |  |  |  | Content/Rules for all slices
extension:deidentifiedIssuedTime |  | 0..1 | dateTime | Indicates the time with a precision of only Year. URL: http://fhir.org/guides/hrsa/uds-plus/StructureDefinition/uds-plus-deidentified-instant-extension
status | S | 1..1 | code | registered | preliminary | final | amended +
category | S | 1..* | CodeableConcept | Classification of type of observation
code | S | 1..1 | CodeableConcept | Type of observation (code / type) Binding: LOINCCodes (preferred): The set of codes indicating the Observations
subject | S | 1..1 | Reference(De-Identified UDS Plus Patient) | Who and/or what the observation is about
display |  | 0..0 |  |
encounter | S | 0..1 | Reference(De-Identified UDS Plus Encounter) | Healthcare event during which this observation is made
display |  | 0..0 |  |
effective[x] | S C | 0..1 |  | Clinically relevant time/time-period for observation uds-plus-obs-1: All dateTime data elements should be truncated to a year only for de-identified resources. uds-plus-obs-1a: All dateTime data elements should have valid year > 1900 uds-plus-obs-1b: All dateTime data elements should have valid year < 2030 uds-plus-obs-2: All Period.start data elements should be truncated to a year only for de-identified resources. uds-plus-obs-2a: All Period.start data elements should have valid year > 1900 uds-plus-obs-2b: All Period.start data elements should have valid year < 2030 uds-plus-obs-3: All Period.emd data elements should be truncated to a year only for de-identified resources. uds-plus-obs-3a: All Period.end data elements should have valid year > 1900 uds-plus-obs-3b: All Period.end data elements should have valid year < 2030 uds-plus-obs-4: All Timing.event data elements should be truncated to a year only for de-identified resources. uds-plus-obs-5: All Timing.event data elements should be truncated to a year only for de-identified resources. uds-plus-obs-5a: All Timing data elements should have valid year > 1900 uds-plus-obs-5b: All Timing data elements should have valid year < 2030
effectiveDateTime |  |  | dateTime S |
effectivePeriod |  |  | Period |
effectiveTiming |  |  | Timing |
issued |  | 0..0 |  |
performer | S | 0..* | Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson) | Who is responsible for the observation
display |  | 0..0 |  |
value[x] | S C | 0..1 |  | Actual result uds-plus-obs-6: All dateTime data elements should be truncated to a year only for de-identified resources. uds-plus-obs-6a: All Period.start data elements should have valid year > 1900 uds-plus-obs-6b: All Period.start data elements should have valid year < 2030 uds-plus-obs-7: All Period.start data elements should be truncated to a year only for de-identified resources. uds-plus-obs-7a: All Period.start data elements should have valid year > 1900 uds-plus-obs-7b: All Period.start data elements should have valid year < 2030 uds-plus-obs-8: All Period.end data elements should be truncated to a year only for de-identified resources. uds-plus-obs-8a: All Period.end data elements should have valid year > 1900 uds-plus-obs-8b: All Period.end data elements should have valid year < 2030
valueQuantity |  |  | Quantity S |
valueCodeableConcept |  |  | CodeableConcept S |
valueString |  |  | string S |
valueBoolean |  |  | boolean |
valueInteger |  |  | integer |
valueRange |  |  | Range |
valueRatio |  |  | Ratio |
valueSampledData |  |  | SampledData |
valueDateTime |  |  | dateTime |
valuePeriod |  |  | Period |
note |  | 0..0 |  |
bodySite | S | 0..1 | CodeableConcept | Observed body part
component | S | 0..* | BackboneElement | Component results
code | S | 1..1 | CodeableConcept | Type of component observation (code / type) Binding: LOINCCodes (preferred): The set of codes indicating the Observations
value[x] | S C | 0..1 |  | Actual component result uds-plus-obs-9: All dateTime data elements should be truncated to a year only for de-identified resources. uds-plus-obs-9a: All dateTime data elements should have valid year > 1900 uds-plus-obs-9b: All dateTime data elements should have valid year < 2030 uds-plus-obs-10: All Period.start data elements should be truncated to a year only for de-identified resources. uds-plus-obs-10a: All Period.start data elements should have valid year > 1900 uds-plus-obs-10b: All Period.start data elements should have valid year < 2030 uds-plus-obs-11: All Period.end data elements should be truncated to a year only for de-identified resources. uds-plus-obs-11a: All Period.end data elements should have valid year > 1900 uds-plus-obs-11b: All Period.end data elements should have valid year < 2030
valueQuantity |  |  | Quantity S |
valueCodeableConcept |  |  | CodeableConcept S |
valueString |  |  | string S |
valueBoolean |  |  | boolean |
valueInteger |  |  | integer |
valueRange |  |  | Range |
valueRatio |  |  | Ratio |
valueSampledData |  |  | SampledData |
valueDateTime |  |  | dateTime |
valuePeriod |  |  | Period |
Documentation for this format

#### Terminology Bindings (Differential)

Path | Conformance | ValueSet | URI
Observation.code | preferred | LOINCCodes (a valid code from LOINC) `http://hl7.org/fhir/ValueSet/observation-codes` from the FHIR Standard
Observation.component.code | preferred | LOINCCodes (a valid code from LOINC) `http://hl7.org/fhir/ValueSet/observation-codes` from the FHIR Standard

#### Constraints

Id | Grade | Path(s) | Details | Requirements
uds-plus-obs-1 | error | Observation.effective[x] | All dateTime data elements should be truncated to a year only for de-identified resources. : $this is DateTime implies $this.toString().length() = 4 |
uds-plus-obs-10a | error | Observation.component.value[x] | All Period.start data elements should have valid year > 1900 : $this is Period and Period.start.exists() implies $this.start.toString() >= '1900' |
uds-plus-obs-10b | error | Observation.component.value[x] | All Period.start data elements should have valid year < 2030 : $this is Period and Period.start.exists() implies $this.start.toString() <= '2030' |
uds-plus-obs-11a | error | Observation.component.value[x] | All Period.end data elements should have valid year > 1900 : $this is Period and Period.end.exists() implies $this.end.toString() >= '1900' |
uds-plus-obs-11b | error | Observation.component.value[x] | All Period.end data elements should have valid year < 2030 : $this is Period and Period.end.exists() implies $this.end.toString() <= '2030' |
uds-plus-obs-1a | error | Observation.effective[x] | All dateTime data elements should have valid year > 1900 : $this is DateTime implies $this.toString() >= '1900' |
uds-plus-obs-1b | error | Observation.effective[x] | All dateTime data elements should have valid year < 2030 : $this is DateTime implies $this.toString() <= '2030' |
uds-plus-obs-2 | error | Observation.effective[x] | All Period.start data elements should be truncated to a year only for de-identified resources. : $this is Period and Period.start.exists() implies $this.start.toString().length() = 4 |
uds-plus-obs-2a | error | Observation.effective[x] | All Period.start data elements should have valid year > 1900 : $this is Period and Period.start.exists() implies $this.start.toString() >= '1900' |
uds-plus-obs-2b | error | Observation.effective[x] | All Period.start data elements should have valid year < 2030 : $this is Period and Period.start.exists() implies $this.start.toString() <= '2030' |
uds-plus-obs-3 | error | Observation.effective[x] | All Period.emd data elements should be truncated to a year only for de-identified resources. : $this is Period and Period.end.exists() implies $this.end.toString().length() = 4 |
uds-plus-obs-3a | error | Observation.effective[x] | All Period.end data elements should have valid year > 1900 : $this is Period and Period.end.exists() implies $this.end.toString() >= '1900' |
uds-plus-obs-3b | error | Observation.effective[x] | All Period.end data elements should have valid year < 2030 : $this is Period and Period.end.exists() implies $this.end.toString() <= '2030' |
uds-plus-obs-4 | error | Observation.effective[x] | All Timing.event data elements should be truncated to a year only for de-identified resources. : $this is Timing and Timing.event.exists() implies $this.event.count() = 1 |
uds-plus-obs-5 | error | Observation.effective[x] | All Timing.event data elements should be truncated to a year only for de-identified resources. : $this is Timing and Timing.event.exists() implies $this.event.first().toString().length() = 4 |
uds-plus-obs-5a | error | Observation.effective[x] | All Timing data elements should have valid year > 1900 : $this is Timing and Timing.event.exists() implies $this.event.first().toString() >= '1900' |
uds-plus-obs-5b | error | Observation.effective[x] | All Timing data elements should have valid year < 2030 : $this is Timing and Timing.event.exists() implies $this.event.first().toString() <= '2030' |
uds-plus-obs-6 | error | Observation.value[x] | All dateTime data elements should be truncated to a year only for de-identified resources. : $this is dateTime implies $this.toString().length() = 4 |
uds-plus-obs-6a | error | Observation.value[x] | All Period.start data elements should have valid year > 1900 : $this is Period and Period.start.exists() implies $this.start.toString() >= '1900' |
uds-plus-obs-6b | error | Observation.value[x] | All Period.start data elements should have valid year < 2030 : $this is Period and Period.start.exists() implies $this.start.toString() <= '2030' |
uds-plus-obs-7 | error | Observation.value[x] | All Period.start data elements should be truncated to a year only for de-identified resources. : $this is Period and Period.start.exists() implies $this.start.toString().length() = 4 |
uds-plus-obs-8 | error | Observation.value[x] | All Period.end data elements should be truncated to a year only for de-identified resources. : $this is Period and Period.end.exists() implies $this.end.toString().length() = 4 |
uds-plus-obs-10 | error | Observation.component.value[x] | All Period.start data elements should be truncated to a year only for de-identified resources. : $this is Period and Period.start.exists() implies $this.start.toString().length() = 4 |
uds-plus-obs-11 | error | Observation.component.value[x] | All Period.end data elements should be truncated to a year only for de-identified resources. : $this is Period and Period.end.exists() implies $this.end.toString().length() = 4 |
uds-plus-obs-7a | error | Observation.value[x] | All Period.start data elements should have valid year > 1900 : $this is Period and Period.start.exists() implies $this.start.toString() >= '1900' |
uds-plus-obs-7b | error | Observation.value[x] | All Period.start data elements should have valid year < 2030 : $this is Period and Period.start.exists() implies $this.start.toString() <= '2030' |
uds-plus-obs-8a | error | Observation.value[x] | All Period.end data elements should have valid year > 1900 : $this is Period and Period.end.exists() implies $this.end.toString() >= '1900' |
uds-plus-obs-8b | error | Observation.value[x] | All Period.end data elements should have valid year < 2030 : $this is Period and Period.end.exists() implies $this.end.toString() <= '2030' |
uds-plus-obs-9 | error | Observation.component.value[x] | All dateTime data elements should be truncated to a year only for de-identified resources. : $this is dateTime implies $this.toString().length() = 4 |
uds-plus-obs-9a | error | Observation.component.value[x] | All dateTime data elements should have valid year > 1900 : $this is DateTime implies $this.toString() >= '1900' |
uds-plus-obs-9b | error | Observation.component.value[x] | All dateTime data elements should have valid year < 2030 : $this is DateTime implies $this.toString() <= '2030' |

Snapshot View

Name | Flags | Card. | Type | Description & Constraints
--- | --- | --- | --- | ---
Observation | C | 0..* | Observation | De-Identified UDS Plus Observation obs-6: dataAbsentReason SHALL only be present if Observation.value[x] is not present obs-7: If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present
id | S Σ | 0..1 | id | The de-identified Observation identifier created by the health center to send data to UDS+ Data Receiver
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
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:deidentifiedIssuedTime |  | 0..1 | dateTime | Indicates the time with a precision of only Year. URL: http://fhir.org/guides/hrsa/uds-plus/StructureDefinition/uds-plus-deidentified-instant-extension
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
identifier | Σ | 0..* | Identifier | Business Identifier for observation
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 | ?!S Σ | 1..1 | code | registered | preliminary | final | amended + Binding: ObservationStatus (required): Codes providing the status of an observation.
category | S | 1..* | CodeableConcept | Classification of type of observation Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
code | S Σ | 1..1 | CodeableConcept | Type of observation (code / type) Binding: LOINCCodes (preferred): The set of codes indicating the Observations
subject | S Σ | 1..1 | Reference(De-Identified UDS Plus Patient) | Who and/or what the observation is about
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 | Σ C | 0..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
focus | Σ | 0..* | Reference(Resource) | What the observation is about, when it is not about the subject of record
encounter | S Σ | 0..1 | Reference(De-Identified UDS Plus Encounter) | Healthcare event during which this observation is made
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 | Σ C | 0..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
effective[x] | S Σ C | 0..1 |  | Clinically relevant time/time-period for observation uds-plus-obs-1: All dateTime data elements should be truncated to a year only for de-identified resources. uds-plus-obs-1a: All dateTime data elements should have valid year > 1900 uds-plus-obs-1b: All dateTime data elements should have valid year < 2030 uds-plus-obs-2: All Period.start data elements should be truncated to a year only for de-identified resources. uds-plus-obs-2a: All Period.start data elements should have valid year > 1900 uds-plus-obs-2b: All Period.start data elements should have valid year < 2030 uds-plus-obs-3: All Period.emd data elements should be truncated to a year only for de-identified resources. uds-plus-obs-3a: All Period.end data elements should have valid year > 1900 uds-plus-obs-3b: All Period.end data elements should have valid year < 2030 uds-plus-obs-4: All Timing.event data elements should be truncated to a year only for de-identified resources. uds-plus-obs-5: All Timing.event data elements should be truncated to a year only for de-identified resources. uds-plus-obs-5a: All Timing data elements should have valid year > 1900 uds-plus-obs-5b: All Timing data elements should have valid year < 2030
effectiveDateTime |  |  | dateTime S |
effectivePeriod |  |  | Period |
effectiveTiming |  |  | Timing |
performer | S Σ | 0..* | Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson) | Who is responsible for the observation
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 | Σ C | 0..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
value[x] | S Σ C | 0..1 |  | Actual result uds-plus-obs-6: All dateTime data elements should be truncated to a year only for de-identified resources. uds-plus-obs-6a: All Period.start data elements should have valid year > 1900 uds-plus-obs-6b: All Period.start data elements should have valid year < 2030 uds-plus-obs-7: All Period.start data elements should be truncated to a year only for de-identified resources. uds-plus-obs-7a: All Period.start data elements should have valid year > 1900 uds-plus-obs-7b: All Period.start data elements should have valid year < 2030 uds-plus-obs-8: All Period.end data elements should be truncated to a year only for de-identified resources. uds-plus-obs-8a: All Period.end data elements should have valid year > 1900 uds-plus-obs-8b: All Period.end data elements should have valid year < 2030
valueQuantity |  |  | Quantity S |
valueCodeableConcept |  |  | CodeableConcept S |
valueString |  |  | string S |
valueBoolean |  |  | boolean |
valueInteger |  |  | integer |
valueRange |  |  | Range |
valueRatio |  |  | Ratio |
valueSampledData |  |  | SampledData |
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.
bodySite | S | 0..1 | CodeableConcept | Observed body part Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
method |  | 0..1 | CodeableConcept | How it was done Binding: ObservationMethods (example): Methods for simple observations.
specimen |  | 0..1 | Reference(Specimen) | Specimen used for this observation
device |  | 0..1 | Reference(Device | DeviceMetric) | (Measurement) Device
referenceRange | C | 0..* | BackboneElement | Provides guide for interpretation obs-3: Must have at least a low or a high or text
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
low | C | 0..1 | SimpleQuantity | Low Range, if relevant
high | C | 0..1 | SimpleQuantity | High Range, if relevant
type |  | 0..1 | CodeableConcept | Reference range qualifier Binding: ObservationReferenceRangeMeaningCodes (preferred): Code for the meaning of a reference range.
appliesTo |  | 0..* | CodeableConcept | Reference range population Binding: ObservationReferenceRangeAppliesToCodes (example): Codes identifying the population the reference range applies to.
age |  | 0..1 | Range | Applicable age range, if relevant
text |  | 0..1 | string | Text based reference range in an observation
hasMember | Σ | 0..* | Reference(Observation | QuestionnaireResponse | MolecularSequence) | Related resource that belongs to the Observation group
derivedFrom | Σ | 0..* | Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | Observation | MolecularSequence) | Related measurements the observation is made from
component | S 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 | S Σ | 1..1 | CodeableConcept | Type of component observation (code / type) Binding: LOINCCodes (preferred): The set of codes indicating the Observations
value[x] | S Σ C | 0..1 |  | Actual component result uds-plus-obs-9: All dateTime data elements should be truncated to a year only for de-identified resources. uds-plus-obs-9a: All dateTime data elements should have valid year > 1900 uds-plus-obs-9b: All dateTime data elements should have valid year < 2030 uds-plus-obs-10: All Period.start data elements should be truncated to a year only for de-identified resources. uds-plus-obs-10a: All Period.start data elements should have valid year > 1900 uds-plus-obs-10b: All Period.start data elements should have valid year < 2030 uds-plus-obs-11: All Period.end data elements should be truncated to a year only for de-identified resources. uds-plus-obs-11a: All Period.end data elements should have valid year > 1900 uds-plus-obs-11b: All Period.end data elements should have valid year < 2030
valueQuantity |  |  | Quantity S |
valueCodeableConcept |  |  | CodeableConcept S |
valueString |  |  | string S |
valueBoolean |  |  | boolean |
valueInteger |  |  | integer |
valueRange |  |  | Range |
valueRatio |  |  | Ratio |
valueSampledData |  |  | SampledData |
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 | URI
Observation.language | preferred | CommonLanguages `http://hl7.org/fhir/ValueSet/languages` from the FHIR Standard
Additional Bindings | Purpose
AllLanguages | Max Binding
Observation.status | required | ObservationStatus `http://hl7.org/fhir/ValueSet/observation-status|4.0.1` from the FHIR Standard
Observation.category | preferred | ObservationCategoryCodes `http://hl7.org/fhir/ValueSet/observation-category` from the FHIR Standard
Observation.code | preferred | LOINCCodes (a valid code from LOINC) `http://hl7.org/fhir/ValueSet/observation-codes` from the FHIR Standard
Observation.subject.type | extensible | ResourceType `http://hl7.org/fhir/ValueSet/resource-types` from the FHIR Standard
Observation.encounter.type | extensible | ResourceType `http://hl7.org/fhir/ValueSet/resource-types` from the FHIR Standard
Observation.performer.type | extensible | ResourceType `http://hl7.org/fhir/ValueSet/resource-types` from the FHIR Standard
Observation.dataAbsentReason | extensible | DataAbsentReason `http://hl7.org/fhir/ValueSet/data-absent-reason` from the FHIR Standard
Observation.interpretation | extensible | ObservationInterpretationCodes `http://hl7.org/fhir/ValueSet/observation-interpretation` from the FHIR Standard
Observation.bodySite | example | SNOMEDCTBodyStructures `http://hl7.org/fhir/ValueSet/body-site` from the FHIR Standard
Observation.method | example | ObservationMethods `http://hl7.org/fhir/ValueSet/observation-methods` from the FHIR Standard
Observation.referenceRange.type | preferred | ObservationReferenceRangeMeaningCodes `http://hl7.org/fhir/ValueSet/referencerange-meaning` from the FHIR Standard
Observation.referenceRange.appliesTo | example | ObservationReferenceRangeAppliesToCodes `http://hl7.org/fhir/ValueSet/referencerange-appliesto` from the FHIR Standard
Observation.component.code | preferred | LOINCCodes (a valid code from LOINC) `http://hl7.org/fhir/ValueSet/observation-codes` from the FHIR Standard
Observation.component.dataAbsentReason | extensible | DataAbsentReason `http://hl7.org/fhir/ValueSet/data-absent-reason` from the FHIR Standard
Observation.component.interpretation | extensible | ObservationInterpretationCodes `http://hl7.org/fhir/ValueSet/observation-interpretation` from the FHIR Standard

#### Constraints

Id | Grade | Path(s) | Details | Requirements
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() |
uds-plus-obs-1 | error | Observation.effective[x] | All dateTime data elements should be truncated to a year only for de-identified resources. : $this is DateTime implies $this.toString().length() = 4 |
uds-plus-obs-10 | error | Observation.component.value[x] | All Period.start data elements should be truncated to a year only for de-identified resources. : $this is Period and Period.start.exists() implies $this.start.toString().length() = 4 |
uds-plus-obs-10a | error | Observation.component.value[x] | All Period.start data elements should have valid year > 1900 : $this is Period and Period.start.exists() implies $this.start.toString() >= '1900' |
uds-plus-obs-10b | error | Observation.component.value[x] | All Period.start data elements should have valid year < 2030 : $this is Period and Period.start.exists() implies $this.start.toString() <= '2030' |
uds-plus-obs-11a | error | Observation.component.value[x] | All Period.end data elements should have valid year > 1900 : $this is Period and Period.end.exists() implies $this.end.toString() >= '1900' |
uds-plus-obs-11b | error | Observation.component.value[x] | All Period.end data elements should have valid year < 2030 : $this is Period and Period.end.exists() implies $this.end.toString() <= '2030' |
uds-plus-obs-1a | error | Observation.effective[x] | All dateTime data elements should have valid year > 1900 : $this is DateTime implies $this.toString() >= '1900' |
uds-plus-obs-1b | error | Observation.effective[x] | All dateTime data elements should have valid year < 2030 : $this is DateTime implies $this.toString() <= '2030' |
uds-plus-obs-2 | error | Observation.effective[x] | All Period.start data elements should be truncated to a year only for de-identified resources. : $this is Period and Period.start.exists() implies $this.start.toString().length() = 4 |
uds-plus-obs-2a | error | Observation.effective[x] | All Period.start data elements should have valid year > 1900 : $this is Period and Period.start.exists() implies $this.start.toString() >= '1900' |
uds-plus-obs-2b | error | Observation.effective[x] | All Period.start data elements should have valid year < 2030 : $this is Period and Period.start.exists() implies $this.start.toString() <= '2030' |
uds-plus-obs-3 | error | Observation.effective[x] | All Period.emd data elements should be truncated to a year only for de-identified resources. : $this is Period and Period.end.exists() implies $this.end.toString().length() = 4 |
uds-plus-obs-3a | error | Observation.effective[x] | All Period.end data elements should have valid year > 1900 : $this is Period and Period.end.exists() implies $this.end.toString() >= '1900' |
uds-plus-obs-3b | error | Observation.effective[x] | All Period.end data elements should have valid year < 2030 : $this is Period and Period.end.exists() implies $this.end.toString() <= '2030' |
uds-plus-obs-4 | error | Observation.effective[x] | All Timing.event data elements should be truncated to a year only for de-identified resources. : $this is Timing and Timing.event.exists() implies $this.event.count() = 1 |
uds-plus-obs-5 | error | Observation.effective[x] | All Timing.event data elements should be truncated to a year only for de-identified resources. : $this is Timing and Timing.event.exists() implies $this.event.first().toString().length() = 4 |
uds-plus-obs-5b | error | Observation.effective[x] | All Timing data elements should have valid year < 2030 : $this is Timing and Timing.event.exists() implies $this.event.first().toString() <= '2030' |
uds-plus-obs-6 | error | Observation.value[x] | All dateTime data elements should be truncated to a year only for de-identified resources. : $this is dateTime implies $this.toString().length() = 4 |
uds-plus-obs-11 | error | Observation.component.value[x] | All Period.end data elements should be truncated to a year only for de-identified resources. : $this is Period and Period.end.exists() implies $this.end.toString().length() = 4 |
uds-plus-obs-5a | error | Observation.effective[x] | All Timing data elements should have valid year > 1900 : $this is Timing and Timing.event.exists() implies $this.event.first().toString() >= '1900' |
uds-plus-obs-6a | error | Observation.value[x] | All Period.start data elements should have valid year > 1900 : $this is Period and Period.start.exists() implies $this.start.toString() >= '1900' |
uds-plus-obs-6b | error | Observation.value[x] | All Period.start data elements should have valid year < 2030 : $this is Period and Period.start.exists() implies $this.start.toString() <= '2030' |
uds-plus-obs-7 | error | Observation.value[x] | All Period.start data elements should be truncated to a year only for de-identified resources. : $this is Period and Period.start.exists() implies $this.start.toString().length() = 4 |
uds-plus-obs-7a | error | Observation.value[x] | All Period.start data elements should have valid year > 1900 : $this is Period and Period.start.exists() implies $this.start.toString() >= '1900' |
uds-plus-obs-7b | error | Observation.value[x] | All Period.start data elements should have valid year < 2030 : $this is Period and Period.start.exists() implies $this.start.toString() <= '2030' |
uds-plus-obs-8 | error | Observation.value[x] | All Period.end data elements should be truncated to a year only for de-identified resources. : $this is Period and Period.end.exists() implies $this.end.toString().length() = 4 |
uds-plus-obs-8a | error | Observation.value[x] | All Period.end data elements should have valid year > 1900 : $this is Period and Period.end.exists() implies $this.end.toString() >= '1900' |
uds-plus-obs-8b | error | Observation.value[x] | All Period.end data elements should have valid year < 2030 : $this is Period and Period.end.exists() implies $this.end.toString() <= '2030' |
uds-plus-obs-9 | error | Observation.component.value[x] | All dateTime data elements should be truncated to a year only for de-identified resources. : $this is dateTime implies $this.toString().length() = 4 |
uds-plus-obs-9a | error | Observation.component.value[x] | All dateTime data elements should have valid year > 1900 : $this is DateTime implies $this.toString() >= '1900' |
uds-plus-obs-9b | error | Observation.component.value[x] | All dateTime data elements should have valid year < 2030 : $this is DateTime implies $this.toString() <= '2030' |

This structure is derived from Observation

Summary

Mandatory: 4 elements(1 nested mandatory element)
Must-Support: 13 elements
Prohibited: 7 elements

Structures

This structure refers to these other structures:

- De-Identified UDS Plus Patient (http://fhir.org/guides/hrsa/uds-plus/StructureDefinition/de-identified-uds-plus-patient)
- De-Identified UDS Plus Encounter (http://fhir.org/guides/hrsa/uds-plus/StructureDefinition/uds-plus-encounter)

Extensions

This structure refers to these extensions:

- http://fhir.org/guides/hrsa/uds-plus/StructureDefinition/uds-plus-deidentified-instant-extension

Maturity: 2

Other representations of profile: CSV, Excel, Schematron