{
  "description": "Israel Core proposed constraints and extensions on the Observation Resource",
  "_filename": "StructureDefinition-il-core-observation.json",
  "package_name": "il.core.fhir.r4",
  "date": "2024-04-07",
  "derivation": "constraint",
  "publisher": "Israel Core Team",
  "fhirVersion": "4.0.1",
  "name": "ILCoreObservation",
  "abstract": false,
  "type": "Observation",
  "experimental": null,
  "resourceType": "StructureDefinition",
  "title": "ILCore Observation Profile",
  "package_version": "0.14.0",
  "extension": [ {
    "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
    "valueCode": "trial-use"
  }, {
    "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm",
    "valueInteger": 1
  } ],
  "status": "draft",
  "id": "def6e907-dc72-4f49-82d3-6cbe0cbf4661",
  "kind": "resource",
  "url": "http://fhir.health.gov.il/StructureDefinition/il-core-observation",
  "version": "0.14.0",
  "differential": {
    "element": [ {
      "id": "Observation",
      "path": "Observation",
      "short": "ILCore Observation Profile",
      "definition": "Israel Core proposed constraints and extensions on the Observation resource profile."
    }, {
      "id": "Observation.basedOn",
      "path": "Observation.basedOn",
      "type": [ {
        "code": "Reference",
        "targetProfile": [ "http://hl7.org/fhir/StructureDefinition/CarePlan", "http://hl7.org/fhir/StructureDefinition/DeviceRequest", "http://fhir.health.gov.il/StructureDefinition/il-core-immunization-recommendation", "http://fhir.health.gov.il/StructureDefinition/il-core-medication-request", "http://hl7.org/fhir/StructureDefinition/NutritionOrder", "http://fhir.health.gov.il/StructureDefinition/il-core-service-request" ]
      } ]
    }, {
      "id": "Observation.partOf",
      "path": "Observation.partOf",
      "type": [ {
        "code": "Reference",
        "targetProfile": [ "http://fhir.health.gov.il/StructureDefinition/il-core-medication-administration", "http://fhir.health.gov.il/StructureDefinition/il-core-medication-dispense", "http://fhir.health.gov.il/StructureDefinition/il-core-procedure", "http://fhir.health.gov.il/StructureDefinition/il-core-immunization", "http://fhir.health.gov.il/StructureDefinition/il-core-imaging-study", "http://fhir.health.gov.il/StructureDefinition/il-core-medication-statement" ]
      } ]
    }, {
      "id": "Observation.status",
      "path": "Observation.status",
      "mustSupport": true
    }, {
      "id": "Observation.category",
      "path": "Observation.category",
      "mustSupport": true
    }, {
      "id": "Observation.code",
      "path": "Observation.code",
      "binding": {
        "strength": "preferred",
        "valueSet": "http://fhir.health.gov.il/ValueSet/il-core-observation-code"
      },
      "mustSupport": true
    }, {
      "id": "Observation.subject",
      "path": "Observation.subject",
      "type": [ {
        "code": "Reference",
        "targetProfile": [ "http://fhir.health.gov.il/StructureDefinition/il-core-patient", "http://fhir.health.gov.il/StructureDefinition/il-core-group", "http://fhir.health.gov.il/StructureDefinition/il-core-device", "http://fhir.health.gov.il/StructureDefinition/il-core-location" ]
      } ],
      "mustSupport": true
    }, {
      "id": "Observation.encounter",
      "path": "Observation.encounter",
      "type": [ {
        "code": "Reference",
        "targetProfile": [ "http://fhir.health.gov.il/StructureDefinition/il-core-encounter" ]
      } ]
    }, {
      "id": "Observation.performer",
      "path": "Observation.performer",
      "type": [ {
        "code": "Reference",
        "targetProfile": [ "http://fhir.health.gov.il/StructureDefinition/il-core-practitioner", "http://fhir.health.gov.il/StructureDefinition/il-core-practitioner-role", "http://fhir.health.gov.il/StructureDefinition/il-core-organization", "http://fhir.health.gov.il/StructureDefinition/il-core-care-team", "http://fhir.health.gov.il/StructureDefinition/il-core-patient", "http://fhir.health.gov.il/StructureDefinition/il-core-related-person" ]
      } ]
    }, {
      "id": "Observation.value[x]",
      "path": "Observation.value[x]",
      "slicing": {
        "rules": "open",
        "ordered": false,
        "discriminator": [ {
          "path": "$this",
          "type": "type"
        } ]
      },
      "mustSupport": true
    }, {
      "id": "Observation.value[x]:valueQuantity",
      "max": "1",
      "min": 0,
      "path": "Observation.value[x]",
      "type": [ {
        "code": "Quantity"
      } ],
      "sliceName": "valueQuantity",
      "constraint": [ {
        "key": "il-obs-ucum",
        "human": "SHOULD use UCUM for coded quantity units",
        "source": "http://fhir.health.gov.il/StructureDefinition/il-core-observation",
        "severity": "warning",
        "expression": "system.empty() or system = 'http://unitsofmeasure.org'"
      } ]
    }, {
      "id": "Observation.value[x]:valueCodeableConcept",
      "max": "1",
      "min": 0,
      "path": "Observation.value[x]",
      "type": [ {
        "code": "CodeableConcept"
      } ],
      "binding": {
        "strength": "preferred",
        "valueSet": "http://fhir.health.gov.il/ValueSet/il-core-observation-value"
      },
      "sliceName": "valueCodeableConcept",
      "constraint": [ {
        "key": "il-obs-value-cc",
        "human": "SHOULD use SNOMED-CT or LOINC Answers for coded results",
        "source": "http://fhir.health.gov.il/StructureDefinition/il-core-observation",
        "severity": "warning",
        "expression": "coding.where(system='http://snomed.info/sct' and code.exists()).exists() OR coding.where(system='http://loinc.org' and code.startsWith('LA')).exists()"
      } ]
    }, {
      "id": "Observation.dataAbsentReason",
      "path": "Observation.dataAbsentReason",
      "constraint": [ {
        "key": "il-obs-not-performed",
        "human": "dataAbsentReason - if an IL-Core 'not-performed-reason' code is supplied, 'not performed' code MUST be supplied as well",
        "source": "http://fhir.health.gov.il/StructureDefinition/il-core-observation",
        "severity": "error",
        "expression": "coding.where(system='http://fhir.health.gov.il/cs/il-core-not-performed-reason').exists() implies coding.where(system='http://terminology.hl7.org/CodeSystem/data-absent-reason' and code='not-performed').exists()"
      } ]
    }, {
      "id": "Observation.dataAbsentReason.coding",
      "path": "Observation.dataAbsentReason.coding",
      "slicing": {
        "rules": "open",
        "discriminator": [ {
          "path": "system",
          "type": "value"
        } ]
      }
    }, {
      "id": "Observation.dataAbsentReason.coding:not-performed-reason",
      "max": "1",
      "min": 0,
      "path": "Observation.dataAbsentReason.coding",
      "sliceName": "not-performed-reason"
    }, {
      "id": "Observation.dataAbsentReason.coding:not-performed-reason.system",
      "min": 1,
      "path": "Observation.dataAbsentReason.coding.system",
      "patternUri": "http://fhir.health.gov.il/cs/il-core-not-performed-reason"
    }, {
      "id": "Observation.dataAbsentReason.coding:not-performed-reason.code",
      "min": 1,
      "path": "Observation.dataAbsentReason.coding.code"
    }, {
      "id": "Observation.bodySite",
      "path": "Observation.bodySite",
      "binding": {
        "strength": "preferred",
        "valueSet": "http://hl7.org/fhir/ValueSet/body-site",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "BodySite"
        } ],
        "description": "Codes describing anatomical locations. May include laterality."
      }
    }, {
      "id": "Observation.method",
      "path": "Observation.method",
      "binding": {
        "strength": "preferred",
        "valueSet": "http://hl7.org/fhir/ValueSet/observation-methods",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "ObservationMethod"
        } ],
        "description": "Methods for simple observations."
      }
    }, {
      "id": "Observation.specimen",
      "path": "Observation.specimen",
      "type": [ {
        "code": "Reference",
        "targetProfile": [ "http://fhir.health.gov.il/StructureDefinition/il-core-specimen" ]
      } ]
    }, {
      "id": "Observation.device",
      "path": "Observation.device",
      "type": [ {
        "code": "Reference",
        "targetProfile": [ "http://fhir.health.gov.il/StructureDefinition/il-core-device", "http://hl7.org/fhir/StructureDefinition/DeviceMetric" ]
      } ]
    }, {
      "id": "Observation.referenceRange.low",
      "path": "Observation.referenceRange.low",
      "constraint": [ {
        "key": "il-obs-ucum",
        "human": "SHOULD use UCUM for coded quantity units",
        "source": "http://fhir.health.gov.il/StructureDefinition/il-core-observation",
        "severity": "warning",
        "expression": "system.empty() or system = 'http://unitsofmeasure.org'"
      } ]
    }, {
      "id": "Observation.referenceRange.high",
      "path": "Observation.referenceRange.high",
      "constraint": [ {
        "key": "il-obs-ucum",
        "human": "SHOULD use UCUM for coded quantity units",
        "source": "http://fhir.health.gov.il/StructureDefinition/il-core-observation",
        "severity": "warning",
        "expression": "system.empty() or system = 'http://unitsofmeasure.org'"
      } ]
    }, {
      "id": "Observation.referenceRange.age.low",
      "path": "Observation.referenceRange.age.low",
      "binding": {
        "strength": "required",
        "valueSet": "http://hl7.org/fhir/ValueSet/age-units"
      }
    }, {
      "id": "Observation.referenceRange.age.high",
      "path": "Observation.referenceRange.age.high",
      "binding": {
        "strength": "required",
        "valueSet": "http://hl7.org/fhir/ValueSet/age-units"
      }
    }, {
      "id": "Observation.hasMember",
      "path": "Observation.hasMember",
      "type": [ {
        "code": "Reference",
        "targetProfile": [ "http://fhir.health.gov.il/StructureDefinition/il-core-observation", "http://fhir.health.gov.il/StructureDefinition/il-core-questionnaire-response", "http://hl7.org/fhir/StructureDefinition/MolecularSequence" ]
      } ]
    }, {
      "id": "Observation.derivedFrom",
      "path": "Observation.derivedFrom",
      "type": [ {
        "code": "Reference",
        "targetProfile": [ "http://fhir.health.gov.il/StructureDefinition/il-core-document-reference", "http://fhir.health.gov.il/StructureDefinition/il-core-imaging-study", "http://fhir.health.gov.il/StructureDefinition/il-core-media", "http://fhir.health.gov.il/StructureDefinition/il-core-questionnaire-response", "http://fhir.health.gov.il/StructureDefinition/il-core-observation", "http://hl7.org/fhir/StructureDefinition/MolecularSequence" ]
      } ]
    }, {
      "id": "Observation.component.code",
      "path": "Observation.component.code",
      "binding": {
        "strength": "preferred",
        "valueSet": "http://fhir.health.gov.il/ValueSet/il-core-observation-code"
      }
    }, {
      "id": "Observation.component.value[x]",
      "path": "Observation.component.value[x]",
      "slicing": {
        "rules": "open",
        "ordered": false,
        "discriminator": [ {
          "path": "$this",
          "type": "type"
        } ]
      }
    }, {
      "id": "Observation.component.value[x]:valueQuantity",
      "max": "1",
      "min": 0,
      "path": "Observation.component.value[x]",
      "type": [ {
        "code": "Quantity"
      } ],
      "sliceName": "valueQuantity",
      "constraint": [ {
        "key": "il-obs-ucum",
        "human": "SHOULD use UCUM for coded quantity units",
        "source": "http://fhir.health.gov.il/StructureDefinition/il-core-observation",
        "severity": "warning",
        "expression": "system.empty() or system = 'http://unitsofmeasure.org'"
      } ]
    }, {
      "id": "Observation.component.value[x]:valueCodeableConcept",
      "max": "1",
      "min": 0,
      "path": "Observation.component.value[x]",
      "type": [ {
        "code": "CodeableConcept"
      } ],
      "binding": {
        "strength": "preferred",
        "valueSet": "http://fhir.health.gov.il/ValueSet/il-core-observation-value"
      },
      "sliceName": "valueCodeableConcept",
      "constraint": [ {
        "key": "il-obs-value-cc",
        "human": "SHOULD use SNOMED-CT or LOINC Answers for coded results",
        "source": "http://fhir.health.gov.il/StructureDefinition/il-core-observation",
        "severity": "warning",
        "expression": "coding.where(system='http://snomed.info/sct' and code.exists()).exists() OR coding.where(system='http://loinc.org' and code.startsWith('LA')).exists()"
      } ]
    }, {
      "id": "Observation.component.referenceRange",
      "path": "Observation.component.referenceRange",
      "type": [ {
        "code": "BackboneElement"
      } ]
    }, {
      "id": "Observation.component.referenceRange.low",
      "path": "Observation.component.referenceRange.low",
      "constraint": [ {
        "key": "il-obs-ucum",
        "human": "SHOULD use UCUM for coded quantity units",
        "source": "http://fhir.health.gov.il/StructureDefinition/il-core-observation",
        "severity": "warning",
        "expression": "system.empty() or system = 'http://unitsofmeasure.org'"
      } ]
    }, {
      "id": "Observation.component.referenceRange.high",
      "path": "Observation.component.referenceRange.high",
      "constraint": [ {
        "key": "il-obs-ucum",
        "human": "SHOULD use UCUM for coded quantity units",
        "source": "http://fhir.health.gov.il/StructureDefinition/il-core-observation",
        "severity": "warning",
        "expression": "system.empty() or system = 'http://unitsofmeasure.org'"
      } ]
    }, {
      "id": "Observation.component.referenceRange.age.low",
      "path": "Observation.component.referenceRange.age.low",
      "binding": {
        "strength": "required",
        "valueSet": "http://hl7.org/fhir/ValueSet/age-units"
      }
    }, {
      "id": "Observation.component.referenceRange.age.high",
      "path": "Observation.component.referenceRange.age.high",
      "binding": {
        "strength": "required",
        "valueSet": "http://hl7.org/fhir/ValueSet/age-units"
      }
    } ]
  },
  "contact": [ {
    "telecom": [ {
      "value": "tal.primak@moh.gov.il",
      "system": "email"
    } ]
  } ],
  "baseDefinition": "http://hl7.org/fhir/StructureDefinition/Observation"
}