{
"description": "This profile represents the constraints applied to the Observation resource by the PS-CA project to represent results produced by laboratory tests or panels/studies in a patient summary. This observation may represent the result of a simple laboratory test such as hematocrit or it may group the set of results produced by a multi-test study or panel such as a complete blood count, a dynamic function test, or a urine specimen study. In the latter case, the observation carries the overall conclusion of the study and or a global interpretation by the producer of the study, in the comment element; and references the atomic results of the study as \\\"has-member\\\" child observations.\\r\\n \\n\\n It is informed by the constraints of the [Observation Results (Laboratory) IPS-UV profile](http://hl7.org/fhir/uv/ips/StructureDefinition-Observation-results-laboratory-uv-ips.html) and the [Canadian Baseline Profile](http://build.fhir.org/ig/HL7-Canada/ca-baseline/branches/master/StructureDefinition-profile-observation-results.html) to allow for cross-border and cross-jurisdiction sharing of laboratory result information",
"_filename": "structuredefinition-profile-observation-results-laboratory-ca-ps.json",
"package_name": "ca.infoway.io.psca",
"date": "2023-12-06T00:00:00-08:00",
"derivation": "constraint",
"publisher": null,
"fhirVersion": "4.0.1",
"purpose": "This profile constrains the Observation resource to represent a laboratory in vitro diagnostic test or panel/study. In case of a panel/study, the results of the panel appear as sub-observations. In this case this top-level Observation acts as a grouper of all the observations belonging to the panel or study. The top-level observation may carry a conclusion in the value element and or a global interpretation by the producer of the study, in the comment element.",
"name": "ObservationResultsLaboratoryPSCA",
"abstract": false,
"copyright": "Copyright © 2024+ Canada Health Infoway. All rights reserved. [Terms of Use and License Agreements](https://ic.infoway-inforoute.ca/en/about/tou). [Privacy Policy](https://www.infoway-inforoute.ca/en/legal/privacy-policy).",
"type": "Observation",
"experimental": "false",
"resourceType": "StructureDefinition",
"title": "Observation Results: laboratory (PS-CA)",
"package_version": "2.0.0-DFT-Ballot",
"status": "draft",
"id": "f04cdeff-8a93-43c6-802d-b58db4649d52",
"kind": "resource",
"url": "http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/observation-results-laboratory-ca-ps",
"version": null,
"differential": {
"element": [ {
"id": "Observation",
"path": "Observation",
"short": "Laboratory result for a simple test or for a panel/study",
"comment": "Represents either a lab simple observation or the group of observations produced by a laboratory study.",
"constraint": [ {
"key": "psca-lab-1",
"human": "if no \"hasMember\" element is present then Observation must have a \"value\"",
"severity": "error",
"expression": "value.exists() or hasMember.exists()"
} ],
"definition": "This observation may represent the result of a simple laboratory test such as hematocrit or it may group the set of results produced by a multi-test study or panel such as a complete blood count, a dynamic function test, or a urine specimen study. In the latter case, the observation carries the overall conclusion of the study and references the atomic results of the study as \"has-member\" child observations"
}, {
"id": "Observation.status",
"path": "Observation.status",
"comment": "Only lab observations with a status of \"final\" may be included in a patient summary.\n\n**Feedback is requested on whether this is too restrictive, and, e.g. \"amended\" or \"corrected\" should also be allowed.**"
}, {
"id": "Observation.category",
"min": 1,
"path": "Observation.category",
"comment": "\"laboratory\" includes laboratory medicine and pathology",
"slicing": {
"rules": "open",
"discriminator": [ {
"path": "$this",
"type": "pattern"
} ]
},
"definition": "A code that classifies the general type of observation being made. In this profile, at least one category code is fixed to \"laboratory\".",
"mustSupport": true
}, {
"id": "Observation.category:laboratory",
"max": "1",
"min": 1,
"path": "Observation.category",
"sliceName": "laboratory",
"mustSupport": true,
"patternCodeableConcept": {
"coding": [ {
"code": "laboratory",
"system": "http://terminology.hl7.org/CodeSystem/observation-category"
} ]
}
}, {
"id": "Observation.code",
"path": "Observation.code",
"binding": {
"strength": "example",
"valueSet": "http://fhir.infoway-inforoute.ca/io/psca/ValueSet/pCLOCD",
"extension": [ {
"url": "http://hl7.org/fhir/tools/StructureDefinition/additional-binding",
"extension": [ {
"url": "purpose",
"valueCode": "candidate"
}, {
"url": "valueSet",
"valueCanonical": "http://hl7.org/fhir/uv/ips/ValueSet/results-laboratory-observations-uv-ips"
}, {
"url": "documentation",
"valueMarkdown": "LOINC Observation codes utilized in IPS. This additional binding is surfaced to socialize the value sets that are proposed for international exchange in IPS. Where multiple codings can be supplied, it is encouraged to supply the original coding alongside the pan-Canadian preferred terminology."
} ]
} ],
"description": "Work is underway to define the pan-Canadian terminology that will be preferred and/or socialized for this element. A stub value set pointing to pCLOCD code system is put forth in the meantime to encourage implementers to utilize the Canadian localization of LOINC"
},
"comment": "In the context of this profile, when the observation plays the role of a grouper of member sub-observations, the code represent the group (for instance a panel code). In case no code is available, at least a text shall be provided.\n\nWork is underway to define the pan-Canadian terminology that will be preferred and/or socialized for this element",
"definition": "Describes what was observed. Sometimes this is called the observation \"name\". In this profile this code represents either a simple laboratory test or a laboratory study with multiple child observations",
"mustSupport": true
}, {
"id": "Observation.performer",
"min": 1,
"path": "Observation.performer",
"type": [ {
"code": "Reference",
"targetProfile": [ "http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/practitioner-lab-ca-ps", "http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/practitionerrole-lab-ca-ps", "http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/organization-lab-ca-ps", "http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/patient-ca-ps", "http://hl7.org/fhir/StructureDefinition/CareTeam", "http://hl7.org/fhir/StructureDefinition/RelatedPerson" ]
} ],
"comment": "IPS considers this a Must Support element with a minimum cardinality of 1. While all jurisdictions supporting laboratory in patient summary have indicated they can populate performer, some jurisdictions indicated this may be populated with provincial health authority information that may not be clinically meaningful. This constraint may be evaluated in IPS and PS-CA in the next release as updates are made to the underlying data models that underpin the FHIR profiles.",
"mustSupport": true
}, {
"id": "Observation.value[x]",
"path": "Observation.value[x]",
"comment": "Consistent with IPS-UV, this profile prohibits lab result values of boolean, integer, or SampledData data types. Feedback is requested on whether this is too restrictive.",
"slicing": {
"rules": "closed",
"discriminator": [ {
"path": "$this",
"type": "type"
} ]
},
"mustSupport": true
}, {
"id": "Observation.value[x]:valueString",
"path": "Observation.value[x]",
"type": [ {
"code": "string"
} ],
"sliceName": "valueString",
"mustSupport": true
}, {
"id": "Observation.value[x]:valueRange",
"path": "Observation.value[x]",
"type": [ {
"code": "Range",
"profile": [ "http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/Range-ca-ps" ]
} ],
"sliceName": "valueRange"
}, {
"id": "Observation.value[x]:valueRatio",
"path": "Observation.value[x]",
"type": [ {
"code": "Ratio",
"profile": [ "http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/Ratio-ca-ps" ]
} ],
"sliceName": "valueRatio"
}, {
"id": "Observation.value[x]:valueTime",
"path": "Observation.value[x]",
"type": [ {
"code": "time"
} ],
"sliceName": "valueTime"
}, {
"id": "Observation.value[x]:valueDateTime",
"path": "Observation.value[x]",
"type": [ {
"code": "dateTime"
} ],
"sliceName": "valueDateTime"
}, {
"id": "Observation.value[x]:valuePeriod",
"path": "Observation.value[x]",
"type": [ {
"code": "Period"
} ],
"sliceName": "valuePeriod"
}, {
"id": "Observation.value[x]:valueQuantity",
"path": "Observation.value[x]",
"type": [ {
"code": "Quantity",
"profile": [ "http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/Quantity-ca-ps" ]
} ],
"comment": "IPS-UV flags this as a Must Support element. It is not currently flagged as Must Support in PS-CA, as stakeholders have indicated the element may not be supported by the majority of systems today. Systems that do support the element are encouraged to include it in generated Patient Summary documents, and support it when received. Vendors should expect that some jurisdictions may add a Must Support requirement within the context of their own jurisdictional content.",
"sliceName": "valueQuantity"
}, {
"id": "Observation.value[x]:valueCodeableConcept",
"path": "Observation.value[x]",
"type": [ {
"code": "CodeableConcept",
"profile": [ "http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/CodeableConcept-ca-ps" ]
} ],
"binding": {
"strength": "example",
"extension": [ {
"url": "http://hl7.org/fhir/tools/StructureDefinition/additional-binding",
"extension": [ {
"url": "purpose",
"valueCode": "candidate"
}, {
"url": "valueSet",
"valueCanonical": "http://hl7.org/fhir/uv/ips/ValueSet/results-coded-values-laboratory-uv-ips"
}, {
"url": "documentation",
"valueMarkdown": "SNOMED CT laboratory result codes utilized in IPS. This additional binding is surfaced to socialize the value sets that are proposed for international exchange in IPS. Where multiple codings can be supplied, it is encouraged to supply the original coding alongside the pan-Canadian preferred terminology."
} ]
} ],
"description": "Work is underway to define the pan-Canadian terminology that will be preferred and/or socialized for this element"
},
"comment": "Work is underway to define the pan-Canadian terminology that will be preferred and/or socialized for this element. IPS-UV flags this as a Must Support element. It is not currently flagged as Must Support in PS-CA, as stakeholders have indicated the element may not be supported by the majority of systems today. Systems that do support the element are encouraged to include it in generated Patient Summary documents, and support it when received. Vendors should expect that some jurisdictions may add a Must Support requirement within the context of their own jurisdictional content.",
"sliceName": "valueCodeableConcept"
} ]
},
"baseDefinition": "http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/observation-results-ca-ps"
}