Nictiz FHIR NL STU3 Zib2017
1.3.15 - CI Build

Nictiz FHIR NL STU3 Zib2017 - Local Development build (v1.3.15) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

Resource Profile: gp-JournalEntry

Official URL: http://nictiz.nl/fhir/StructureDefinition/gp-JournalEntry Version: 1.3.15
Active as of 2024-04-09 Computable Name: gp-JournalEntry

JournalEntry S-O-A-P (Dutch S-O-E-P) as defined in the NHG HIS Referentiemodel.

Usage:

  • This Resource Profile is not used by any profiles in this Implementation Guide

Formal Views of Profile Content

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

This structure is derived from nl-core-observation

NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation 0..* nl-core-observation Measurements and simple assertions
... identifier 0..1 Identifier Business Identifier for observation
... basedOn 0..0
... status 1..1 code final
Fixed Value: final
... subject 1..1 Reference(nl-core-patient) Who and/or what this is about
... context 1..1 Reference(gp-Encounter) Encounter during which this observation is made
... effective[x] S 0..1 dateTime, Period Clinically relevant time/time-period for observation
... issued 0..0
... valueString:valueString 1..1 string Journal Entry text
... dataAbsentReason 0..0
... interpretation 0..0
... comment 0..0
... bodySite 0..0
... method 0..0
... specimen 0..0
... device 0..0
... referenceRange 0..0
... related 0..0
... Slices for component 0..2 BackboneElement Component results
Slice: Unordered, Open by pattern:code
.... component:ICPC_S 0..1 BackboneElement Component results
..... code 1..1 CodeableConcept Type of component observation (code / type)
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://hl7.org/fhir/v3/ActCode
....... code 1..1 code Symbol in syntax defined by the system
Fixed Value: ADMDX
....... display 1..1 string Representation defined by the system
Fixed Value: admitting diagnosis
..... valueCodeableConcept:valueCodeableConcept 1..1 CodeableConcept Actual component result
...... coding 1..1 Coding Code defined by a terminology system
....... system 1..1 uri Identity of the terminology system
Fixed Value: http://hl7.org/fhir/sid/icpc-1-nl
....... code 1..1 code Symbol in syntax defined by the system
.... component:ICPC_E 0..1 BackboneElement Component results
..... code 1..1 CodeableConcept Type of component observation (code / type)
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://hl7.org/fhir/v3/ActCode
....... code 1..1 code Symbol in syntax defined by the system
Fixed Value: DISDX
....... display 1..1 string Representation defined by the system
Fixed Value: discharge diagnosis
..... valueCodeableConcept:valueCodeableConcept 1..1 CodeableConcept Actual component result
...... coding 1..1 Coding Code defined by a terminology system
....... system 1..1 uri Identity of the terminology system
Fixed Value: http://hl7.org/fhir/sid/icpc-1-nl
....... code 1..1 code Symbol in syntax defined by the system

doco Documentation for this format

Terminology Bindings (Differential)

PathConformanceValueSetURI
Observation.coderequiredJournaalregelType
http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.103.11.2--20111012000000
from this IG
NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation C 0..* nl-core-observation Measurements and simple assertions
obs-7: If code is the same as a component code then the value element associated with the code SHALL NOT be present
obs-6: dataAbsentReason SHALL only be present if Observation.value[x] is not present
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... identifier Σ 0..1 Identifier Business Identifier for observation
... code Σ 1..1 CodeableConcept NHG SOAP Code
Binding: JournaalregelType (required): NHG SOAP codes

... subject Σ 1..1 Reference(nl-core-patient) Who and/or what this is about
... context 1..1 Reference(gp-Encounter) Encounter during which this observation is made
... effective[x] SΣ 0..1 Clinically relevant time/time-period for observation
.... effectiveDateTime dateTime
.... effectivePeriod Period
... Slices for value[x] ΣC 1..1 string Actual result
Slice: Unordered, Closed by type:$this
.... value[x]:valueString ΣC 1..1 string Journal Entry text
... Slices for component Σ 0..2 BackboneElement Component results
Slice: Unordered, Open by pattern:code
.... component:All Slices Content/Rules for all slices
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored
..... code Σ 1..1 CodeableConcept Type of component observation (code / type)
Binding: LOINC Codes (example): Codes identifying names of simple observations.

.... component:ICPC_S Σ 0..1 BackboneElement Component results
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored
..... code Σ 1..1 CodeableConcept Type of component observation (code / type)
Binding: LOINC Codes (example): Codes identifying names of simple observations.


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://hl7.org/fhir/v3/ActCode
....... code 1..1 code Symbol in syntax defined by the system
Fixed Value: ADMDX
....... display 1..1 string Representation defined by the system
Fixed Value: admitting diagnosis
..... value[x]:valueCodeableConcept Σ 1..1 CodeableConcept Actual component result
...... coding Σ 1..1 Coding Code defined by a terminology system
....... system Σ 1..1 uri Identity of the terminology system
Fixed Value: http://hl7.org/fhir/sid/icpc-1-nl
....... code Σ 1..1 code Symbol in syntax defined by the system
.... component:ICPC_E Σ 0..1 BackboneElement Component results
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored
..... code Σ 1..1 CodeableConcept Type of component observation (code / type)
Binding: LOINC Codes (example): Codes identifying names of simple observations.


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://hl7.org/fhir/v3/ActCode
....... code 1..1 code Symbol in syntax defined by the system
Fixed Value: DISDX
....... display 1..1 string Representation defined by the system
Fixed Value: discharge diagnosis
..... value[x]:valueCodeableConcept Σ 1..1 CodeableConcept Actual component result
...... coding Σ 1..1 Coding Code defined by a terminology system
....... system Σ 1..1 uri Identity of the terminology system
Fixed Value: http://hl7.org/fhir/sid/icpc-1-nl
....... code Σ 1..1 code Symbol in syntax defined by the system

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / CodeURI
Observation.statusrequiredFixed Value: final
http://hl7.org/fhir/ValueSet/observation-status
from the FHIR Standard
Observation.coderequiredJournaalregelType
http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.103.11.2--20111012000000
from this IG
Observation.component.codeexampleLOINC Codes (a valid code from LOINC)
http://hl7.org/fhir/ValueSet/observation-codes
from the FHIR Standard
Observation.component:ICPC_S.codeexamplePattern: ADMDX("admitting diagnosis")
http://hl7.org/fhir/ValueSet/observation-codes
from the FHIR Standard
Observation.component:ICPC_E.codeexamplePattern: DISDX("discharge diagnosis")
http://hl7.org/fhir/ValueSet/observation-codes
from the FHIR Standard

Constraints

IdGradePath(s)DetailsRequirements
dom-1errorObservationIf the resource is contained in another resource, it SHALL NOT contain any narrative
: contained.text.empty()
dom-2errorObservationIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorObservationIf the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource
: contained.where(('#'+id in %resource.descendants().reference).not()).empty()
dom-4errorObservationIf 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()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() | (children().count() > id.count())
obs-6errorObservationdataAbsentReason SHALL only be present if Observation.value[x] is not present
: dataAbsentReason.empty() or value.empty()
obs-7errorObservationIf code is the same as a component code then the value element associated with the code SHALL NOT be present
: value.empty() or component.code.where( (coding.code = %resource.code.coding.code) and (coding.system = %resource.code.coding.system)).empty()
NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation C 0..* nl-core-observation Measurements and simple assertions
obs-7: If code is the same as a component code then the value element associated with the code SHALL NOT be present
obs-6: dataAbsentReason SHALL only be present if Observation.value[x] is not present
... 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
... text 0..1 Narrative Text summary of the resource, for human interpretation
... contained 0..* Resource Contained, inline Resources
... extension 0..* Extension Additional Content defined by implementations
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... identifier Σ 0..1 Identifier Business Identifier for observation
... status ?!Σ 1..1 code final
Binding: ObservationStatus (required): Codes providing the status of an observation.


Fixed Value: final
... category 0..* CodeableConcept Classification of type of observation
Binding: Observation Category Codes (preferred): Codes for high level observation categories.


... code Σ 1..1 CodeableConcept NHG SOAP Code
Binding: JournaalregelType (required): NHG SOAP codes

... subject Σ 1..1 Reference(nl-core-patient) Who and/or what this is about
... context 1..1 Reference(gp-Encounter) Encounter during which this observation is made
... effective[x] SΣ 0..1 Clinically relevant time/time-period for observation
.... effectiveDateTime dateTime
.... effectivePeriod Period
... performer Σ 0..* Reference(nl-core-organization | nl-core-patient | nl-core-practitioner | nl-core-relatedperson) Who is responsible for the observation
.... id 0..1 string xml:id (or equivalent in JSON)
.... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
.... practitionerRole 0..1 Reference(nl-core-practitionerrole) Optional Extensions Element
URL: http://nictiz.nl/fhir/StructureDefinition/practitionerrole-reference
.... reference ΣC 0..1 string Literal reference, Relative, internal or absolute URL
.... 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] ΣC 1..1 string Actual result
Slice: Unordered, Closed by type:$this
.... value[x]:valueString ΣC 1..1 string Journal Entry text
... Slices for component Σ 0..2 BackboneElement Component results
Slice: Unordered, Open by pattern:code
.... component:All Slices Content/Rules for all slices
..... id 0..1 string xml:id (or equivalent in JSON)
..... extension 0..* Extension Additional Content defined by implementations
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored
..... code Σ 1..1 CodeableConcept Type of component observation (code / type)
Binding: LOINC Codes (example): Codes identifying names of simple observations.

..... value[x] Σ 0..1 Actual component result
...... valueQuantity Quantity
...... valueCodeableConcept CodeableConcept
...... valueString string
...... valueRange Range
...... valueRatio Ratio
...... valueSampledData SampledData
...... valueAttachment Attachment
...... valueTime time
...... valueDateTime dateTime
...... valuePeriod Period
..... dataAbsentReason C 0..1 CodeableConcept Why the component result is missing
Binding: Observation Value Absent Reason (extensible): Codes specifying why the result (Observation.value[x]) is missing.

..... interpretation 0..1 CodeableConcept High, low, normal, etc.
Binding: Observation Interpretation Codes (extensible): Codes identifying interpretations of observations.

..... referenceRange 0..* See referenceRange (Observation) Provides guide for interpretation of component result
.... component:ICPC_S Σ 0..1 BackboneElement Component results
..... id 0..1 string xml:id (or equivalent in JSON)
..... extension 0..* Extension Additional Content defined by implementations
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored
..... code Σ 1..1 CodeableConcept Type of component observation (code / type)
Binding: LOINC Codes (example): Codes identifying names of simple observations.


Required Pattern: At least the following
...... id 0..1 string xml:id (or equivalent in JSON)
...... extension 0..* Extension Additional Content defined by implementations
...... coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
....... id 0..1 string xml:id (or equivalent in JSON)
....... extension 0..* Extension Additional Content defined by implementations
....... system 1..1 uri Identity of the terminology system
Fixed Value: http://hl7.org/fhir/v3/ActCode
....... version 0..1 string Version of the system - if relevant
....... code 1..1 code Symbol in syntax defined by the system
Fixed Value: ADMDX
....... display 1..1 string Representation defined by the system
Fixed Value: admitting diagnosis
....... userSelected 0..1 boolean If this coding was chosen directly by the user
...... text 0..1 string Plain text representation of the concept
..... value[x]:valueCodeableConcept Σ 1..1 CodeableConcept Actual component result
...... id 0..1 string xml:id (or equivalent in JSON)
...... extension 0..* Extension Additional Content defined by implementations
Slice: Unordered, Open by value:url
...... coding Σ 1..1 Coding Code defined by a terminology system
....... id 0..1 string xml:id (or equivalent in JSON)
....... extension 0..* Extension Additional Content defined by implementations
Slice: Unordered, Open by value:url
....... system Σ 1..1 uri Identity of the terminology system
Fixed Value: http://hl7.org/fhir/sid/icpc-1-nl
....... version Σ 0..1 string Version of the system - if relevant
....... code Σ 1..1 code Symbol in syntax defined by the system
....... display Σ 0..1 string Representation defined by the system
....... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
...... text Σ 0..1 string Plain text representation of the concept
..... dataAbsentReason C 0..1 CodeableConcept Why the component result is missing
Binding: Observation Value Absent Reason (extensible): Codes specifying why the result (Observation.value[x]) is missing.

..... interpretation 0..1 CodeableConcept High, low, normal, etc.
Binding: Observation Interpretation Codes (extensible): Codes identifying interpretations of observations.

..... referenceRange 0..* See referenceRange (Observation) Provides guide for interpretation of component result
.... component:ICPC_E Σ 0..1 BackboneElement Component results
..... id 0..1 string xml:id (or equivalent in JSON)
..... extension 0..* Extension Additional Content defined by implementations
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored
..... code Σ 1..1 CodeableConcept Type of component observation (code / type)
Binding: LOINC Codes (example): Codes identifying names of simple observations.


Required Pattern: At least the following
...... id 0..1 string xml:id (or equivalent in JSON)
...... extension 0..* Extension Additional Content defined by implementations
...... coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
....... id 0..1 string xml:id (or equivalent in JSON)
....... extension 0..* Extension Additional Content defined by implementations
....... system 1..1 uri Identity of the terminology system
Fixed Value: http://hl7.org/fhir/v3/ActCode
....... version 0..1 string Version of the system - if relevant
....... code 1..1 code Symbol in syntax defined by the system
Fixed Value: DISDX
....... display 1..1 string Representation defined by the system
Fixed Value: discharge diagnosis
....... userSelected 0..1 boolean If this coding was chosen directly by the user
...... text 0..1 string Plain text representation of the concept
..... value[x]:valueCodeableConcept Σ 1..1 CodeableConcept Actual component result
...... id 0..1 string xml:id (or equivalent in JSON)
...... extension 0..* Extension Additional Content defined by implementations
Slice: Unordered, Open by value:url
...... coding Σ 1..1 Coding Code defined by a terminology system
....... id 0..1 string xml:id (or equivalent in JSON)
....... extension 0..* Extension Additional Content defined by implementations
Slice: Unordered, Open by value:url
....... system Σ 1..1 uri Identity of the terminology system
Fixed Value: http://hl7.org/fhir/sid/icpc-1-nl
....... version Σ 0..1 string Version of the system - if relevant
....... code Σ 1..1 code Symbol in syntax defined by the system
....... display Σ 0..1 string Representation defined by the system
....... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
...... text Σ 0..1 string Plain text representation of the concept
..... dataAbsentReason C 0..1 CodeableConcept Why the component result is missing
Binding: Observation Value Absent Reason (extensible): Codes specifying why the result (Observation.value[x]) is missing.

..... interpretation 0..1 CodeableConcept High, low, normal, etc.
Binding: Observation Interpretation Codes (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

PathConformanceValueSet / CodeURI
Observation.languageextensibleCommon Languages
Additional Bindings Purpose
AllLanguages Max Binding
http://hl7.org/fhir/ValueSet/languages
from the FHIR Standard
Observation.statusrequiredFixed Value: final
http://hl7.org/fhir/ValueSet/observation-status
from the FHIR Standard
Observation.categorypreferredObservation Category Codes
http://hl7.org/fhir/ValueSet/observation-category
from the FHIR Standard
Observation.coderequiredJournaalregelType
http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.103.11.2--20111012000000
from this IG
Observation.referenceRange.typeextensibleObservation Reference Range Meaning Codes
http://hl7.org/fhir/ValueSet/referencerange-meaning
from the FHIR Standard
Observation.referenceRange.appliesToexampleObservation Reference Range Applies To Codes
http://hl7.org/fhir/ValueSet/referencerange-appliesto
from the FHIR Standard
Observation.related.typerequiredObservationRelationshipType
http://hl7.org/fhir/ValueSet/observation-relationshiptypes
from the FHIR Standard
Observation.component.codeexampleLOINC Codes (a valid code from LOINC)
http://hl7.org/fhir/ValueSet/observation-codes
from the FHIR Standard
Observation.component.dataAbsentReasonextensibleObservation Value Absent Reason
http://hl7.org/fhir/ValueSet/observation-valueabsentreason
from the FHIR Standard
Observation.component.interpretationextensibleObservation Interpretation Codes
http://hl7.org/fhir/ValueSet/observation-interpretation
from the FHIR Standard
Observation.component:ICPC_S.codeexamplePattern: ADMDX("admitting diagnosis")
http://hl7.org/fhir/ValueSet/observation-codes
from the FHIR Standard
Observation.component:ICPC_S.dataAbsentReasonextensibleObservation Value Absent Reason
http://hl7.org/fhir/ValueSet/observation-valueabsentreason
from the FHIR Standard
Observation.component:ICPC_S.interpretationextensibleObservation Interpretation Codes
http://hl7.org/fhir/ValueSet/observation-interpretation
from the FHIR Standard
Observation.component:ICPC_E.codeexamplePattern: DISDX("discharge diagnosis")
http://hl7.org/fhir/ValueSet/observation-codes
from the FHIR Standard
Observation.component:ICPC_E.dataAbsentReasonextensibleObservation Value Absent Reason
http://hl7.org/fhir/ValueSet/observation-valueabsentreason
from the FHIR Standard
Observation.component:ICPC_E.interpretationextensibleObservation Interpretation Codes
http://hl7.org/fhir/ValueSet/observation-interpretation
from the FHIR Standard

Constraints

IdGradePath(s)DetailsRequirements
dom-1errorObservationIf the resource is contained in another resource, it SHALL NOT contain any narrative
: contained.text.empty()
dom-2errorObservationIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorObservationIf the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource
: contained.where(('#'+id in %resource.descendants().reference).not()).empty()
dom-4errorObservationIf 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()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() | (children().count() > id.count())
obs-6errorObservationdataAbsentReason SHALL only be present if Observation.value[x] is not present
: dataAbsentReason.empty() or value.empty()
obs-7errorObservationIf code is the same as a component code then the value element associated with the code SHALL NOT be present
: value.empty() or component.code.where( (coding.code = %resource.code.coding.code) and (coding.system = %resource.code.coding.system)).empty()

This structure is derived from nl-core-observation

Summary

Mandatory: 2 elements(8 nested mandatory elements)
Must-Support: 1 element
Fixed: 3 elements
Prohibited: 11 elements

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.component

Differential View

This structure is derived from nl-core-observation

NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation 0..* nl-core-observation Measurements and simple assertions
... identifier 0..1 Identifier Business Identifier for observation
... basedOn 0..0
... status 1..1 code final
Fixed Value: final
... subject 1..1 Reference(nl-core-patient) Who and/or what this is about
... context 1..1 Reference(gp-Encounter) Encounter during which this observation is made
... effective[x] S 0..1 dateTime, Period Clinically relevant time/time-period for observation
... issued 0..0
... valueString:valueString 1..1 string Journal Entry text
... dataAbsentReason 0..0
... interpretation 0..0
... comment 0..0
... bodySite 0..0
... method 0..0
... specimen 0..0
... device 0..0
... referenceRange 0..0
... related 0..0
... Slices for component 0..2 BackboneElement Component results
Slice: Unordered, Open by pattern:code
.... component:ICPC_S 0..1 BackboneElement Component results
..... code 1..1 CodeableConcept Type of component observation (code / type)
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://hl7.org/fhir/v3/ActCode
....... code 1..1 code Symbol in syntax defined by the system
Fixed Value: ADMDX
....... display 1..1 string Representation defined by the system
Fixed Value: admitting diagnosis
..... valueCodeableConcept:valueCodeableConcept 1..1 CodeableConcept Actual component result
...... coding 1..1 Coding Code defined by a terminology system
....... system 1..1 uri Identity of the terminology system
Fixed Value: http://hl7.org/fhir/sid/icpc-1-nl
....... code 1..1 code Symbol in syntax defined by the system
.... component:ICPC_E 0..1 BackboneElement Component results
..... code 1..1 CodeableConcept Type of component observation (code / type)
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://hl7.org/fhir/v3/ActCode
....... code 1..1 code Symbol in syntax defined by the system
Fixed Value: DISDX
....... display 1..1 string Representation defined by the system
Fixed Value: discharge diagnosis
..... valueCodeableConcept:valueCodeableConcept 1..1 CodeableConcept Actual component result
...... coding 1..1 Coding Code defined by a terminology system
....... system 1..1 uri Identity of the terminology system
Fixed Value: http://hl7.org/fhir/sid/icpc-1-nl
....... code 1..1 code Symbol in syntax defined by the system

doco Documentation for this format

Terminology Bindings (Differential)

PathConformanceValueSetURI
Observation.coderequiredJournaalregelType
http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.103.11.2--20111012000000
from this IG

Key Elements View

NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation C 0..* nl-core-observation Measurements and simple assertions
obs-7: If code is the same as a component code then the value element associated with the code SHALL NOT be present
obs-6: dataAbsentReason SHALL only be present if Observation.value[x] is not present
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... identifier Σ 0..1 Identifier Business Identifier for observation
... code Σ 1..1 CodeableConcept NHG SOAP Code
Binding: JournaalregelType (required): NHG SOAP codes

... subject Σ 1..1 Reference(nl-core-patient) Who and/or what this is about
... context 1..1 Reference(gp-Encounter) Encounter during which this observation is made
... effective[x] SΣ 0..1 Clinically relevant time/time-period for observation
.... effectiveDateTime dateTime
.... effectivePeriod Period
... Slices for value[x] ΣC 1..1 string Actual result
Slice: Unordered, Closed by type:$this
.... value[x]:valueString ΣC 1..1 string Journal Entry text
... Slices for component Σ 0..2 BackboneElement Component results
Slice: Unordered, Open by pattern:code
.... component:All Slices Content/Rules for all slices
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored
..... code Σ 1..1 CodeableConcept Type of component observation (code / type)
Binding: LOINC Codes (example): Codes identifying names of simple observations.

.... component:ICPC_S Σ 0..1 BackboneElement Component results
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored
..... code Σ 1..1 CodeableConcept Type of component observation (code / type)
Binding: LOINC Codes (example): Codes identifying names of simple observations.


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://hl7.org/fhir/v3/ActCode
....... code 1..1 code Symbol in syntax defined by the system
Fixed Value: ADMDX
....... display 1..1 string Representation defined by the system
Fixed Value: admitting diagnosis
..... value[x]:valueCodeableConcept Σ 1..1 CodeableConcept Actual component result
...... coding Σ 1..1 Coding Code defined by a terminology system
....... system Σ 1..1 uri Identity of the terminology system
Fixed Value: http://hl7.org/fhir/sid/icpc-1-nl
....... code Σ 1..1 code Symbol in syntax defined by the system
.... component:ICPC_E Σ 0..1 BackboneElement Component results
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored
..... code Σ 1..1 CodeableConcept Type of component observation (code / type)
Binding: LOINC Codes (example): Codes identifying names of simple observations.


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://hl7.org/fhir/v3/ActCode
....... code 1..1 code Symbol in syntax defined by the system
Fixed Value: DISDX
....... display 1..1 string Representation defined by the system
Fixed Value: discharge diagnosis
..... value[x]:valueCodeableConcept Σ 1..1 CodeableConcept Actual component result
...... coding Σ 1..1 Coding Code defined by a terminology system
....... system Σ 1..1 uri Identity of the terminology system
Fixed Value: http://hl7.org/fhir/sid/icpc-1-nl
....... code Σ 1..1 code Symbol in syntax defined by the system

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / CodeURI
Observation.statusrequiredFixed Value: final
http://hl7.org/fhir/ValueSet/observation-status
from the FHIR Standard
Observation.coderequiredJournaalregelType
http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.103.11.2--20111012000000
from this IG
Observation.component.codeexampleLOINC Codes (a valid code from LOINC)
http://hl7.org/fhir/ValueSet/observation-codes
from the FHIR Standard
Observation.component:ICPC_S.codeexamplePattern: ADMDX("admitting diagnosis")
http://hl7.org/fhir/ValueSet/observation-codes
from the FHIR Standard
Observation.component:ICPC_E.codeexamplePattern: DISDX("discharge diagnosis")
http://hl7.org/fhir/ValueSet/observation-codes
from the FHIR Standard

Constraints

IdGradePath(s)DetailsRequirements
dom-1errorObservationIf the resource is contained in another resource, it SHALL NOT contain any narrative
: contained.text.empty()
dom-2errorObservationIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorObservationIf the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource
: contained.where(('#'+id in %resource.descendants().reference).not()).empty()
dom-4errorObservationIf 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()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() | (children().count() > id.count())
obs-6errorObservationdataAbsentReason SHALL only be present if Observation.value[x] is not present
: dataAbsentReason.empty() or value.empty()
obs-7errorObservationIf code is the same as a component code then the value element associated with the code SHALL NOT be present
: value.empty() or component.code.where( (coding.code = %resource.code.coding.code) and (coding.system = %resource.code.coding.system)).empty()

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation C 0..* nl-core-observation Measurements and simple assertions
obs-7: If code is the same as a component code then the value element associated with the code SHALL NOT be present
obs-6: dataAbsentReason SHALL only be present if Observation.value[x] is not present
... 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
... text 0..1 Narrative Text summary of the resource, for human interpretation
... contained 0..* Resource Contained, inline Resources
... extension 0..* Extension Additional Content defined by implementations
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... identifier Σ 0..1 Identifier Business Identifier for observation
... status ?!Σ 1..1 code final
Binding: ObservationStatus (required): Codes providing the status of an observation.


Fixed Value: final
... category 0..* CodeableConcept Classification of type of observation
Binding: Observation Category Codes (preferred): Codes for high level observation categories.


... code Σ 1..1 CodeableConcept NHG SOAP Code
Binding: JournaalregelType (required): NHG SOAP codes

... subject Σ 1..1 Reference(nl-core-patient) Who and/or what this is about
... context 1..1 Reference(gp-Encounter) Encounter during which this observation is made
... effective[x] SΣ 0..1 Clinically relevant time/time-period for observation
.... effectiveDateTime dateTime
.... effectivePeriod Period
... performer Σ 0..* Reference(nl-core-organization | nl-core-patient | nl-core-practitioner | nl-core-relatedperson) Who is responsible for the observation
.... id 0..1 string xml:id (or equivalent in JSON)
.... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
.... practitionerRole 0..1 Reference(nl-core-practitionerrole) Optional Extensions Element
URL: http://nictiz.nl/fhir/StructureDefinition/practitionerrole-reference
.... reference ΣC 0..1 string Literal reference, Relative, internal or absolute URL
.... 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] ΣC 1..1 string Actual result
Slice: Unordered, Closed by type:$this
.... value[x]:valueString ΣC 1..1 string Journal Entry text
... Slices for component Σ 0..2 BackboneElement Component results
Slice: Unordered, Open by pattern:code
.... component:All Slices Content/Rules for all slices
..... id 0..1 string xml:id (or equivalent in JSON)
..... extension 0..* Extension Additional Content defined by implementations
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored
..... code Σ 1..1 CodeableConcept Type of component observation (code / type)
Binding: LOINC Codes (example): Codes identifying names of simple observations.

..... value[x] Σ 0..1 Actual component result
...... valueQuantity Quantity
...... valueCodeableConcept CodeableConcept
...... valueString string
...... valueRange Range
...... valueRatio Ratio
...... valueSampledData SampledData
...... valueAttachment Attachment
...... valueTime time
...... valueDateTime dateTime
...... valuePeriod Period
..... dataAbsentReason C 0..1 CodeableConcept Why the component result is missing
Binding: Observation Value Absent Reason (extensible): Codes specifying why the result (Observation.value[x]) is missing.

..... interpretation 0..1 CodeableConcept High, low, normal, etc.
Binding: Observation Interpretation Codes (extensible): Codes identifying interpretations of observations.

..... referenceRange 0..* See referenceRange (Observation) Provides guide for interpretation of component result
.... component:ICPC_S Σ 0..1 BackboneElement Component results
..... id 0..1 string xml:id (or equivalent in JSON)
..... extension 0..* Extension Additional Content defined by implementations
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored
..... code Σ 1..1 CodeableConcept Type of component observation (code / type)
Binding: LOINC Codes (example): Codes identifying names of simple observations.


Required Pattern: At least the following
...... id 0..1 string xml:id (or equivalent in JSON)
...... extension 0..* Extension Additional Content defined by implementations
...... coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
....... id 0..1 string xml:id (or equivalent in JSON)
....... extension 0..* Extension Additional Content defined by implementations
....... system 1..1 uri Identity of the terminology system
Fixed Value: http://hl7.org/fhir/v3/ActCode
....... version 0..1 string Version of the system - if relevant
....... code 1..1 code Symbol in syntax defined by the system
Fixed Value: ADMDX
....... display 1..1 string Representation defined by the system
Fixed Value: admitting diagnosis
....... userSelected 0..1 boolean If this coding was chosen directly by the user
...... text 0..1 string Plain text representation of the concept
..... value[x]:valueCodeableConcept Σ 1..1 CodeableConcept Actual component result
...... id 0..1 string xml:id (or equivalent in JSON)
...... extension 0..* Extension Additional Content defined by implementations
Slice: Unordered, Open by value:url
...... coding Σ 1..1 Coding Code defined by a terminology system
....... id 0..1 string xml:id (or equivalent in JSON)
....... extension 0..* Extension Additional Content defined by implementations
Slice: Unordered, Open by value:url
....... system Σ 1..1 uri Identity of the terminology system
Fixed Value: http://hl7.org/fhir/sid/icpc-1-nl
....... version Σ 0..1 string Version of the system - if relevant
....... code Σ 1..1 code Symbol in syntax defined by the system
....... display Σ 0..1 string Representation defined by the system
....... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
...... text Σ 0..1 string Plain text representation of the concept
..... dataAbsentReason C 0..1 CodeableConcept Why the component result is missing
Binding: Observation Value Absent Reason (extensible): Codes specifying why the result (Observation.value[x]) is missing.

..... interpretation 0..1 CodeableConcept High, low, normal, etc.
Binding: Observation Interpretation Codes (extensible): Codes identifying interpretations of observations.

..... referenceRange 0..* See referenceRange (Observation) Provides guide for interpretation of component result
.... component:ICPC_E Σ 0..1 BackboneElement Component results
..... id 0..1 string xml:id (or equivalent in JSON)
..... extension 0..* Extension Additional Content defined by implementations
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored
..... code Σ 1..1 CodeableConcept Type of component observation (code / type)
Binding: LOINC Codes (example): Codes identifying names of simple observations.


Required Pattern: At least the following
...... id 0..1 string xml:id (or equivalent in JSON)
...... extension 0..* Extension Additional Content defined by implementations
...... coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
....... id 0..1 string xml:id (or equivalent in JSON)
....... extension 0..* Extension Additional Content defined by implementations
....... system 1..1 uri Identity of the terminology system
Fixed Value: http://hl7.org/fhir/v3/ActCode
....... version 0..1 string Version of the system - if relevant
....... code 1..1 code Symbol in syntax defined by the system
Fixed Value: DISDX
....... display 1..1 string Representation defined by the system
Fixed Value: discharge diagnosis
....... userSelected 0..1 boolean If this coding was chosen directly by the user
...... text 0..1 string Plain text representation of the concept
..... value[x]:valueCodeableConcept Σ 1..1 CodeableConcept Actual component result
...... id 0..1 string xml:id (or equivalent in JSON)
...... extension 0..* Extension Additional Content defined by implementations
Slice: Unordered, Open by value:url
...... coding Σ 1..1 Coding Code defined by a terminology system
....... id 0..1 string xml:id (or equivalent in JSON)
....... extension 0..* Extension Additional Content defined by implementations
Slice: Unordered, Open by value:url
....... system Σ 1..1 uri Identity of the terminology system
Fixed Value: http://hl7.org/fhir/sid/icpc-1-nl
....... version Σ 0..1 string Version of the system - if relevant
....... code Σ 1..1 code Symbol in syntax defined by the system
....... display Σ 0..1 string Representation defined by the system
....... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
...... text Σ 0..1 string Plain text representation of the concept
..... dataAbsentReason C 0..1 CodeableConcept Why the component result is missing
Binding: Observation Value Absent Reason (extensible): Codes specifying why the result (Observation.value[x]) is missing.

..... interpretation 0..1 CodeableConcept High, low, normal, etc.
Binding: Observation Interpretation Codes (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

PathConformanceValueSet / CodeURI
Observation.languageextensibleCommon Languages
Additional Bindings Purpose
AllLanguages Max Binding
http://hl7.org/fhir/ValueSet/languages
from the FHIR Standard
Observation.statusrequiredFixed Value: final
http://hl7.org/fhir/ValueSet/observation-status
from the FHIR Standard
Observation.categorypreferredObservation Category Codes
http://hl7.org/fhir/ValueSet/observation-category
from the FHIR Standard
Observation.coderequiredJournaalregelType
http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.103.11.2--20111012000000
from this IG
Observation.referenceRange.typeextensibleObservation Reference Range Meaning Codes
http://hl7.org/fhir/ValueSet/referencerange-meaning
from the FHIR Standard
Observation.referenceRange.appliesToexampleObservation Reference Range Applies To Codes
http://hl7.org/fhir/ValueSet/referencerange-appliesto
from the FHIR Standard
Observation.related.typerequiredObservationRelationshipType
http://hl7.org/fhir/ValueSet/observation-relationshiptypes
from the FHIR Standard
Observation.component.codeexampleLOINC Codes (a valid code from LOINC)
http://hl7.org/fhir/ValueSet/observation-codes
from the FHIR Standard
Observation.component.dataAbsentReasonextensibleObservation Value Absent Reason
http://hl7.org/fhir/ValueSet/observation-valueabsentreason
from the FHIR Standard
Observation.component.interpretationextensibleObservation Interpretation Codes
http://hl7.org/fhir/ValueSet/observation-interpretation
from the FHIR Standard
Observation.component:ICPC_S.codeexamplePattern: ADMDX("admitting diagnosis")
http://hl7.org/fhir/ValueSet/observation-codes
from the FHIR Standard
Observation.component:ICPC_S.dataAbsentReasonextensibleObservation Value Absent Reason
http://hl7.org/fhir/ValueSet/observation-valueabsentreason
from the FHIR Standard
Observation.component:ICPC_S.interpretationextensibleObservation Interpretation Codes
http://hl7.org/fhir/ValueSet/observation-interpretation
from the FHIR Standard
Observation.component:ICPC_E.codeexamplePattern: DISDX("discharge diagnosis")
http://hl7.org/fhir/ValueSet/observation-codes
from the FHIR Standard
Observation.component:ICPC_E.dataAbsentReasonextensibleObservation Value Absent Reason
http://hl7.org/fhir/ValueSet/observation-valueabsentreason
from the FHIR Standard
Observation.component:ICPC_E.interpretationextensibleObservation Interpretation Codes
http://hl7.org/fhir/ValueSet/observation-interpretation
from the FHIR Standard

Constraints

IdGradePath(s)DetailsRequirements
dom-1errorObservationIf the resource is contained in another resource, it SHALL NOT contain any narrative
: contained.text.empty()
dom-2errorObservationIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorObservationIf the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource
: contained.where(('#'+id in %resource.descendants().reference).not()).empty()
dom-4errorObservationIf 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()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() | (children().count() > id.count())
obs-6errorObservationdataAbsentReason SHALL only be present if Observation.value[x] is not present
: dataAbsentReason.empty() or value.empty()
obs-7errorObservationIf code is the same as a component code then the value element associated with the code SHALL NOT be present
: value.empty() or component.code.where( (coding.code = %resource.code.coding.code) and (coding.system = %resource.code.coding.system)).empty()

This structure is derived from nl-core-observation

Summary

Mandatory: 2 elements(8 nested mandatory elements)
Must-Support: 1 element
Fixed: 3 elements
Prohibited: 11 elements

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.component

 

Other representations of profile: CSV, Excel, Schematron