Bangladesh Core FHIR Implementation Guide
0.4.5 - Published by DGHS, MoHFW Bangladesh flag

Bangladesh Core FHIR Implementation Guide - Published by Ministry of Health and Family Welfare. See the Directory of published versions

Resource Profile: Bangladesh Laboratory Result Observation

Official URL: https://fhir.dghs.gov.bd/core/StructureDefinition/bd-lab-result-observation Version: 0.4.5
Standards status: Informative Maturity Level: 1 Computable Name: BDLabResultObservationProfile

Profile for individual laboratory result (component-level) Observations in Bangladesh. Represents a single test result within a laboratory panel (e.g. Haemoglobin within a CBC panel).

Usage:

  • Observation.code is the result/component code (from BD LOINC Lab Results ValueSet)
  • Observation.value[x] is required — every leaf result must carry a value
  • Observation.hasMember is prohibited — leaf results cannot group further
  • Observation.derivedFrom references the parent panel Observation
  • Observation.category is fixed to 'laboratory'

FHIR hasMember pattern: bd-lab-panel-observation └── hasMember –> bd-lab-result-observation (this profile)

Coded results (Ord/Nom scale): Use valueCodeableConcept with codes from BD LOINC Answer Lists ValueSet.

Usages:

You can also check for usages in the FHIR IG Statistics

Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work.

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Observation C 0..* BDObservationProfile Measurements and simple assertions
Constraints: obs-6, obs-7
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... identifier SΣ 1..* Identifier Business Identifier for observation
.... use ?!Σ 0..1 code usual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
.... value Σ 1..1 string The value that is unique
Example General: 123456
... category S 1..* CodeableConcept Classification of type of observation
Binding: ObservationCategoryCodes (preferred)

Required Pattern: At least the following
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... coding 1..* Coding Code defined by a terminology system
Fixed Value: (Complex)
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
..... system 1..1 uri Identity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category
..... version 0..1 string Version of the system - if relevant
..... code 1..1 code Symbol in syntax defined by the system
Fixed Value: laboratory
..... display 0..1 string Representation defined by the system
..... userSelected 0..1 boolean If this coding was chosen directly by the user
.... text 0..1 string Plain text representation of the concept
... code SΣ 1..1 CodeableConcept ​Type of observation (code / type)
Binding: https://fhir.dghs.gov.bd/core/ValueSet/loinc-lab-results (extensible)
... subject SΣ 1..1 Reference(Patient) Who and/or what the observation is about
.... reference SΣC 1..1 string Literal reference, Relative, internal or absolute URL
.... display SΣ 1..1 string Text alternative for the resource
... encounter SΣ 1..1 Reference(Encounter) Healthcare event during which this observation is made
.... reference SΣC 1..1 string Literal reference, Relative, internal or absolute URL
... Slices for effective[x] SΣ 1..1 Clinically relevant time/time-period for observation
Slice: Unordered, Open by type:$this
.... effectiveDateTime dateTime
.... effectivePeriod Period
.... effective[x]:effectiveDateTime Σ 0..1 dateTime Clinically relevant time/time-period for observation
... performer Σ 1..* Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson) Who is responsible for the observation
.... reference ΣC 1..1 string Literal reference, Relative, internal or absolute URL
... Slices for value[x] SΣC 1..1 Actual result
Slice: Unordered, Closed by type:$this
.... valueQuantity Quantity
.... valueCodeableConcept CodeableConcept
.... value[x]:valueQuantity SΣC 0..1 Quantity Actual result
..... value Σ 1..1 decimal Numerical value (with implicit precision)
..... comparator ?!Σ 0..1 code < | <= | >= | > - how to understand the value
Binding: QuantityComparator (required): How the Quantity should be understood and represented.
..... unit Σ 1..1 string Unit representation
..... system ΣC 1..1 uri System that defines coded unit form
Required Pattern: http://unitsofmeasure.org
..... code Σ 1..1 code Coded form of the unit
.... value[x]:valueCodeableConcept SΣC 0..1 CodeableConcept ​Actual result
Binding: https://fhir.dghs.gov.bd/core/ValueSet/loinc-answer-lists (extensible)
.... value[x]:valueString ΣC 0..1 string Actual result
.... value[x]:valueBoolean ΣC 0..1 boolean Actual result
.... value[x]:valueInteger ΣC 0..1 integer Actual result
.... value[x]:valueRange ΣC 0..1 Range Actual result
.... value[x]:valueRatio ΣC 0..1 Ratio Actual result
.... value[x]:valueSampledData ΣC 0..1 SampledData Actual result
.... value[x]:valueTime ΣC 0..1 time Actual result
.... value[x]:valueDateTime ΣC 0..1 dateTime Actual result
.... value[x]:valuePeriod ΣC 0..1 Period Actual result
... interpretation S 0..* CodeableConcept High, low, normal, etc.
Binding: ObservationInterpretationCodes (extensible)
... note S 0..* Annotation Comments about the observation
... specimen S 0..1 Reference(Specimen) Specimen used for this observation
... referenceRange SC 0..* BackboneElement Provides guide for interpretation
Constraints: obs-3
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
... derivedFrom SΣ 0..* Reference(Bangladesh Laboratory Panel Observation) Related measurements the observation is made from

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
Observation.identifier.​use Base required IdentifierUse 📍4.0.1 FHIR Std.
Observation.status Base required ObservationStatus 📦4.0.1 FHIR Std.
Observation.category Base preferred Observation Category Codes 📦4.0.1 FHIR Std.
Observation.code Base extensible ​ https://fhir.dghs.gov.bd/core/ValueSet/loinc-lab-results Not State Unknown
Observation.value[x]:valueQuantity.​comparator Base required QuantityComparator 📍4.0.1 FHIR Std.
Observation.value[x]:valueCodeableConcept Base extensible ​ https://fhir.dghs.gov.bd/core/ValueSet/loinc-answer-lists Not State Unknown
Observation.interpretation Base extensible Observation Interpretation Codes 📦4.0.1 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
dom-2 error Observation If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error Observation If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4 error Observation If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5 error Observation If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice Observation A resource should have narrative for robust management text.`div`.exists()
ele-1 error **ALL** elements All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ext-1 error **ALL** extensions Must have either extensions or value[x], not both extension.exists() != value.exists()
obs-3 error Observation.referenceRange Must have at least a low or a high or text low.exists() or high.exists() or text.exists()
obs-6 error Observation dataAbsentReason SHALL only be present if Observation.value[x] is not present dataAbsentReason.empty() or value.empty()
obs-7 error Observation If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present value.empty() or component.code.where(coding.intersect(%resource.code.coding).exists()).empty()

This structure is derived from BDObservationProfile

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Observation 0..* BDObservationProfile Measurements and simple assertions
... identifier 1..* Identifier Business Identifier for observation
... status 1..1 code registered | preliminary | final | amended +
Binding: ObservationStatus (required)
... category 1..* CodeableConcept Classification of type of observation
Required Pattern: At least the following
.... coding 1..* Coding Code defined by a terminology system
Fixed Value: (Complex)
..... system 1..1 uri Identity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category
..... code 1..1 code Symbol in syntax defined by the system
Fixed Value: laboratory
... Slices for effective[x] S 1..1 Clinically relevant time/time-period for observation
Slice: Unordered, Open by type:$this
.... effectiveDateTime dateTime
.... effectivePeriod Period
.... effective[x]:effectiveDateTime 0..1 dateTime Clinically relevant time/time-period for observation
... value[x] S 1..1 Actual result
.... valueQuantity Quantity
.... valueCodeableConcept CodeableConcept
... Slices for value[x] Content/Rules for all slices
.... value[x]:valueQuantity S 0..1 Quantity Actual result
..... value 1..1 decimal Numerical value (with implicit precision)
..... unit 1..1 string Unit representation
..... system 1..1 uri System that defines coded unit form
..... code 1..1 code Coded form of the unit
.... value[x]:valueCodeableConcept S 0..1 CodeableConcept ​Actual result
Binding: https://fhir.dghs.gov.bd/core/ValueSet/loinc-answer-lists (extensible)
... interpretation S 0..* CodeableConcept High, low, normal, etc.
... note S 0..* Annotation Comments about the observation
... specimen 0..1 Reference(Specimen) Specimen used for this observation
... referenceRange S 0..* BackboneElement Provides guide for interpretation
... hasMember 0..0 Related resource that belongs to the Observation group
... derivedFrom 0..* Reference(Bangladesh Laboratory Panel Observation) Related measurements the observation is made from

doco Documentation for this format

Terminology Bindings (Differential)

Path Status Usage ValueSet Version Source
Observation.status Base required ObservationStatus 📦4.0.1 FHIR Std.
Observation.code Base extensible ​ https://fhir.dghs.gov.bd/core/ValueSet/loinc-lab-results Not State Unknown
Observation.value[x]:valueCodeableConcept Base extensible ​ https://fhir.dghs.gov.bd/core/ValueSet/loinc-answer-lists Not State Unknown
NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Observation C 0..* BDObservationProfile Measurements and simple assertions
Constraints: obs-6, obs-7
... id Σ 0..1 id Logical id of this artifact
... meta Σ 0..1 Meta Metadata about the resource
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... language 0..1 code Language of the resource content
Binding: CommonLanguages (preferred): A human language.
Additional BindingsPurpose
AllLanguages Max Binding
... text 0..1 Narrative Text summary of the resource, for human interpretation
This profile does not constrain the narrative in regard to content, language, or traceability to data elements
... contained 0..* Resource Contained, inline Resources
... extension 0..* Extension Additional content defined by implementations
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... identifier SΣ 1..* Identifier Business Identifier for observation
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... use ?!Σ 0..1 code usual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
.... type Σ 0..1 CodeableConcept Description of identifier
Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
.... system Σ 0..1 uri The namespace for the identifier value
Example General: http://www.acme.com/identifiers/patient
.... value Σ 1..1 string The value that is unique
Example General: 123456
.... period Σ 0..1 Period Time period when id is/was valid for use
.... assigner Σ 0..1 Reference(Organization) Organization that issued id (may be just text)
... basedOn Σ 0..* Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest) Fulfills plan, proposal or order
... partOf Σ 0..* Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy) Part of referenced event
... status ?!Σ 1..1 code registered | preliminary | final | amended +
Binding: ObservationStatus (required)
... category S 1..* CodeableConcept Classification of type of observation
Binding: ObservationCategoryCodes (preferred)

Required Pattern: At least the following
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... coding 1..* Coding Code defined by a terminology system
Fixed Value: (Complex)
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
..... system 1..1 uri Identity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category
..... version 0..1 string Version of the system - if relevant
..... code 1..1 code Symbol in syntax defined by the system
Fixed Value: laboratory
..... display 0..1 string Representation defined by the system
..... userSelected 0..1 boolean If this coding was chosen directly by the user
.... text 0..1 string Plain text representation of the concept
... code SΣ 1..1 CodeableConcept ​Type of observation (code / type)
Binding: https://fhir.dghs.gov.bd/core/ValueSet/loinc-lab-results (extensible)
... subject SΣ 1..1 Reference(Patient) Who and/or what the observation is about
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... reference SΣC 1..1 string Literal reference, Relative, internal or absolute URL
.... type Σ 0..1 uri Type the reference refers to (e.g. "Patient")
Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
.... identifier Σ 0..1 Identifier Logical reference, when literal reference is not known
.... display SΣ 1..1 string Text alternative for the resource
... focus Σ 0..* Reference(Resource) What the observation is about, when it is not about the subject of record
... encounter SΣ 1..1 Reference(Encounter) Healthcare event during which this observation is made
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... reference SΣC 1..1 string Literal reference, Relative, internal or absolute URL
.... type Σ 0..1 uri Type the reference refers to (e.g. "Patient")
Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
.... identifier Σ 0..1 Identifier Logical reference, when literal reference is not known
.... display Σ 0..1 string Text alternative for the resource
... Slices for effective[x] SΣ 1..1 Clinically relevant time/time-period for observation
Slice: Unordered, Open by type:$this
.... effectiveDateTime dateTime
.... effectivePeriod Period
.... effective[x]:effectiveDateTime Σ 0..1 dateTime Clinically relevant time/time-period for observation
... issued Σ 0..1 instant Date/Time this version was made available
... performer Σ 1..* Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson) Who is responsible for the observation
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... reference ΣC 1..1 string Literal reference, Relative, internal or absolute URL
.... type Σ 0..1 uri Type the reference refers to (e.g. "Patient")
Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
.... identifier Σ 0..1 Identifier Logical reference, when literal reference is not known
.... display Σ 0..1 string Text alternative for the resource
... Slices for value[x] SΣC 1..1 Actual result
Slice: Unordered, Closed by type:$this
.... valueQuantity Quantity
.... valueCodeableConcept CodeableConcept
.... value[x]:valueQuantity SΣC 0..1 Quantity Actual result
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... value Σ 1..1 decimal Numerical value (with implicit precision)
..... comparator ?!Σ 0..1 code < | <= | >= | > - how to understand the value
Binding: QuantityComparator (required): How the Quantity should be understood and represented.
..... unit Σ 1..1 string Unit representation
..... system ΣC 1..1 uri System that defines coded unit form
Required Pattern: http://unitsofmeasure.org
..... code Σ 1..1 code Coded form of the unit
.... value[x]:valueCodeableConcept SΣC 0..1 CodeableConcept ​Actual result
Binding: https://fhir.dghs.gov.bd/core/ValueSet/loinc-answer-lists (extensible)
.... value[x]:valueString ΣC 0..1 string Actual result
.... value[x]:valueBoolean ΣC 0..1 boolean Actual result
.... value[x]:valueInteger ΣC 0..1 integer Actual result
.... value[x]:valueRange ΣC 0..1 Range Actual result
.... value[x]:valueRatio ΣC 0..1 Ratio Actual result
.... value[x]:valueSampledData ΣC 0..1 SampledData Actual result
.... value[x]:valueTime ΣC 0..1 time Actual result
.... value[x]:valueDateTime ΣC 0..1 dateTime Actual result
.... value[x]:valuePeriod ΣC 0..1 Period Actual result
... dataAbsentReason C 0..1 CodeableConcept Why the result is missing
Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
... interpretation S 0..* CodeableConcept High, low, normal, etc.
Binding: ObservationInterpretationCodes (extensible)
... note S 0..* Annotation Comments about the observation
... bodySite 0..1 CodeableConcept Observed body part
Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
... method 0..1 CodeableConcept How it was done
Binding: ObservationMethods (extensible)
... specimen S 0..1 Reference(Specimen) Specimen used for this observation
... device 0..1 Reference(Device | DeviceMetric) (Measurement) Device
... referenceRange SC 0..* BackboneElement Provides guide for interpretation
Constraints: obs-3
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... low C 0..1 SimpleQuantity(4.0.1) Low Range, if relevant
.... high C 0..1 SimpleQuantity(4.0.1) High Range, if relevant
.... type 0..1 CodeableConcept Reference range qualifier
Binding: ObservationReferenceRangeMeaningCodes (preferred): Code for the meaning of a reference range.
.... appliesTo 0..* CodeableConcept Reference range population
Binding: ObservationReferenceRangeAppliesToCodes (example): Codes identifying the population the reference range applies to.
.... age 0..1 Range Applicable age range, if relevant
.... text 0..1 string Text based reference range in an observation
... derivedFrom SΣ 0..* Reference(Bangladesh Laboratory Panel Observation) Related measurements the observation is made from
... component Σ 0..* BackboneElement Component results
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... code Σ 1..1 CodeableConcept Type of component observation (code / type)
Binding: LOINCCodes (example): Codes identifying names of simple observations.
.... value[x] Σ 0..1 Actual component result
..... valueQuantity Quantity
..... valueCodeableConcept CodeableConcept
..... valueString string
..... valueBoolean boolean
..... valueInteger integer
..... valueRange Range
..... valueRatio Ratio
..... valueSampledData SampledData
..... valueTime time
..... valueDateTime dateTime
..... valuePeriod Period
.... dataAbsentReason C 0..1 CodeableConcept Why the component result is missing
Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
.... interpretation 0..* CodeableConcept High, low, normal, etc.
Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
.... referenceRange 0..* See referenceRange (Observation) Provides guide for interpretation of component result

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
Observation.language Base preferred Common Languages 📍4.0.1 FHIR Std.
Observation.identifier.​use Base required IdentifierUse 📍4.0.1 FHIR Std.
Observation.identifier.​type Base extensible IdentifierType 📍4.0.1 FHIR Std.
Observation.status Base required ObservationStatus 📦4.0.1 FHIR Std.
Observation.category Base preferred Observation Category Codes 📦4.0.1 FHIR Std.
Observation.code Base extensible ​ https://fhir.dghs.gov.bd/core/ValueSet/loinc-lab-results Not State Unknown
Observation.subject.​type Base extensible ResourceType 📍4.0.1 FHIR Std.
Observation.encounter.​type Base extensible ResourceType 📍4.0.1 FHIR Std.
Observation.performer.​type Base extensible ResourceType 📍4.0.1 FHIR Std.
Observation.value[x]:valueQuantity.​comparator Base required QuantityComparator 📍4.0.1 FHIR Std.
Observation.value[x]:valueCodeableConcept Base extensible ​ https://fhir.dghs.gov.bd/core/ValueSet/loinc-answer-lists Not State Unknown
Observation.dataAbsentReason Base extensible DataAbsentReason 📍4.0.1 FHIR Std.
Observation.interpretation Base extensible Observation Interpretation Codes 📦4.0.1 FHIR Std.
Observation.bodySite Base example SNOMED CT Body Structures 📍4.0.1 FHIR Std.
Observation.method Base extensible Observation Methods 📦4.0.1 FHIR Std.
Observation.referenceRange.​type Base preferred Observation Reference Range Meaning Codes 📍4.0.1 FHIR Std.
Observation.referenceRange.​appliesTo Base example Observation Reference Range Applies To Codes 📍4.0.1 FHIR Std.
Observation.component.​code Base example LOINC Codes 📍4.0.1 FHIR Std.
Observation.component.​dataAbsentReason Base extensible DataAbsentReason 📍4.0.1 FHIR Std.
Observation.component.​interpretation Base extensible Observation Interpretation Codes 📍4.0.1 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
dom-2 error Observation If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error Observation If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4 error Observation If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5 error Observation If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice Observation A resource should have narrative for robust management text.`div`.exists()
ele-1 error **ALL** elements All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ext-1 error **ALL** extensions Must have either extensions or value[x], not both extension.exists() != value.exists()
obs-3 error Observation.referenceRange Must have at least a low or a high or text low.exists() or high.exists() or text.exists()
obs-6 error Observation dataAbsentReason SHALL only be present if Observation.value[x] is not present dataAbsentReason.empty() or value.empty()
obs-7 error Observation If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present value.empty() or component.code.where(coding.intersect(%resource.code.coding).exists()).empty()

This structure is derived from BDObservationProfile

Summary

Mandatory: 3 elements(4 nested mandatory elements)
Must-Support: 7 elements
Prohibited: 1 element

Structures

This structure refers to these other structures:

Slices

This structure defines the following Slices:

  • The element 1 is sliced based on the value of Observation.effective[x]

Maturity: 1

Key Elements View

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Observation C 0..* BDObservationProfile Measurements and simple assertions
Constraints: obs-6, obs-7
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... identifier SΣ 1..* Identifier Business Identifier for observation
.... use ?!Σ 0..1 code usual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
.... value Σ 1..1 string The value that is unique
Example General: 123456
... category S 1..* CodeableConcept Classification of type of observation
Binding: ObservationCategoryCodes (preferred)

Required Pattern: At least the following
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... coding 1..* Coding Code defined by a terminology system
Fixed Value: (Complex)
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
..... system 1..1 uri Identity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category
..... version 0..1 string Version of the system - if relevant
..... code 1..1 code Symbol in syntax defined by the system
Fixed Value: laboratory
..... display 0..1 string Representation defined by the system
..... userSelected 0..1 boolean If this coding was chosen directly by the user
.... text 0..1 string Plain text representation of the concept
... code SΣ 1..1 CodeableConcept ​Type of observation (code / type)
Binding: https://fhir.dghs.gov.bd/core/ValueSet/loinc-lab-results (extensible)
... subject SΣ 1..1 Reference(Patient) Who and/or what the observation is about
.... reference SΣC 1..1 string Literal reference, Relative, internal or absolute URL
.... display SΣ 1..1 string Text alternative for the resource
... encounter SΣ 1..1 Reference(Encounter) Healthcare event during which this observation is made
.... reference SΣC 1..1 string Literal reference, Relative, internal or absolute URL
... Slices for effective[x] SΣ 1..1 Clinically relevant time/time-period for observation
Slice: Unordered, Open by type:$this
.... effectiveDateTime dateTime
.... effectivePeriod Period
.... effective[x]:effectiveDateTime Σ 0..1 dateTime Clinically relevant time/time-period for observation
... performer Σ 1..* Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson) Who is responsible for the observation
.... reference ΣC 1..1 string Literal reference, Relative, internal or absolute URL
... Slices for value[x] SΣC 1..1 Actual result
Slice: Unordered, Closed by type:$this
.... valueQuantity Quantity
.... valueCodeableConcept CodeableConcept
.... value[x]:valueQuantity SΣC 0..1 Quantity Actual result
..... value Σ 1..1 decimal Numerical value (with implicit precision)
..... comparator ?!Σ 0..1 code < | <= | >= | > - how to understand the value
Binding: QuantityComparator (required): How the Quantity should be understood and represented.
..... unit Σ 1..1 string Unit representation
..... system ΣC 1..1 uri System that defines coded unit form
Required Pattern: http://unitsofmeasure.org
..... code Σ 1..1 code Coded form of the unit
.... value[x]:valueCodeableConcept SΣC 0..1 CodeableConcept ​Actual result
Binding: https://fhir.dghs.gov.bd/core/ValueSet/loinc-answer-lists (extensible)
.... value[x]:valueString ΣC 0..1 string Actual result
.... value[x]:valueBoolean ΣC 0..1 boolean Actual result
.... value[x]:valueInteger ΣC 0..1 integer Actual result
.... value[x]:valueRange ΣC 0..1 Range Actual result
.... value[x]:valueRatio ΣC 0..1 Ratio Actual result
.... value[x]:valueSampledData ΣC 0..1 SampledData Actual result
.... value[x]:valueTime ΣC 0..1 time Actual result
.... value[x]:valueDateTime ΣC 0..1 dateTime Actual result
.... value[x]:valuePeriod ΣC 0..1 Period Actual result
... interpretation S 0..* CodeableConcept High, low, normal, etc.
Binding: ObservationInterpretationCodes (extensible)
... note S 0..* Annotation Comments about the observation
... specimen S 0..1 Reference(Specimen) Specimen used for this observation
... referenceRange SC 0..* BackboneElement Provides guide for interpretation
Constraints: obs-3
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
... derivedFrom SΣ 0..* Reference(Bangladesh Laboratory Panel Observation) Related measurements the observation is made from

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
Observation.identifier.​use Base required IdentifierUse 📍4.0.1 FHIR Std.
Observation.status Base required ObservationStatus 📦4.0.1 FHIR Std.
Observation.category Base preferred Observation Category Codes 📦4.0.1 FHIR Std.
Observation.code Base extensible ​ https://fhir.dghs.gov.bd/core/ValueSet/loinc-lab-results Not State Unknown
Observation.value[x]:valueQuantity.​comparator Base required QuantityComparator 📍4.0.1 FHIR Std.
Observation.value[x]:valueCodeableConcept Base extensible ​ https://fhir.dghs.gov.bd/core/ValueSet/loinc-answer-lists Not State Unknown
Observation.interpretation Base extensible Observation Interpretation Codes 📦4.0.1 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
dom-2 error Observation If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error Observation If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4 error Observation If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5 error Observation If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice Observation A resource should have narrative for robust management text.`div`.exists()
ele-1 error **ALL** elements All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ext-1 error **ALL** extensions Must have either extensions or value[x], not both extension.exists() != value.exists()
obs-3 error Observation.referenceRange Must have at least a low or a high or text low.exists() or high.exists() or text.exists()
obs-6 error Observation dataAbsentReason SHALL only be present if Observation.value[x] is not present dataAbsentReason.empty() or value.empty()
obs-7 error Observation If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present value.empty() or component.code.where(coding.intersect(%resource.code.coding).exists()).empty()

Differential View

This structure is derived from BDObservationProfile

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Observation 0..* BDObservationProfile Measurements and simple assertions
... identifier 1..* Identifier Business Identifier for observation
... status 1..1 code registered | preliminary | final | amended +
Binding: ObservationStatus (required)
... category 1..* CodeableConcept Classification of type of observation
Required Pattern: At least the following
.... coding 1..* Coding Code defined by a terminology system
Fixed Value: (Complex)
..... system 1..1 uri Identity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category
..... code 1..1 code Symbol in syntax defined by the system
Fixed Value: laboratory
... Slices for effective[x] S 1..1 Clinically relevant time/time-period for observation
Slice: Unordered, Open by type:$this
.... effectiveDateTime dateTime
.... effectivePeriod Period
.... effective[x]:effectiveDateTime 0..1 dateTime Clinically relevant time/time-period for observation
... value[x] S 1..1 Actual result
.... valueQuantity Quantity
.... valueCodeableConcept CodeableConcept
... Slices for value[x] Content/Rules for all slices
.... value[x]:valueQuantity S 0..1 Quantity Actual result
..... value 1..1 decimal Numerical value (with implicit precision)
..... unit 1..1 string Unit representation
..... system 1..1 uri System that defines coded unit form
..... code 1..1 code Coded form of the unit
.... value[x]:valueCodeableConcept S 0..1 CodeableConcept ​Actual result
Binding: https://fhir.dghs.gov.bd/core/ValueSet/loinc-answer-lists (extensible)
... interpretation S 0..* CodeableConcept High, low, normal, etc.
... note S 0..* Annotation Comments about the observation
... specimen 0..1 Reference(Specimen) Specimen used for this observation
... referenceRange S 0..* BackboneElement Provides guide for interpretation
... hasMember 0..0 Related resource that belongs to the Observation group
... derivedFrom 0..* Reference(Bangladesh Laboratory Panel Observation) Related measurements the observation is made from

doco Documentation for this format

Terminology Bindings (Differential)

Path Status Usage ValueSet Version Source
Observation.status Base required ObservationStatus 📦4.0.1 FHIR Std.
Observation.code Base extensible ​ https://fhir.dghs.gov.bd/core/ValueSet/loinc-lab-results Not State Unknown
Observation.value[x]:valueCodeableConcept Base extensible ​ https://fhir.dghs.gov.bd/core/ValueSet/loinc-answer-lists Not State Unknown

Snapshot View

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Observation C 0..* BDObservationProfile Measurements and simple assertions
Constraints: obs-6, obs-7
... id Σ 0..1 id Logical id of this artifact
... meta Σ 0..1 Meta Metadata about the resource
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... language 0..1 code Language of the resource content
Binding: CommonLanguages (preferred): A human language.
Additional BindingsPurpose
AllLanguages Max Binding
... text 0..1 Narrative Text summary of the resource, for human interpretation
This profile does not constrain the narrative in regard to content, language, or traceability to data elements
... contained 0..* Resource Contained, inline Resources
... extension 0..* Extension Additional content defined by implementations
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... identifier SΣ 1..* Identifier Business Identifier for observation
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... use ?!Σ 0..1 code usual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
.... type Σ 0..1 CodeableConcept Description of identifier
Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
.... system Σ 0..1 uri The namespace for the identifier value
Example General: http://www.acme.com/identifiers/patient
.... value Σ 1..1 string The value that is unique
Example General: 123456
.... period Σ 0..1 Period Time period when id is/was valid for use
.... assigner Σ 0..1 Reference(Organization) Organization that issued id (may be just text)
... basedOn Σ 0..* Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest) Fulfills plan, proposal or order
... partOf Σ 0..* Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy) Part of referenced event
... status ?!Σ 1..1 code registered | preliminary | final | amended +
Binding: ObservationStatus (required)
... category S 1..* CodeableConcept Classification of type of observation
Binding: ObservationCategoryCodes (preferred)

Required Pattern: At least the following
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... coding 1..* Coding Code defined by a terminology system
Fixed Value: (Complex)
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
..... system 1..1 uri Identity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category
..... version 0..1 string Version of the system - if relevant
..... code 1..1 code Symbol in syntax defined by the system
Fixed Value: laboratory
..... display 0..1 string Representation defined by the system
..... userSelected 0..1 boolean If this coding was chosen directly by the user
.... text 0..1 string Plain text representation of the concept
... code SΣ 1..1 CodeableConcept ​Type of observation (code / type)
Binding: https://fhir.dghs.gov.bd/core/ValueSet/loinc-lab-results (extensible)
... subject SΣ 1..1 Reference(Patient) Who and/or what the observation is about
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... reference SΣC 1..1 string Literal reference, Relative, internal or absolute URL
.... type Σ 0..1 uri Type the reference refers to (e.g. "Patient")
Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
.... identifier Σ 0..1 Identifier Logical reference, when literal reference is not known
.... display SΣ 1..1 string Text alternative for the resource
... focus Σ 0..* Reference(Resource) What the observation is about, when it is not about the subject of record
... encounter SΣ 1..1 Reference(Encounter) Healthcare event during which this observation is made
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... reference SΣC 1..1 string Literal reference, Relative, internal or absolute URL
.... type Σ 0..1 uri Type the reference refers to (e.g. "Patient")
Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
.... identifier Σ 0..1 Identifier Logical reference, when literal reference is not known
.... display Σ 0..1 string Text alternative for the resource
... Slices for effective[x] SΣ 1..1 Clinically relevant time/time-period for observation
Slice: Unordered, Open by type:$this
.... effectiveDateTime dateTime
.... effectivePeriod Period
.... effective[x]:effectiveDateTime Σ 0..1 dateTime Clinically relevant time/time-period for observation
... issued Σ 0..1 instant Date/Time this version was made available
... performer Σ 1..* Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson) Who is responsible for the observation
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... reference ΣC 1..1 string Literal reference, Relative, internal or absolute URL
.... type Σ 0..1 uri Type the reference refers to (e.g. "Patient")
Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
.... identifier Σ 0..1 Identifier Logical reference, when literal reference is not known
.... display Σ 0..1 string Text alternative for the resource
... Slices for value[x] SΣC 1..1 Actual result
Slice: Unordered, Closed by type:$this
.... valueQuantity Quantity
.... valueCodeableConcept CodeableConcept
.... value[x]:valueQuantity SΣC 0..1 Quantity Actual result
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... value Σ 1..1 decimal Numerical value (with implicit precision)
..... comparator ?!Σ 0..1 code < | <= | >= | > - how to understand the value
Binding: QuantityComparator (required): How the Quantity should be understood and represented.
..... unit Σ 1..1 string Unit representation
..... system ΣC 1..1 uri System that defines coded unit form
Required Pattern: http://unitsofmeasure.org
..... code Σ 1..1 code Coded form of the unit
.... value[x]:valueCodeableConcept SΣC 0..1 CodeableConcept ​Actual result
Binding: https://fhir.dghs.gov.bd/core/ValueSet/loinc-answer-lists (extensible)
.... value[x]:valueString ΣC 0..1 string Actual result
.... value[x]:valueBoolean ΣC 0..1 boolean Actual result
.... value[x]:valueInteger ΣC 0..1 integer Actual result
.... value[x]:valueRange ΣC 0..1 Range Actual result
.... value[x]:valueRatio ΣC 0..1 Ratio Actual result
.... value[x]:valueSampledData ΣC 0..1 SampledData Actual result
.... value[x]:valueTime ΣC 0..1 time Actual result
.... value[x]:valueDateTime ΣC 0..1 dateTime Actual result
.... value[x]:valuePeriod ΣC 0..1 Period Actual result
... dataAbsentReason C 0..1 CodeableConcept Why the result is missing
Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
... interpretation S 0..* CodeableConcept High, low, normal, etc.
Binding: ObservationInterpretationCodes (extensible)
... note S 0..* Annotation Comments about the observation
... bodySite 0..1 CodeableConcept Observed body part
Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
... method 0..1 CodeableConcept How it was done
Binding: ObservationMethods (extensible)
... specimen S 0..1 Reference(Specimen) Specimen used for this observation
... device 0..1 Reference(Device | DeviceMetric) (Measurement) Device
... referenceRange SC 0..* BackboneElement Provides guide for interpretation
Constraints: obs-3
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... low C 0..1 SimpleQuantity(4.0.1) Low Range, if relevant
.... high C 0..1 SimpleQuantity(4.0.1) High Range, if relevant
.... type 0..1 CodeableConcept Reference range qualifier
Binding: ObservationReferenceRangeMeaningCodes (preferred): Code for the meaning of a reference range.
.... appliesTo 0..* CodeableConcept Reference range population
Binding: ObservationReferenceRangeAppliesToCodes (example): Codes identifying the population the reference range applies to.
.... age 0..1 Range Applicable age range, if relevant
.... text 0..1 string Text based reference range in an observation
... derivedFrom SΣ 0..* Reference(Bangladesh Laboratory Panel Observation) Related measurements the observation is made from
... component Σ 0..* BackboneElement Component results
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... code Σ 1..1 CodeableConcept Type of component observation (code / type)
Binding: LOINCCodes (example): Codes identifying names of simple observations.
.... value[x] Σ 0..1 Actual component result
..... valueQuantity Quantity
..... valueCodeableConcept CodeableConcept
..... valueString string
..... valueBoolean boolean
..... valueInteger integer
..... valueRange Range
..... valueRatio Ratio
..... valueSampledData SampledData
..... valueTime time
..... valueDateTime dateTime
..... valuePeriod Period
.... dataAbsentReason C 0..1 CodeableConcept Why the component result is missing
Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
.... interpretation 0..* CodeableConcept High, low, normal, etc.
Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
.... referenceRange 0..* See referenceRange (Observation) Provides guide for interpretation of component result

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
Observation.language Base preferred Common Languages 📍4.0.1 FHIR Std.
Observation.identifier.​use Base required IdentifierUse 📍4.0.1 FHIR Std.
Observation.identifier.​type Base extensible IdentifierType 📍4.0.1 FHIR Std.
Observation.status Base required ObservationStatus 📦4.0.1 FHIR Std.
Observation.category Base preferred Observation Category Codes 📦4.0.1 FHIR Std.
Observation.code Base extensible ​ https://fhir.dghs.gov.bd/core/ValueSet/loinc-lab-results Not State Unknown
Observation.subject.​type Base extensible ResourceType 📍4.0.1 FHIR Std.
Observation.encounter.​type Base extensible ResourceType 📍4.0.1 FHIR Std.
Observation.performer.​type Base extensible ResourceType 📍4.0.1 FHIR Std.
Observation.value[x]:valueQuantity.​comparator Base required QuantityComparator 📍4.0.1 FHIR Std.
Observation.value[x]:valueCodeableConcept Base extensible ​ https://fhir.dghs.gov.bd/core/ValueSet/loinc-answer-lists Not State Unknown
Observation.dataAbsentReason Base extensible DataAbsentReason 📍4.0.1 FHIR Std.
Observation.interpretation Base extensible Observation Interpretation Codes 📦4.0.1 FHIR Std.
Observation.bodySite Base example SNOMED CT Body Structures 📍4.0.1 FHIR Std.
Observation.method Base extensible Observation Methods 📦4.0.1 FHIR Std.
Observation.referenceRange.​type Base preferred Observation Reference Range Meaning Codes 📍4.0.1 FHIR Std.
Observation.referenceRange.​appliesTo Base example Observation Reference Range Applies To Codes 📍4.0.1 FHIR Std.
Observation.component.​code Base example LOINC Codes 📍4.0.1 FHIR Std.
Observation.component.​dataAbsentReason Base extensible DataAbsentReason 📍4.0.1 FHIR Std.
Observation.component.​interpretation Base extensible Observation Interpretation Codes 📍4.0.1 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
dom-2 error Observation If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error Observation If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4 error Observation If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5 error Observation If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice Observation A resource should have narrative for robust management text.`div`.exists()
ele-1 error **ALL** elements All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ext-1 error **ALL** extensions Must have either extensions or value[x], not both extension.exists() != value.exists()
obs-3 error Observation.referenceRange Must have at least a low or a high or text low.exists() or high.exists() or text.exists()
obs-6 error Observation dataAbsentReason SHALL only be present if Observation.value[x] is not present dataAbsentReason.empty() or value.empty()
obs-7 error Observation If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present value.empty() or component.code.where(coding.intersect(%resource.code.coding).exists()).empty()

This structure is derived from BDObservationProfile

Summary

Mandatory: 3 elements(4 nested mandatory elements)
Must-Support: 7 elements
Prohibited: 1 element

Structures

This structure refers to these other structures:

Slices

This structure defines the following Slices:

  • The element 1 is sliced based on the value of Observation.effective[x]

Maturity: 1

 

Other representations of profile: CSV, Excel, Schematron