{
"description": "This profile represents the constraints applied to the Observation resource by the pan-Canadian Patient Summary project, which specifies a radiology observation for a patient summary based on the FHIR standard R4.\\n\\nThis observation may represent the conclusions of a diagnostic procedure such a Chest RX, or it may group the set of results produced by that single or multi-modality procedure.\\n\\nIn the latter case, the main observation (this one) carries the overall conclusion of the study and/or a global interpretation by the observer of the study as value of this observation; and may references the atomic results of the study as \\\"child observations\\\".\\n\\nIt also allows providing details about the related study using the partOf element referring to an ImagingStudy resource.",
"_filename": "structuredefinition-profile-observation-results-radiology-ca-ps.json",
"package_name": "ca.infoway.io.psca",
"date": "2023-12-06T00:00:00-08:00",
"derivation": "constraint",
"publisher": null,
"fhirVersion": "4.0.1",
"name": "ObservationResultsRadiologyPSCA",
"abstract": false,
"copyright": "Copyright © 2024+ Canada Health Infoway. All rights reserved. [Terms of Use and License Agreements](https://ic.infoway-inforoute.ca/en/about/tou). [Privacy Policy](https://www.infoway-inforoute.ca/en/legal/privacy-policy).",
"type": "Observation",
"experimental": "false",
"resourceType": "StructureDefinition",
"title": "Observation Results: Radiology (PS-CA)",
"package_version": "2.0.0-DFT-Ballot",
"status": "draft",
"id": "7d3765f2-26e1-43db-a010-9f2ed0b21d6f",
"kind": "resource",
"url": "http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/observation-results-radiology-ca-ps",
"version": null,
"differential": {
"element": [ {
"id": "Observation",
"path": "Observation",
"comment": "Preliminary analysis has identified that radiology result information may have limited support in current systems intending to produce a diagnostic results section in their initial patient summaries, further feedback and investigation is required with participating jurisdictions to confirm the support of any of the radiology observation elements - until then, initial constraints put forth in the IPS-UV specification have been maintained with minimal relaxation.",
"constraint": [ {
"key": "psca-rad-1",
"human": "component and hasMember are mutually exclusive",
"severity": "error",
"expression": "hasMember.empty() or component.empty()"
} ]
}, {
"id": "Observation.partOf",
"path": "Observation.partOf",
"type": [ {
"code": "Reference",
"targetProfile": [ "http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/imagingstudy-ca-ps" ]
} ]
}, {
"id": "Observation.status",
"path": "Observation.status",
"label": "Observation 'complete' status codes",
"binding": {
"strength": "required",
"valueSet": "http://hl7.org/fhir/uv/ips/ValueSet/results-status-uv-ips",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "ObservationStatus"
} ]
}
}, {
"id": "Observation.category",
"min": 1,
"path": "Observation.category",
"type": [ {
"code": "CodeableConcept",
"profile": [ "http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/CodeableConcept-ca-ps" ]
} ],
"slicing": {
"rules": "open",
"discriminator": [ {
"path": "$this",
"type": "pattern"
} ]
},
"definition": "A code that classifies the general type of observation being made. In this profile, fixed to \"imaging\"."
}, {
"id": "Observation.category:radiology",
"max": "1",
"min": 1,
"path": "Observation.category",
"sliceName": "radiology",
"mustSupport": true,
"patternCodeableConcept": {
"coding": [ {
"code": "imaging",
"system": "http://terminology.hl7.org/CodeSystem/observation-category"
} ]
}
}, {
"id": "Observation.code",
"path": "Observation.code",
"label": "Diagnostic Procedure Code",
"binding": {
"strength": "example",
"valueSet": "http://fhir.infoway-inforoute.ca/io/psca/ValueSet/pCLOCD",
"extension": [ {
"url": "http://hl7.org/fhir/tools/StructureDefinition/additional-binding",
"extension": [ {
"url": "purpose",
"valueCode": "candidate"
}, {
"url": "valueSet",
"valueCanonical": "http://hl7.org/fhir/uv/ips/ValueSet/results-radiology-observations-uv-ips"
}, {
"url": "documentation",
"valueMarkdown": "LOINC Radiology Observation codes utilized in IPS. This additional binding is surfaced to socialize the value sets that are proposed for international exchange in IPS. Where multiple codings can be supplied, it is encouraged to supply the original coding alongside the pan-Canadian preferred terminology."
} ]
} ],
"description": "Work is underway to define the pan-Canadian terminology that will be preferred and/or socialized for this element. A stub value set pointing to pCLOCD code system is put forth in the meantime to encourage implementers to utilize the Canadian localization of LOINC"
},
"comment": "Work is underway to define the pan-Canadian terminology that will be preferred and/or socialized for this element",
"definition": "Describes what was observed. Sometimes this is called the observation \"name\". In this profile this may correspond to the procedure code (e.g. Chest X-Ray).",
"mustSupport": true
}, {
"id": "Observation.subject",
"path": "Observation.subject",
"type": [ {
"code": "Reference",
"targetProfile": [ "http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/patient-ca-ps" ]
} ],
"definition": "The patient, or group of patients, location, or device whose characteristics (direct or indirect) are described by the observation and into whose record the observation is placed. Comments: Indirect characteristics may be those of a specimen, fetus, donor, other observer (for example a relative or EMT), or any observation made about the subject.\n\nIn this profile, subject is constrained to the patient.",
"mustSupport": true
}, {
"id": "Observation.subject.reference",
"min": 1,
"path": "Observation.subject.reference",
"mustSupport": true
}, {
"id": "Observation.effective[x]",
"min": 1,
"path": "Observation.effective[x]",
"type": [ {
"code": "dateTime"
}, {
"code": "Period"
} ],
"constraint": [ {
"key": "psca-rad-2",
"human": "Datetime must be at least to day",
"xpath": "not(boolean(effectiveDateTime)) or f:matches(effectiveDateTime,/\\d{4}-[01]\\d-[0-3]\\dT[0-2]\\d:[0-5]\\d([+-][0-2]\\d:[0-5]\\d|Z)/)",
"severity": "error",
"expression": "$this.ofType(dateTime).empty() or ($this as dateTime).toString().length() >= 8"
} ],
"mustSupport": true
}, {
"path": "Observation.effective[x].extension",
"min": 0,
"definition": "Provides a reason why the effectiveTime is missing.",
"short": "effective[x] absence reason",
"type": [ {
"code": "Extension",
"profile": [ "http://hl7.org/fhir/StructureDefinition/data-absent-reason" ]
} ],
"mustSupport": true,
"sliceName": "data-absent-reason",
"max": "1",
"id": "Observation.effective[x].extension:data-absent-reason"
}, {
"id": "Observation.performer",
"min": 1,
"path": "Observation.performer",
"type": [ {
"code": "Reference",
"targetProfile": [ "http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/practitioner-lab-ca-ps", "http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/practitionerrole-lab-ca-ps", "http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/organization-lab-ca-ps", "http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/patient-ca-ps", "http://hl7.org/fhir/StructureDefinition/CareTeam", "http://hl7.org/fhir/StructureDefinition/RelatedPerson" ]
} ],
"comment": "IPS considers this a Must Support element with a minimum cardinality of 1. While all jurisdictions supporting pathology in patient summary have indicated they can populate performer, some jurisdictions indicated this may be populated with provincial health authority information that may not be clinically meaningful. This constraint may be evaluated in IPS and PS-CA in the next release as updates are made to the underlying data models that underpin the FHIR profiles.",
"mustSupport": true
}, {
"id": "Observation.value[x]",
"path": "Observation.value[x]",
"slicing": {
"rules": "open",
"ordered": false,
"discriminator": [ {
"path": "$this",
"type": "type"
} ]
}
}, {
"id": "Observation.value[x]:valueString",
"max": "1",
"min": 0,
"path": "Observation.value[x]",
"type": [ {
"code": "string"
} ],
"label": "Overall Conclusion",
"sliceName": "valueString",
"mustSupport": true
}, {
"id": "Observation.bodySite",
"path": "Observation.bodySite",
"type": [ {
"code": "CodeableConcept",
"profile": [ "http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/CodeableConcept-ca-ps" ]
} ],
"label": "body site"
}, {
"id": "Observation.device",
"path": "Observation.device",
"type": [ {
"code": "Reference",
"targetProfile": [ "http://hl7.org/fhir/uv/ips/StructureDefinition/Device-observer-uv-ips" ]
} ]
}, {
"id": "Observation.hasMember",
"path": "Observation.hasMember",
"type": [ {
"code": "Reference",
"targetProfile": [ "http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/observation-results-radiology-ca-ps" ]
} ]
}, {
"id": "Observation.component",
"path": "Observation.component",
"slicing": {
"rules": "closed",
"description": "Slicing based on value[x] type.",
"discriminator": [ {
"path": "value",
"type": "type"
} ]
},
"mustSupport": true,
"requirements": "Required if not(exists(Observation.valueString))"
}, {
"id": "Observation.component:observationText",
"max": "*",
"min": 0,
"path": "Observation.component",
"short": "Observation Text",
"sliceName": "observationText"
}, {
"id": "Observation.component:observationText.code",
"path": "Observation.component.code",
"type": [ {
"code": "CodeableConcept",
"profile": [ "http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/CodeableConcept-ca-ps" ]
} ],
"binding": {
"strength": "extensible",
"valueSet": "http://hl7.org/fhir/uv/ips/ValueSet/results-radiology-txtobs-uv-ips",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "ObservationCode"
} ]
}
}, {
"id": "Observation.component:observationText.value[x]",
"min": 1,
"path": "Observation.component.value[x]",
"type": [ {
"code": "string"
} ]
}, {
"id": "Observation.component:observationCode",
"max": "*",
"min": 0,
"path": "Observation.component",
"short": "Observation Code",
"sliceName": "observationCode"
}, {
"id": "Observation.component:observationCode.code",
"path": "Observation.component.code",
"type": [ {
"code": "CodeableConcept",
"profile": [ "http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/CodeableConcept-ca-ps" ]
} ],
"binding": {
"strength": "extensible",
"valueSet": "http://hl7.org/fhir/uv/ips/ValueSet/results-radiology-observations-uv-ips"
}
}, {
"id": "Observation.component:observationCode.value[x]",
"min": 1,
"path": "Observation.component.value[x]",
"type": [ {
"code": "CodeableConcept",
"profile": [ "http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/CodeableConcept-ca-ps" ]
} ]
}, {
"id": "Observation.component:numericQuantityMeasurement",
"max": "*",
"min": 0,
"path": "Observation.component",
"short": "Observation Measurement, including linear, area and volume quantity measurements",
"sliceName": "numericQuantityMeasurement"
}, {
"id": "Observation.component:numericQuantityMeasurement.code",
"path": "Observation.component.code",
"type": [ {
"code": "CodeableConcept",
"profile": [ "http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/CodeableConcept-ca-ps" ]
} ],
"binding": {
"strength": "extensible",
"valueSet": "http://hl7.org/fhir/uv/ips/ValueSet/results-radiology-numobs-uv-ips",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "ObservationMeasurements"
} ],
"description": "Codes identifying numeric measurements"
}
}, {
"id": "Observation.component:numericQuantityMeasurement.value[x]",
"min": 1,
"path": "Observation.component.value[x]",
"type": [ {
"code": "Quantity",
"profile": [ "http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/Quantity-ca-ps" ]
} ]
}, {
"id": "Observation.component:numericRangeMeasurement",
"max": "*",
"min": 0,
"path": "Observation.component",
"short": "Observation Measurement, including linear, area and volume range measurements",
"sliceName": "numericRangeMeasurement"
}, {
"id": "Observation.component:numericRangeMeasurement.code",
"path": "Observation.component.code",
"type": [ {
"code": "CodeableConcept",
"profile": [ "http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/CodeableConcept-ca-ps" ]
} ],
"binding": {
"strength": "extensible",
"valueSet": "http://hl7.org/fhir/uv/ips/ValueSet/results-radiology-numobs-uv-ips",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "ObservationMeasurements"
} ],
"description": "Codes identifying numeric measurements"
}
}, {
"id": "Observation.component:numericRangeMeasurement.value[x]",
"min": 1,
"path": "Observation.component.value[x]",
"type": [ {
"code": "Range",
"profile": [ "http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/Range-ca-ps" ]
} ]
}, {
"id": "Observation.component:numericRatioMeasurement",
"max": "*",
"min": 0,
"path": "Observation.component",
"short": "Observation Measurement, including linear, area and volume ratio measurements",
"sliceName": "numericRatioMeasurement"
}, {
"id": "Observation.component:numericRatioMeasurement.code",
"path": "Observation.component.code",
"type": [ {
"code": "CodeableConcept",
"profile": [ "http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/CodeableConcept-ca-ps" ]
} ],
"binding": {
"strength": "extensible",
"valueSet": "http://hl7.org/fhir/uv/ips/ValueSet/results-radiology-numobs-uv-ips",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "ObservationMeasurements"
} ],
"description": "Codes identifying numeric measurements"
}
}, {
"id": "Observation.component:numericRatioMeasurement.value[x]",
"min": 1,
"path": "Observation.component.value[x]",
"type": [ {
"code": "Ratio",
"profile": [ "http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/Ratio-ca-ps" ]
} ]
}, {
"id": "Observation.component:numericSampledDataMeasurement",
"max": "*",
"min": 0,
"path": "Observation.component",
"short": "Observation Measurement, including linear, area and volume sampled data measurements",
"sliceName": "numericSampledDataMeasurement"
}, {
"id": "Observation.component:numericSampledDataMeasurement.code",
"path": "Observation.component.code",
"type": [ {
"code": "CodeableConcept",
"profile": [ "http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/CodeableConcept-ca-ps" ]
} ],
"binding": {
"strength": "extensible",
"valueSet": "http://hl7.org/fhir/uv/ips/ValueSet/results-radiology-numobs-uv-ips",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "ObservationMeasurements"
} ],
"description": "Codes identifying numeric measurements"
}
}, {
"id": "Observation.component:numericSampledDataMeasurement.value[x]",
"min": 1,
"path": "Observation.component.value[x]",
"type": [ {
"code": "SampledData"
} ]
} ]
},
"baseDefinition": "http://hl7.org/fhir/StructureDefinition/Observation"
}