{
  "description": null,
  "_filename": "StructureDefinition-VRDR-Death-Date.json",
  "package_name": "hl7.fhir.us.vrdr",
  "date": "2019-03-27T07:24:20+11:00",
  "derivation": "constraint",
  "publisher": "Hi3 Solutions",
  "fhirVersion": "3.0.1",
  "name": "VRDR Death Date",
  "mapping": [ {
    "uri": "http://hl7.org/fhir/workflow",
    "name": "Workflow Mapping",
    "identity": "workflow"
  }, {
    "uri": "http://snomed.info/conceptdomain",
    "name": "SNOMED CT Concept Domain Binding",
    "identity": "sct-concept"
  }, {
    "uri": "http://hl7.org/v2",
    "name": "HL7 v2 Mapping",
    "identity": "v2"
  }, {
    "uri": "http://hl7.org/v3",
    "name": "RIM Mapping",
    "identity": "rim"
  }, {
    "uri": "http://hl7.org/fhir/w5",
    "name": "W5 Mapping",
    "identity": "w5"
  }, {
    "uri": "http://snomed.info/sct",
    "name": "SNOMED CT Attribute Binding",
    "identity": "sct-attr"
  } ],
  "abstract": false,
  "type": "Observation",
  "experimental": null,
  "resourceType": "StructureDefinition",
  "title": null,
  "package_version": "0.1.0",
  "snapshot": {
    "element": [ {
      "constraint": [ {
        "key": "dom-2",
        "human": "If the resource is contained in another resource, it SHALL NOT contain nested Resources",
        "xpath": "not(parent::f:contained and f:contained)",
        "source": "DomainResource",
        "severity": "error",
        "expression": "contained.contained.empty()"
      }, {
        "key": "dom-1",
        "human": "If the resource is contained in another resource, it SHALL NOT contain any narrative",
        "xpath": "not(parent::f:contained and f:text)",
        "source": "DomainResource",
        "severity": "error",
        "expression": "contained.text.empty()"
      }, {
        "key": "dom-4",
        "human": "If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated",
        "xpath": "not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))",
        "source": "DomainResource",
        "severity": "error",
        "expression": "contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()"
      }, {
        "key": "dom-3",
        "human": "If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource",
        "xpath": "not(exists(for $id in f:contained/*/@id return $id[not(ancestor::f:contained/parent::*/descendant::f:reference/@value=concat('#', $id))]))",
        "source": "DomainResource",
        "severity": "error",
        "expression": "contained.where(('#'+id in %resource.descendants().reference).not()).empty()"
      }, {
        "key": "obs-7",
        "human": "If code is the same as a component code then the value element associated with the code SHALL NOT be present",
        "xpath": "not(exists(f:*[starts-with(local-name(.), 'value')])) or not(count(for $coding in f:code/f:coding return parent::*/f:component/f:code/f:coding[f:code/@value=$coding/f:code/@value and f:system/@value=$coding/f:system/@value])=0)",
        "source": "Observation",
        "severity": "error",
        "expression": "value.empty() or code!=component.code"
      }, {
        "key": "obs-6",
        "human": "dataAbsentReason SHALL only be present if Observation.value[x] is not present",
        "xpath": "not(exists(f:dataAbsentReason)) or (not(exists(*[starts-with(local-name(.), 'value')])))",
        "source": "Observation",
        "severity": "error",
        "expression": "dataAbsentReason.empty() or value.empty()"
      } ],
      "path": "Observation",
      "min": 0,
      "definition": "Measurements and simple assertions made about a patient, device or other subject.",
      "short": "Measurements and simple assertions",
      "mapping": [ {
        "map": "Entity. Role, or Act",
        "identity": "rim"
      }, {
        "map": "Event",
        "identity": "workflow"
      }, {
        "map": "< 363787002 |Observable entity|",
        "identity": "sct-concept"
      }, {
        "map": "OBX",
        "identity": "v2"
      }, {
        "map": "Observation[classCode=OBS, moodCode=EVN]",
        "identity": "rim"
      }, {
        "map": "clinical.diagnostics",
        "identity": "w5"
      } ],
      "alias": [ "Vital Signs", "Measurement", "Results", "Tests" ],
      "max": "*",
      "id": "Observation",
      "comment": "Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc.  Other resources are used to provide context for observations such as lab reports, etc.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Observation"
      }
    }, {
      "path": "Observation.id",
      "min": 1,
      "definition": "SHALL contain exactly one [1..1] id (CONF:4393-74).",
      "short": "id",
      "type": [ {
        "code": "id"
      } ],
      "max": "1",
      "id": "Observation.id",
      "comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Resource.id"
      },
      "isSummary": true
    }, {
      "path": "Observation.meta",
      "min": 0,
      "definition": "MAY contain zero or one [0..1] meta (CONF:4393-73).",
      "short": "meta",
      "type": [ {
        "code": "Meta"
      } ],
      "max": "1",
      "id": "Observation.meta",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Resource.meta"
      },
      "isSummary": true
    }, {
      "path": "Observation.meta.id",
      "min": 0,
      "definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
      "short": "xml:id (or equivalent in JSON)",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "representation": [ "xmlAttr" ],
      "max": "1",
      "id": "Observation.meta.id",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Element.id"
      }
    }, {
      "path": "Observation.meta.extension",
      "min": 0,
      "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
      "short": "Additional Content defined by implementations",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      } ],
      "slicing": {
        "rules": "open",
        "description": "Extensions are always sliced by (at least) url",
        "discriminator": [ {
          "path": "url",
          "type": "value"
        } ]
      },
      "type": [ {
        "code": "Extension"
      } ],
      "alias": [ "extensions", "user content" ],
      "max": "*",
      "id": "Observation.meta.extension",
      "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Element.extension"
      }
    }, {
      "path": "Observation.meta.versionId",
      "min": 0,
      "definition": "The version specific identifier, as it appears in the version portion of the URL. This values changes when the resource is created, updated, or deleted.",
      "short": "Version specific identifier",
      "type": [ {
        "code": "id"
      } ],
      "max": "1",
      "id": "Observation.meta.versionId",
      "comment": "The server assigns this value, and ignores what the client specifies, except in the case that the server is imposing version integrity on updates/deletes.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Meta.versionId"
      },
      "isSummary": true
    }, {
      "path": "Observation.meta.lastUpdated",
      "min": 0,
      "definition": "When the resource last changed - e.g. when the version changed.",
      "short": "When the resource version last changed",
      "type": [ {
        "code": "instant"
      } ],
      "max": "1",
      "id": "Observation.meta.lastUpdated",
      "comment": "This value is always populated except when the resource is first being created. The server / resource manager sets this value; what a client provides is irrelevant.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Meta.lastUpdated"
      },
      "isSummary": true
    }, {
      "path": "Observation.meta.profile",
      "min": 1,
      "definition": "The meta, if present, SHALL contain exactly one [1..1] profile=\"http://hl7.org/fhir/us/vrdr/StructureDefinition/VRDR-Death-Date\" (CONF:4393-75).",
      "short": "profile",
      "type": [ {
        "code": "uri"
      } ],
      "patternString": "http://hl7.org/fhir/us/vrdr/StructureDefinition/VRDR-Death-Date",
      "max": "1",
      "id": "Observation.meta.profile",
      "comment": "It is up to the server and/or other infrastructure of policy to determine whether/how these claims are verified and/or updated over time.  The list of profile URLs is a set.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Meta.profile"
      },
      "isSummary": true
    }, {
      "path": "Observation.meta.security",
      "min": 0,
      "definition": "Security labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure.",
      "short": "Security Labels applied to this resource",
      "type": [ {
        "code": "Coding"
      } ],
      "binding": {
        "strength": "extensible",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "SecurityLabels"
        }, {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
          "valueBoolean": true
        } ],
        "description": "Security Labels from the Healthcare Privacy and Security Classification System.",
        "valueSetReference": {
          "reference": "http://hl7.org/fhir/ValueSet/security-labels"
        }
      },
      "max": "*",
      "id": "Observation.meta.security",
      "comment": "The security labels can be updated without changing the stated version of the resource  The list of security labels is a set. Uniqueness is based the system/code, and version and display are ignored.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Meta.security"
      },
      "isSummary": true
    }, {
      "path": "Observation.meta.tag",
      "min": 0,
      "definition": "Tags applied to this resource. Tags are intended to be used to identify and relate resources to process and workflow, and applications are not required to consider the tags when interpreting the meaning of a resource.",
      "short": "Tags applied to this resource",
      "type": [ {
        "code": "Coding"
      } ],
      "binding": {
        "strength": "example",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "Tags"
        } ],
        "description": "Codes that represent various types of tags, commonly workflow-related; e.g. \"Needs review by Dr. Jones\"",
        "valueSetReference": {
          "reference": "http://hl7.org/fhir/ValueSet/common-tags"
        }
      },
      "max": "*",
      "id": "Observation.meta.tag",
      "comment": "The tags can be updated without changing the stated version of the resource.  The list of tags is a set. Uniqueness is based the system/code, and version and display are ignored.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Meta.tag"
      },
      "isSummary": true
    }, {
      "path": "Observation.implicitRules",
      "min": 0,
      "definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.",
      "isModifier": true,
      "short": "A set of rules under which this content was created",
      "type": [ {
        "code": "uri"
      } ],
      "max": "1",
      "id": "Observation.implicitRules",
      "comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. \n\nThis element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Resource.implicitRules"
      },
      "isSummary": true
    }, {
      "path": "Observation.language",
      "min": 0,
      "definition": "The base language in which the resource is written.",
      "short": "Language of the resource content",
      "type": [ {
        "code": "code"
      } ],
      "binding": {
        "strength": "extensible",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet",
          "valueReference": {
            "reference": "http://hl7.org/fhir/ValueSet/all-languages"
          }
        }, {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "Language"
        }, {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
          "valueBoolean": true
        } ],
        "description": "A human language.",
        "valueSetReference": {
          "reference": "http://hl7.org/fhir/ValueSet/languages"
        }
      },
      "max": "1",
      "id": "Observation.language",
      "comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Resource.language"
      }
    }, {
      "path": "Observation.text",
      "min": 0,
      "definition": "A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
      "short": "Text summary of the resource, for human interpretation",
      "mapping": [ {
        "map": "Act.text?",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Narrative"
      } ],
      "alias": [ "narrative", "html", "xhtml", "display" ],
      "max": "1",
      "id": "Observation.text",
      "condition": [ "dom-1" ],
      "comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "DomainResource.text"
      }
    }, {
      "path": "Observation.contained",
      "min": 0,
      "definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
      "short": "Contained, inline Resources",
      "mapping": [ {
        "map": "N/A",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Resource"
      } ],
      "alias": [ "inline resources", "anonymous resources", "contained resources" ],
      "max": "*",
      "id": "Observation.contained",
      "comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "DomainResource.contained"
      }
    }, {
      "path": "Observation.extension",
      "min": 0,
      "definition": "SHALL contain exactly one [1..1] extension (CONF:4393-76) such that it",
      "short": "Extension",
      "slicing": {
        "rules": "open",
        "discriminator": [ {
          "path": "url",
          "type": "value"
        } ]
      },
      "type": [ {
        "code": "Extension"
      } ],
      "max": "*",
      "id": "Observation.extension",
      "base": {
        "max": "*",
        "min": 0,
        "path": "DomainResource.extension"
      }
    }, {
      "path": "Observation.extension",
      "min": 1,
      "definition": "SHALL contain exactly one [1..1] extension (CONF:4393-76) such that it",
      "short": "extension",
      "type": [ {
        "code": "Extension"
      } ],
      "sliceName": "extension1",
      "max": "1",
      "id": "Observation.extension:extension1",
      "base": {
        "max": "*",
        "min": 0,
        "path": "DomainResource.extension"
      }
    }, {
      "path": "Observation.extension.id",
      "min": 0,
      "definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
      "short": "xml:id (or equivalent in JSON)",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "representation": [ "xmlAttr" ],
      "max": "1",
      "id": "Observation.extension:extension1.id",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Element.id"
      }
    }, {
      "path": "Observation.extension.extension",
      "min": 0,
      "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
      "short": "Additional Content defined by implementations",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      } ],
      "slicing": {
        "rules": "open",
        "description": "Extensions are always sliced by (at least) url",
        "discriminator": [ {
          "path": "url",
          "type": "value"
        } ]
      },
      "type": [ {
        "code": "Extension"
      } ],
      "alias": [ "extensions", "user content" ],
      "max": "*",
      "id": "Observation.extension:extension1.extension",
      "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Element.extension"
      }
    }, {
      "path": "Observation.extension.url",
      "min": 1,
      "definition": "SHALL contain exactly one [1..1] @url=\"http://hl7.org/fhir/us/vrdr/StructureDefinition/Patient-Location\" (CONF:4393-78).",
      "short": "@url",
      "mapping": [ {
        "map": "N/A",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "uri"
      } ],
      "sliceName": "extension1",
      "representation": [ "xmlAttr" ],
      "max": "1",
      "id": "Observation.extension:extension1.url:extension1",
      "comment": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
      "base": {
        "max": "1",
        "min": 1,
        "path": "Extension.url"
      }
    }, {
      "path": "Observation.extension.value[x]",
      "min": 1,
      "definition": "SHALL contain exactly one [1..1] value[x], where value[x] is (CONF:4393-77)",
      "short": "value[x]",
      "mapping": [ {
        "map": "N/A",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "base64Binary"
      }, {
        "code": "boolean"
      }, {
        "code": "code"
      }, {
        "code": "date"
      }, {
        "code": "dateTime"
      }, {
        "code": "decimal"
      }, {
        "code": "id"
      }, {
        "code": "instant"
      }, {
        "code": "integer"
      }, {
        "code": "markdown"
      }, {
        "code": "oid"
      }, {
        "code": "positiveInt"
      }, {
        "code": "string"
      }, {
        "code": "time"
      }, {
        "code": "unsignedInt"
      }, {
        "code": "uri"
      }, {
        "code": "Address"
      }, {
        "code": "Age"
      }, {
        "code": "Annotation"
      }, {
        "code": "Attachment"
      }, {
        "code": "CodeableConcept"
      }, {
        "code": "Coding"
      }, {
        "code": "ContactPoint"
      }, {
        "code": "Count"
      }, {
        "code": "Distance"
      }, {
        "code": "Duration"
      }, {
        "code": "HumanName"
      }, {
        "code": "Identifier"
      }, {
        "code": "Money"
      }, {
        "code": "Period"
      }, {
        "code": "Quantity"
      }, {
        "code": "Range"
      }, {
        "code": "Ratio"
      }, {
        "code": "Reference"
      }, {
        "code": "SampledData"
      }, {
        "code": "Signature"
      }, {
        "code": "Timing"
      }, {
        "code": "Meta"
      } ],
      "sliceName": "extension1",
      "max": "1",
      "id": "Observation.extension:extension1.value[x]:extension1",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Extension.value[x]"
      }
    }, {
      "path": "Observation.extension.value[x]",
      "min": 0,
      "definition": "SHALL contain exactly one [1..1] valueReference=\"VRDR-Death-Location\" (CONF:4393-79).",
      "short": "valueReference",
      "mapping": [ {
        "map": "N/A",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "base64Binary"
      }, {
        "code": "boolean"
      }, {
        "code": "code"
      }, {
        "code": "date"
      }, {
        "code": "dateTime"
      }, {
        "code": "decimal"
      }, {
        "code": "id"
      }, {
        "code": "instant"
      }, {
        "code": "integer"
      }, {
        "code": "markdown"
      }, {
        "code": "oid"
      }, {
        "code": "positiveInt"
      }, {
        "code": "string"
      }, {
        "code": "time"
      }, {
        "code": "unsignedInt"
      }, {
        "code": "uri"
      }, {
        "code": "Address"
      }, {
        "code": "Age"
      }, {
        "code": "Annotation"
      }, {
        "code": "Attachment"
      }, {
        "code": "CodeableConcept"
      }, {
        "code": "Coding"
      }, {
        "code": "ContactPoint"
      }, {
        "code": "Count"
      }, {
        "code": "Distance"
      }, {
        "code": "Duration"
      }, {
        "code": "HumanName"
      }, {
        "code": "Identifier"
      }, {
        "code": "Money"
      }, {
        "code": "Period"
      }, {
        "code": "Quantity"
      }, {
        "code": "Range"
      }, {
        "code": "Ratio"
      }, {
        "code": "Reference"
      }, {
        "code": "SampledData"
      }, {
        "code": "Signature"
      }, {
        "code": "Timing"
      }, {
        "code": "Meta"
      } ],
      "sliceName": "valueReference",
      "patternString": "VRDR-Death-Location",
      "max": "1",
      "id": "Observation.extension:extension1.value[x]:valueReference",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Extension.value[x]"
      }
    }, {
      "path": "Observation.modifierExtension",
      "min": 0,
      "definition": "May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
      "isModifier": true,
      "short": "Extensions that cannot be ignored",
      "mapping": [ {
        "map": "N/A",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Extension"
      } ],
      "alias": [ "extensions", "user content" ],
      "max": "*",
      "id": "Observation.modifierExtension",
      "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "DomainResource.modifierExtension"
      }
    }, {
      "path": "Observation.identifier",
      "requirements": "Allows observations to be distinguished and referenced.",
      "min": 0,
      "definition": "A unique identifier assigned to this observation.",
      "short": "Business Identifier for observation",
      "mapping": [ {
        "map": "Event.identifier",
        "identity": "workflow"
      }, {
        "map": "OBX.21  For OBX segments from systems without OBX-21 support a combination of ORC/OBR and OBX must be negotiated between trading partners to uniquely identify the OBX segment. Depending on how V2 has been implemented each of these may be an option: 1) OBR-3 + OBX-3 + OBX-4 or 2) OBR-3 + OBR-4 + OBX-3 + OBX-4 or 2) some other way to uniquely ID the OBR/ORC + OBX-3 + OBX-4.",
        "identity": "v2"
      }, {
        "map": "id",
        "identity": "rim"
      }, {
        "map": "id",
        "identity": "w5"
      } ],
      "type": [ {
        "code": "Identifier"
      } ],
      "max": "*",
      "id": "Observation.identifier",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Observation.identifier"
      },
      "isSummary": true
    }, {
      "path": "Observation.basedOn",
      "requirements": "Allows tracing of authorization for the event and tracking whether proposals/recommendations were acted upon.",
      "min": 0,
      "definition": "A plan, proposal or order that is fulfilled in whole or in part by this event.",
      "short": "Fulfills plan, proposal or order",
      "mapping": [ {
        "map": "Event.basedOn",
        "identity": "workflow"
      }, {
        "map": "ORC",
        "identity": "v2"
      }, {
        "map": ".outboundRelationship[typeCode=FLFS].target",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Reference",
        "targetProfile": "http://hl7.org/fhir/StructureDefinition/CarePlan"
      }, {
        "code": "Reference",
        "targetProfile": "http://hl7.org/fhir/StructureDefinition/DeviceRequest"
      }, {
        "code": "Reference",
        "targetProfile": "http://hl7.org/fhir/StructureDefinition/ImmunizationRecommendation"
      }, {
        "code": "Reference",
        "targetProfile": "http://hl7.org/fhir/StructureDefinition/MedicationRequest"
      }, {
        "code": "Reference",
        "targetProfile": "http://hl7.org/fhir/StructureDefinition/NutritionOrder"
      }, {
        "code": "Reference",
        "targetProfile": "http://hl7.org/fhir/StructureDefinition/ProcedureRequest"
      }, {
        "code": "Reference",
        "targetProfile": "http://hl7.org/fhir/StructureDefinition/ReferralRequest"
      } ],
      "alias": [ "Fulfills" ],
      "max": "*",
      "id": "Observation.basedOn",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Observation.basedOn"
      },
      "isSummary": true
    }, {
      "path": "Observation.status",
      "requirements": "Need to track the status of individual results. Some results are finalized before the whole report is finalized.",
      "min": 1,
      "definition": "SHALL contain exactly one [1..1] status=\"final\" Final (CodeSystem: FHIR ObservationStatus http://hl7.org/fhir/observation-status) (CONF:4393-55).",
      "isModifier": true,
      "short": "status",
      "mapping": [ {
        "map": "Event.status",
        "identity": "workflow"
      }, {
        "map": "< 445584004 |Report by finality status|",
        "identity": "sct-concept"
      }, {
        "map": "OBX-11",
        "identity": "v2"
      }, {
        "map": "status  Amended & Final are differentiated by whether it is the subject of a ControlAct event with a type of \"revise\"",
        "identity": "rim"
      }, {
        "map": "status",
        "identity": "w5"
      } ],
      "type": [ {
        "code": "code"
      } ],
      "extension": [ {
        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-display-hint",
        "valueString": "default: final"
      } ],
      "binding": {
        "strength": "required",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "ObservationStatus"
        } ],
        "description": "Codes providing the status of an observation.",
        "valueSetReference": {
          "reference": "http://hl7.org/fhir/ValueSet/observation-status"
        }
      },
      "max": "1",
      "fixedString": "final",
      "id": "Observation.status",
      "comment": "This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.",
      "base": {
        "max": "1",
        "min": 1,
        "path": "Observation.status"
      },
      "isSummary": true
    }, {
      "path": "Observation.category",
      "requirements": "Used for filtering what observations are retrieved and displayed.",
      "min": 0,
      "definition": "A code that classifies the general type of observation being made.",
      "short": "Classification of  type of observation",
      "mapping": [ {
        "map": ".outboundRelationship[typeCode=\"COMP].target[classCode=\"LIST\", moodCode=\"EVN\"].code",
        "identity": "rim"
      }, {
        "map": "class",
        "identity": "w5"
      } ],
      "type": [ {
        "code": "CodeableConcept"
      } ],
      "binding": {
        "strength": "preferred",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "ObservationCategory"
        } ],
        "description": "Codes for high level observation categories.",
        "valueSetReference": {
          "reference": "http://hl7.org/fhir/ValueSet/observation-category"
        }
      },
      "max": "*",
      "id": "Observation.category",
      "comment": "In addition to the required category valueset, this element allows various categorization schemes based on the owner’s definition of the category and effectively multiple categories can be used at once.  The level of granularity is defined by the category concepts in the value set.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Observation.category"
      }
    }, {
      "path": "Observation.code",
      "requirements": "Knowing what kind of observation is being made is essential to understanding the observation.",
      "min": 1,
      "definition": "SHALL contain exactly one [1..1] code=\"81956-5\" Date and time of death (CodeSystem: LOINC urn:oid:2.16.840.1.113883.6.1) (CONF:4393-52).",
      "short": "code",
      "mapping": [ {
        "map": "Event.code",
        "identity": "workflow"
      }, {
        "map": "< 363787002 |Observable entity| OR < 386053000 |Evaluation procedure|",
        "identity": "sct-concept"
      }, {
        "map": "OBX-3",
        "identity": "v2"
      }, {
        "map": "code",
        "identity": "rim"
      }, {
        "map": "116680003 |Is a|",
        "identity": "sct-attr"
      }, {
        "map": "what",
        "identity": "w5"
      } ],
      "type": [ {
        "code": "CodeableConcept"
      } ],
      "fixedCodeableConcept": {
        "coding": [ {
          "code": "81956-5",
          "system": "urn:oid:2.16.840.1.113883.6.1",
          "display": "Date and time of death"
        } ]
      },
      "binding": {
        "strength": "example",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "ObservationCode"
        } ],
        "description": "Codes identifying names of simple observations.",
        "valueSetReference": {
          "reference": "http://hl7.org/fhir/ValueSet/observation-codes"
        }
      },
      "alias": [ "Name" ],
      "max": "1",
      "id": "Observation.code",
      "base": {
        "max": "1",
        "min": 1,
        "path": "Observation.code"
      },
      "isSummary": true
    }, {
      "path": "Observation.subject",
      "requirements": "Observations have no value if you don't know who or what they're about.",
      "min": 1,
      "definition": "SHALL contain exactly one [1..1] VRDR Decedent (identifier: http://hl7.org/fhir/us/vrdr/StructureDefinition/VRDR-Decedent) (CONF:4393-53).",
      "short": "subject",
      "mapping": [ {
        "map": "Event.subject",
        "identity": "workflow"
      }, {
        "map": "PID-3",
        "identity": "v2"
      }, {
        "map": "participation[typeCode=SBJ]",
        "identity": "rim"
      }, {
        "map": "who.focus",
        "identity": "w5"
      } ],
      "type": [ {
        "code": "Reference",
        "targetProfile": "http://hl7.org/fhir/us/vrdr/StructureDefinition/VRDR-Decedent"
      } ],
      "max": "1",
      "id": "Observation.subject",
      "comment": "One would expect this element to be a cardinality  of 1..1.  The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.\r\rIf the target of the observation is different than the subject, the general extension [observation-focal-subject](http://hl7.org/fhir/extension-observation-focal-subject.html).  may be used.  However, the distinction between the patient's own value for an observation versus that of the fetus, or the donor or blood product unit, etc., are often specified in the observation code.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Observation.subject"
      },
      "isSummary": true
    }, {
      "path": "Observation.context",
      "requirements": "For some observations it may be important to know the link between an observation and a particular encounter.",
      "min": 0,
      "definition": "The healthcare event  (e.g. a patient and healthcare provider interaction) during which this observation is made.",
      "short": "Healthcare event during which this observation is made",
      "mapping": [ {
        "map": "Event.context",
        "identity": "workflow"
      }, {
        "map": "PV1",
        "identity": "v2"
      }, {
        "map": "inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN]",
        "identity": "rim"
      }, {
        "map": "context",
        "identity": "w5"
      } ],
      "type": [ {
        "code": "Reference",
        "targetProfile": "http://hl7.org/fhir/StructureDefinition/Encounter"
      }, {
        "code": "Reference",
        "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
      } ],
      "alias": [ "Encounter" ],
      "max": "1",
      "id": "Observation.context",
      "comment": "This will typically be the encounter the event occurred within, but some events may be initiated prior to or after the official completion of an encounter or episode but still be tied to the context of the encounter or episode (e.g. pre-admission lab tests).",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Observation.context"
      }
    }, {
      "path": "Observation.effective[x]",
      "requirements": "Knowing when an observation was deemed true is important to its relevance as well as determining trends.",
      "min": 1,
      "definition": "SHALL contain exactly one [1..1] effective[x], where effective[x] is (CONF:4393-54)",
      "short": "effective[x]",
      "mapping": [ {
        "map": "Event.occurrence[x]",
        "identity": "workflow"
      }, {
        "map": "OBX-14, and/or OBX-19 after v2.4  (depends on who observation made)",
        "identity": "v2"
      }, {
        "map": "effectiveTime",
        "identity": "rim"
      }, {
        "map": "when.done",
        "identity": "w5"
      } ],
      "type": [ {
        "code": "dateTime"
      }, {
        "code": "Period"
      } ],
      "alias": [ "Occurrence" ],
      "max": "1",
      "id": "Observation.effective[x]",
      "comment": "At least a date should be present unless this observation is a historical report.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Observation.effective[x]"
      },
      "isSummary": true
    }, {
      "path": "Observation.effective[x]",
      "requirements": "Knowing when an observation was deemed true is important to its relevance as well as determining trends.",
      "min": 0,
      "definition": "effectiveDateTime (CONF:4393-57)",
      "short": "effectiveDateTime",
      "mapping": [ {
        "map": "Event.occurrence[x]",
        "identity": "workflow"
      }, {
        "map": "OBX-14, and/or OBX-19 after v2.4  (depends on who observation made)",
        "identity": "v2"
      }, {
        "map": "effectiveTime",
        "identity": "rim"
      }, {
        "map": "when.done",
        "identity": "w5"
      } ],
      "type": [ {
        "code": "dateTime"
      }, {
        "code": "Period"
      } ],
      "sliceName": "effectiveDateTime",
      "alias": [ "Occurrence" ],
      "max": "1",
      "id": "Observation.effective[x]:effectiveDateTime",
      "comment": "At least a date should be present unless this observation is a historical report.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Observation.effective[x]"
      },
      "isSummary": true
    }, {
      "path": "Observation.issued",
      "min": 0,
      "definition": "The date and time this observation was made available to providers, typically after the results have been reviewed and verified.",
      "short": "Date/Time this was made available",
      "mapping": [ {
        "map": "OBR.22 (or MSH.7), or perhaps OBX-19 (depends on who observation made)",
        "identity": "v2"
      }, {
        "map": "participation[typeCode=AUT].time",
        "identity": "rim"
      }, {
        "map": "when.recorded",
        "identity": "w5"
      } ],
      "type": [ {
        "code": "instant"
      } ],
      "max": "1",
      "id": "Observation.issued",
      "comment": "Updated when the result is updated.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Observation.issued"
      },
      "isSummary": true
    }, {
      "path": "Observation.performer",
      "requirements": "May give a degree of confidence in the observation and also indicates where follow-up questions should be directed.",
      "min": 1,
      "definition": "SHALL contain exactly one [1..1] VRDR Death Pronouncement Performer (identifier: http://hl7.org/fhir/us/vrdr/StructureDefinition/VRDR-Death-Pronouncement-Performer) (CONF:4393-58).",
      "short": "performer",
      "mapping": [ {
        "map": "Event.performer",
        "identity": "workflow"
      }, {
        "map": "OBX.15 / (Practitioner)  OBX-16,  PRT-5:PRT-4='RO' /  (Device)  OBX-18 , PRT-10:PRT-4='EQUIP' / (Organization)  OBX-23,  PRT-8:PRT-4='PO'",
        "identity": "v2"
      }, {
        "map": "participation[typeCode=PRF]",
        "identity": "rim"
      }, {
        "map": "who.actor",
        "identity": "w5"
      } ],
      "type": [ {
        "code": "Reference",
        "targetProfile": "http://hl7.org/fhir/us/vrdr/StructureDefinition/VRDR-Death-Pronouncement-Performer"
      } ],
      "max": "1",
      "id": "Observation.performer",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Observation.performer"
      },
      "isSummary": true
    }, {
      "path": "Observation.value[x]",
      "requirements": "An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.",
      "min": 0,
      "definition": "The information determined as a result of making the observation, if the information has a simple value.",
      "short": "Actual result",
      "mapping": [ {
        "map": "Event.notDone, Event.notDoneReason  (maps to valeu[x] or dataAbsentReason)",
        "identity": "workflow"
      }, {
        "map": "< 441742003 |Evaluation finding|",
        "identity": "sct-concept"
      }, {
        "map": "OBX.2, OBX.5, OBX.6",
        "identity": "v2"
      }, {
        "map": "value",
        "identity": "rim"
      }, {
        "map": "363714003 |Interprets|",
        "identity": "sct-attr"
      } ],
      "type": [ {
        "code": "Quantity"
      }, {
        "code": "CodeableConcept"
      }, {
        "code": "string"
      }, {
        "code": "boolean"
      }, {
        "code": "Range"
      }, {
        "code": "Ratio"
      }, {
        "code": "SampledData"
      }, {
        "code": "Attachment"
      }, {
        "code": "time"
      }, {
        "code": "dateTime"
      }, {
        "code": "Period"
      } ],
      "max": "1",
      "id": "Observation.value[x]",
      "condition": [ "obs-7" ],
      "comment": "Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. This element has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueString, valueBoolean, valueRange, valueRatio, valueSampledData, valueAttachment, valueTime, valueDateTime, or valuePeriod. (The name format is \"'value' + the type name\" with a capital on the first letter of the type).\r\r\rIf the data element is usually coded or if the type associated with the Observation.value defines a coded value, use CodeableConcept instead of string datatype even if the value is uncoded text.  A value set is bound to the ValueCodeableConcept element.    For further discussion and examples see the  [notes section](http://hl7.org/fhir/observation.html#notes) below.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Observation.value[x]"
      },
      "isSummary": true
    }, {
      "path": "Observation.dataAbsentReason",
      "requirements": "For many results it is necessary to handle exceptional values in measurements.",
      "min": 0,
      "definition": "Provides a reason why the expected value in the element Observation.value[x] is missing.",
      "short": "Why the result is missing",
      "mapping": [ {
        "map": "Event.notDone, Event.notDoneReason  (maps to valeu[x] or dataAbsentReason)",
        "identity": "workflow"
      }, {
        "map": "N/A",
        "identity": "v2"
      }, {
        "map": "value.nullFlavor",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "CodeableConcept"
      } ],
      "binding": {
        "strength": "extensible",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "ObservationValueAbsentReason"
        } ],
        "description": "Codes specifying why the result (Observation.value[x]) is missing.",
        "valueSetReference": {
          "reference": "http://hl7.org/fhir/ValueSet/observation-valueabsentreason"
        }
      },
      "max": "1",
      "id": "Observation.dataAbsentReason",
      "condition": [ "obs-6" ],
      "comment": "Null or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"specimen unsatisfactory\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed. Note that an observation may only be reported if there are values to report. For example differential cell counts values may be reported only when > 0.  Because of these options, use-case agreements are required to interpret general observations for null or exceptional values.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Observation.dataAbsentReason"
      }
    }, {
      "path": "Observation.interpretation",
      "requirements": "For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.",
      "min": 0,
      "definition": "The assessment made based on the result of the observation.  Intended as a simple compact code often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result. Otherwise known as abnormal flag.",
      "short": "High, low, normal, etc.",
      "mapping": [ {
        "map": "< 260245000 |Findings values|",
        "identity": "sct-concept"
      }, {
        "map": "OBX-8",
        "identity": "v2"
      }, {
        "map": "interpretationCode",
        "identity": "rim"
      }, {
        "map": "363713009 |Has interpretation|",
        "identity": "sct-attr"
      } ],
      "type": [ {
        "code": "CodeableConcept"
      } ],
      "binding": {
        "strength": "extensible",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "ObservationInterpretation"
        } ],
        "description": "Codes identifying interpretations of observations.",
        "valueSetReference": {
          "reference": "http://hl7.org/fhir/ValueSet/observation-interpretation"
        }
      },
      "alias": [ "Abnormal Flag" ],
      "max": "1",
      "id": "Observation.interpretation",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Observation.interpretation"
      }
    }, {
      "path": "Observation.comment",
      "requirements": "Need to be able to provide free text additional information.",
      "min": 0,
      "definition": "MAY contain zero or one [0..1] comment (CONF:4393-59).",
      "short": "comment",
      "mapping": [ {
        "map": "Event.note",
        "identity": "workflow"
      }, {
        "map": "NTE.3 (partner NTE to OBX, or sometimes another (child?) OBX)",
        "identity": "v2"
      }, {
        "map": "subjectOf.observationEvent[code=\"annotation\"].value",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "max": "1",
      "id": "Observation.comment",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Observation.comment"
      }
    }, {
      "path": "Observation.bodySite",
      "min": 0,
      "definition": "Indicates the site on the subject's body where the observation was made (i.e. the target site).",
      "short": "Observed body part",
      "mapping": [ {
        "map": "< 123037004 |Body structure|",
        "identity": "sct-concept"
      }, {
        "map": "OBX-20",
        "identity": "v2"
      }, {
        "map": "targetSiteCode",
        "identity": "rim"
      }, {
        "map": "718497002 |Inherent location|",
        "identity": "sct-attr"
      } ],
      "type": [ {
        "code": "CodeableConcept"
      } ],
      "binding": {
        "strength": "example",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "BodySite"
        } ],
        "description": "Codes describing anatomical locations. May include laterality.",
        "valueSetReference": {
          "reference": "http://hl7.org/fhir/ValueSet/body-site"
        }
      },
      "max": "1",
      "id": "Observation.bodySite",
      "comment": "Only used if not implicit in code found in Observation.code.  In many systems, this may be represented as a related observation instead of an inline component.   If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use the standard extension[ body-site-instance](http://hl7.org/fhir/extension-body-site-instance.html).",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Observation.bodySite"
      }
    }, {
      "path": "Observation.method",
      "requirements": "In some cases, method can impact results and is thus used for determining whether results can be compared or determining significance of results.",
      "min": 0,
      "definition": "MAY contain zero or one [0..1] method=\"414135002\" Estimated (CodeSystem: SNOMED CT urn:oid:2.16.840.1.113883.6.96) (CONF:4393-60).",
      "short": "method",
      "mapping": [ {
        "map": "OBX-17",
        "identity": "v2"
      }, {
        "map": "methodCode",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "CodeableConcept"
      } ],
      "fixedCodeableConcept": {
        "coding": [ {
          "code": "414135002",
          "system": "urn:oid:2.16.840.1.113883.6.96",
          "display": "Estimated"
        } ]
      },
      "binding": {
        "strength": "example",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "ObservationMethod"
        } ],
        "description": "Methods for simple observations.",
        "valueSetReference": {
          "reference": "http://hl7.org/fhir/ValueSet/observation-methods"
        }
      },
      "max": "1",
      "id": "Observation.method",
      "comment": "Only used if not implicit in code for Observation.code.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Observation.method"
      }
    }, {
      "path": "Observation.specimen",
      "min": 0,
      "definition": "The specimen that was used when this observation was made.",
      "short": "Specimen used for this observation",
      "mapping": [ {
        "map": "< 123038009 |Specimen|",
        "identity": "sct-concept"
      }, {
        "map": "SPM segment",
        "identity": "v2"
      }, {
        "map": "participation[typeCode=SPC].specimen",
        "identity": "rim"
      }, {
        "map": "704319004 |Inherent in|",
        "identity": "sct-attr"
      } ],
      "type": [ {
        "code": "Reference",
        "targetProfile": "http://hl7.org/fhir/StructureDefinition/Specimen"
      } ],
      "max": "1",
      "id": "Observation.specimen",
      "comment": "Should only be used if not implicit in code found in `Observation.code`.  Observations are not made on specimens themselves; they are made on a subject, but in many cases by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Observation.specimen"
      }
    }, {
      "path": "Observation.device",
      "min": 0,
      "definition": "The device used to generate the observation data.",
      "short": "(Measurement) Device",
      "mapping": [ {
        "map": "< 49062001 |Device|",
        "identity": "sct-concept"
      }, {
        "map": "OBX-17 / PRT -10",
        "identity": "v2"
      }, {
        "map": "participation[typeCode=DEV]",
        "identity": "rim"
      }, {
        "map": "424226004 |Using device|",
        "identity": "sct-attr"
      } ],
      "type": [ {
        "code": "Reference",
        "targetProfile": "http://hl7.org/fhir/StructureDefinition/Device"
      }, {
        "code": "Reference",
        "targetProfile": "http://hl7.org/fhir/StructureDefinition/DeviceMetric"
      } ],
      "max": "1",
      "id": "Observation.device",
      "comment": "An extension should be used if further typing of the device is needed.  Devices used to support obtaining an observation can be represented using either an extension or through the Observation.related element.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Observation.device"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "Element",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      }, {
        "key": "obs-3",
        "human": "Must have at least a low or a high or text",
        "xpath": "(exists(f:low) or exists(f:high)or exists(f:text))",
        "severity": "error",
        "expression": "low.exists() or high.exists() or text.exists()"
      } ],
      "path": "Observation.referenceRange",
      "requirements": "Knowing what values are considered \"normal\" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.",
      "min": 0,
      "definition": "Guidance on how to interpret the value by comparison to a normal or recommended range.",
      "short": "Provides guide for interpretation",
      "mapping": [ {
        "map": "OBX.7",
        "identity": "v2"
      }, {
        "map": "outboundRelationship[typeCode=REFV]/target[classCode=OBS, moodCode=EVN]",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "BackboneElement"
      } ],
      "max": "*",
      "id": "Observation.referenceRange",
      "comment": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Observation.referenceRange"
      }
    }, {
      "path": "Observation.referenceRange.id",
      "min": 0,
      "definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
      "short": "xml:id (or equivalent in JSON)",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "representation": [ "xmlAttr" ],
      "max": "1",
      "id": "Observation.referenceRange.id",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Element.id"
      }
    }, {
      "path": "Observation.referenceRange.extension",
      "min": 0,
      "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
      "short": "Additional Content defined by implementations",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Extension"
      } ],
      "alias": [ "extensions", "user content" ],
      "max": "*",
      "id": "Observation.referenceRange.extension",
      "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Element.extension"
      }
    }, {
      "path": "Observation.referenceRange.modifierExtension",
      "min": 0,
      "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
      "isModifier": true,
      "short": "Extensions that cannot be ignored",
      "mapping": [ {
        "map": "N/A",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Extension"
      } ],
      "alias": [ "extensions", "user content", "modifiers" ],
      "max": "*",
      "id": "Observation.referenceRange.modifierExtension",
      "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "BackboneElement.modifierExtension"
      },
      "isSummary": true
    }, {
      "path": "Observation.referenceRange.low",
      "min": 0,
      "definition": "The value of the low bound of the reference range.  The low bound of the reference range endpoint is inclusive of the value (e.g.  reference range is >=5 - <=9).   If the low bound is omitted,  it is assumed to be meaningless (e.g. reference range is <=2.3).",
      "short": "Low Range, if relevant",
      "mapping": [ {
        "map": "OBX-7",
        "identity": "v2"
      }, {
        "map": "value:IVL_PQ.low",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Quantity",
        "profile": "http://hl7.org/fhir/StructureDefinition/SimpleQuantity"
      } ],
      "max": "1",
      "id": "Observation.referenceRange.low",
      "condition": [ "obs-3" ],
      "base": {
        "max": "1",
        "min": 0,
        "path": "Observation.referenceRange.low"
      }
    }, {
      "path": "Observation.referenceRange.high",
      "min": 0,
      "definition": "The value of the high bound of the reference range.  The high bound of the reference range endpoint is inclusive of the value (e.g.  reference range is >=5 - <=9).   If the high bound is omitted,  it is assumed to be meaningless (e.g. reference range is >= 2.3).",
      "short": "High Range, if relevant",
      "mapping": [ {
        "map": "OBX-7",
        "identity": "v2"
      }, {
        "map": "value:IVL_PQ.high",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Quantity",
        "profile": "http://hl7.org/fhir/StructureDefinition/SimpleQuantity"
      } ],
      "max": "1",
      "id": "Observation.referenceRange.high",
      "condition": [ "obs-3" ],
      "base": {
        "max": "1",
        "min": 0,
        "path": "Observation.referenceRange.high"
      }
    }, {
      "path": "Observation.referenceRange.type",
      "requirements": "Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc,  - for proper interpretation.",
      "min": 0,
      "definition": "Codes to indicate the what part of the targeted reference population it applies to. For example, the normal or therapeutic range.",
      "short": "Reference range qualifier",
      "mapping": [ {
        "map": "< 260245000 |Findings values| OR  \r< 365860008 |General clinical state finding| \rOR \r< 250171008 |Clinical history or observation findings| OR  \r< 415229000 |Racial group| OR \r< 365400002 |Finding of puberty stage| OR\r< 443938003 |Procedure carried out on subject|",
        "identity": "sct-concept"
      }, {
        "map": "OBX-10",
        "identity": "v2"
      }, {
        "map": "interpretationCode",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "CodeableConcept"
      } ],
      "binding": {
        "strength": "extensible",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "ObservationRangeMeaning"
        } ],
        "description": "Code for the meaning of a reference range.",
        "valueSetReference": {
          "reference": "http://hl7.org/fhir/ValueSet/referencerange-meaning"
        }
      },
      "max": "1",
      "id": "Observation.referenceRange.type",
      "comment": "This SHOULD be populated if there is more than one range.  If this element is not present then the normal range is assumed.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Observation.referenceRange.type"
      }
    }, {
      "path": "Observation.referenceRange.appliesTo",
      "requirements": "Need to be able to identify the target population for proper interpretation.",
      "min": 0,
      "definition": "Codes to indicate the target population this reference range applies to.  For example, a reference range may be based on the normal population or a particular sex or race.",
      "short": "Reference range population",
      "mapping": [ {
        "map": "< 260245000 |Findings values| OR  \r< 365860008 |General clinical state finding| \rOR \r< 250171008 |Clinical history or observation findings| OR  \r< 415229000 |Racial group| OR \r< 365400002 |Finding of puberty stage| OR\r< 443938003 |Procedure carried out on subject|",
        "identity": "sct-concept"
      }, {
        "map": "OBX-10",
        "identity": "v2"
      }, {
        "map": "interpretationCode",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "CodeableConcept"
      } ],
      "binding": {
        "strength": "example",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "ObservationRangeType"
        } ],
        "description": "Codes identifying the population the reference range applies to.",
        "valueSetReference": {
          "reference": "http://hl7.org/fhir/ValueSet/referencerange-appliesto"
        }
      },
      "max": "*",
      "id": "Observation.referenceRange.appliesTo",
      "comment": "This SHOULD be populated if there is more than one range.  If this element is not present then the normal population is assumed.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Observation.referenceRange.appliesTo"
      }
    }, {
      "path": "Observation.referenceRange.age",
      "requirements": "Some analytes vary greatly over age.",
      "min": 0,
      "definition": "The age at which this reference range is applicable. This is a neonatal age (e.g. number of weeks at term) if the meaning says so.",
      "short": "Applicable age range, if relevant",
      "mapping": [ {
        "map": "outboundRelationship[typeCode=PRCN].targetObservationCriterion[code=\"age\"].value",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Range"
      } ],
      "max": "1",
      "id": "Observation.referenceRange.age",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Observation.referenceRange.age"
      }
    }, {
      "path": "Observation.referenceRange.text",
      "min": 0,
      "definition": "Text based reference range in an observation which may be used when a quantitative range is not appropriate for an observation.  An example would be a reference value of \"Negative\" or a list or table of 'normals'.",
      "short": "Text based reference range in an observation",
      "mapping": [ {
        "map": "OBX-7",
        "identity": "v2"
      }, {
        "map": "value:ST",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "max": "1",
      "id": "Observation.referenceRange.text",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Observation.referenceRange.text"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "Element",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "Observation.related",
      "requirements": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and a set of related observations or sometimes a QuestionnaireResponse from which the measure is derived.",
      "min": 0,
      "definition": "A  reference to another resource (usually another Observation) whose relationship is defined by the relationship type code.",
      "short": "Resource related to this observation",
      "mapping": [ {
        "map": "Relationships established by OBX-4 usage",
        "identity": "v2"
      }, {
        "map": "outBoundRelationship",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "BackboneElement"
      } ],
      "max": "*",
      "id": "Observation.related",
      "comment": "For a discussion on the ways Observations can assembled in groups together see [Notes below](http://hl7.org/fhir/observation.html#4.20.4).",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Observation.related"
      },
      "isSummary": true
    }, {
      "path": "Observation.related.id",
      "min": 0,
      "definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
      "short": "xml:id (or equivalent in JSON)",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "representation": [ "xmlAttr" ],
      "max": "1",
      "id": "Observation.related.id",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Element.id"
      }
    }, {
      "path": "Observation.related.extension",
      "min": 0,
      "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
      "short": "Additional Content defined by implementations",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Extension"
      } ],
      "alias": [ "extensions", "user content" ],
      "max": "*",
      "id": "Observation.related.extension",
      "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Element.extension"
      }
    }, {
      "path": "Observation.related.modifierExtension",
      "min": 0,
      "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
      "isModifier": true,
      "short": "Extensions that cannot be ignored",
      "mapping": [ {
        "map": "N/A",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Extension"
      } ],
      "alias": [ "extensions", "user content", "modifiers" ],
      "max": "*",
      "id": "Observation.related.modifierExtension",
      "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "BackboneElement.modifierExtension"
      },
      "isSummary": true
    }, {
      "path": "Observation.related.type",
      "requirements": "A relationship type SHOULD be provided.",
      "min": 0,
      "definition": "A code specifying the kind of relationship that exists with the target resource.",
      "short": "has-member | derived-from | sequel-to | replaces | qualified-by | interfered-by",
      "mapping": [ {
        "map": "N/A",
        "identity": "v2"
      }, {
        "map": ".typeCode",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "code"
      } ],
      "binding": {
        "strength": "required",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "ObservationRelationshipType"
        } ],
        "description": "Codes specifying how two observations are related.",
        "valueSetReference": {
          "reference": "http://hl7.org/fhir/ValueSet/observation-relationshiptypes"
        }
      },
      "max": "1",
      "id": "Observation.related.type",
      "comment": "The \"derived-from\" type is the only logical choice when referencing the QuestionnaireAnswer resource.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Observation.related.type"
      }
    }, {
      "path": "Observation.related.target",
      "min": 1,
      "definition": "A reference to the observation or [QuestionnaireResponse](http://hl7.org/fhir/questionnaireresponse.html#) resource that is related to this observation.",
      "short": "Resource that is related to this one",
      "mapping": [ {
        "map": ".targetObservation",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Reference",
        "targetProfile": "http://hl7.org/fhir/StructureDefinition/Observation"
      }, {
        "code": "Reference",
        "targetProfile": "http://hl7.org/fhir/StructureDefinition/QuestionnaireResponse"
      }, {
        "code": "Reference",
        "targetProfile": "http://hl7.org/fhir/StructureDefinition/Sequence"
      } ],
      "max": "1",
      "id": "Observation.related.target",
      "base": {
        "max": "1",
        "min": 1,
        "path": "Observation.related.target"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "Element",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "Observation.component",
      "requirements": "Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable).   However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.",
      "min": 1,
      "definition": "SHALL contain exactly one [1..1] component (CONF:4393-62).",
      "short": "component",
      "mapping": [ {
        "map": "containment by OBX-4?",
        "identity": "v2"
      }, {
        "map": "outBoundRelationship[typeCode=COMP]",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "BackboneElement"
      } ],
      "max": "1",
      "id": "Observation.component",
      "comment": "For a discussion on the ways Observations can be assembled in groups together see [Notes](http://hl7.org/fhir/observation.html#notes) below.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Observation.component"
      },
      "isSummary": true
    }, {
      "path": "Observation.component.id",
      "min": 0,
      "definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
      "short": "xml:id (or equivalent in JSON)",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "representation": [ "xmlAttr" ],
      "max": "1",
      "id": "Observation.component.id",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Element.id"
      }
    }, {
      "path": "Observation.component.extension",
      "min": 0,
      "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
      "short": "Additional Content defined by implementations",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Extension"
      } ],
      "alias": [ "extensions", "user content" ],
      "max": "*",
      "id": "Observation.component.extension",
      "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Element.extension"
      }
    }, {
      "path": "Observation.component.modifierExtension",
      "min": 0,
      "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
      "isModifier": true,
      "short": "Extensions that cannot be ignored",
      "mapping": [ {
        "map": "N/A",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Extension"
      } ],
      "alias": [ "extensions", "user content", "modifiers" ],
      "max": "*",
      "id": "Observation.component.modifierExtension",
      "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "BackboneElement.modifierExtension"
      },
      "isSummary": true
    }, {
      "path": "Observation.component.code",
      "requirements": "Knowing what kind of observation is being made is essential to understanding the observation.",
      "min": 1,
      "definition": "This component SHALL contain exactly one [1..1] code=\"80616-6\" Date and time pronounced dead (CodeSystem: LOINC urn:oid:2.16.840.1.113883.6.1) (CONF:4393-64).",
      "short": "code",
      "mapping": [ {
        "map": "< 363787002 |Observable entity| OR \r< 386053000 |Evaluation procedure|",
        "identity": "sct-concept"
      }, {
        "map": "OBX-3",
        "identity": "v2"
      }, {
        "map": "code",
        "identity": "rim"
      }, {
        "map": "what",
        "identity": "w5"
      } ],
      "type": [ {
        "code": "CodeableConcept"
      } ],
      "binding": {
        "strength": "example",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "ObservationCode"
        } ],
        "description": "Codes identifying names of simple observations.",
        "valueSetReference": {
          "reference": "http://hl7.org/fhir/ValueSet/observation-codes"
        }
      },
      "max": "1",
      "id": "Observation.component.code",
      "patternCodeableConcept": {
        "coding": [ {
          "code": "80616-6",
          "system": "urn:oid:2.16.840.1.113883.6.1",
          "display": "Date and time pronounced dead"
        } ]
      },
      "base": {
        "max": "1",
        "min": 1,
        "path": "Observation.component.code"
      },
      "isSummary": true
    }, {
      "path": "Observation.component.value[x]",
      "requirements": "An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.",
      "min": 1,
      "definition": "This component SHALL contain exactly one [1..1] value[x], where value[x] is (CONF:4393-63)",
      "short": "value[x]",
      "mapping": [ {
        "map": "363714003 |Interprets| < 441742003 |Evaluation finding|",
        "identity": "sct-concept"
      }, {
        "map": "OBX.2, OBX.5, OBX.6",
        "identity": "v2"
      }, {
        "map": "value",
        "identity": "rim"
      }, {
        "map": "363714003 |Interprets|",
        "identity": "sct-attr"
      } ],
      "type": [ {
        "code": "Quantity"
      }, {
        "code": "CodeableConcept"
      }, {
        "code": "string"
      }, {
        "code": "Range"
      }, {
        "code": "Ratio"
      }, {
        "code": "SampledData"
      }, {
        "code": "Attachment"
      }, {
        "code": "time"
      }, {
        "code": "dateTime"
      }, {
        "code": "Period"
      } ],
      "max": "1",
      "id": "Observation.component.value[x]",
      "comment": "Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.   For boolean values use valueCodeableConcept and select codes from  (these \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed\").  The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (the name format is \"'value' + the type name\" with a capital on the first letter of the type).",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Observation.component.value[x]"
      },
      "isSummary": true
    }, {
      "path": "Observation.component.value[x]",
      "requirements": "An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.",
      "min": 0,
      "definition": "This component SHALL contain exactly one [1..1] valueDateTime (CONF:4393-65).",
      "short": "valueDateTime",
      "mapping": [ {
        "map": "363714003 |Interprets| < 441742003 |Evaluation finding|",
        "identity": "sct-concept"
      }, {
        "map": "OBX.2, OBX.5, OBX.6",
        "identity": "v2"
      }, {
        "map": "value",
        "identity": "rim"
      }, {
        "map": "363714003 |Interprets|",
        "identity": "sct-attr"
      } ],
      "type": [ {
        "code": "Quantity"
      }, {
        "code": "CodeableConcept"
      }, {
        "code": "string"
      }, {
        "code": "Range"
      }, {
        "code": "Ratio"
      }, {
        "code": "SampledData"
      }, {
        "code": "Attachment"
      }, {
        "code": "time"
      }, {
        "code": "dateTime"
      }, {
        "code": "Period"
      } ],
      "sliceName": "valueDateTime",
      "max": "1",
      "id": "Observation.component.value[x]:valueDateTime",
      "comment": "Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.   For boolean values use valueCodeableConcept and select codes from  (these \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed\").  The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (the name format is \"'value' + the type name\" with a capital on the first letter of the type).",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Observation.component.value[x]"
      },
      "isSummary": true
    }, {
      "path": "Observation.component.dataAbsentReason",
      "requirements": "For many results it is necessary to handle exceptional values in measurements.",
      "min": 0,
      "definition": "Provides a reason why the expected value in the element Observation.value[x] is missing.",
      "short": "Why the component result is missing",
      "mapping": [ {
        "map": "N/A",
        "identity": "v2"
      }, {
        "map": "value.nullFlavor",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "CodeableConcept"
      } ],
      "binding": {
        "strength": "extensible",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "ObservationValueAbsentReason"
        } ],
        "description": "Codes specifying why the result (Observation.value[x]) is missing.",
        "valueSetReference": {
          "reference": "http://hl7.org/fhir/ValueSet/observation-valueabsentreason"
        }
      },
      "max": "1",
      "id": "Observation.component.dataAbsentReason",
      "condition": [ "obs-6" ],
      "comment": "\"Null\" or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"test not done\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Observation.component.dataAbsentReason"
      }
    }, {
      "path": "Observation.component.interpretation",
      "requirements": "For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.",
      "min": 0,
      "definition": "The assessment made based on the result of the observation.  Intended as a simple compact code often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result. Otherwise known as abnormal flag.",
      "short": "High, low, normal, etc.",
      "mapping": [ {
        "map": "< 260245000 |Findings values|",
        "identity": "sct-concept"
      }, {
        "map": "OBX-8",
        "identity": "v2"
      }, {
        "map": "interpretationCode",
        "identity": "rim"
      }, {
        "map": "363713009 |Has interpretation|",
        "identity": "sct-attr"
      } ],
      "type": [ {
        "code": "CodeableConcept"
      } ],
      "binding": {
        "strength": "extensible",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "ObservationInterpretation"
        } ],
        "description": "Codes identifying interpretations of observations.",
        "valueSetReference": {
          "reference": "http://hl7.org/fhir/ValueSet/observation-interpretation"
        }
      },
      "alias": [ "Abnormal Flag" ],
      "max": "1",
      "id": "Observation.component.interpretation",
      "comment": "The component interpretation applies only to the individual component value.  For an overall interpretation all components together use thes Observation.interpretation element.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Observation.component.interpretation"
      }
    }, {
      "path": "Observation.component.referenceRange",
      "requirements": "Knowing what values are considered \"normal\" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.",
      "min": 0,
      "definition": "Guidance on how to interpret the value by comparison to a normal or recommended range.",
      "short": "Provides guide for interpretation of component result",
      "mapping": [ {
        "map": "OBX.7",
        "identity": "v2"
      }, {
        "map": "outboundRelationship[typeCode=REFV]/target[classCode=OBS, moodCode=EVN]",
        "identity": "rim"
      } ],
      "contentReference": "#Observation.referenceRange",
      "max": "*",
      "id": "Observation.component.referenceRange",
      "comment": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Observation.component.referenceRange"
      }
    } ]
  },
  "status": "draft",
  "id": "88398065-ce0d-48d7-9a83-159ec7e71e62",
  "kind": "resource",
  "url": "http://hl7.org/fhir/us/vrdr/StructureDefinition/VRDR-Death-Date",
  "context": [ "Observation" ],
  "version": "0.1.0",
  "differential": {
    "element": [ {
      "id": "Observation",
      "path": "Observation"
    }, {
      "id": "Observation.id",
      "max": "1",
      "min": 1,
      "path": "Observation.id",
      "short": "id",
      "definition": "SHALL contain exactly one [1..1] id (CONF:4393-74)."
    }, {
      "id": "Observation.meta",
      "max": "1",
      "min": 0,
      "path": "Observation.meta",
      "short": "meta",
      "definition": "MAY contain zero or one [0..1] meta (CONF:4393-73)."
    }, {
      "id": "Observation.meta.profile",
      "max": "1",
      "min": 1,
      "path": "Observation.meta.profile",
      "short": "profile",
      "definition": "The meta, if present, SHALL contain exactly one [1..1] profile=\"http://hl7.org/fhir/us/vrdr/StructureDefinition/VRDR-Death-Date\" (CONF:4393-75).",
      "patternString": "http://hl7.org/fhir/us/vrdr/StructureDefinition/VRDR-Death-Date"
    }, {
      "id": "Observation.extension",
      "path": "Observation.extension",
      "slicing": {
        "rules": "open",
        "discriminator": [ {
          "path": "url",
          "type": "value"
        } ]
      },
      "definition": "SHALL contain exactly one [1..1] extension (CONF:4393-76) such that it"
    }, {
      "id": "Observation.extension:extension1",
      "max": "1",
      "min": 1,
      "path": "Observation.extension",
      "short": "extension",
      "sliceName": "extension1",
      "definition": "SHALL contain exactly one [1..1] extension (CONF:4393-76) such that it"
    }, {
      "id": "Observation.extension:extension1.url:extension1",
      "max": "1",
      "min": 1,
      "path": "Observation.extension.url",
      "short": "@url",
      "sliceName": "extension1",
      "definition": "SHALL contain exactly one [1..1] @url=\"http://hl7.org/fhir/us/vrdr/StructureDefinition/Patient-Location\" (CONF:4393-78)."
    }, {
      "id": "Observation.extension:extension1.value[x]:extension1",
      "max": "1",
      "min": 1,
      "path": "Observation.extension.value[x]",
      "short": "value[x]",
      "slicing": {
        "rules": "open",
        "discriminator": [ {
          "path": "$this",
          "type": "type"
        } ]
      },
      "sliceName": "extension1",
      "definition": "SHALL contain exactly one [1..1] value[x], where value[x] is (CONF:4393-77)"
    }, {
      "id": "Observation.extension:extension1.valueReference:valueReference",
      "path": "Observation.extension.valueReference",
      "short": "valueReference",
      "sliceName": "valueReference",
      "definition": "SHALL contain exactly one [1..1] valueReference=\"VRDR-Death-Location\" (CONF:4393-79).",
      "patternString": "VRDR-Death-Location"
    }, {
      "id": "Observation.status",
      "max": "1",
      "min": 1,
      "path": "Observation.status",
      "type": [ {
        "code": "code"
      } ],
      "short": "status",
      "definition": "SHALL contain exactly one [1..1] status=\"final\" Final (CodeSystem: FHIR ObservationStatus http://hl7.org/fhir/observation-status) (CONF:4393-55).",
      "fixedString": "final"
    }, {
      "id": "Observation.code",
      "max": "1",
      "min": 1,
      "path": "Observation.code",
      "type": [ {
        "code": "CodeableConcept"
      } ],
      "short": "code",
      "definition": "SHALL contain exactly one [1..1] code=\"81956-5\" Date and time of death (CodeSystem: LOINC urn:oid:2.16.840.1.113883.6.1) (CONF:4393-52).",
      "fixedCodeableConcept": {
        "coding": [ {
          "code": "81956-5",
          "system": "urn:oid:2.16.840.1.113883.6.1",
          "display": "Date and time of death"
        } ]
      }
    }, {
      "id": "Observation.subject",
      "max": "1",
      "min": 1,
      "path": "Observation.subject",
      "type": [ {
        "code": "Reference",
        "targetProfile": "http://hl7.org/fhir/us/vrdr/StructureDefinition/VRDR-Decedent"
      } ],
      "short": "subject",
      "definition": "SHALL contain exactly one [1..1] VRDR Decedent (identifier: http://hl7.org/fhir/us/vrdr/StructureDefinition/VRDR-Decedent) (CONF:4393-53)."
    }, {
      "id": "Observation.effective[x]",
      "max": "1",
      "min": 1,
      "path": "Observation.effective[x]",
      "short": "effective[x]",
      "slicing": {
        "rules": "open",
        "discriminator": [ {
          "path": "$this",
          "type": "type"
        } ]
      },
      "definition": "SHALL contain exactly one [1..1] effective[x], where effective[x] is (CONF:4393-54)"
    }, {
      "id": "Observation.effectiveDateTime:effectiveDateTime",
      "path": "Observation.effectiveDateTime",
      "short": "effectiveDateTime",
      "sliceName": "effectiveDateTime",
      "definition": "effectiveDateTime (CONF:4393-57)"
    }, {
      "id": "Observation.performer",
      "max": "1",
      "min": 1,
      "path": "Observation.performer",
      "type": [ {
        "code": "Reference",
        "targetProfile": "http://hl7.org/fhir/us/vrdr/StructureDefinition/VRDR-Death-Pronouncement-Performer"
      } ],
      "short": "performer",
      "definition": "SHALL contain exactly one [1..1] VRDR Death Pronouncement Performer (identifier: http://hl7.org/fhir/us/vrdr/StructureDefinition/VRDR-Death-Pronouncement-Performer) (CONF:4393-58)."
    }, {
      "id": "Observation.comment",
      "max": "1",
      "min": 0,
      "path": "Observation.comment",
      "short": "comment",
      "definition": "MAY contain zero or one [0..1] comment (CONF:4393-59)."
    }, {
      "id": "Observation.method",
      "max": "1",
      "min": 0,
      "path": "Observation.method",
      "type": [ {
        "code": "CodeableConcept"
      } ],
      "short": "method",
      "definition": "MAY contain zero or one [0..1] method=\"414135002\" Estimated (CodeSystem: SNOMED CT urn:oid:2.16.840.1.113883.6.96) (CONF:4393-60).",
      "fixedCodeableConcept": {
        "coding": [ {
          "code": "414135002",
          "system": "urn:oid:2.16.840.1.113883.6.96",
          "display": "Estimated"
        } ]
      }
    }, {
      "id": "Observation.component",
      "max": "1",
      "min": 1,
      "path": "Observation.component",
      "short": "component",
      "definition": "SHALL contain exactly one [1..1] component (CONF:4393-62)."
    }, {
      "id": "Observation.component.code",
      "max": "1",
      "min": 1,
      "path": "Observation.component.code",
      "type": [ {
        "code": "CodeableConcept"
      } ],
      "short": "code",
      "definition": "This component SHALL contain exactly one [1..1] code=\"80616-6\" Date and time pronounced dead (CodeSystem: LOINC urn:oid:2.16.840.1.113883.6.1) (CONF:4393-64).",
      "patternCodeableConcept": {
        "coding": [ {
          "code": "80616-6",
          "system": "urn:oid:2.16.840.1.113883.6.1",
          "display": "Date and time pronounced dead"
        } ]
      }
    }, {
      "id": "Observation.component.value[x]",
      "max": "1",
      "min": 1,
      "path": "Observation.component.value[x]",
      "short": "value[x]",
      "slicing": {
        "rules": "open",
        "discriminator": [ {
          "path": "$this",
          "type": "type"
        } ]
      },
      "definition": "This component SHALL contain exactly one [1..1] value[x], where value[x] is (CONF:4393-63)"
    }, {
      "id": "Observation.component.valueDateTime:valueDateTime",
      "path": "Observation.component.valueDateTime",
      "short": "valueDateTime",
      "sliceName": "valueDateTime",
      "definition": "This component SHALL contain exactly one [1..1] valueDateTime (CONF:4393-65)."
    } ]
  },
  "contact": [ {
    "name": "AbdulMalik Shakir",
    "telecom": [ {
      "use": "work",
      "value": "6266444491",
      "system": "phone"
    }, {
      "use": "work",
      "value": "abdulmalik.shakir@hi3solutions.com",
      "system": "email"
    } ]
  } ],
  "contextType": "resource",
  "baseDefinition": "http://hl7.org/fhir/StructureDefinition/Observation"
}