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 Income

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

The UDS+ profile is based on the Observation resource and establishes the core elements, extensions, vocabularies and value sets for representing Income ranges for UDS+ program.

### Introduction

This profile is used to represent de-identified Income 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.

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 Income Observation resource text element may contain Patient information such as names. 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 resource id should not be included in the De-identified Observation instance. Instead a new id should be created and provided as part of the FHIR resource. This Data Submitter should be capable of using the generated id to relink the data to the original Income Observation. All resource references to the Income Observation 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

Representing Income Ranges

Income ranges are represented using the Observation.valueRange or Observation.valueQuanity element. The following values can be used to represent the Income ranges:

    * 100% and below : use valueRange.high to represent 100% (Includes 100)
    * 101–150% : use valueRange.low to represent 101, valueRange.high to represent 150 (Includes 101 and 150)
    * 151–200% : use valueRange.low to represent 151, valueRange.high to represent 200 (Includes 151 and 200)
    * Over 200% : use valueQuantity.value to represent 200, units of % and comparator of ">", valueRange cannot be used for representing more than 200%.
    * For unknown use the dataAbsentReason

Date Truncation

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

- effectiveDateTime.

Examples

Examples of identifiable data and its corresponding de-identifiable data is present in Reporting Guidance.

Usage:

- Examples for this Resource Profile: Observation/de-identified-income-example, Observation/de-identified-income-with-quantity-example and Observation/de-identified-low-income-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 Income 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 Fixed Value: final
code | S Σ | 1..1 | CodeableConcept | Type of observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations. ele-1: All FHIR elements must have a @value or children Required Pattern: At least the following
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (complex)
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://loinc.org
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: 63058-2
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
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-inc-1: All dateTime data elements should be truncated to a year only for de-identified resources. uds-plus-inc-1a: All dateTime data elements should have valid year > 1900 uds-plus-inc-1b: All dateTime data elements should have valid year < 2030 uds-plus-inc-2: All Period.start data elements should be truncated to a year only for de-identified resources. uds-plus-inc-2a: All Period.start data elements should have valid year > 1900 uds-plus-inc-2b: All Period.start data elements should have valid year < 2030 uds-plus-inc-3: All Period.emd data elements should be truncated to a year only for de-identified resources. uds-plus-inc-3a: All Period.end data elements should have valid year > 1900 uds-plus-inc-3b: All Period.end data elements should have valid year < 2030 uds-plus-inc-4: All Timing.event data elements should be truncated to a year only for de-identified resources. uds-plus-inc-5: All Timing.event data elements should be truncated to a year only for de-identified resources. uds-plus-res-5a: All Timing data elements should have valid year > 1900 uds-plus-res-5b: All Timing data elements should have valid year < 2030
effectiveDateTime |  |  | dateTime |
value[x] | S Σ C | 0..1 |  | Actual result ele-1: All FHIR elements must have a @value or children uds-plus-inc-6: Income Ranges should be coded according to the UDS+ requirements to be between 101% and 150% or between 151% and 200% uds-plus-inc-7: Income Ranges should be coded according to the UDS+ requirements when less than 100% uds-plus-inc-8: Income Ranges should be coded according to the UDS+ requirements when more than 200%, Quantity should include value(200), code(%) and comparator(>)
value[x]All Types |  |  |  | Content/Rules for all Types
Slices for extension |  |  |  | Content/Rules for all slices
extension:dataAbsentReason | S | 0..1 | code | Reason why the data is not present URL: http://hl7.org/fhir/StructureDefinition/data-absent-reason Binding: DataAbsentReason (required): Used to specify why the normally expected content of the data element is missing. ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
valueRange |  |  | Range |
valueQuantity |  |  | Quantity |
Documentation for this format

#### Terminology Bindings

Path | Conformance | ValueSet / Code | URI
Observation.status | required | Fixed Value: final `http://hl7.org/fhir/ValueSet/observation-status|4.0.1` from the FHIR Standard
Observation.code | example | Pattern: LOINC Code 63058-2 `http://hl7.org/fhir/ValueSet/observation-codes` from the FHIR Standard
Observation.component.code | example | LOINCCodes (a valid code from LOINC) `http://hl7.org/fhir/ValueSet/observation-codes` from the FHIR Standard

#### Constraints

Id | Grade | Path(s) | Details | Requirements
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-inc-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-inc-1a | error | Observation.effective[x] | All dateTime data elements should have valid year > 1900 : $this is DateTime implies $this.toString() >= '1900' |
uds-plus-inc-1b | error | Observation.effective[x] | All dateTime data elements should have valid year < 2030 : $this is DateTime implies $this.toString() <= '2030' |
uds-plus-inc-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-inc-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-inc-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-inc-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-inc-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-inc-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-inc-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-inc-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-inc-6 | error | Observation.value[x] | Income Ranges should be coded according to the UDS+ requirements to be between 101% and 150% or between 151% and 200% : $this is Range and Range.low.exists() and Range.high.exists() implies ((Range.low.value >= 101 and Range.high.value <= 150) or (Range.low.value >= 151 and Range.high.value <= 200)) |
uds-plus-inc-7 | error | Observation.value[x] | Income Ranges should be coded according to the UDS+ requirements when less than 100% : $this is Range and Range.low.exists().not() and Range.high.exists() implies (Range.high.value <= 100) |
uds-plus-inc-8 | error | Observation.value[x] | Income Ranges should be coded according to the UDS+ requirements when more than 200%, Quantity should include value(200), code(%) and comparator(>) : $this is Quantity implies ($this.value >= 200 and $this.code = '%' and $this.comparator = '>') |
uds-plus-res-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-res-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' |

This structure is derived from Observation

Name | Flags | Card. | Type | Description & Constraints
--- | --- | --- | --- | ---
Observation |  | 0..* | Observation | De-Identified UDS Plus Income
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 + Fixed Value: final
code | S | 1..1 | CodeableConcept | Type of observation (code / type) Required Pattern: At least the following
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (complex)
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://loinc.org
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: 63058-2
subject | S | 1..1 | Reference(De-Identified UDS Plus Patient) | Who and/or what the observation is about
display |  | 0..0 |  |
encounter |  |  |  |
display |  | 0..0 |  |
effective[x] | S C | 0..1 |  | Clinically relevant time/time-period for observation uds-plus-inc-1: All dateTime data elements should be truncated to a year only for de-identified resources. uds-plus-inc-1a: All dateTime data elements should have valid year > 1900 uds-plus-inc-1b: All dateTime data elements should have valid year < 2030 uds-plus-inc-2: All Period.start data elements should be truncated to a year only for de-identified resources. uds-plus-inc-2a: All Period.start data elements should have valid year > 1900 uds-plus-inc-2b: All Period.start data elements should have valid year < 2030 uds-plus-inc-3: All Period.emd data elements should be truncated to a year only for de-identified resources. uds-plus-inc-3a: All Period.end data elements should have valid year > 1900 uds-plus-inc-3b: All Period.end data elements should have valid year < 2030 uds-plus-inc-4: All Timing.event data elements should be truncated to a year only for de-identified resources. uds-plus-inc-5: All Timing.event data elements should be truncated to a year only for de-identified resources. uds-plus-res-5a: All Timing data elements should have valid year > 1900 uds-plus-res-5b: All Timing data elements should have valid year < 2030
effectiveDateTime |  |  | dateTime S |
effectivePeriod |  |  | Period |
effectiveTiming |  |  | Timing |
issued | S | 0..0 |  |
performer |  |  |  |
display |  | 0..0 |  |
value[x] | S C | 0..1 |  | Actual result uds-plus-inc-6: Income Ranges should be coded according to the UDS+ requirements to be between 101% and 150% or between 151% and 200% uds-plus-inc-7: Income Ranges should be coded according to the UDS+ requirements when less than 100% uds-plus-inc-8: Income Ranges should be coded according to the UDS+ requirements when more than 200%, Quantity should include value(200), code(%) and comparator(>)
value[x]All Types |  |  |  | Content/Rules for all Types
Slices for extension |  |  |  | Content/Rules for all slices
extension:dataAbsentReason | S | 0..1 | code | Reason why the data is not present URL: http://hl7.org/fhir/StructureDefinition/data-absent-reason Binding: DataAbsentReason (required): Used to specify why the normally expected content of the data element is missing.
valueRange |  |  | Range |
valueQuantity |  |  | Quantity |
note |  | 0..0 |  |
bodySite |  | 0..0 |  |
specimen |  | 0..0 |  |
device |  | 0..0 |  |
hasMember |  | 0..0 |  |
derivedFrom |  | 0..0 |  |
component |  | 0..0 |  |
Documentation for this format

#### Constraints

Id | Grade | Path(s) | Details | Requirements
uds-plus-inc-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-inc-1a | error | Observation.effective[x] | All dateTime data elements should have valid year > 1900 : $this is DateTime implies $this.toString() >= '1900' |
uds-plus-inc-1b | error | Observation.effective[x] | All dateTime data elements should have valid year < 2030 : $this is DateTime implies $this.toString() <= '2030' |
uds-plus-inc-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-inc-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-inc-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-inc-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-inc-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-inc-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-inc-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-inc-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-inc-6 | error | Observation.value[x] | Income Ranges should be coded according to the UDS+ requirements to be between 101% and 150% or between 151% and 200% : $this is Range and Range.low.exists() and Range.high.exists() implies ((Range.low.value >= 101 and Range.high.value <= 150) or (Range.low.value >= 151 and Range.high.value <= 200)) |
uds-plus-inc-7 | error | Observation.value[x] | Income Ranges should be coded according to the UDS+ requirements when less than 100% : $this is Range and Range.low.exists().not() and Range.high.exists() implies (Range.high.value <= 100) |
uds-plus-inc-8 | error | Observation.value[x] | Income Ranges should be coded according to the UDS+ requirements when more than 200%, Quantity should include value(200), code(%) and comparator(>) : $this is Quantity implies ($this.value >= 200 and $this.code = '%' and $this.comparator = '>') |
uds-plus-res-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-res-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' |

Name | Flags | Card. | Type | Description & Constraints
--- | --- | --- | --- | ---
Observation | C | 0..* | Observation | De-Identified UDS Plus Income 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. Fixed Value: final
category |  | 0..* | 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 (example): Codes identifying names of simple observations. Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (complex)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://loinc.org
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: 63058-2
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
text |  | 0..1 | string | Plain text representation of the concept
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 | Σ | 0..1 | Reference(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-inc-1: All dateTime data elements should be truncated to a year only for de-identified resources. uds-plus-inc-1a: All dateTime data elements should have valid year > 1900 uds-plus-inc-1b: All dateTime data elements should have valid year < 2030 uds-plus-inc-2: All Period.start data elements should be truncated to a year only for de-identified resources. uds-plus-inc-2a: All Period.start data elements should have valid year > 1900 uds-plus-inc-2b: All Period.start data elements should have valid year < 2030 uds-plus-inc-3: All Period.emd data elements should be truncated to a year only for de-identified resources. uds-plus-inc-3a: All Period.end data elements should have valid year > 1900 uds-plus-inc-3b: All Period.end data elements should have valid year < 2030 uds-plus-inc-4: All Timing.event data elements should be truncated to a year only for de-identified resources. uds-plus-inc-5: All Timing.event data elements should be truncated to a year only for de-identified resources. uds-plus-res-5a: All Timing data elements should have valid year > 1900 uds-plus-res-5b: All Timing data elements should have valid year < 2030
effectiveDateTime |  |  | dateTime S |
effectivePeriod |  |  | Period |
effectiveTiming |  |  | Timing |
performer | 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-inc-6: Income Ranges should be coded according to the UDS+ requirements to be between 101% and 150% or between 151% and 200% uds-plus-inc-7: Income Ranges should be coded according to the UDS+ requirements when less than 100% uds-plus-inc-8: Income Ranges should be coded according to the UDS+ requirements when more than 200%, Quantity should include value(200), code(%) and comparator(>)
value[x]All Types |  |  |  | Content/Rules for all Types
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
extension:dataAbsentReason | S | 0..1 | code | Reason why the data is not present URL: http://hl7.org/fhir/StructureDefinition/data-absent-reason Binding: DataAbsentReason (required): Used to specify why the normally expected content of the data element is missing.
valueRange |  |  | Range |
valueQuantity |  |  | Quantity |
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.
method |  | 0..1 | CodeableConcept | How it was done Binding: ObservationMethods (example): Methods for simple observations.
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
Documentation for this format

#### Terminology Bindings

Path | Conformance | ValueSet / Code | URI
Observation.language | preferred | CommonLanguages `http://hl7.org/fhir/ValueSet/languages` from the FHIR Standard
Additional Bindings | Purpose
AllLanguages | Max Binding
Observation.status | required | Fixed Value: final `http://hl7.org/fhir/ValueSet/observation-status|4.0.1` from the FHIR Standard
Observation.category | preferred | ObservationCategoryCodes `http://hl7.org/fhir/ValueSet/observation-category` from the FHIR Standard
Observation.code | example | Pattern: LOINC Code 63058-2 `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.method | example | ObservationMethods `http://hl7.org/fhir/ValueSet/observation-methods` from the FHIR Standard
Observation.referenceRange.type | preferred | ObservationReferenceRangeMeaningCodes `http://hl7.org/fhir/ValueSet/referencerange-meaning` from the FHIR Standard
Observation.referenceRange.appliesTo | example | ObservationReferenceRangeAppliesToCodes `http://hl7.org/fhir/ValueSet/referencerange-appliesto` from the FHIR Standard
Observation.component.code | example | LOINCCodes (a valid code from LOINC) `http://hl7.org/fhir/ValueSet/observation-codes` from the FHIR Standard
Observation.component.dataAbsentReason | extensible | DataAbsentReason `http://hl7.org/fhir/ValueSet/data-absent-reason` from the FHIR Standard
Observation.component.interpretation | extensible | ObservationInterpretationCodes `http://hl7.org/fhir/ValueSet/observation-interpretation` from the FHIR Standard

#### Constraints

Id | Grade | Path(s) | Details | Requirements
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-inc-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-inc-1a | error | Observation.effective[x] | All dateTime data elements should have valid year > 1900 : $this is DateTime implies $this.toString() >= '1900' |
uds-plus-inc-1b | error | Observation.effective[x] | All dateTime data elements should have valid year < 2030 : $this is DateTime implies $this.toString() <= '2030' |
uds-plus-inc-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-inc-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-inc-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-inc-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-inc-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-inc-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-inc-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-inc-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-inc-6 | error | Observation.value[x] | Income Ranges should be coded according to the UDS+ requirements to be between 101% and 150% or between 151% and 200% : $this is Range and Range.low.exists() and Range.high.exists() implies ((Range.low.value >= 101 and Range.high.value <= 150) or (Range.low.value >= 151 and Range.high.value <= 200)) |
uds-plus-inc-7 | error | Observation.value[x] | Income Ranges should be coded according to the UDS+ requirements when less than 100% : $this is Range and Range.low.exists().not() and Range.high.exists() implies (Range.high.value <= 100) |
uds-plus-inc-8 | error | Observation.value[x] | Income Ranges should be coded according to the UDS+ requirements when more than 200%, Quantity should include value(200), code(%) and comparator(>) : $this is Quantity implies ($this.value >= 200 and $this.code = '%' and $this.comparator = '>') |
uds-plus-res-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-res-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' |

This structure is derived from Observation

Summary

Mandatory: 3 elements
Must-Support: 8 elements
Fixed: 1 element
Prohibited: 13 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)

Extensions

This structure refers to these extensions:

- http://fhir.org/guides/hrsa/uds-plus/StructureDefinition/uds-plus-deidentified-instant-extension
- http://hl7.org/fhir/StructureDefinition/data-absent-reason|4.0.1

Maturity: 2

Key Elements View

Name | Flags | Card. | Type | Description & Constraints
--- | --- | --- | --- | ---
Observation | C | 0..* | Observation | De-Identified UDS Plus Income 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 Fixed Value: final
code | S Σ | 1..1 | CodeableConcept | Type of observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations. ele-1: All FHIR elements must have a @value or children Required Pattern: At least the following
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (complex)
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://loinc.org
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: 63058-2
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
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-inc-1: All dateTime data elements should be truncated to a year only for de-identified resources. uds-plus-inc-1a: All dateTime data elements should have valid year > 1900 uds-plus-inc-1b: All dateTime data elements should have valid year < 2030 uds-plus-inc-2: All Period.start data elements should be truncated to a year only for de-identified resources. uds-plus-inc-2a: All Period.start data elements should have valid year > 1900 uds-plus-inc-2b: All Period.start data elements should have valid year < 2030 uds-plus-inc-3: All Period.emd data elements should be truncated to a year only for de-identified resources. uds-plus-inc-3a: All Period.end data elements should have valid year > 1900 uds-plus-inc-3b: All Period.end data elements should have valid year < 2030 uds-plus-inc-4: All Timing.event data elements should be truncated to a year only for de-identified resources. uds-plus-inc-5: All Timing.event data elements should be truncated to a year only for de-identified resources. uds-plus-res-5a: All Timing data elements should have valid year > 1900 uds-plus-res-5b: All Timing data elements should have valid year < 2030
effectiveDateTime |  |  | dateTime |
value[x] | S Σ C | 0..1 |  | Actual result ele-1: All FHIR elements must have a @value or children uds-plus-inc-6: Income Ranges should be coded according to the UDS+ requirements to be between 101% and 150% or between 151% and 200% uds-plus-inc-7: Income Ranges should be coded according to the UDS+ requirements when less than 100% uds-plus-inc-8: Income Ranges should be coded according to the UDS+ requirements when more than 200%, Quantity should include value(200), code(%) and comparator(>)
value[x]All Types |  |  |  | Content/Rules for all Types
Slices for extension |  |  |  | Content/Rules for all slices
extension:dataAbsentReason | S | 0..1 | code | Reason why the data is not present URL: http://hl7.org/fhir/StructureDefinition/data-absent-reason Binding: DataAbsentReason (required): Used to specify why the normally expected content of the data element is missing. ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
valueRange |  |  | Range |
valueQuantity |  |  | Quantity |
Documentation for this format

#### Terminology Bindings

Path | Conformance | ValueSet / Code | URI
Observation.status | required | Fixed Value: final `http://hl7.org/fhir/ValueSet/observation-status|4.0.1` from the FHIR Standard
Observation.code | example | Pattern: LOINC Code 63058-2 `http://hl7.org/fhir/ValueSet/observation-codes` from the FHIR Standard
Observation.component.code | example | LOINCCodes (a valid code from LOINC) `http://hl7.org/fhir/ValueSet/observation-codes` from the FHIR Standard

#### Constraints

Id | Grade | Path(s) | Details | Requirements
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-inc-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-inc-1a | error | Observation.effective[x] | All dateTime data elements should have valid year > 1900 : $this is DateTime implies $this.toString() >= '1900' |
uds-plus-inc-1b | error | Observation.effective[x] | All dateTime data elements should have valid year < 2030 : $this is DateTime implies $this.toString() <= '2030' |
uds-plus-inc-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-inc-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-inc-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-inc-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-inc-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-inc-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-inc-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-inc-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-inc-6 | error | Observation.value[x] | Income Ranges should be coded according to the UDS+ requirements to be between 101% and 150% or between 151% and 200% : $this is Range and Range.low.exists() and Range.high.exists() implies ((Range.low.value >= 101 and Range.high.value <= 150) or (Range.low.value >= 151 and Range.high.value <= 200)) |
uds-plus-inc-7 | error | Observation.value[x] | Income Ranges should be coded according to the UDS+ requirements when less than 100% : $this is Range and Range.low.exists().not() and Range.high.exists() implies (Range.high.value <= 100) |
uds-plus-inc-8 | error | Observation.value[x] | Income Ranges should be coded according to the UDS+ requirements when more than 200%, Quantity should include value(200), code(%) and comparator(>) : $this is Quantity implies ($this.value >= 200 and $this.code = '%' and $this.comparator = '>') |
uds-plus-res-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-res-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' |

Differential View

This structure is derived from Observation

Name | Flags | Card. | Type | Description & Constraints
--- | --- | --- | --- | ---
Observation |  | 0..* | Observation | De-Identified UDS Plus Income
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 + Fixed Value: final
code | S | 1..1 | CodeableConcept | Type of observation (code / type) Required Pattern: At least the following
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (complex)
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://loinc.org
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: 63058-2
subject | S | 1..1 | Reference(De-Identified UDS Plus Patient) | Who and/or what the observation is about
display |  | 0..0 |  |
encounter |  |  |  |
display |  | 0..0 |  |
effective[x] | S C | 0..1 |  | Clinically relevant time/time-period for observation uds-plus-inc-1: All dateTime data elements should be truncated to a year only for de-identified resources. uds-plus-inc-1a: All dateTime data elements should have valid year > 1900 uds-plus-inc-1b: All dateTime data elements should have valid year < 2030 uds-plus-inc-2: All Period.start data elements should be truncated to a year only for de-identified resources. uds-plus-inc-2a: All Period.start data elements should have valid year > 1900 uds-plus-inc-2b: All Period.start data elements should have valid year < 2030 uds-plus-inc-3: All Period.emd data elements should be truncated to a year only for de-identified resources. uds-plus-inc-3a: All Period.end data elements should have valid year > 1900 uds-plus-inc-3b: All Period.end data elements should have valid year < 2030 uds-plus-inc-4: All Timing.event data elements should be truncated to a year only for de-identified resources. uds-plus-inc-5: All Timing.event data elements should be truncated to a year only for de-identified resources. uds-plus-res-5a: All Timing data elements should have valid year > 1900 uds-plus-res-5b: All Timing data elements should have valid year < 2030
effectiveDateTime |  |  | dateTime S |
effectivePeriod |  |  | Period |
effectiveTiming |  |  | Timing |
issued | S | 0..0 |  |
performer |  |  |  |
display |  | 0..0 |  |
value[x] | S C | 0..1 |  | Actual result uds-plus-inc-6: Income Ranges should be coded according to the UDS+ requirements to be between 101% and 150% or between 151% and 200% uds-plus-inc-7: Income Ranges should be coded according to the UDS+ requirements when less than 100% uds-plus-inc-8: Income Ranges should be coded according to the UDS+ requirements when more than 200%, Quantity should include value(200), code(%) and comparator(>)
value[x]All Types |  |  |  | Content/Rules for all Types
Slices for extension |  |  |  | Content/Rules for all slices
extension:dataAbsentReason | S | 0..1 | code | Reason why the data is not present URL: http://hl7.org/fhir/StructureDefinition/data-absent-reason Binding: DataAbsentReason (required): Used to specify why the normally expected content of the data element is missing.
valueRange |  |  | Range |
valueQuantity |  |  | Quantity |
note |  | 0..0 |  |
bodySite |  | 0..0 |  |
specimen |  | 0..0 |  |
device |  | 0..0 |  |
hasMember |  | 0..0 |  |
derivedFrom |  | 0..0 |  |
component |  | 0..0 |  |
Documentation for this format

#### Constraints

Id | Grade | Path(s) | Details | Requirements
uds-plus-inc-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-inc-1a | error | Observation.effective[x] | All dateTime data elements should have valid year > 1900 : $this is DateTime implies $this.toString() >= '1900' |
uds-plus-inc-1b | error | Observation.effective[x] | All dateTime data elements should have valid year < 2030 : $this is DateTime implies $this.toString() <= '2030' |
uds-plus-inc-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-inc-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-inc-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-inc-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-inc-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-inc-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-inc-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-inc-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-inc-6 | error | Observation.value[x] | Income Ranges should be coded according to the UDS+ requirements to be between 101% and 150% or between 151% and 200% : $this is Range and Range.low.exists() and Range.high.exists() implies ((Range.low.value >= 101 and Range.high.value <= 150) or (Range.low.value >= 151 and Range.high.value <= 200)) |
uds-plus-inc-7 | error | Observation.value[x] | Income Ranges should be coded according to the UDS+ requirements when less than 100% : $this is Range and Range.low.exists().not() and Range.high.exists() implies (Range.high.value <= 100) |
uds-plus-inc-8 | error | Observation.value[x] | Income Ranges should be coded according to the UDS+ requirements when more than 200%, Quantity should include value(200), code(%) and comparator(>) : $this is Quantity implies ($this.value >= 200 and $this.code = '%' and $this.comparator = '>') |
uds-plus-res-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-res-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' |

Snapshot View

Name | Flags | Card. | Type | Description & Constraints
--- | --- | --- | --- | ---
Observation | C | 0..* | Observation | De-Identified UDS Plus Income 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. Fixed Value: final
category |  | 0..* | 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 (example): Codes identifying names of simple observations. Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (complex)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://loinc.org
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: 63058-2
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
text |  | 0..1 | string | Plain text representation of the concept
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 | Σ | 0..1 | Reference(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-inc-1: All dateTime data elements should be truncated to a year only for de-identified resources. uds-plus-inc-1a: All dateTime data elements should have valid year > 1900 uds-plus-inc-1b: All dateTime data elements should have valid year < 2030 uds-plus-inc-2: All Period.start data elements should be truncated to a year only for de-identified resources. uds-plus-inc-2a: All Period.start data elements should have valid year > 1900 uds-plus-inc-2b: All Period.start data elements should have valid year < 2030 uds-plus-inc-3: All Period.emd data elements should be truncated to a year only for de-identified resources. uds-plus-inc-3a: All Period.end data elements should have valid year > 1900 uds-plus-inc-3b: All Period.end data elements should have valid year < 2030 uds-plus-inc-4: All Timing.event data elements should be truncated to a year only for de-identified resources. uds-plus-inc-5: All Timing.event data elements should be truncated to a year only for de-identified resources. uds-plus-res-5a: All Timing data elements should have valid year > 1900 uds-plus-res-5b: All Timing data elements should have valid year < 2030
effectiveDateTime |  |  | dateTime S |
effectivePeriod |  |  | Period |
effectiveTiming |  |  | Timing |
performer | 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-inc-6: Income Ranges should be coded according to the UDS+ requirements to be between 101% and 150% or between 151% and 200% uds-plus-inc-7: Income Ranges should be coded according to the UDS+ requirements when less than 100% uds-plus-inc-8: Income Ranges should be coded according to the UDS+ requirements when more than 200%, Quantity should include value(200), code(%) and comparator(>)
value[x]All Types |  |  |  | Content/Rules for all Types
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
extension:dataAbsentReason | S | 0..1 | code | Reason why the data is not present URL: http://hl7.org/fhir/StructureDefinition/data-absent-reason Binding: DataAbsentReason (required): Used to specify why the normally expected content of the data element is missing.
valueRange |  |  | Range |
valueQuantity |  |  | Quantity |
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.
method |  | 0..1 | CodeableConcept | How it was done Binding: ObservationMethods (example): Methods for simple observations.
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
Documentation for this format

#### Terminology Bindings

Path | Conformance | ValueSet / Code | URI
Observation.language | preferred | CommonLanguages `http://hl7.org/fhir/ValueSet/languages` from the FHIR Standard
Additional Bindings | Purpose
AllLanguages | Max Binding
Observation.status | required | Fixed Value: final `http://hl7.org/fhir/ValueSet/observation-status|4.0.1` from the FHIR Standard
Observation.category | preferred | ObservationCategoryCodes `http://hl7.org/fhir/ValueSet/observation-category` from the FHIR Standard
Observation.code | example | Pattern: LOINC Code 63058-2 `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.method | example | ObservationMethods `http://hl7.org/fhir/ValueSet/observation-methods` from the FHIR Standard
Observation.referenceRange.type | preferred | ObservationReferenceRangeMeaningCodes `http://hl7.org/fhir/ValueSet/referencerange-meaning` from the FHIR Standard
Observation.referenceRange.appliesTo | example | ObservationReferenceRangeAppliesToCodes `http://hl7.org/fhir/ValueSet/referencerange-appliesto` from the FHIR Standard
Observation.component.code | example | LOINCCodes (a valid code from LOINC) `http://hl7.org/fhir/ValueSet/observation-codes` from the FHIR Standard
Observation.component.dataAbsentReason | extensible | DataAbsentReason `http://hl7.org/fhir/ValueSet/data-absent-reason` from the FHIR Standard
Observation.component.interpretation | extensible | ObservationInterpretationCodes `http://hl7.org/fhir/ValueSet/observation-interpretation` from the FHIR Standard

#### Constraints

Id | Grade | Path(s) | Details | Requirements
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-inc-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-inc-1a | error | Observation.effective[x] | All dateTime data elements should have valid year > 1900 : $this is DateTime implies $this.toString() >= '1900' |
uds-plus-inc-1b | error | Observation.effective[x] | All dateTime data elements should have valid year < 2030 : $this is DateTime implies $this.toString() <= '2030' |
uds-plus-inc-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-inc-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-inc-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-inc-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-inc-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-inc-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-inc-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-inc-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-inc-6 | error | Observation.value[x] | Income Ranges should be coded according to the UDS+ requirements to be between 101% and 150% or between 151% and 200% : $this is Range and Range.low.exists() and Range.high.exists() implies ((Range.low.value >= 101 and Range.high.value <= 150) or (Range.low.value >= 151 and Range.high.value <= 200)) |
uds-plus-inc-7 | error | Observation.value[x] | Income Ranges should be coded according to the UDS+ requirements when less than 100% : $this is Range and Range.low.exists().not() and Range.high.exists() implies (Range.high.value <= 100) |
uds-plus-inc-8 | error | Observation.value[x] | Income Ranges should be coded according to the UDS+ requirements when more than 200%, Quantity should include value(200), code(%) and comparator(>) : $this is Quantity implies ($this.value >= 200 and $this.code = '%' and $this.comparator = '>') |
uds-plus-res-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-res-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' |

This structure is derived from Observation

Summary

Mandatory: 3 elements
Must-Support: 8 elements
Fixed: 1 element
Prohibited: 13 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)

Extensions

This structure refers to these extensions:

- http://fhir.org/guides/hrsa/uds-plus/StructureDefinition/uds-plus-deidentified-instant-extension
- http://hl7.org/fhir/StructureDefinition/data-absent-reason|4.0.1

Maturity: 2

Other representations of profile: CSV, Excel, Schematron