description: The US Core Observation Screening Assessment Profile inherits from the FHIR [Observation](https://hl7.org/fhir/R4/observation.html) resource; refer to it for scope and usage definitions. This profile meets the requirements of the U.S. Core Data for Interoperability (USCDI) *Health Status Assessments* Data Class. It sets the minimum expectations for the Observation Resource to record, search, and fetch observations representing the questions and responses to surveys and screening and assessment tools. For example, a social history status such as education or food insecurity or an assessment of cognitive, functional, or disability status. It can represent a single response, multiple responses, and multi-select \"check all that apply\" type questions. This profile specifies which core elements, extensions,  vocabularies, and value sets **SHALL** be present in the resource and constrains how the elements are used. Providing the floor for standards development for specific use cases promotes interoperability and adoption. Before reviewing this profile, implementers are encouraged to read the Screening and Assessments guidance page, which documents the process of recording responses and capturing assertions/determinations resulting from surveys and questionnaires.
package_name: hl7.fhir.us.core
derivation: constraint
name: USCoreObservationScreeningAssessmentProfile
type: Observation
elements:
  category:
    mustSupport: true
    index: 1
    slicing:
      rules: open
      discriminator:
      - {path: $this, type: value}
      min: 1
      slices:
        survey:
          match:
            coding:
            - {code: survey, system: 'http://terminology.hl7.org/CodeSystem/observation-category'}
          schema:
            mustSupport: true
            pattern:
              type: CodeableConcept
              value:
                coding:
                - {code: survey, system: 'http://terminology.hl7.org/CodeSystem/observation-category'}
            _required: true
            index: 2
          min: 1
          max: 1
        screening-assessment:
          match: {}
          schema:
            binding: {strength: required, valueSet: 'http://hl7.org/fhir/us/core/ValueSet/us-core-screening-assessment-observation-maximum-category'}
            mustSupport: true
            index: 3
  hasMember:
    type: Reference
    short: Reference to panel members or multi-select responses or multi-select responses
    mustSupport: true
    refers: ['http://hl7.org/fhir/StructureDefinition/MolecularSequence', 'http://hl7.org/fhir/StructureDefinition/QuestionnaireResponse', 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-screening-assessment']
    index: 27
  derivedFrom:
    type: Reference
    mustSupport: true
    refers: ['http://hl7.org/fhir/StructureDefinition/ImagingStudy', 'http://hl7.org/fhir/StructureDefinition/Media', 'http://hl7.org/fhir/StructureDefinition/MolecularSequence', 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-documentreference', 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-screening-assessment', 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-questionnaireresponse']
    index: 28
  valueTime:
    type: time
    constraint:
      us-core-3: {human: SHALL use UCUM for coded quantity units., severity: error, expression: 'ofType(Quantity).system.empty() or ofType(Quantity).system = ''http://unitsofmeasure.org'''}
    mustSupport: true
    choiceOf: value
    index: 23
  valueQuantity:
    type: Quantity
    constraint:
      us-core-3: {human: SHALL use UCUM for coded quantity units., severity: error, expression: 'ofType(Quantity).system.empty() or ofType(Quantity).system = ''http://unitsofmeasure.org'''}
    mustSupport: true
    choiceOf: value
    index: 15
  value:
    constraint:
      us-core-3: {human: SHALL use UCUM for coded quantity units., severity: error, expression: 'ofType(Quantity).system.empty() or ofType(Quantity).system = ''http://unitsofmeasure.org'''}
    mustSupport: true
    choices: [valueQuantity, valueCodeableConcept, valueString, valueBoolean, valueInteger, valueRange, valueRatio, valueSampledData, valueTime, valueDateTime, valuePeriod]
    index: 14
  valueString:
    type: string
    constraint:
      us-core-3: {human: SHALL use UCUM for coded quantity units., severity: error, expression: 'ofType(Quantity).system.empty() or ofType(Quantity).system = ''http://unitsofmeasure.org'''}
    mustSupport: true
    choiceOf: value
    index: 17
  valueRatio:
    type: Ratio
    constraint:
      us-core-3: {human: SHALL use UCUM for coded quantity units., severity: error, expression: 'ofType(Quantity).system.empty() or ofType(Quantity).system = ''http://unitsofmeasure.org'''}
    mustSupport: true
    choiceOf: value
    index: 21
  valueBoolean:
    type: boolean
    constraint:
      us-core-3: {human: SHALL use UCUM for coded quantity units., severity: error, expression: 'ofType(Quantity).system.empty() or ofType(Quantity).system = ''http://unitsofmeasure.org'''}
    mustSupport: true
    choiceOf: value
    index: 18
  valueDateTime:
    type: dateTime
    constraint:
      us-core-3: {human: SHALL use UCUM for coded quantity units., severity: error, expression: 'ofType(Quantity).system.empty() or ofType(Quantity).system = ''http://unitsofmeasure.org'''}
    mustSupport: true
    choiceOf: value
    index: 24
  valueSampledData:
    type: SampledData
    constraint:
      us-core-3: {human: SHALL use UCUM for coded quantity units., severity: error, expression: 'ofType(Quantity).system.empty() or ofType(Quantity).system = ''http://unitsofmeasure.org'''}
    mustSupport: true
    choiceOf: value
    index: 22
  effectiveDateTime:
    constraint:
      us-core-1: {human: Datetime must be at least to day., severity: error, expression: $this is dateTime implies $this.toString().length() >= 10}
    type: dateTime
    mustSupport: true
    choiceOf: effective
    index: 8
  status: {mustSupport: true, index: 0}
  effective:
    constraint:
      us-core-1: {human: Datetime must be at least to day., severity: error, expression: $this is dateTime implies $this.toString().length() >= 10}
    mustSupport: true
    choices: [effectiveDateTime, effectivePeriod, effectiveTiming, effectiveInstant]
    index: 7
  code:
    binding: {strength: preferred, valueSet: 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1267.13'}
    mustSupport: true
    index: 4
  effectiveTiming:
    constraint:
      us-core-1: {human: Datetime must be at least to day., severity: error, expression: $this is dateTime implies $this.toString().length() >= 10}
    type: Timing
    mustSupport: true
    choiceOf: effective
    index: 10
  valueCodeableConcept:
    type: CodeableConcept
    constraint:
      us-core-3: {human: SHALL use UCUM for coded quantity units., severity: error, expression: 'ofType(Quantity).system.empty() or ofType(Quantity).system = ''http://unitsofmeasure.org'''}
    mustSupport: true
    choiceOf: value
    index: 16
  valuePeriod:
    type: Period
    constraint:
      us-core-3: {human: SHALL use UCUM for coded quantity units., severity: error, expression: 'ofType(Quantity).system.empty() or ofType(Quantity).system = ''http://unitsofmeasure.org'''}
    mustSupport: true
    choiceOf: value
    index: 25
  effectiveInstant:
    constraint:
      us-core-1: {human: Datetime must be at least to day., severity: error, expression: $this is dateTime implies $this.toString().length() >= 10}
    type: instant
    mustSupport: true
    choiceOf: effective
    index: 11
  valueRange:
    type: Range
    constraint:
      us-core-3: {human: SHALL use UCUM for coded quantity units., severity: error, expression: 'ofType(Quantity).system.empty() or ofType(Quantity).system = ''http://unitsofmeasure.org'''}
    mustSupport: true
    choiceOf: value
    index: 20
  valueInteger:
    type: integer
    constraint:
      us-core-3: {human: SHALL use UCUM for coded quantity units., severity: error, expression: 'ofType(Quantity).system.empty() or ofType(Quantity).system = ''http://unitsofmeasure.org'''}
    mustSupport: true
    choiceOf: value
    index: 19
  subject:
    type: Reference
    mustSupport: true
    refers: ['http://hl7.org/fhir/StructureDefinition/Device', 'http://hl7.org/fhir/StructureDefinition/Group', 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-location', 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient']
    index: 5
  performer:
    type: Reference
    mustSupport: true
    refers: ['http://hl7.org/fhir/StructureDefinition/PractitionerRole', 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-careteam', 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-organization', 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient', 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitioner', 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-relatedperson']
    index: 12
  dataAbsentReason: {mustSupport: true, index: 26}
  effectivePeriod:
    constraint:
      us-core-1: {human: Datetime must be at least to day., severity: error, expression: $this is dateTime implies $this.toString().length() >= 10}
    type: Period
    mustSupport: true
    choiceOf: effective
    index: 9
package_version: 8.0.0-ballot
class: profile
kind: resource
url: http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-screening-assessment
base: http://hl7.org/fhir/StructureDefinition/Observation
version: 8.0.0-ballot
required: [subject, category]