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: Zib ApgarScore - Detailed Descriptions

Draft as of 2024-04-09

Definitions for the zib-ApgarScore resource profile.

Guidance on how to interpret the contents of this table can be found here

0. Observation
Definition

Root concept of the ApgarScore information model. This root concept contains all data elements of the ApgarScore information model.

ShortApgarScore
Invariantszib-apgarscore-1: Exactly one of the time code slices SHALL be used for Observation.code (code.coding.where(system='http://loinc.org').where(code='9272-6' or code='9274-2' or code='9271-8').count()=1)
zib-apgarscore-2: Components for 1 minute Apgar score are only allowed when Observation.code indicates 1 minute Apgar score (component.code.coding.where(system='http://loinc.org').where(code='32410-3' or code='32406-1' or code='32407-9' or code='32409-5' or code='32408-7').exists() implies code.coding.where(system='http://loinc.org').where(code='9272-6').exists())
zib-apgarscore-3: Components for 5 minute Apgar score are only allowed when Observation.code indicates 5 minute Apgar score (component.code.coding.where(system='http://loinc.org').where(code='32415-2' or code='32411-1' or code='32412-9' or code='32414-5' or code='32413-7').exists() implies code.coding.where(system='http://loinc.org').where(code='9274-2').exists())
zib-apgarscore-4: Components for 10 minute Apgar score are only allowed when Observation.code indicates 10 minute Apgar score (component.code.coding.where(system='http://loinc.org').where(code='32405-3' or code='32401-2' or code='32402-0' or code='32404-6' or code='32403-8').exists() implies code.coding.where(system='http://loinc.org').where(code='9271-8').exists())
2. Observation.code
Example<br/><b>Example of 1 Minute ApgarScore</b>:{ "coding" : [{ "system" : "http://loinc.org", "code" : "9272-6", "display" : "1 minute Apgar Score" }] }
4. Observation.code.coding
Control1..?
SlicingThis element introduces a set of slices on Observation.code.coding. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ system
  • value @ code
  • 6. Observation.code.coding:1MinuteApgarScore
    Slice Name1MinuteApgarScore
    Control0..1
    8. Observation.code.coding:1MinuteApgarScore.system
    Control1..?
    Fixed Valuehttp://loinc.org
    10. Observation.code.coding:1MinuteApgarScore.code
    Control1..?
    Fixed Value9272-6
    12. Observation.code.coding:1MinuteApgarScore.display
    Default Value1 minute Apgar Score
    14. Observation.code.coding:5MinuteApgarScore
    Slice Name5MinuteApgarScore
    Control0..1
    16. Observation.code.coding:5MinuteApgarScore.system
    Control1..?
    Fixed Valuehttp://loinc.org
    18. Observation.code.coding:5MinuteApgarScore.code
    Control1..?
    Fixed Value9274-2
    20. Observation.code.coding:5MinuteApgarScore.display
    Default Value5 minute Apgar Score
    22. Observation.code.coding:10MinuteApgarScore
    Slice Name10MinuteApgarScore
    Control0..1
    24. Observation.code.coding:10MinuteApgarScore.system
    Control1..?
    Fixed Valuehttp://loinc.org
    26. Observation.code.coding:10MinuteApgarScore.code
    Control1..?
    Fixed Value9271-8
    28. Observation.code.coding:10MinuteApgarScore.display
    Default Value10 minute Apgar Score
    30. Observation.effectiveDateTime:effectiveDateTime
    Slice NameeffectiveDateTime
    Definition

    The day and time at which the Apgar score is registered.

    ShortApgarScoreDateTime
    Control1..?
    TypedateTime
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Alternate NamesApgarScoreDatumTijd
    32. Observation.value[x]:valueQuantity
    Slice NamevalueQuantity
    Definition

    Total of the Apgar score.

    ShortApgarScoreTotal
    Control1..?
    TypeQuantity
    [x] NoteSee Choice of Data Types for further information about how to use [x]
    Alternate NamesApgarScoreTotaal
    34. Observation.value[x]:valueQuantity.value
    Min Value0
    Max Value10
    36. Observation.comment
    Definition

    Comment on the Apgar score.

    ShortComment
    Alternate NamesToelichting
    38. Observation.component
    SlicingThis element introduces a set of slices on Observation.component. The slices are unordered and Open, and can be differentiated using the following discriminators:
    • pattern @ code
    • 40. Observation.component:1MinuteRespiratoryScore
      Slice Name1MinuteRespiratoryScore
      Control0..1
      42. Observation.component:1MinuteRespiratoryScore.code
      Pattern Value{
        "coding" : [{
          "system" : "http://loinc.org",
          "code" : "32410-3"
        }]
      }
      44. Observation.component:1MinuteRespiratoryScore.valueCodeableConcept:valueCodeableConcept
      Slice NamevalueCodeableConcept
      Definition

      The Apgar subscore for respiration.

      ShortRespiratoryScore
      BindingUnless not suitable, these codes SHALL be taken from AdemhalingScoreCodelijst
      (extensible to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.12.16.1--20171231000000)

      AdemhalingScoreCodelijst

      TypeCodeableConcept
      Alternate NamesAdemhalingScore
      46. Observation.component:5MinuteRespiratoryScore
      Slice Name5MinuteRespiratoryScore
      Control0..1
      48. Observation.component:5MinuteRespiratoryScore.code
      Pattern Value{
        "coding" : [{
          "system" : "http://loinc.org",
          "code" : "32415-2"
        }]
      }
      50. Observation.component:5MinuteRespiratoryScore.valueCodeableConcept:valueCodeableConcept
      Slice NamevalueCodeableConcept
      Definition

      The Apgar subscore for respiration.

      ShortRespiratoryScore
      BindingUnless not suitable, these codes SHALL be taken from AdemhalingScoreCodelijst
      (extensible to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.12.16.1--20171231000000)

      AdemhalingScoreCodelijst

      TypeCodeableConcept
      Alternate NamesAdemhalingScore
      52. Observation.component:10MinuteRespiratoryScore
      Slice Name10MinuteRespiratoryScore
      Control0..1
      54. Observation.component:10MinuteRespiratoryScore.code
      Pattern Value{
        "coding" : [{
          "system" : "http://loinc.org",
          "code" : "32405-3"
        }]
      }
      56. Observation.component:10MinuteRespiratoryScore.valueCodeableConcept:valueCodeableConcept
      Slice NamevalueCodeableConcept
      Definition

      The Apgar subscore for respiration.

      ShortRespiratoryScore
      BindingUnless not suitable, these codes SHALL be taken from AdemhalingScoreCodelijst
      (extensible to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.12.16.1--20171231000000)

      AdemhalingScoreCodelijst

      TypeCodeableConcept
      Alternate NamesAdemhalingScore
      58. Observation.component:1MinuteAppearanceScore
      Slice Name1MinuteAppearanceScore
      Control0..1
      60. Observation.component:1MinuteAppearanceScore.code
      Pattern Value{
        "coding" : [{
          "system" : "http://loinc.org",
          "code" : "32406-1"
        }]
      }
      62. Observation.component:1MinuteAppearanceScore.valueCodeableConcept:valueCodeableConcept
      Slice NamevalueCodeableConcept
      Definition

      The Apgar subscore for skin color/appearance.

      ShortAppearanceScore
      BindingUnless not suitable, these codes SHALL be taken from HuidskleurScoreCodelijst
      (extensible to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.12.16.4--20171231000000)

      HuidskleurScoreCodelijst

      TypeCodeableConcept
      Alternate NamesHuidskleurScore
      64. Observation.component:5MinuteAppearanceScore
      Slice Name5MinuteAppearanceScore
      Control0..1
      66. Observation.component:5MinuteAppearanceScore.code
      Pattern Value{
        "coding" : [{
          "system" : "http://loinc.org",
          "code" : "32411-1"
        }]
      }
      68. Observation.component:5MinuteAppearanceScore.valueCodeableConcept:valueCodeableConcept
      Slice NamevalueCodeableConcept
      Definition

      The Apgar subscore for skin color/appearance.

      ShortAppearanceScore
      BindingUnless not suitable, these codes SHALL be taken from HuidskleurScoreCodelijst
      (extensible to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.12.16.4--20171231000000)

      HuidskleurScoreCodelijst

      TypeCodeableConcept
      Alternate NamesHuidskleurScore
      70. Observation.component:10MinuteAppearanceScore
      Slice Name10MinuteAppearanceScore
      Control0..1
      72. Observation.component:10MinuteAppearanceScore.code
      Pattern Value{
        "coding" : [{
          "system" : "http://loinc.org",
          "code" : "32401-2"
        }]
      }
      74. Observation.component:10MinuteAppearanceScore.valueCodeableConcept:valueCodeableConcept
      Slice NamevalueCodeableConcept
      Definition

      The Apgar subscore for skin color/appearance.

      ShortAppearanceScore
      BindingUnless not suitable, these codes SHALL be taken from HuidskleurScoreCodelijst
      (extensible to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.12.16.4--20171231000000)

      HuidskleurScoreCodelijst

      TypeCodeableConcept
      Alternate NamesHuidskleurScore
      76. Observation.component:1MinutePulseScore
      Slice Name1MinutePulseScore
      Control0..1
      78. Observation.component:1MinutePulseScore.code
      Pattern Value{
        "coding" : [{
          "system" : "http://loinc.org",
          "code" : "32407-9"
        }]
      }
      80. Observation.component:1MinutePulseScore.valueCodeableConcept:valueCodeableConcept
      Slice NamevalueCodeableConcept
      Definition

      The Apgar subscore for pulse.

      ShortPulseScore
      BindingUnless not suitable, these codes SHALL be taken from HartslagScoreCodelijst
      (extensible to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.12.16.2--20171231000000)

      HartslagScoreCodelijst

      TypeCodeableConcept
      Alternate NamesHartslagScore
      82. Observation.component:5MinutePulseScore
      Slice Name5MinutePulseScore
      Control0..1
      84. Observation.component:5MinutePulseScore.code
      Pattern Value{
        "coding" : [{
          "system" : "http://loinc.org",
          "code" : "32412-9"
        }]
      }
      86. Observation.component:5MinutePulseScore.valueCodeableConcept:valueCodeableConcept
      Slice NamevalueCodeableConcept
      Definition

      The Apgar subscore for pulse.

      ShortPulseScore
      BindingUnless not suitable, these codes SHALL be taken from HartslagScoreCodelijst
      (extensible to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.12.16.2--20171231000000)

      HartslagScoreCodelijst

      TypeCodeableConcept
      Alternate NamesHartslagScore
      88. Observation.component:10MinutePulseScore
      Slice Name10MinutePulseScore
      Control0..1
      90. Observation.component:10MinutePulseScore.code
      Pattern Value{
        "coding" : [{
          "system" : "http://loinc.org",
          "code" : "32402-0"
        }]
      }
      92. Observation.component:10MinutePulseScore.valueCodeableConcept:valueCodeableConcept
      Slice NamevalueCodeableConcept
      Definition

      The Apgar subscore for pulse.

      ShortPulseScore
      BindingUnless not suitable, these codes SHALL be taken from HartslagScoreCodelijst
      (extensible to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.12.16.2--20171231000000)

      HartslagScoreCodelijst

      TypeCodeableConcept
      Alternate NamesHartslagScore
      94. Observation.component:1MinuteGrimaceScore
      Slice Name1MinuteGrimaceScore
      Control0..1
      96. Observation.component:1MinuteGrimaceScore.code
      Pattern Value{
        "coding" : [{
          "system" : "http://loinc.org",
          "code" : "32409-5"
        }]
      }
      98. Observation.component:1MinuteGrimaceScore.valueCodeableConcept:valueCodeableConcept
      Slice NamevalueCodeableConcept
      Definition

      The Apgar subscore for grimace.

      ShortGrimaceScore
      BindingUnless not suitable, these codes SHALL be taken from ReflexenScoreCodelijst
      (extensible to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.12.16.5--20171231000000)

      ReflexenScoreCodelijst

      TypeCodeableConcept
      Alternate NamesReflexenScore
      100. Observation.component:5MinuteGrimaceScore
      Slice Name5MinuteGrimaceScore
      Control0..1
      102. Observation.component:5MinuteGrimaceScore.code
      Pattern Value{
        "coding" : [{
          "system" : "http://loinc.org",
          "code" : "32414-5"
        }]
      }
      104. Observation.component:5MinuteGrimaceScore.valueCodeableConcept:valueCodeableConcept
      Slice NamevalueCodeableConcept
      Definition

      The Apgar subscore for grimace.

      ShortGrimaceScore
      BindingUnless not suitable, these codes SHALL be taken from ReflexenScoreCodelijst
      (extensible to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.12.16.5--20171231000000)

      ReflexenScoreCodelijst

      TypeCodeableConcept
      Alternate NamesReflexenScore
      106. Observation.component:10MinuteGrimaceScore
      Slice Name10MinuteGrimaceScore
      Control0..1
      108. Observation.component:10MinuteGrimaceScore.code
      Pattern Value{
        "coding" : [{
          "system" : "http://loinc.org",
          "code" : "32404-6"
        }]
      }
      110. Observation.component:10MinuteGrimaceScore.valueCodeableConcept:valueCodeableConcept
      Slice NamevalueCodeableConcept
      Definition

      The Apgar subscore for grimace.

      ShortGrimaceScore
      BindingUnless not suitable, these codes SHALL be taken from ReflexenScoreCodelijst
      (extensible to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.12.16.5--20171231000000)

      ReflexenScoreCodelijst

      TypeCodeableConcept
      Alternate NamesReflexenScore
      112. Observation.component:1MinuteMuscleToneScore
      Slice Name1MinuteMuscleToneScore
      Control0..1
      114. Observation.component:1MinuteMuscleToneScore.code
      Pattern Value{
        "coding" : [{
          "system" : "http://loinc.org",
          "code" : "32408-7"
        }]
      }
      116. Observation.component:1MinuteMuscleToneScore.valueCodeableConcept:valueCodeableConcept
      Slice NamevalueCodeableConcept
      Definition

      The Apgar subscore for activity/muscle tone.

      ShortMusleToneScore
      BindingUnless not suitable, these codes SHALL be taken from SpierspanningScoreCodelijst
      (extensible to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.12.16.3--20171231000000)

      SpierspanningScoreCodelijst

      TypeCodeableConcept
      Alternate NamesSpierspanningScore
      118. Observation.component:5MinuteMuscleToneScore
      Slice Name5MinuteMuscleToneScore
      Control0..1
      120. Observation.component:5MinuteMuscleToneScore.code
      Pattern Value{
        "coding" : [{
          "system" : "http://loinc.org",
          "code" : "32413-7"
        }]
      }
      122. Observation.component:5MinuteMuscleToneScore.valueCodeableConcept:valueCodeableConcept
      Slice NamevalueCodeableConcept
      Definition

      The Apgar subscore for activity/muscle tone.

      ShortMusleToneScore
      BindingUnless not suitable, these codes SHALL be taken from SpierspanningScoreCodelijst
      (extensible to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.12.16.3--20171231000000)

      SpierspanningScoreCodelijst

      TypeCodeableConcept
      Alternate NamesSpierspanningScore
      124. Observation.component:10MinuteMuscleToneScore
      Slice Name10MinuteMuscleToneScore
      Control0..1
      126. Observation.component:10MinuteMuscleToneScore.code
      Pattern Value{
        "coding" : [{
          "system" : "http://loinc.org",
          "code" : "32403-8"
        }]
      }
      128. Observation.component:10MinuteMuscleToneScore.valueCodeableConcept:valueCodeableConcept
      Slice NamevalueCodeableConcept
      Definition

      The Apgar subscore for activity/muscle tone.

      ShortMusleToneScore
      BindingUnless not suitable, these codes SHALL be taken from SpierspanningScoreCodelijst
      (extensible to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.12.16.3--20171231000000)

      SpierspanningScoreCodelijst

      TypeCodeableConcept
      Alternate NamesSpierspanningScore

      Guidance on how to interpret the contents of this table can be found here

      0. Observation
      Definition

      Root concept of the ApgarScore information model. This root concept contains all data elements of the ApgarScore information model.


      Measurements and simple assertions made about a patient, device or other subject.

      ShortApgarScoreMeasurements and simple assertions
      Comments

      Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc. Other resources are used to provide context for observations such as lab reports, etc.

      Control0..*
      Alternate NamesVital Signs, Measurement, Results, Tests
      Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
      dom-1: If the resource is contained in another resource, it SHALL NOT contain any narrative (contained.text.empty())
      dom-4: 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-3: If 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())
      obs-7: If 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())
      obs-6: dataAbsentReason SHALL only be present if Observation.value[x] is not present (dataAbsentReason.empty() or value.empty())
      zib-apgarscore-1: Exactly one of the time code slices SHALL be used for Observation.code (code.coding.where(system='http://loinc.org').where(code='9272-6' or code='9274-2' or code='9271-8').count()=1)
      zib-apgarscore-2: Components for 1 minute Apgar score are only allowed when Observation.code indicates 1 minute Apgar score (component.code.coding.where(system='http://loinc.org').where(code='32410-3' or code='32406-1' or code='32407-9' or code='32409-5' or code='32408-7').exists() implies code.coding.where(system='http://loinc.org').where(code='9272-6').exists())
      zib-apgarscore-3: Components for 5 minute Apgar score are only allowed when Observation.code indicates 5 minute Apgar score (component.code.coding.where(system='http://loinc.org').where(code='32415-2' or code='32411-1' or code='32412-9' or code='32414-5' or code='32413-7').exists() implies code.coding.where(system='http://loinc.org').where(code='9274-2').exists())
      zib-apgarscore-4: Components for 10 minute Apgar score are only allowed when Observation.code indicates 10 minute Apgar score (component.code.coding.where(system='http://loinc.org').where(code='32405-3' or code='32401-2' or code='32402-0' or code='32404-6' or code='32403-8').exists() implies code.coding.where(system='http://loinc.org').where(code='9271-8').exists())
      dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
      dom-1: If the resource is contained in another resource, it SHALL NOT contain any narrative (contained.text.empty())
      dom-4: 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-3: If 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())
      obs-7: If 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())
      obs-6: dataAbsentReason SHALL only be present if Observation.value[x] is not present (dataAbsentReason.empty() or value.empty())
      2. Observation.implicitRules
      Definition

      A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.

      ShortA set of rules under which this content was created
      Comments

      Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element.

      This element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.

      Control0..1
      Typeuri
      Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      4. Observation.modifierExtension
      Definition

      May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

      ShortExtensions that cannot be ignored
      Comments

      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

      Control0..*
      TypeExtension
      Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
      Alternate Namesextensions, user content
      6. Observation.status
      Definition

      The status of the result value.

      Shortregistered | preliminary | final | amended +
      Comments

      This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.

      Control1..1
      BindingThe codes SHALL be taken from ObservationStatushttp://hl7.org/fhir/ValueSet/observation-status
      (required to http://hl7.org/fhir/ValueSet/observation-status)

      Codes providing the status of an observation.

      Typecode
      Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Requirements

      Need to track the status of individual results. Some results are finalized before the whole report is finalized.

      8. Observation.code
      Definition

      Describes what was observed. Sometimes this is called the observation "name".

      ShortType of observation (code / type)
      Control1..1
      BindingFor example codes, see LOINC Codeshttp://hl7.org/fhir/ValueSet/observation-codes
      (example to http://hl7.org/fhir/ValueSet/observation-codes)

      Codes identifying names of simple observations.

      TypeCodeableConcept
      Summarytrue
      Requirements

      Knowing what kind of observation is being made is essential to understanding the observation.

      Alternate NamesName
      Example<br/><b>Example of 1 Minute ApgarScore</b>:{ "coding" : [{ "system" : "http://loinc.org", "code" : "9272-6", "display" : "1 minute Apgar Score" }] }
      10. Observation.code.coding
      Definition

      A reference to a code defined by a terminology system.

      ShortCode defined by a terminology system
      Comments

      Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

      Control10..*
      TypeCoding
      Summarytrue
      Requirements

      Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.

      SlicingThis element introduces a set of slices on Observation.code.coding. The slices are unordered and Open, and can be differentiated using the following discriminators:
      • value @ system
      • value @ code
      • 12. Observation.code.coding:1MinuteApgarScore
        Slice Name1MinuteApgarScore
        Definition

        A reference to a code defined by a terminology system.

        ShortCode defined by a terminology system
        Comments

        Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

        Control0..1*
        TypeCoding
        Summarytrue
        Requirements

        Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.

        14. Observation.code.coding:1MinuteApgarScore.system
        Definition

        The identification of the code system that defines the meaning of the symbol in the code.

        ShortIdentity of the terminology system
        Comments

        The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously.

        Control10..1
        Typeuri
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Requirements

        Need to be unambiguous about the source of the definition of the symbol.

        Fixed Valuehttp://loinc.org
        16. Observation.code.coding:1MinuteApgarScore.code
        Definition

        A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

        ShortSymbol in syntax defined by the system
        Control10..1
        Typecode
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Requirements

        Need to refer to a particular code in the system.

        Fixed Value9272-6
        18. Observation.code.coding:1MinuteApgarScore.display
        Definition

        A representation of the meaning of the code in the system, following the rules of the system.

        ShortRepresentation defined by the system
        Control0..1
        Typestring
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Requirements

        Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

        20. Observation.code.coding:5MinuteApgarScore
        Slice Name5MinuteApgarScore
        Definition

        A reference to a code defined by a terminology system.

        ShortCode defined by a terminology system
        Comments

        Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

        Control0..1*
        TypeCoding
        Summarytrue
        Requirements

        Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.

        22. Observation.code.coding:5MinuteApgarScore.system
        Definition

        The identification of the code system that defines the meaning of the symbol in the code.

        ShortIdentity of the terminology system
        Comments

        The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously.

        Control10..1
        Typeuri
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Requirements

        Need to be unambiguous about the source of the definition of the symbol.

        Fixed Valuehttp://loinc.org
        24. Observation.code.coding:5MinuteApgarScore.code
        Definition

        A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

        ShortSymbol in syntax defined by the system
        Control10..1
        Typecode
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Requirements

        Need to refer to a particular code in the system.

        Fixed Value9274-2
        26. Observation.code.coding:5MinuteApgarScore.display
        Definition

        A representation of the meaning of the code in the system, following the rules of the system.

        ShortRepresentation defined by the system
        Control0..1
        Typestring
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Requirements

        Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

        28. Observation.code.coding:10MinuteApgarScore
        Slice Name10MinuteApgarScore
        Definition

        A reference to a code defined by a terminology system.

        ShortCode defined by a terminology system
        Comments

        Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

        Control0..1*
        TypeCoding
        Summarytrue
        Requirements

        Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.

        30. Observation.code.coding:10MinuteApgarScore.system
        Definition

        The identification of the code system that defines the meaning of the symbol in the code.

        ShortIdentity of the terminology system
        Comments

        The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously.

        Control10..1
        Typeuri
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Requirements

        Need to be unambiguous about the source of the definition of the symbol.

        Fixed Valuehttp://loinc.org
        32. Observation.code.coding:10MinuteApgarScore.code
        Definition

        A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

        ShortSymbol in syntax defined by the system
        Control10..1
        Typecode
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Requirements

        Need to refer to a particular code in the system.

        Fixed Value9271-8
        34. Observation.code.coding:10MinuteApgarScore.display
        Definition

        A representation of the meaning of the code in the system, following the rules of the system.

        ShortRepresentation defined by the system
        Control0..1
        Typestring
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Requirements

        Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

        36. Observation.subject
        Definition

        The patient, or group of patients, location, or device whose characteristics (direct or indirect) are described by the observation and into whose record the observation is placed. Comments: Indirect characteristics may be those of a specimen, fetus, donor, other observer (for example a relative or EMT), or any observation made about the subject.

        ShortWho and/or what this is about
        Comments

        One would expect this element to be a cardinality of 1..1. The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.

        If the target of the observation is different than the subject, the general extension observation-focal-subject. may be used. However, the distinction between the patient's own value for an observation versus that of the fetus, or the donor or blood product unit, etc., are often specified in the observation code.

        Control10..1
        TypeReference(Group, Device, nl-core-location, nl-core-patient, Patient, Location)
        Summarytrue
        Requirements

        Observations have no value if you don't know who or what they're about.

        38. Observation.effective[x]
        Definition

        The time or time-period the observed value is asserted as being true. For biological subjects - e.g. human patients - this is usually called the "physiologically relevant time". This is usually either the time of the procedure or of specimen collection, but very often the source of the date/time is not known, only the date/time itself.

        ShortClinically relevant time/time-period for observation
        Comments

        At least a date should be present unless this observation is a historical report.

        Control10..1
        TypedateTime, Period
        [x] NoteSee Choice of Data Types for further information about how to use [x]
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Requirements

        Knowing when an observation was deemed true is important to its relevance as well as determining trends.

        Alternate NamesOccurrence
        SlicingThis element introduces a set of slices on Observation.effective[x]. The slices are unordered and Closed, and can be differentiated using the following discriminators:
        • type @ $this
        • 40. Observation.effective[x]:effectiveDateTime
          Slice NameeffectiveDateTime
          Definition

          The day and time at which the Apgar score is registered.


          The time or time-period the observed value is asserted as being true. For biological subjects - e.g. human patients - this is usually called the "physiologically relevant time". This is usually either the time of the procedure or of specimen collection, but very often the source of the date/time is not known, only the date/time itself.

          ShortApgarScoreDateTimeClinically relevant time/time-period for observation
          Comments

          At least a date should be present unless this observation is a historical report.

          Control10..1
          TypedateTime, Period
          [x] NoteSee Choice of Data Types for further information about how to use [x]
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Requirements

          Knowing when an observation was deemed true is important to its relevance as well as determining trends.

          Alternate NamesOccurrence, ApgarScoreDatumTijd
          42. Observation.value[x]:valueQuantity
          Slice NamevalueQuantity
          Definition

          Total of the Apgar score.


          The information determined as a result of making the observation, if the information has a simple value.

          ShortApgarScoreTotalActual result
          Comments

          Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. This element has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueString, valueBoolean, valueRange, valueRatio, valueSampledData, valueAttachment, valueTime, valueDateTime, or valuePeriod. (The name format is "'value' + the type name" with a capital on the first letter of the type).

          If the data element is usually coded or if the type associated with the Observation.value defines a coded value, use CodeableConcept instead of string datatype even if the value is uncoded text. A value set is bound to the ValueCodeableConcept element. For further discussion and examples see the notes section below.

          Control10..1
          This element is affected by the following invariants: obs-7
          TypeQuantity, dateTime, boolean, string, SampledData, Period, Ratio, Attachment, time, Range, CodeableConcept
          [x] NoteSee Choice of Data Types for further information about how to use [x]
          Summarytrue
          Requirements

          An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.

          Alternate NamesApgarScoreTotaal
          44. Observation.value[x]:valueQuantity.value
          Definition

          The value of the measured amount. The value includes an implicit precision in the presentation of the value.

          ShortNumerical value (with implicit precision)
          Comments

          The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).

          Control0..1
          Typedecimal
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Requirements

          Precision is handled implicitly in almost all cases of measurement.

          Min Value0
          Max Value10
          46. Observation.value[x]:valueQuantity.comparator
          Definition

          How the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is "<" , then the real value is < stated value.

          Short< | <= | >= | > - how to understand the value
          Comments

          This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value.

          Control0..1
          BindingThe codes SHALL be taken from QuantityComparatorhttp://hl7.org/fhir/ValueSet/quantity-comparator
          (required to http://hl7.org/fhir/ValueSet/quantity-comparator)

          How the Quantity should be understood and represented.

          Typecode
          Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Requirements

          Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.

          Meaning if MissingIf there is no comparator, then there is no modification of the value
          48. Observation.comment
          Definition

          Comment on the Apgar score.


          May include statements about significant, unexpected or unreliable values, or information about the source of the value where this may be relevant to the interpretation of the result.

          ShortCommentComments about result
          Control0..1
          Typestring
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Requirements

          Need to be able to provide free text additional information.

          Alternate NamesToelichting
          50. Observation.component
          Definition

          Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.

          ShortComponent results
          Comments

          For a discussion on the ways Observations can be assembled in groups together see Notes below.

          Control0..*
          TypeBackboneElement
          Summarytrue
          Requirements

          Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
          ele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
          SlicingThis element introduces a set of slices on Observation.component. The slices are unordered and Open, and can be differentiated using the following discriminators:
          • pattern @ code
          • 52. Observation.component.modifierExtension
            Definition

            May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

            ShortExtensions that cannot be ignored
            Comments

            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

            Control0..*
            TypeExtension
            Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
            Summarytrue
            Alternate Namesextensions, user content, modifiers
            54. Observation.component.code
            Definition

            Describes what was observed. Sometimes this is called the observation "code".

            ShortType of component observation (code / type)
            Control1..1
            BindingFor example codes, see LOINC Codeshttp://hl7.org/fhir/ValueSet/observation-codes
            (example to http://hl7.org/fhir/ValueSet/observation-codes)

            Codes identifying names of simple observations.

            TypeCodeableConcept
            Summarytrue
            Requirements

            Knowing what kind of observation is being made is essential to understanding the observation.

            56. Observation.component:1MinuteRespiratoryScore
            Slice Name1MinuteRespiratoryScore
            Definition

            Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.

            ShortComponent results
            Comments

            For a discussion on the ways Observations can be assembled in groups together see Notes below.

            Control0..1*
            TypeBackboneElement
            Summarytrue
            Requirements

            Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
            ele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
            58. Observation.component:1MinuteRespiratoryScore.modifierExtension
            Definition

            May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

            ShortExtensions that cannot be ignored
            Comments

            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

            Control0..*
            TypeExtension
            Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
            Summarytrue
            Alternate Namesextensions, user content, modifiers
            60. Observation.component:1MinuteRespiratoryScore.code
            Definition

            Describes what was observed. Sometimes this is called the observation "code".

            ShortType of component observation (code / type)
            Control1..1
            BindingFor example codes, see LOINC Codeshttp://hl7.org/fhir/ValueSet/observation-codes
            (example to http://hl7.org/fhir/ValueSet/observation-codes)

            Codes identifying names of simple observations.

            TypeCodeableConcept
            Summarytrue
            Requirements

            Knowing what kind of observation is being made is essential to understanding the observation.

            Pattern Value{
              "coding" : [{
                "system" : "http://loinc.org",
                "code" : "32410-3"
              }]
            }
            62. Observation.component:1MinuteRespiratoryScore.value[x]:valueCodeableConcept
            Slice NamevalueCodeableConcept
            Definition

            The Apgar subscore for respiration.


            The information determined as a result of making the observation, if the information has a simple value.

            ShortRespiratoryScoreActual component result
            Comments

            Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (these "yes/no" concepts can be mapped to the display name "true/false" or other mutually exclusive terms that may be needed"). The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (the name format is "'value' + the type name" with a capital on the first letter of the type).

            Control0..1
            BindingUnless not suitable, these codes SHALL be taken from For codes, see AdemhalingScoreCodelijst
            (extensible to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.12.16.1--20171231000000)

            AdemhalingScoreCodelijst

            TypeCodeableConcept, dateTime, string, SampledData, Quantity, Period, Ratio, Attachment, time, Range
            [x] NoteSee Choice of Data Types for further information about how to use [x]
            Summarytrue
            Requirements

            An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.

            Alternate NamesAdemhalingScore
            64. Observation.component:5MinuteRespiratoryScore
            Slice Name5MinuteRespiratoryScore
            Definition

            Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.

            ShortComponent results
            Comments

            For a discussion on the ways Observations can be assembled in groups together see Notes below.

            Control0..1*
            TypeBackboneElement
            Summarytrue
            Requirements

            Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
            ele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
            66. Observation.component:5MinuteRespiratoryScore.modifierExtension
            Definition

            May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

            ShortExtensions that cannot be ignored
            Comments

            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

            Control0..*
            TypeExtension
            Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
            Summarytrue
            Alternate Namesextensions, user content, modifiers
            68. Observation.component:5MinuteRespiratoryScore.code
            Definition

            Describes what was observed. Sometimes this is called the observation "code".

            ShortType of component observation (code / type)
            Control1..1
            BindingFor example codes, see LOINC Codeshttp://hl7.org/fhir/ValueSet/observation-codes
            (example to http://hl7.org/fhir/ValueSet/observation-codes)

            Codes identifying names of simple observations.

            TypeCodeableConcept
            Summarytrue
            Requirements

            Knowing what kind of observation is being made is essential to understanding the observation.

            Pattern Value{
              "coding" : [{
                "system" : "http://loinc.org",
                "code" : "32415-2"
              }]
            }
            70. Observation.component:5MinuteRespiratoryScore.value[x]:valueCodeableConcept
            Slice NamevalueCodeableConcept
            Definition

            The Apgar subscore for respiration.


            The information determined as a result of making the observation, if the information has a simple value.

            ShortRespiratoryScoreActual component result
            Comments

            Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (these "yes/no" concepts can be mapped to the display name "true/false" or other mutually exclusive terms that may be needed"). The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (the name format is "'value' + the type name" with a capital on the first letter of the type).

            Control0..1
            BindingUnless not suitable, these codes SHALL be taken from For codes, see AdemhalingScoreCodelijst
            (extensible to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.12.16.1--20171231000000)

            AdemhalingScoreCodelijst

            TypeCodeableConcept, dateTime, string, SampledData, Quantity, Period, Ratio, Attachment, time, Range
            [x] NoteSee Choice of Data Types for further information about how to use [x]
            Summarytrue
            Requirements

            An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.

            Alternate NamesAdemhalingScore
            72. Observation.component:10MinuteRespiratoryScore
            Slice Name10MinuteRespiratoryScore
            Definition

            Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.

            ShortComponent results
            Comments

            For a discussion on the ways Observations can be assembled in groups together see Notes below.

            Control0..1*
            TypeBackboneElement
            Summarytrue
            Requirements

            Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
            ele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
            74. Observation.component:10MinuteRespiratoryScore.modifierExtension
            Definition

            May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

            ShortExtensions that cannot be ignored
            Comments

            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

            Control0..*
            TypeExtension
            Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
            Summarytrue
            Alternate Namesextensions, user content, modifiers
            76. Observation.component:10MinuteRespiratoryScore.code
            Definition

            Describes what was observed. Sometimes this is called the observation "code".

            ShortType of component observation (code / type)
            Control1..1
            BindingFor example codes, see LOINC Codeshttp://hl7.org/fhir/ValueSet/observation-codes
            (example to http://hl7.org/fhir/ValueSet/observation-codes)

            Codes identifying names of simple observations.

            TypeCodeableConcept
            Summarytrue
            Requirements

            Knowing what kind of observation is being made is essential to understanding the observation.

            Pattern Value{
              "coding" : [{
                "system" : "http://loinc.org",
                "code" : "32405-3"
              }]
            }
            78. Observation.component:10MinuteRespiratoryScore.value[x]:valueCodeableConcept
            Slice NamevalueCodeableConcept
            Definition

            The Apgar subscore for respiration.


            The information determined as a result of making the observation, if the information has a simple value.

            ShortRespiratoryScoreActual component result
            Comments

            Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (these "yes/no" concepts can be mapped to the display name "true/false" or other mutually exclusive terms that may be needed"). The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (the name format is "'value' + the type name" with a capital on the first letter of the type).

            Control0..1
            BindingUnless not suitable, these codes SHALL be taken from For codes, see AdemhalingScoreCodelijst
            (extensible to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.12.16.1--20171231000000)

            AdemhalingScoreCodelijst

            TypeCodeableConcept, dateTime, string, SampledData, Quantity, Period, Ratio, Attachment, time, Range
            [x] NoteSee Choice of Data Types for further information about how to use [x]
            Summarytrue
            Requirements

            An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.

            Alternate NamesAdemhalingScore
            80. Observation.component:1MinuteAppearanceScore
            Slice Name1MinuteAppearanceScore
            Definition

            Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.

            ShortComponent results
            Comments

            For a discussion on the ways Observations can be assembled in groups together see Notes below.

            Control0..1*
            TypeBackboneElement
            Summarytrue
            Requirements

            Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
            ele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
            82. Observation.component:1MinuteAppearanceScore.modifierExtension
            Definition

            May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

            ShortExtensions that cannot be ignored
            Comments

            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

            Control0..*
            TypeExtension
            Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
            Summarytrue
            Alternate Namesextensions, user content, modifiers
            84. Observation.component:1MinuteAppearanceScore.code
            Definition

            Describes what was observed. Sometimes this is called the observation "code".

            ShortType of component observation (code / type)
            Control1..1
            BindingFor example codes, see LOINC Codeshttp://hl7.org/fhir/ValueSet/observation-codes
            (example to http://hl7.org/fhir/ValueSet/observation-codes)

            Codes identifying names of simple observations.

            TypeCodeableConcept
            Summarytrue
            Requirements

            Knowing what kind of observation is being made is essential to understanding the observation.

            Pattern Value{
              "coding" : [{
                "system" : "http://loinc.org",
                "code" : "32406-1"
              }]
            }
            86. Observation.component:1MinuteAppearanceScore.value[x]:valueCodeableConcept
            Slice NamevalueCodeableConcept
            Definition

            The Apgar subscore for skin color/appearance.


            The information determined as a result of making the observation, if the information has a simple value.

            ShortAppearanceScoreActual component result
            Comments

            Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (these "yes/no" concepts can be mapped to the display name "true/false" or other mutually exclusive terms that may be needed"). The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (the name format is "'value' + the type name" with a capital on the first letter of the type).

            Control0..1
            BindingUnless not suitable, these codes SHALL be taken from For codes, see HuidskleurScoreCodelijst
            (extensible to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.12.16.4--20171231000000)

            HuidskleurScoreCodelijst

            TypeCodeableConcept, dateTime, string, SampledData, Quantity, Period, Ratio, Attachment, time, Range
            [x] NoteSee Choice of Data Types for further information about how to use [x]
            Summarytrue
            Requirements

            An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.

            Alternate NamesHuidskleurScore
            88. Observation.component:5MinuteAppearanceScore
            Slice Name5MinuteAppearanceScore
            Definition

            Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.

            ShortComponent results
            Comments

            For a discussion on the ways Observations can be assembled in groups together see Notes below.

            Control0..1*
            TypeBackboneElement
            Summarytrue
            Requirements

            Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
            ele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
            90. Observation.component:5MinuteAppearanceScore.modifierExtension
            Definition

            May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

            ShortExtensions that cannot be ignored
            Comments

            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

            Control0..*
            TypeExtension
            Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
            Summarytrue
            Alternate Namesextensions, user content, modifiers
            92. Observation.component:5MinuteAppearanceScore.code
            Definition

            Describes what was observed. Sometimes this is called the observation "code".

            ShortType of component observation (code / type)
            Control1..1
            BindingFor example codes, see LOINC Codeshttp://hl7.org/fhir/ValueSet/observation-codes
            (example to http://hl7.org/fhir/ValueSet/observation-codes)

            Codes identifying names of simple observations.

            TypeCodeableConcept
            Summarytrue
            Requirements

            Knowing what kind of observation is being made is essential to understanding the observation.

            Pattern Value{
              "coding" : [{
                "system" : "http://loinc.org",
                "code" : "32411-1"
              }]
            }
            94. Observation.component:5MinuteAppearanceScore.value[x]:valueCodeableConcept
            Slice NamevalueCodeableConcept
            Definition

            The Apgar subscore for skin color/appearance.


            The information determined as a result of making the observation, if the information has a simple value.

            ShortAppearanceScoreActual component result
            Comments

            Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (these "yes/no" concepts can be mapped to the display name "true/false" or other mutually exclusive terms that may be needed"). The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (the name format is "'value' + the type name" with a capital on the first letter of the type).

            Control0..1
            BindingUnless not suitable, these codes SHALL be taken from For codes, see HuidskleurScoreCodelijst
            (extensible to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.12.16.4--20171231000000)

            HuidskleurScoreCodelijst

            TypeCodeableConcept, dateTime, string, SampledData, Quantity, Period, Ratio, Attachment, time, Range
            [x] NoteSee Choice of Data Types for further information about how to use [x]
            Summarytrue
            Requirements

            An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.

            Alternate NamesHuidskleurScore
            96. Observation.component:10MinuteAppearanceScore
            Slice Name10MinuteAppearanceScore
            Definition

            Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.

            ShortComponent results
            Comments

            For a discussion on the ways Observations can be assembled in groups together see Notes below.

            Control0..1*
            TypeBackboneElement
            Summarytrue
            Requirements

            Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
            ele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
            98. Observation.component:10MinuteAppearanceScore.modifierExtension
            Definition

            May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

            ShortExtensions that cannot be ignored
            Comments

            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

            Control0..*
            TypeExtension
            Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
            Summarytrue
            Alternate Namesextensions, user content, modifiers
            100. Observation.component:10MinuteAppearanceScore.code
            Definition

            Describes what was observed. Sometimes this is called the observation "code".

            ShortType of component observation (code / type)
            Control1..1
            BindingFor example codes, see LOINC Codeshttp://hl7.org/fhir/ValueSet/observation-codes
            (example to http://hl7.org/fhir/ValueSet/observation-codes)

            Codes identifying names of simple observations.

            TypeCodeableConcept
            Summarytrue
            Requirements

            Knowing what kind of observation is being made is essential to understanding the observation.

            Pattern Value{
              "coding" : [{
                "system" : "http://loinc.org",
                "code" : "32401-2"
              }]
            }
            102. Observation.component:10MinuteAppearanceScore.value[x]:valueCodeableConcept
            Slice NamevalueCodeableConcept
            Definition

            The Apgar subscore for skin color/appearance.


            The information determined as a result of making the observation, if the information has a simple value.

            ShortAppearanceScoreActual component result
            Comments

            Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (these "yes/no" concepts can be mapped to the display name "true/false" or other mutually exclusive terms that may be needed"). The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (the name format is "'value' + the type name" with a capital on the first letter of the type).

            Control0..1
            BindingUnless not suitable, these codes SHALL be taken from For codes, see HuidskleurScoreCodelijst
            (extensible to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.12.16.4--20171231000000)

            HuidskleurScoreCodelijst

            TypeCodeableConcept, dateTime, string, SampledData, Quantity, Period, Ratio, Attachment, time, Range
            [x] NoteSee Choice of Data Types for further information about how to use [x]
            Summarytrue
            Requirements

            An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.

            Alternate NamesHuidskleurScore
            104. Observation.component:1MinutePulseScore
            Slice Name1MinutePulseScore
            Definition

            Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.

            ShortComponent results
            Comments

            For a discussion on the ways Observations can be assembled in groups together see Notes below.

            Control0..1*
            TypeBackboneElement
            Summarytrue
            Requirements

            Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
            ele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
            106. Observation.component:1MinutePulseScore.modifierExtension
            Definition

            May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

            ShortExtensions that cannot be ignored
            Comments

            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

            Control0..*
            TypeExtension
            Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
            Summarytrue
            Alternate Namesextensions, user content, modifiers
            108. Observation.component:1MinutePulseScore.code
            Definition

            Describes what was observed. Sometimes this is called the observation "code".

            ShortType of component observation (code / type)
            Control1..1
            BindingFor example codes, see LOINC Codeshttp://hl7.org/fhir/ValueSet/observation-codes
            (example to http://hl7.org/fhir/ValueSet/observation-codes)

            Codes identifying names of simple observations.

            TypeCodeableConcept
            Summarytrue
            Requirements

            Knowing what kind of observation is being made is essential to understanding the observation.

            Pattern Value{
              "coding" : [{
                "system" : "http://loinc.org",
                "code" : "32407-9"
              }]
            }
            110. Observation.component:1MinutePulseScore.value[x]:valueCodeableConcept
            Slice NamevalueCodeableConcept
            Definition

            The Apgar subscore for pulse.


            The information determined as a result of making the observation, if the information has a simple value.

            ShortPulseScoreActual component result
            Comments

            Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (these "yes/no" concepts can be mapped to the display name "true/false" or other mutually exclusive terms that may be needed"). The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (the name format is "'value' + the type name" with a capital on the first letter of the type).

            Control0..1
            BindingUnless not suitable, these codes SHALL be taken from For codes, see HartslagScoreCodelijst
            (extensible to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.12.16.2--20171231000000)

            HartslagScoreCodelijst

            TypeCodeableConcept, dateTime, string, SampledData, Quantity, Period, Ratio, Attachment, time, Range
            [x] NoteSee Choice of Data Types for further information about how to use [x]
            Summarytrue
            Requirements

            An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.

            Alternate NamesHartslagScore
            112. Observation.component:5MinutePulseScore
            Slice Name5MinutePulseScore
            Definition

            Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.

            ShortComponent results
            Comments

            For a discussion on the ways Observations can be assembled in groups together see Notes below.

            Control0..1*
            TypeBackboneElement
            Summarytrue
            Requirements

            Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
            ele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
            114. Observation.component:5MinutePulseScore.modifierExtension
            Definition

            May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

            ShortExtensions that cannot be ignored
            Comments

            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

            Control0..*
            TypeExtension
            Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
            Summarytrue
            Alternate Namesextensions, user content, modifiers
            116. Observation.component:5MinutePulseScore.code
            Definition

            Describes what was observed. Sometimes this is called the observation "code".

            ShortType of component observation (code / type)
            Control1..1
            BindingFor example codes, see LOINC Codeshttp://hl7.org/fhir/ValueSet/observation-codes
            (example to http://hl7.org/fhir/ValueSet/observation-codes)

            Codes identifying names of simple observations.

            TypeCodeableConcept
            Summarytrue
            Requirements

            Knowing what kind of observation is being made is essential to understanding the observation.

            Pattern Value{
              "coding" : [{
                "system" : "http://loinc.org",
                "code" : "32412-9"
              }]
            }
            118. Observation.component:5MinutePulseScore.value[x]:valueCodeableConcept
            Slice NamevalueCodeableConcept
            Definition

            The Apgar subscore for pulse.


            The information determined as a result of making the observation, if the information has a simple value.

            ShortPulseScoreActual component result
            Comments

            Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (these "yes/no" concepts can be mapped to the display name "true/false" or other mutually exclusive terms that may be needed"). The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (the name format is "'value' + the type name" with a capital on the first letter of the type).

            Control0..1
            BindingUnless not suitable, these codes SHALL be taken from For codes, see HartslagScoreCodelijst
            (extensible to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.12.16.2--20171231000000)

            HartslagScoreCodelijst

            TypeCodeableConcept, dateTime, string, SampledData, Quantity, Period, Ratio, Attachment, time, Range
            [x] NoteSee Choice of Data Types for further information about how to use [x]
            Summarytrue
            Requirements

            An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.

            Alternate NamesHartslagScore
            120. Observation.component:10MinutePulseScore
            Slice Name10MinutePulseScore
            Definition

            Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.

            ShortComponent results
            Comments

            For a discussion on the ways Observations can be assembled in groups together see Notes below.

            Control0..1*
            TypeBackboneElement
            Summarytrue
            Requirements

            Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
            ele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
            122. Observation.component:10MinutePulseScore.modifierExtension
            Definition

            May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

            ShortExtensions that cannot be ignored
            Comments

            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

            Control0..*
            TypeExtension
            Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
            Summarytrue
            Alternate Namesextensions, user content, modifiers
            124. Observation.component:10MinutePulseScore.code
            Definition

            Describes what was observed. Sometimes this is called the observation "code".

            ShortType of component observation (code / type)
            Control1..1
            BindingFor example codes, see LOINC Codeshttp://hl7.org/fhir/ValueSet/observation-codes
            (example to http://hl7.org/fhir/ValueSet/observation-codes)

            Codes identifying names of simple observations.

            TypeCodeableConcept
            Summarytrue
            Requirements

            Knowing what kind of observation is being made is essential to understanding the observation.

            Pattern Value{
              "coding" : [{
                "system" : "http://loinc.org",
                "code" : "32402-0"
              }]
            }
            126. Observation.component:10MinutePulseScore.value[x]:valueCodeableConcept
            Slice NamevalueCodeableConcept
            Definition

            The Apgar subscore for pulse.


            The information determined as a result of making the observation, if the information has a simple value.

            ShortPulseScoreActual component result
            Comments

            Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (these "yes/no" concepts can be mapped to the display name "true/false" or other mutually exclusive terms that may be needed"). The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (the name format is "'value' + the type name" with a capital on the first letter of the type).

            Control0..1
            BindingUnless not suitable, these codes SHALL be taken from For codes, see HartslagScoreCodelijst
            (extensible to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.12.16.2--20171231000000)

            HartslagScoreCodelijst

            TypeCodeableConcept, dateTime, string, SampledData, Quantity, Period, Ratio, Attachment, time, Range
            [x] NoteSee Choice of Data Types for further information about how to use [x]
            Summarytrue
            Requirements

            An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.

            Alternate NamesHartslagScore
            128. Observation.component:1MinuteGrimaceScore
            Slice Name1MinuteGrimaceScore
            Definition

            Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.

            ShortComponent results
            Comments

            For a discussion on the ways Observations can be assembled in groups together see Notes below.

            Control0..1*
            TypeBackboneElement
            Summarytrue
            Requirements

            Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
            ele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
            130. Observation.component:1MinuteGrimaceScore.modifierExtension
            Definition

            May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

            ShortExtensions that cannot be ignored
            Comments

            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

            Control0..*
            TypeExtension
            Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
            Summarytrue
            Alternate Namesextensions, user content, modifiers
            132. Observation.component:1MinuteGrimaceScore.code
            Definition

            Describes what was observed. Sometimes this is called the observation "code".

            ShortType of component observation (code / type)
            Control1..1
            BindingFor example codes, see LOINC Codeshttp://hl7.org/fhir/ValueSet/observation-codes
            (example to http://hl7.org/fhir/ValueSet/observation-codes)

            Codes identifying names of simple observations.

            TypeCodeableConcept
            Summarytrue
            Requirements

            Knowing what kind of observation is being made is essential to understanding the observation.

            Pattern Value{
              "coding" : [{
                "system" : "http://loinc.org",
                "code" : "32409-5"
              }]
            }
            134. Observation.component:1MinuteGrimaceScore.value[x]:valueCodeableConcept
            Slice NamevalueCodeableConcept
            Definition

            The Apgar subscore for grimace.


            The information determined as a result of making the observation, if the information has a simple value.

            ShortGrimaceScoreActual component result
            Comments

            Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (these "yes/no" concepts can be mapped to the display name "true/false" or other mutually exclusive terms that may be needed"). The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (the name format is "'value' + the type name" with a capital on the first letter of the type).

            Control0..1
            BindingUnless not suitable, these codes SHALL be taken from For codes, see ReflexenScoreCodelijst
            (extensible to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.12.16.5--20171231000000)

            ReflexenScoreCodelijst

            TypeCodeableConcept, dateTime, string, SampledData, Quantity, Period, Ratio, Attachment, time, Range
            [x] NoteSee Choice of Data Types for further information about how to use [x]
            Summarytrue
            Requirements

            An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.

            Alternate NamesReflexenScore
            136. Observation.component:5MinuteGrimaceScore
            Slice Name5MinuteGrimaceScore
            Definition

            Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.

            ShortComponent results
            Comments

            For a discussion on the ways Observations can be assembled in groups together see Notes below.

            Control0..1*
            TypeBackboneElement
            Summarytrue
            Requirements

            Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
            ele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
            138. Observation.component:5MinuteGrimaceScore.modifierExtension
            Definition

            May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

            ShortExtensions that cannot be ignored
            Comments

            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

            Control0..*
            TypeExtension
            Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
            Summarytrue
            Alternate Namesextensions, user content, modifiers
            140. Observation.component:5MinuteGrimaceScore.code
            Definition

            Describes what was observed. Sometimes this is called the observation "code".

            ShortType of component observation (code / type)
            Control1..1
            BindingFor example codes, see LOINC Codeshttp://hl7.org/fhir/ValueSet/observation-codes
            (example to http://hl7.org/fhir/ValueSet/observation-codes)

            Codes identifying names of simple observations.

            TypeCodeableConcept
            Summarytrue
            Requirements

            Knowing what kind of observation is being made is essential to understanding the observation.

            Pattern Value{
              "coding" : [{
                "system" : "http://loinc.org",
                "code" : "32414-5"
              }]
            }
            142. Observation.component:5MinuteGrimaceScore.value[x]:valueCodeableConcept
            Slice NamevalueCodeableConcept
            Definition

            The Apgar subscore for grimace.


            The information determined as a result of making the observation, if the information has a simple value.

            ShortGrimaceScoreActual component result
            Comments

            Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (these "yes/no" concepts can be mapped to the display name "true/false" or other mutually exclusive terms that may be needed"). The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (the name format is "'value' + the type name" with a capital on the first letter of the type).

            Control0..1
            BindingUnless not suitable, these codes SHALL be taken from For codes, see ReflexenScoreCodelijst
            (extensible to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.12.16.5--20171231000000)

            ReflexenScoreCodelijst

            TypeCodeableConcept, dateTime, string, SampledData, Quantity, Period, Ratio, Attachment, time, Range
            [x] NoteSee Choice of Data Types for further information about how to use [x]
            Summarytrue
            Requirements

            An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.

            Alternate NamesReflexenScore
            144. Observation.component:10MinuteGrimaceScore
            Slice Name10MinuteGrimaceScore
            Definition

            Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.

            ShortComponent results
            Comments

            For a discussion on the ways Observations can be assembled in groups together see Notes below.

            Control0..1*
            TypeBackboneElement
            Summarytrue
            Requirements

            Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
            ele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
            146. Observation.component:10MinuteGrimaceScore.modifierExtension
            Definition

            May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

            ShortExtensions that cannot be ignored
            Comments

            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

            Control0..*
            TypeExtension
            Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
            Summarytrue
            Alternate Namesextensions, user content, modifiers
            148. Observation.component:10MinuteGrimaceScore.code
            Definition

            Describes what was observed. Sometimes this is called the observation "code".

            ShortType of component observation (code / type)
            Control1..1
            BindingFor example codes, see LOINC Codeshttp://hl7.org/fhir/ValueSet/observation-codes
            (example to http://hl7.org/fhir/ValueSet/observation-codes)

            Codes identifying names of simple observations.

            TypeCodeableConcept
            Summarytrue
            Requirements

            Knowing what kind of observation is being made is essential to understanding the observation.

            Pattern Value{
              "coding" : [{
                "system" : "http://loinc.org",
                "code" : "32404-6"
              }]
            }
            150. Observation.component:10MinuteGrimaceScore.value[x]:valueCodeableConcept
            Slice NamevalueCodeableConcept
            Definition

            The Apgar subscore for grimace.


            The information determined as a result of making the observation, if the information has a simple value.

            ShortGrimaceScoreActual component result
            Comments

            Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (these "yes/no" concepts can be mapped to the display name "true/false" or other mutually exclusive terms that may be needed"). The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (the name format is "'value' + the type name" with a capital on the first letter of the type).

            Control0..1
            BindingUnless not suitable, these codes SHALL be taken from For codes, see ReflexenScoreCodelijst
            (extensible to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.12.16.5--20171231000000)

            ReflexenScoreCodelijst

            TypeCodeableConcept, dateTime, string, SampledData, Quantity, Period, Ratio, Attachment, time, Range
            [x] NoteSee Choice of Data Types for further information about how to use [x]
            Summarytrue
            Requirements

            An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.

            Alternate NamesReflexenScore
            152. Observation.component:1MinuteMuscleToneScore
            Slice Name1MinuteMuscleToneScore
            Definition

            Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.

            ShortComponent results
            Comments

            For a discussion on the ways Observations can be assembled in groups together see Notes below.

            Control0..1*
            TypeBackboneElement
            Summarytrue
            Requirements

            Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
            ele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
            154. Observation.component:1MinuteMuscleToneScore.modifierExtension
            Definition

            May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

            ShortExtensions that cannot be ignored
            Comments

            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

            Control0..*
            TypeExtension
            Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
            Summarytrue
            Alternate Namesextensions, user content, modifiers
            156. Observation.component:1MinuteMuscleToneScore.code
            Definition

            Describes what was observed. Sometimes this is called the observation "code".

            ShortType of component observation (code / type)
            Control1..1
            BindingFor example codes, see LOINC Codeshttp://hl7.org/fhir/ValueSet/observation-codes
            (example to http://hl7.org/fhir/ValueSet/observation-codes)

            Codes identifying names of simple observations.

            TypeCodeableConcept
            Summarytrue
            Requirements

            Knowing what kind of observation is being made is essential to understanding the observation.

            Pattern Value{
              "coding" : [{
                "system" : "http://loinc.org",
                "code" : "32408-7"
              }]
            }
            158. Observation.component:1MinuteMuscleToneScore.value[x]:valueCodeableConcept
            Slice NamevalueCodeableConcept
            Definition

            The Apgar subscore for activity/muscle tone.


            The information determined as a result of making the observation, if the information has a simple value.

            ShortMusleToneScoreActual component result
            Comments

            Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (these "yes/no" concepts can be mapped to the display name "true/false" or other mutually exclusive terms that may be needed"). The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (the name format is "'value' + the type name" with a capital on the first letter of the type).

            Control0..1
            BindingUnless not suitable, these codes SHALL be taken from For codes, see SpierspanningScoreCodelijst
            (extensible to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.12.16.3--20171231000000)

            SpierspanningScoreCodelijst

            TypeCodeableConcept, dateTime, string, SampledData, Quantity, Period, Ratio, Attachment, time, Range
            [x] NoteSee Choice of Data Types for further information about how to use [x]
            Summarytrue
            Requirements

            An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.

            Alternate NamesSpierspanningScore
            160. Observation.component:5MinuteMuscleToneScore
            Slice Name5MinuteMuscleToneScore
            Definition

            Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.

            ShortComponent results
            Comments

            For a discussion on the ways Observations can be assembled in groups together see Notes below.

            Control0..1*
            TypeBackboneElement
            Summarytrue
            Requirements

            Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
            ele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
            162. Observation.component:5MinuteMuscleToneScore.modifierExtension
            Definition

            May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

            ShortExtensions that cannot be ignored
            Comments

            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

            Control0..*
            TypeExtension
            Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
            Summarytrue
            Alternate Namesextensions, user content, modifiers
            164. Observation.component:5MinuteMuscleToneScore.code
            Definition

            Describes what was observed. Sometimes this is called the observation "code".

            ShortType of component observation (code / type)
            Control1..1
            BindingFor example codes, see LOINC Codeshttp://hl7.org/fhir/ValueSet/observation-codes
            (example to http://hl7.org/fhir/ValueSet/observation-codes)

            Codes identifying names of simple observations.

            TypeCodeableConcept
            Summarytrue
            Requirements

            Knowing what kind of observation is being made is essential to understanding the observation.

            Pattern Value{
              "coding" : [{
                "system" : "http://loinc.org",
                "code" : "32413-7"
              }]
            }
            166. Observation.component:5MinuteMuscleToneScore.value[x]:valueCodeableConcept
            Slice NamevalueCodeableConcept
            Definition

            The Apgar subscore for activity/muscle tone.


            The information determined as a result of making the observation, if the information has a simple value.

            ShortMusleToneScoreActual component result
            Comments

            Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (these "yes/no" concepts can be mapped to the display name "true/false" or other mutually exclusive terms that may be needed"). The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (the name format is "'value' + the type name" with a capital on the first letter of the type).

            Control0..1
            BindingUnless not suitable, these codes SHALL be taken from For codes, see SpierspanningScoreCodelijst
            (extensible to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.12.16.3--20171231000000)

            SpierspanningScoreCodelijst

            TypeCodeableConcept, dateTime, string, SampledData, Quantity, Period, Ratio, Attachment, time, Range
            [x] NoteSee Choice of Data Types for further information about how to use [x]
            Summarytrue
            Requirements

            An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.

            Alternate NamesSpierspanningScore
            168. Observation.component:10MinuteMuscleToneScore
            Slice Name10MinuteMuscleToneScore
            Definition

            Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.

            ShortComponent results
            Comments

            For a discussion on the ways Observations can be assembled in groups together see Notes below.

            Control0..1*
            TypeBackboneElement
            Summarytrue
            Requirements

            Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
            ele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
            170. Observation.component:10MinuteMuscleToneScore.modifierExtension
            Definition

            May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

            ShortExtensions that cannot be ignored
            Comments

            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

            Control0..*
            TypeExtension
            Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
            Summarytrue
            Alternate Namesextensions, user content, modifiers
            172. Observation.component:10MinuteMuscleToneScore.code
            Definition

            Describes what was observed. Sometimes this is called the observation "code".

            ShortType of component observation (code / type)
            Control1..1
            BindingFor example codes, see LOINC Codeshttp://hl7.org/fhir/ValueSet/observation-codes
            (example to http://hl7.org/fhir/ValueSet/observation-codes)

            Codes identifying names of simple observations.

            TypeCodeableConcept
            Summarytrue
            Requirements

            Knowing what kind of observation is being made is essential to understanding the observation.

            Pattern Value{
              "coding" : [{
                "system" : "http://loinc.org",
                "code" : "32403-8"
              }]
            }
            174. Observation.component:10MinuteMuscleToneScore.value[x]:valueCodeableConcept
            Slice NamevalueCodeableConcept
            Definition

            The Apgar subscore for activity/muscle tone.


            The information determined as a result of making the observation, if the information has a simple value.

            ShortMusleToneScoreActual component result
            Comments

            Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (these "yes/no" concepts can be mapped to the display name "true/false" or other mutually exclusive terms that may be needed"). The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (the name format is "'value' + the type name" with a capital on the first letter of the type).

            Control0..1
            BindingUnless not suitable, these codes SHALL be taken from For codes, see SpierspanningScoreCodelijst
            (extensible to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.12.16.3--20171231000000)

            SpierspanningScoreCodelijst

            TypeCodeableConcept, dateTime, string, SampledData, Quantity, Period, Ratio, Attachment, time, Range
            [x] NoteSee Choice of Data Types for further information about how to use [x]
            Summarytrue
            Requirements

            An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.

            Alternate NamesSpierspanningScore

            Guidance on how to interpret the contents of this table can be found here

            0. Observation
            Definition

            Root concept of the ApgarScore information model. This root concept contains all data elements of the ApgarScore information model.

            ShortApgarScore
            Comments

            Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc. Other resources are used to provide context for observations such as lab reports, etc.

            Control0..*
            Alternate NamesVital Signs, Measurement, Results, Tests
            Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
            dom-1: If the resource is contained in another resource, it SHALL NOT contain any narrative (contained.text.empty())
            dom-4: 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-3: If 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())
            obs-7: If 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())
            obs-6: dataAbsentReason SHALL only be present if Observation.value[x] is not present (dataAbsentReason.empty() or value.empty())
            zib-apgarscore-1: Exactly one of the time code slices SHALL be used for Observation.code (code.coding.where(system='http://loinc.org').where(code='9272-6' or code='9274-2' or code='9271-8').count()=1)
            zib-apgarscore-2: Components for 1 minute Apgar score are only allowed when Observation.code indicates 1 minute Apgar score (component.code.coding.where(system='http://loinc.org').where(code='32410-3' or code='32406-1' or code='32407-9' or code='32409-5' or code='32408-7').exists() implies code.coding.where(system='http://loinc.org').where(code='9272-6').exists())
            zib-apgarscore-3: Components for 5 minute Apgar score are only allowed when Observation.code indicates 5 minute Apgar score (component.code.coding.where(system='http://loinc.org').where(code='32415-2' or code='32411-1' or code='32412-9' or code='32414-5' or code='32413-7').exists() implies code.coding.where(system='http://loinc.org').where(code='9274-2').exists())
            zib-apgarscore-4: Components for 10 minute Apgar score are only allowed when Observation.code indicates 10 minute Apgar score (component.code.coding.where(system='http://loinc.org').where(code='32405-3' or code='32401-2' or code='32402-0' or code='32404-6' or code='32403-8').exists() implies code.coding.where(system='http://loinc.org').where(code='9271-8').exists())
            2. Observation.id
            Definition

            The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

            ShortLogical id of this artifact
            Comments

            The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

            Control0..1
            Typeid
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summarytrue
            4. Observation.meta
            Definition

            The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content may not always be associated with version changes to the resource.

            ShortMetadata about the resource
            Control0..1
            TypeMeta
            Summarytrue
            6. Observation.implicitRules
            Definition

            A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.

            ShortA set of rules under which this content was created
            Comments

            Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element.

            This element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.

            Control0..1
            Typeuri
            Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summarytrue
            8. Observation.language
            Definition

            The base language in which the resource is written.

            ShortLanguage of the resource content
            Comments

            Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).

            Control0..1
            BindingUnless not suitable, these codes SHALL be taken from Common Languages
            (extensible to http://hl7.org/fhir/ValueSet/languages)

            A human language.

            Additional BindingsPurpose
            AllLanguagesMax Binding
            Typecode
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            10. Observation.text
            Definition

            A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.

            ShortText summary of the resource, for human interpretation
            Comments

            Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded in formation is added later.

            Control0..1
            This element is affected by the following invariants: dom-1
            TypeNarrative
            Alternate Namesnarrative, html, xhtml, display
            12. Observation.contained
            Definition

            These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.

            ShortContained, inline Resources
            Comments

            This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.

            Control0..*
            TypeResource
            Alternate Namesinline resources, anonymous resources, contained resources
            14. Observation.extension
            Definition

            May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

            ShortAdditional Content defined by implementations
            Comments

            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

            Control0..*
            TypeExtension
            Alternate Namesextensions, user content
            16. Observation.modifierExtension
            Definition

            May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

            ShortExtensions that cannot be ignored
            Comments

            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

            Control0..*
            TypeExtension
            Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
            Alternate Namesextensions, user content
            18. Observation.identifier
            Definition

            A unique identifier assigned to this observation.

            ShortBusiness Identifier for observation
            NoteThis is a business identifier, not a resource identifier (see discussion)
            Control0..*
            TypeIdentifier
            Summarytrue
            Requirements

            Allows observations to be distinguished and referenced.

            20. Observation.basedOn
            Definition

            A plan, proposal or order that is fulfilled in whole or in part by this event.

            ShortFulfills plan, proposal or order
            Control0..*
            TypeReference(CarePlan, DeviceRequest, ImmunizationRecommendation, MedicationRequest, NutritionOrder, ProcedureRequest, ReferralRequest)
            Summarytrue
            Requirements

            Allows tracing of authorization for the event and tracking whether proposals/recommendations were acted upon.

            Alternate NamesFulfills
            22. Observation.status
            Definition

            The status of the result value.

            Shortregistered | preliminary | final | amended +
            Comments

            This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.

            Control1..1
            BindingThe codes SHALL be taken from ObservationStatus
            (required to http://hl7.org/fhir/ValueSet/observation-status)

            Codes providing the status of an observation.

            Typecode
            Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summarytrue
            Requirements

            Need to track the status of individual results. Some results are finalized before the whole report is finalized.

            24. Observation.category
            Definition

            A code that classifies the general type of observation being made.

            ShortClassification of type of observation
            Comments

            In addition to the required category valueset, this element allows various categorization schemes based on the owner’s definition of the category and effectively multiple categories can be used at once. The level of granularity is defined by the category concepts in the value set.

            Control0..*
            BindingThe codes SHOULD be taken from Observation Category Codes
            (preferred to http://hl7.org/fhir/ValueSet/observation-category)

            Codes for high level observation categories.

            TypeCodeableConcept
            Requirements

            Used for filtering what observations are retrieved and displayed.

            26. Observation.code
            Definition

            Describes what was observed. Sometimes this is called the observation "name".

            ShortType of observation (code / type)
            Control1..1
            BindingFor example codes, see LOINC Codes
            (example to http://hl7.org/fhir/ValueSet/observation-codes)

            Codes identifying names of simple observations.

            TypeCodeableConcept
            Summarytrue
            Requirements

            Knowing what kind of observation is being made is essential to understanding the observation.

            Alternate NamesName
            Example<br/><b>Example of 1 Minute ApgarScore</b>:{ "coding" : [{ "system" : "http://loinc.org", "code" : "9272-6", "display" : "1 minute Apgar Score" }] }
            28. Observation.code.id
            Definition

            unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

            Shortxml:id (or equivalent in JSON)
            Control0..1
            Typestring
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            XML FormatIn the XML format, this property is represented as an attribute.
            30. Observation.code.extension
            Definition

            May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

            ShortAdditional Content defined by implementations
            Comments

            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

            Control0..*
            TypeExtension
            Alternate Namesextensions, user content
            SlicingThis element introduces a set of slices on Observation.code.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
            • value @ url
            • 32. Observation.code.coding
              Definition

              A reference to a code defined by a terminology system.

              ShortCode defined by a terminology system
              Comments

              Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

              Control1..*
              TypeCoding
              Summarytrue
              Requirements

              Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.

              SlicingThis element introduces a set of slices on Observation.code.coding. The slices are unordered and Open, and can be differentiated using the following discriminators:
              • value @ system
              • value @ code
              • 34. Observation.code.coding:1MinuteApgarScore
                Slice Name1MinuteApgarScore
                Definition

                A reference to a code defined by a terminology system.

                ShortCode defined by a terminology system
                Comments

                Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                Control0..1
                TypeCoding
                Summarytrue
                Requirements

                Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.

                36. Observation.code.coding:1MinuteApgarScore.id
                Definition

                unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                Shortxml:id (or equivalent in JSON)
                Control0..1
                Typestring
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                XML FormatIn the XML format, this property is represented as an attribute.
                38. Observation.code.coding:1MinuteApgarScore.extension
                Definition

                May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                ShortAdditional Content defined by implementations
                Comments

                There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                Control0..*
                TypeExtension
                Alternate Namesextensions, user content
                SlicingThis element introduces a set of slices on Observation.code.coding.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
                • value @ url
                • 40. Observation.code.coding:1MinuteApgarScore.system
                  Definition

                  The identification of the code system that defines the meaning of the symbol in the code.

                  ShortIdentity of the terminology system
                  Comments

                  The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously.

                  Control1..1
                  Typeuri
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Summarytrue
                  Requirements

                  Need to be unambiguous about the source of the definition of the symbol.

                  Fixed Valuehttp://loinc.org
                  42. Observation.code.coding:1MinuteApgarScore.version
                  Definition

                  The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

                  ShortVersion of the system - if relevant
                  Comments

                  Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

                  NoteThis is a business versionId, not a resource version id (see discussion)
                  Control0..1
                  Typestring
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Summarytrue
                  44. Observation.code.coding:1MinuteApgarScore.code
                  Definition

                  A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

                  ShortSymbol in syntax defined by the system
                  Control1..1
                  Typecode
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Summarytrue
                  Requirements

                  Need to refer to a particular code in the system.

                  Fixed Value9272-6
                  46. Observation.code.coding:1MinuteApgarScore.display
                  Definition

                  A representation of the meaning of the code in the system, following the rules of the system.

                  ShortRepresentation defined by the system
                  Control0..1
                  Typestring
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Summarytrue
                  Requirements

                  Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

                  48. Observation.code.coding:1MinuteApgarScore.userSelected
                  Definition

                  Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays).

                  ShortIf this coding was chosen directly by the user
                  Comments

                  Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

                  Control0..1
                  Typeboolean
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Summarytrue
                  Requirements

                  This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

                  50. Observation.code.coding:5MinuteApgarScore
                  Slice Name5MinuteApgarScore
                  Definition

                  A reference to a code defined by a terminology system.

                  ShortCode defined by a terminology system
                  Comments

                  Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                  Control0..1
                  TypeCoding
                  Summarytrue
                  Requirements

                  Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.

                  52. Observation.code.coding:5MinuteApgarScore.id
                  Definition

                  unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                  Shortxml:id (or equivalent in JSON)
                  Control0..1
                  Typestring
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  XML FormatIn the XML format, this property is represented as an attribute.
                  54. Observation.code.coding:5MinuteApgarScore.extension
                  Definition

                  May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                  ShortAdditional Content defined by implementations
                  Comments

                  There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                  Control0..*
                  TypeExtension
                  Alternate Namesextensions, user content
                  SlicingThis element introduces a set of slices on Observation.code.coding.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
                  • value @ url
                  • 56. Observation.code.coding:5MinuteApgarScore.system
                    Definition

                    The identification of the code system that defines the meaning of the symbol in the code.

                    ShortIdentity of the terminology system
                    Comments

                    The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously.

                    Control1..1
                    Typeuri
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Summarytrue
                    Requirements

                    Need to be unambiguous about the source of the definition of the symbol.

                    Fixed Valuehttp://loinc.org
                    58. Observation.code.coding:5MinuteApgarScore.version
                    Definition

                    The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

                    ShortVersion of the system - if relevant
                    Comments

                    Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

                    NoteThis is a business versionId, not a resource version id (see discussion)
                    Control0..1
                    Typestring
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Summarytrue
                    60. Observation.code.coding:5MinuteApgarScore.code
                    Definition

                    A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

                    ShortSymbol in syntax defined by the system
                    Control1..1
                    Typecode
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Summarytrue
                    Requirements

                    Need to refer to a particular code in the system.

                    Fixed Value9274-2
                    62. Observation.code.coding:5MinuteApgarScore.display
                    Definition

                    A representation of the meaning of the code in the system, following the rules of the system.

                    ShortRepresentation defined by the system
                    Control0..1
                    Typestring
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Summarytrue
                    Requirements

                    Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

                    64. Observation.code.coding:5MinuteApgarScore.userSelected
                    Definition

                    Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays).

                    ShortIf this coding was chosen directly by the user
                    Comments

                    Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

                    Control0..1
                    Typeboolean
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Summarytrue
                    Requirements

                    This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

                    66. Observation.code.coding:10MinuteApgarScore
                    Slice Name10MinuteApgarScore
                    Definition

                    A reference to a code defined by a terminology system.

                    ShortCode defined by a terminology system
                    Comments

                    Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                    Control0..1
                    TypeCoding
                    Summarytrue
                    Requirements

                    Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.

                    68. Observation.code.coding:10MinuteApgarScore.id
                    Definition

                    unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                    Shortxml:id (or equivalent in JSON)
                    Control0..1
                    Typestring
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    XML FormatIn the XML format, this property is represented as an attribute.
                    70. Observation.code.coding:10MinuteApgarScore.extension
                    Definition

                    May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                    ShortAdditional Content defined by implementations
                    Comments

                    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                    Control0..*
                    TypeExtension
                    Alternate Namesextensions, user content
                    SlicingThis element introduces a set of slices on Observation.code.coding.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
                    • value @ url
                    • 72. Observation.code.coding:10MinuteApgarScore.system
                      Definition

                      The identification of the code system that defines the meaning of the symbol in the code.

                      ShortIdentity of the terminology system
                      Comments

                      The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously.

                      Control1..1
                      Typeuri
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Summarytrue
                      Requirements

                      Need to be unambiguous about the source of the definition of the symbol.

                      Fixed Valuehttp://loinc.org
                      74. Observation.code.coding:10MinuteApgarScore.version
                      Definition

                      The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

                      ShortVersion of the system - if relevant
                      Comments

                      Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

                      NoteThis is a business versionId, not a resource version id (see discussion)
                      Control0..1
                      Typestring
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Summarytrue
                      76. Observation.code.coding:10MinuteApgarScore.code
                      Definition

                      A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

                      ShortSymbol in syntax defined by the system
                      Control1..1
                      Typecode
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Summarytrue
                      Requirements

                      Need to refer to a particular code in the system.

                      Fixed Value9271-8
                      78. Observation.code.coding:10MinuteApgarScore.display
                      Definition

                      A representation of the meaning of the code in the system, following the rules of the system.

                      ShortRepresentation defined by the system
                      Control0..1
                      Typestring
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Summarytrue
                      Requirements

                      Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

                      80. Observation.code.coding:10MinuteApgarScore.userSelected
                      Definition

                      Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays).

                      ShortIf this coding was chosen directly by the user
                      Comments

                      Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

                      Control0..1
                      Typeboolean
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Summarytrue
                      Requirements

                      This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

                      82. Observation.code.text
                      Definition

                      A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

                      ShortPlain text representation of the concept
                      Comments

                      Very often the text is the same as a displayName of one of the codings.

                      Control0..1
                      Typestring
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Summarytrue
                      Requirements

                      The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

                      84. Observation.subject
                      Definition

                      The patient, or group of patients, location, or device whose characteristics (direct or indirect) are described by the observation and into whose record the observation is placed. Comments: Indirect characteristics may be those of a specimen, fetus, donor, other observer (for example a relative or EMT), or any observation made about the subject.

                      ShortWho and/or what this is about
                      Comments

                      One would expect this element to be a cardinality of 1..1. The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.

                      If the target of the observation is different than the subject, the general extension observation-focal-subject. may be used. However, the distinction between the patient's own value for an observation versus that of the fetus, or the donor or blood product unit, etc., are often specified in the observation code.

                      Control1..1
                      TypeReference(Group, Device, nl-core-location, nl-core-patient)
                      Summarytrue
                      Requirements

                      Observations have no value if you don't know who or what they're about.

                      86. Observation.context
                      Definition

                      The healthcare event (e.g. a patient and healthcare provider interaction) during which this observation is made.

                      ShortHealthcare event during which this observation is made
                      Comments

                      This will typically be the encounter the event occurred within, but some events may be initiated prior to or after the official completion of an encounter or episode but still be tied to the context of the encounter or episode (e.g. pre-admission lab tests).

                      Control0..1
                      TypeReference(nl-core-episodeofcare, HCIM Encounter, gp-Encounter)
                      Requirements

                      For some observations it may be important to know the link between an observation and a particular encounter.

                      Alternate NamesEncounter
                      88. Observation.effective[x]
                      Definition

                      The time or time-period the observed value is asserted as being true. For biological subjects - e.g. human patients - this is usually called the "physiologically relevant time". This is usually either the time of the procedure or of specimen collection, but very often the source of the date/time is not known, only the date/time itself.

                      ShortClinically relevant time/time-period for observation
                      Comments

                      At least a date should be present unless this observation is a historical report.

                      Control1..1
                      TypedateTime
                      [x] NoteSee Choice of Data Types for further information about how to use [x]
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Summarytrue
                      Requirements

                      Knowing when an observation was deemed true is important to its relevance as well as determining trends.

                      Alternate NamesOccurrence
                      SlicingThis element introduces a set of slices on Observation.effective[x]. The slices are unordered and Closed, and can be differentiated using the following discriminators:
                      • type @ $this
                      • 90. Observation.effective[x]:effectiveDateTime
                        Slice NameeffectiveDateTime
                        Definition

                        The day and time at which the Apgar score is registered.

                        ShortApgarScoreDateTime
                        Comments

                        At least a date should be present unless this observation is a historical report.

                        Control1..1
                        TypedateTime
                        [x] NoteSee Choice of Data Types for further information about how to use [x]
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Summarytrue
                        Requirements

                        Knowing when an observation was deemed true is important to its relevance as well as determining trends.

                        Alternate NamesOccurrence, ApgarScoreDatumTijd
                        92. Observation.issued
                        Definition

                        The date and time this observation was made available to providers, typically after the results have been reviewed and verified.

                        ShortDate/Time this was made available
                        Comments

                        Updated when the result is updated.

                        Control0..1
                        Typeinstant
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Summarytrue
                        94. Observation.performer
                        Definition

                        Who was responsible for asserting the observed value as "true".

                        ShortWho is responsible for the observation
                        Control0..*
                        TypeReference(nl-core-organization, nl-core-patient, nl-core-practitioner, nl-core-relatedperson)
                        Summarytrue
                        Requirements

                        May give a degree of confidence in the observation and also indicates where follow-up questions should be directed.

                        96. Observation.performer.id
                        Definition

                        unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                        Shortxml:id (or equivalent in JSON)
                        Control0..1
                        Typestring
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        XML FormatIn the XML format, this property is represented as an attribute.
                        98. Observation.performer.extension
                        Definition

                        An Extension

                        ShortExtension
                        Control0..*
                        TypeExtension
                        SlicingThis element introduces a set of slices on Observation.performer.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
                        • value @ url
                        • 100. Observation.performer.extension:practitionerRole
                          Slice NamepractitionerRole
                          Definition

                          Optional Extension Element - found in all resources.

                          ShortOptional Extensions Element
                          Control0..1
                          TypeExtension(PractitionerRole Reference) (Extension Type: Reference)
                          102. Observation.performer.reference
                          Definition

                          A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

                          ShortLiteral reference, Relative, internal or absolute URL
                          Comments

                          Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

                          Control0..1
                          This element is affected by the following invariants: ref-1
                          Typestring
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Summarytrue
                          104. Observation.performer.identifier
                          Definition

                          An identifier for the other resource. This is used when there is no way to reference the other resource directly, either because the entity is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

                          ShortLogical reference, when literal reference is not known
                          Comments

                          When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

                          When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

                          Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

                          NoteThis is a business identifier, not a resource identifier (see discussion)
                          Control0..1
                          TypeIdentifier
                          Summarytrue
                          106. Observation.performer.display
                          Definition

                          Plain text narrative that identifies the resource in addition to the resource reference.

                          ShortText alternative for the resource
                          Comments

                          This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

                          Control0..1
                          Typestring
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Summarytrue
                          108. Observation.value[x]:valueQuantity
                          Slice NamevalueQuantity
                          Definition

                          Total of the Apgar score.

                          ShortApgarScoreTotal
                          Comments

                          Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. This element has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueString, valueBoolean, valueRange, valueRatio, valueSampledData, valueAttachment, valueTime, valueDateTime, or valuePeriod. (The name format is "'value' + the type name" with a capital on the first letter of the type).

                          If the data element is usually coded or if the type associated with the Observation.value defines a coded value, use CodeableConcept instead of string datatype even if the value is uncoded text. A value set is bound to the ValueCodeableConcept element. For further discussion and examples see the notes section below.

                          Control1..1
                          This element is affected by the following invariants: obs-7
                          TypeQuantity
                          [x] NoteSee Choice of Data Types for further information about how to use [x]
                          Summarytrue
                          Requirements

                          An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.

                          Alternate NamesApgarScoreTotaal
                          110. Observation.value[x]:valueQuantity.id
                          Definition

                          unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                          Shortxml:id (or equivalent in JSON)
                          Control0..1
                          Typestring
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          XML FormatIn the XML format, this property is represented as an attribute.
                          112. Observation.value[x]:valueQuantity.extension
                          Definition

                          May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                          ShortAdditional Content defined by implementations
                          Comments

                          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                          Control0..*
                          TypeExtension
                          Alternate Namesextensions, user content
                          SlicingThis element introduces a set of slices on Observation.value[x].extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
                          • value @ url
                          • 114. Observation.value[x]:valueQuantity.value
                            Definition

                            The value of the measured amount. The value includes an implicit precision in the presentation of the value.

                            ShortNumerical value (with implicit precision)
                            Comments

                            The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).

                            Control0..1
                            Typedecimal
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            Summarytrue
                            Requirements

                            Precision is handled implicitly in almost all cases of measurement.

                            Min Value0
                            Max Value10
                            116. Observation.value[x]:valueQuantity.comparator
                            Definition

                            How the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is "<" , then the real value is < stated value.

                            Short< | <= | >= | > - how to understand the value
                            Comments

                            This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value.

                            Control0..1
                            BindingThe codes SHALL be taken from QuantityComparator
                            (required to http://hl7.org/fhir/ValueSet/quantity-comparator)

                            How the Quantity should be understood and represented.

                            Typecode
                            Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            Summarytrue
                            Requirements

                            Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.

                            Meaning if MissingIf there is no comparator, then there is no modification of the value
                            118. Observation.value[x]:valueQuantity.unit
                            Definition

                            A human-readable form of the unit.

                            ShortUnit representation
                            Control0..1
                            Typestring
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            Summarytrue
                            Requirements

                            There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.

                            120. Observation.value[x]:valueQuantity.system
                            Definition

                            The identification of the system that provides the coded form of the unit.

                            ShortSystem that defines coded unit form
                            Control0..1
                            This element is affected by the following invariants: qty-3
                            Typeuri
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            Summarytrue
                            Requirements

                            Need to know the system that defines the coded form of the unit.

                            122. Observation.value[x]:valueQuantity.code
                            Definition

                            A computer processable form of the unit in some unit representation system.

                            ShortCoded form of the unit
                            Comments

                            The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system.

                            Control0..1
                            Typecode
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            Summarytrue
                            Requirements

                            Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest.

                            124. Observation.dataAbsentReason
                            Definition

                            Provides a reason why the expected value in the element Observation.value[x] is missing.

                            ShortWhy the result is missing
                            Comments

                            Null or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "specimen unsatisfactory". The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Note that an observation may only be reported if there are values to report. For example differential cell counts values may be reported only when > 0. Because of these options, use-case agreements are required to interpret general observations for null or exceptional values.

                            Control0..1
                            This element is affected by the following invariants: obs-6
                            BindingUnless not suitable, these codes SHALL be taken from Observation Value Absent Reason
                            (extensible to http://hl7.org/fhir/ValueSet/observation-valueabsentreason)

                            Codes specifying why the result (Observation.value[x]) is missing.

                            TypeCodeableConcept
                            Requirements

                            For many results it is necessary to handle exceptional values in measurements.

                            126. Observation.interpretation
                            Definition

                            The assessment made based on the result of the observation. Intended as a simple compact code often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result. Otherwise known as abnormal flag.

                            ShortHigh, low, normal, etc.
                            Control0..1
                            BindingUnless not suitable, these codes SHALL be taken from Observation Interpretation Codes
                            (extensible to http://hl7.org/fhir/ValueSet/observation-interpretation)

                            Codes identifying interpretations of observations.

                            TypeCodeableConcept
                            Requirements

                            For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.

                            Alternate NamesAbnormal Flag
                            128. Observation.comment
                            Definition

                            Comment on the Apgar score.

                            ShortComment
                            Control0..1
                            Typestring
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            Requirements

                            Need to be able to provide free text additional information.

                            Alternate NamesToelichting
                            130. Observation.bodySite
                            Definition

                            Indicates the site on the subject's body where the observation was made (i.e. the target site).

                            ShortObserved body part
                            Comments

                            Only used if not implicit in code found in Observation.code. In many systems, this may be represented as a related observation instead of an inline component. If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use the standard extension body-site-instance.

                            Control0..1
                            BindingFor example codes, see SNOMED CT Body Structures
                            (example to http://hl7.org/fhir/ValueSet/body-site)

                            Codes describing anatomical locations. May include laterality.

                            TypeCodeableConcept
                            132. Observation.method
                            Definition

                            Indicates the mechanism used to perform the observation.

                            ShortHow it was done
                            Comments

                            Only used if not implicit in code for Observation.code.

                            Control0..1
                            BindingFor example codes, see Observation Methods
                            (example to http://hl7.org/fhir/ValueSet/observation-methods)

                            Methods for simple observations.

                            TypeCodeableConcept
                            Requirements

                            In some cases, method can impact results and is thus used for determining whether results can be compared or determining significance of results.

                            134. Observation.specimen
                            Definition

                            The specimen that was used when this observation was made.

                            ShortSpecimen used for this observation
                            Comments

                            Should only be used if not implicit in code found in Observation.code. Observations are not made on specimens themselves; they are made on a subject, but in many cases by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).

                            Control0..1
                            TypeReference(Specimen)
                            136. Observation.device
                            Definition

                            The device used to generate the observation data.

                            Short(Measurement) Device
                            Comments

                            An extension should be used if further typing of the device is needed. Devices used to support obtaining an observation can be represented using either an extension or through the Observation.related element.

                            Control0..1
                            TypeReference(Device, DeviceMetric)
                            138. Observation.referenceRange
                            Definition

                            Guidance on how to interpret the value by comparison to a normal or recommended range.

                            ShortProvides guide for interpretation
                            Comments

                            Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.

                            Control0..*
                            TypeBackboneElement
                            Requirements

                            Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.

                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
                            obs-3: Must have at least a low or a high or text (low.exists() or high.exists() or text.exists())
                            140. Observation.referenceRange.id
                            Definition

                            unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                            Shortxml:id (or equivalent in JSON)
                            Control0..1
                            Typestring
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            XML FormatIn the XML format, this property is represented as an attribute.
                            142. Observation.referenceRange.extension
                            Definition

                            May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                            ShortAdditional Content defined by implementations
                            Comments

                            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                            Control0..*
                            TypeExtension
                            Alternate Namesextensions, user content
                            144. Observation.referenceRange.modifierExtension
                            Definition

                            May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                            ShortExtensions that cannot be ignored
                            Comments

                            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                            Control0..*
                            TypeExtension
                            Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
                            Summarytrue
                            Alternate Namesextensions, user content, modifiers
                            146. Observation.referenceRange.low
                            Definition

                            The value of the low bound of the reference range. The low bound of the reference range endpoint is inclusive of the value (e.g. reference range is >=5 - <=9). If the low bound is omitted, it is assumed to be meaningless (e.g. reference range is <=2.3).

                            ShortLow Range, if relevant
                            Control0..1
                            This element is affected by the following invariants: obs-3
                            TypeQuantity(SimpleQuantity)
                            148. Observation.referenceRange.high
                            Definition

                            The value of the high bound of the reference range. The high bound of the reference range endpoint is inclusive of the value (e.g. reference range is >=5 - <=9). If the high bound is omitted, it is assumed to be meaningless (e.g. reference range is >= 2.3).

                            ShortHigh Range, if relevant
                            Control0..1
                            This element is affected by the following invariants: obs-3
                            TypeQuantity(SimpleQuantity)
                            150. Observation.referenceRange.type
                            Definition

                            Codes to indicate the what part of the targeted reference population it applies to. For example, the normal or therapeutic range.

                            ShortReference range qualifier
                            Comments

                            This SHOULD be populated if there is more than one range. If this element is not present then the normal range is assumed.

                            Control0..1
                            BindingUnless not suitable, these codes SHALL be taken from Observation Reference Range Meaning Codes
                            (extensible to http://hl7.org/fhir/ValueSet/referencerange-meaning)

                            Code for the meaning of a reference range.

                            TypeCodeableConcept
                            Requirements

                            Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc, - for proper interpretation.

                            152. Observation.referenceRange.appliesTo
                            Definition

                            Codes to indicate the target population this reference range applies to. For example, a reference range may be based on the normal population or a particular sex or race.

                            ShortReference range population
                            Comments

                            This SHOULD be populated if there is more than one range. If this element is not present then the normal population is assumed.

                            Control0..*
                            BindingFor example codes, see Observation Reference Range Applies To Codes
                            (example to http://hl7.org/fhir/ValueSet/referencerange-appliesto)

                            Codes identifying the population the reference range applies to.

                            TypeCodeableConcept
                            Requirements

                            Need to be able to identify the target population for proper interpretation.

                            154. Observation.referenceRange.age
                            Definition

                            The age at which this reference range is applicable. This is a neonatal age (e.g. number of weeks at term) if the meaning says so.

                            ShortApplicable age range, if relevant
                            Control0..1
                            TypeRange
                            Requirements

                            Some analytes vary greatly over age.

                            156. Observation.referenceRange.text
                            Definition

                            Text based reference range in an observation which may be used when a quantitative range is not appropriate for an observation. An example would be a reference value of "Negative" or a list or table of 'normals'.

                            ShortText based reference range in an observation
                            Control0..1
                            Typestring
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            158. Observation.related
                            Definition

                            A reference to another resource (usually another Observation) whose relationship is defined by the relationship type code.

                            ShortResource related to this observation
                            Comments

                            For a discussion on the ways Observations can assembled in groups together see Notes below.

                            Control0..*
                            TypeBackboneElement
                            Summarytrue
                            Requirements

                            Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and a set of related observations or sometimes a QuestionnaireResponse from which the measure is derived.

                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
                            160. Observation.related.id
                            Definition

                            unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                            Shortxml:id (or equivalent in JSON)
                            Control0..1
                            Typestring
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            XML FormatIn the XML format, this property is represented as an attribute.
                            162. Observation.related.extension
                            Definition

                            May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                            ShortAdditional Content defined by implementations
                            Comments

                            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                            Control0..*
                            TypeExtension
                            Alternate Namesextensions, user content
                            164. Observation.related.modifierExtension
                            Definition

                            May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                            ShortExtensions that cannot be ignored
                            Comments

                            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                            Control0..*
                            TypeExtension
                            Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
                            Summarytrue
                            Alternate Namesextensions, user content, modifiers
                            166. Observation.related.type
                            Definition

                            A code specifying the kind of relationship that exists with the target resource.

                            Shorthas-member | derived-from | sequel-to | replaces | qualified-by | interfered-by
                            Comments

                            The "derived-from" type is the only logical choice when referencing the QuestionnaireAnswer resource.

                            Control0..1
                            BindingThe codes SHALL be taken from ObservationRelationshipType
                            (required to http://hl7.org/fhir/ValueSet/observation-relationshiptypes)

                            Codes specifying how two observations are related.

                            Typecode
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            Requirements

                            A relationship type SHOULD be provided.

                            168. Observation.related.target
                            Definition

                            A reference to the observation or QuestionnaireResponse resource that is related to this observation.

                            ShortResource that is related to this one
                            Control1..1
                            TypeReference(Observation, QuestionnaireResponse, Sequence)
                            170. Observation.component
                            Definition

                            Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.

                            ShortComponent results
                            Comments

                            For a discussion on the ways Observations can be assembled in groups together see Notes below.

                            Control0..*
                            TypeBackboneElement
                            Summarytrue
                            Requirements

                            Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
                            SlicingThis element introduces a set of slices on Observation.component. The slices are unordered and Open, and can be differentiated using the following discriminators:
                            • pattern @ code
                            • 172. Observation.component.id
                              Definition

                              unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                              Shortxml:id (or equivalent in JSON)
                              Control0..1
                              Typestring
                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                              XML FormatIn the XML format, this property is represented as an attribute.
                              174. Observation.component.extension
                              Definition

                              May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                              ShortAdditional Content defined by implementations
                              Comments

                              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                              Control0..*
                              TypeExtension
                              Alternate Namesextensions, user content
                              176. Observation.component.modifierExtension
                              Definition

                              May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                              ShortExtensions that cannot be ignored
                              Comments

                              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                              Control0..*
                              TypeExtension
                              Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
                              Summarytrue
                              Alternate Namesextensions, user content, modifiers
                              178. Observation.component.code
                              Definition

                              Describes what was observed. Sometimes this is called the observation "code".

                              ShortType of component observation (code / type)
                              Control1..1
                              BindingFor example codes, see LOINC Codes
                              (example to http://hl7.org/fhir/ValueSet/observation-codes)

                              Codes identifying names of simple observations.

                              TypeCodeableConcept
                              Summarytrue
                              Requirements

                              Knowing what kind of observation is being made is essential to understanding the observation.

                              180. Observation.component.value[x]
                              Definition

                              The information determined as a result of making the observation, if the information has a simple value.

                              ShortActual component result
                              Comments

                              Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (these "yes/no" concepts can be mapped to the display name "true/false" or other mutually exclusive terms that may be needed"). The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (the name format is "'value' + the type name" with a capital on the first letter of the type).

                              Control0..1
                              TypeChoice of: Quantity, CodeableConcept, string, Range, Ratio, SampledData, Attachment, time, dateTime, Period
                              [x] NoteSee Choice of Data Types for further information about how to use [x]
                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                              Summarytrue
                              Requirements

                              An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.

                              182. Observation.component.dataAbsentReason
                              Definition

                              Provides a reason why the expected value in the element Observation.value[x] is missing.

                              ShortWhy the component result is missing
                              Comments

                              "Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done". The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

                              Control0..1
                              This element is affected by the following invariants: obs-6
                              BindingUnless not suitable, these codes SHALL be taken from Observation Value Absent Reason
                              (extensible to http://hl7.org/fhir/ValueSet/observation-valueabsentreason)

                              Codes specifying why the result (Observation.value[x]) is missing.

                              TypeCodeableConcept
                              Requirements

                              For many results it is necessary to handle exceptional values in measurements.

                              184. Observation.component.interpretation
                              Definition

                              The assessment made based on the result of the observation. Intended as a simple compact code often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result. Otherwise known as abnormal flag.

                              ShortHigh, low, normal, etc.
                              Comments

                              The component interpretation applies only to the individual component value. For an overall interpretation all components together use thes Observation.interpretation element.

                              Control0..1
                              BindingUnless not suitable, these codes SHALL be taken from Observation Interpretation Codes
                              (extensible to http://hl7.org/fhir/ValueSet/observation-interpretation)

                              Codes identifying interpretations of observations.

                              TypeCodeableConcept
                              Requirements

                              For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.

                              Alternate NamesAbnormal Flag
                              186. Observation.component.referenceRange
                              Definition

                              Guidance on how to interpret the value by comparison to a normal or recommended range.

                              ShortProvides guide for interpretation of component result
                              Comments

                              Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.

                              Control0..*
                              TypeSee ttp://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange
                              Requirements

                              Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.

                              188. Observation.component:1MinuteRespiratoryScore
                              Slice Name1MinuteRespiratoryScore
                              Definition

                              Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.

                              ShortComponent results
                              Comments

                              For a discussion on the ways Observations can be assembled in groups together see Notes below.

                              Control0..1
                              TypeBackboneElement
                              Summarytrue
                              Requirements

                              Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
                              190. Observation.component:1MinuteRespiratoryScore.id
                              Definition

                              unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                              Shortxml:id (or equivalent in JSON)
                              Control0..1
                              Typestring
                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                              XML FormatIn the XML format, this property is represented as an attribute.
                              192. Observation.component:1MinuteRespiratoryScore.extension
                              Definition

                              May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                              ShortAdditional Content defined by implementations
                              Comments

                              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                              Control0..*
                              TypeExtension
                              Alternate Namesextensions, user content
                              194. Observation.component:1MinuteRespiratoryScore.modifierExtension
                              Definition

                              May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                              ShortExtensions that cannot be ignored
                              Comments

                              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                              Control0..*
                              TypeExtension
                              Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
                              Summarytrue
                              Alternate Namesextensions, user content, modifiers
                              196. Observation.component:1MinuteRespiratoryScore.code
                              Definition

                              Describes what was observed. Sometimes this is called the observation "code".

                              ShortType of component observation (code / type)
                              Control1..1
                              BindingFor example codes, see LOINC Codes
                              (example to http://hl7.org/fhir/ValueSet/observation-codes)

                              Codes identifying names of simple observations.

                              TypeCodeableConcept
                              Summarytrue
                              Requirements

                              Knowing what kind of observation is being made is essential to understanding the observation.

                              Pattern Value{
                                "coding" : [{
                                  "system" : "http://loinc.org",
                                  "code" : "32410-3"
                                }]
                              }
                              198. Observation.component:1MinuteRespiratoryScore.value[x]:valueCodeableConcept
                              Slice NamevalueCodeableConcept
                              Definition

                              The Apgar subscore for respiration.

                              ShortRespiratoryScore
                              Comments

                              Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (these "yes/no" concepts can be mapped to the display name "true/false" or other mutually exclusive terms that may be needed"). The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (the name format is "'value' + the type name" with a capital on the first letter of the type).

                              Control0..1
                              BindingUnless not suitable, these codes SHALL be taken from AdemhalingScoreCodelijst
                              (extensible to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.12.16.1--20171231000000)

                              AdemhalingScoreCodelijst

                              TypeCodeableConcept
                              [x] NoteSee Choice of Data Types for further information about how to use [x]
                              Summarytrue
                              Requirements

                              An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.

                              Alternate NamesAdemhalingScore
                              200. Observation.component:1MinuteRespiratoryScore.dataAbsentReason
                              Definition

                              Provides a reason why the expected value in the element Observation.value[x] is missing.

                              ShortWhy the component result is missing
                              Comments

                              "Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done". The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

                              Control0..1
                              This element is affected by the following invariants: obs-6
                              BindingUnless not suitable, these codes SHALL be taken from Observation Value Absent Reason
                              (extensible to http://hl7.org/fhir/ValueSet/observation-valueabsentreason)

                              Codes specifying why the result (Observation.value[x]) is missing.

                              TypeCodeableConcept
                              Requirements

                              For many results it is necessary to handle exceptional values in measurements.

                              202. Observation.component:1MinuteRespiratoryScore.interpretation
                              Definition

                              The assessment made based on the result of the observation. Intended as a simple compact code often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result. Otherwise known as abnormal flag.

                              ShortHigh, low, normal, etc.
                              Comments

                              The component interpretation applies only to the individual component value. For an overall interpretation all components together use thes Observation.interpretation element.

                              Control0..1
                              BindingUnless not suitable, these codes SHALL be taken from Observation Interpretation Codes
                              (extensible to http://hl7.org/fhir/ValueSet/observation-interpretation)

                              Codes identifying interpretations of observations.

                              TypeCodeableConcept
                              Requirements

                              For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.

                              Alternate NamesAbnormal Flag
                              204. Observation.component:1MinuteRespiratoryScore.referenceRange
                              Definition

                              Guidance on how to interpret the value by comparison to a normal or recommended range.

                              ShortProvides guide for interpretation of component result
                              Comments

                              Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.

                              Control0..*
                              TypeSee ttp://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange
                              Requirements

                              Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.

                              206. Observation.component:5MinuteRespiratoryScore
                              Slice Name5MinuteRespiratoryScore
                              Definition

                              Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.

                              ShortComponent results
                              Comments

                              For a discussion on the ways Observations can be assembled in groups together see Notes below.

                              Control0..1
                              TypeBackboneElement
                              Summarytrue
                              Requirements

                              Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
                              208. Observation.component:5MinuteRespiratoryScore.id
                              Definition

                              unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                              Shortxml:id (or equivalent in JSON)
                              Control0..1
                              Typestring
                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                              XML FormatIn the XML format, this property is represented as an attribute.
                              210. Observation.component:5MinuteRespiratoryScore.extension
                              Definition

                              May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                              ShortAdditional Content defined by implementations
                              Comments

                              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                              Control0..*
                              TypeExtension
                              Alternate Namesextensions, user content
                              212. Observation.component:5MinuteRespiratoryScore.modifierExtension
                              Definition

                              May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                              ShortExtensions that cannot be ignored
                              Comments

                              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                              Control0..*
                              TypeExtension
                              Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
                              Summarytrue
                              Alternate Namesextensions, user content, modifiers
                              214. Observation.component:5MinuteRespiratoryScore.code
                              Definition

                              Describes what was observed. Sometimes this is called the observation "code".

                              ShortType of component observation (code / type)
                              Control1..1
                              BindingFor example codes, see LOINC Codes
                              (example to http://hl7.org/fhir/ValueSet/observation-codes)

                              Codes identifying names of simple observations.

                              TypeCodeableConcept
                              Summarytrue
                              Requirements

                              Knowing what kind of observation is being made is essential to understanding the observation.

                              Pattern Value{
                                "coding" : [{
                                  "system" : "http://loinc.org",
                                  "code" : "32415-2"
                                }]
                              }
                              216. Observation.component:5MinuteRespiratoryScore.value[x]:valueCodeableConcept
                              Slice NamevalueCodeableConcept
                              Definition

                              The Apgar subscore for respiration.

                              ShortRespiratoryScore
                              Comments

                              Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (these "yes/no" concepts can be mapped to the display name "true/false" or other mutually exclusive terms that may be needed"). The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (the name format is "'value' + the type name" with a capital on the first letter of the type).

                              Control0..1
                              BindingUnless not suitable, these codes SHALL be taken from AdemhalingScoreCodelijst
                              (extensible to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.12.16.1--20171231000000)

                              AdemhalingScoreCodelijst

                              TypeCodeableConcept
                              [x] NoteSee Choice of Data Types for further information about how to use [x]
                              Summarytrue
                              Requirements

                              An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.

                              Alternate NamesAdemhalingScore
                              218. Observation.component:5MinuteRespiratoryScore.dataAbsentReason
                              Definition

                              Provides a reason why the expected value in the element Observation.value[x] is missing.

                              ShortWhy the component result is missing
                              Comments

                              "Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done". The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

                              Control0..1
                              This element is affected by the following invariants: obs-6
                              BindingUnless not suitable, these codes SHALL be taken from Observation Value Absent Reason
                              (extensible to http://hl7.org/fhir/ValueSet/observation-valueabsentreason)

                              Codes specifying why the result (Observation.value[x]) is missing.

                              TypeCodeableConcept
                              Requirements

                              For many results it is necessary to handle exceptional values in measurements.

                              220. Observation.component:5MinuteRespiratoryScore.interpretation
                              Definition

                              The assessment made based on the result of the observation. Intended as a simple compact code often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result. Otherwise known as abnormal flag.

                              ShortHigh, low, normal, etc.
                              Comments

                              The component interpretation applies only to the individual component value. For an overall interpretation all components together use thes Observation.interpretation element.

                              Control0..1
                              BindingUnless not suitable, these codes SHALL be taken from Observation Interpretation Codes
                              (extensible to http://hl7.org/fhir/ValueSet/observation-interpretation)

                              Codes identifying interpretations of observations.

                              TypeCodeableConcept
                              Requirements

                              For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.

                              Alternate NamesAbnormal Flag
                              222. Observation.component:5MinuteRespiratoryScore.referenceRange
                              Definition

                              Guidance on how to interpret the value by comparison to a normal or recommended range.

                              ShortProvides guide for interpretation of component result
                              Comments

                              Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.

                              Control0..*
                              TypeSee ttp://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange
                              Requirements

                              Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.

                              224. Observation.component:10MinuteRespiratoryScore
                              Slice Name10MinuteRespiratoryScore
                              Definition

                              Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.

                              ShortComponent results
                              Comments

                              For a discussion on the ways Observations can be assembled in groups together see Notes below.

                              Control0..1
                              TypeBackboneElement
                              Summarytrue
                              Requirements

                              Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
                              226. Observation.component:10MinuteRespiratoryScore.id
                              Definition

                              unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                              Shortxml:id (or equivalent in JSON)
                              Control0..1
                              Typestring
                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                              XML FormatIn the XML format, this property is represented as an attribute.
                              228. Observation.component:10MinuteRespiratoryScore.extension
                              Definition

                              May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                              ShortAdditional Content defined by implementations
                              Comments

                              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                              Control0..*
                              TypeExtension
                              Alternate Namesextensions, user content
                              230. Observation.component:10MinuteRespiratoryScore.modifierExtension
                              Definition

                              May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                              ShortExtensions that cannot be ignored
                              Comments

                              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                              Control0..*
                              TypeExtension
                              Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
                              Summarytrue
                              Alternate Namesextensions, user content, modifiers
                              232. Observation.component:10MinuteRespiratoryScore.code
                              Definition

                              Describes what was observed. Sometimes this is called the observation "code".

                              ShortType of component observation (code / type)
                              Control1..1
                              BindingFor example codes, see LOINC Codes
                              (example to http://hl7.org/fhir/ValueSet/observation-codes)

                              Codes identifying names of simple observations.

                              TypeCodeableConcept
                              Summarytrue
                              Requirements

                              Knowing what kind of observation is being made is essential to understanding the observation.

                              Pattern Value{
                                "coding" : [{
                                  "system" : "http://loinc.org",
                                  "code" : "32405-3"
                                }]
                              }
                              234. Observation.component:10MinuteRespiratoryScore.value[x]:valueCodeableConcept
                              Slice NamevalueCodeableConcept
                              Definition

                              The Apgar subscore for respiration.

                              ShortRespiratoryScore
                              Comments

                              Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (these "yes/no" concepts can be mapped to the display name "true/false" or other mutually exclusive terms that may be needed"). The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (the name format is "'value' + the type name" with a capital on the first letter of the type).

                              Control0..1
                              BindingUnless not suitable, these codes SHALL be taken from AdemhalingScoreCodelijst
                              (extensible to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.12.16.1--20171231000000)

                              AdemhalingScoreCodelijst

                              TypeCodeableConcept
                              [x] NoteSee Choice of Data Types for further information about how to use [x]
                              Summarytrue
                              Requirements

                              An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.

                              Alternate NamesAdemhalingScore
                              236. Observation.component:10MinuteRespiratoryScore.dataAbsentReason
                              Definition

                              Provides a reason why the expected value in the element Observation.value[x] is missing.

                              ShortWhy the component result is missing
                              Comments

                              "Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done". The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

                              Control0..1
                              This element is affected by the following invariants: obs-6
                              BindingUnless not suitable, these codes SHALL be taken from Observation Value Absent Reason
                              (extensible to http://hl7.org/fhir/ValueSet/observation-valueabsentreason)

                              Codes specifying why the result (Observation.value[x]) is missing.

                              TypeCodeableConcept
                              Requirements

                              For many results it is necessary to handle exceptional values in measurements.

                              238. Observation.component:10MinuteRespiratoryScore.interpretation
                              Definition

                              The assessment made based on the result of the observation. Intended as a simple compact code often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result. Otherwise known as abnormal flag.

                              ShortHigh, low, normal, etc.
                              Comments

                              The component interpretation applies only to the individual component value. For an overall interpretation all components together use thes Observation.interpretation element.

                              Control0..1
                              BindingUnless not suitable, these codes SHALL be taken from Observation Interpretation Codes
                              (extensible to http://hl7.org/fhir/ValueSet/observation-interpretation)

                              Codes identifying interpretations of observations.

                              TypeCodeableConcept
                              Requirements

                              For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.

                              Alternate NamesAbnormal Flag
                              240. Observation.component:10MinuteRespiratoryScore.referenceRange
                              Definition

                              Guidance on how to interpret the value by comparison to a normal or recommended range.

                              ShortProvides guide for interpretation of component result
                              Comments

                              Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.

                              Control0..*
                              TypeSee ttp://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange
                              Requirements

                              Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.

                              242. Observation.component:1MinuteAppearanceScore
                              Slice Name1MinuteAppearanceScore
                              Definition

                              Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.

                              ShortComponent results
                              Comments

                              For a discussion on the ways Observations can be assembled in groups together see Notes below.

                              Control0..1
                              TypeBackboneElement
                              Summarytrue
                              Requirements

                              Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
                              244. Observation.component:1MinuteAppearanceScore.id
                              Definition

                              unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                              Shortxml:id (or equivalent in JSON)
                              Control0..1
                              Typestring
                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                              XML FormatIn the XML format, this property is represented as an attribute.
                              246. Observation.component:1MinuteAppearanceScore.extension
                              Definition

                              May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                              ShortAdditional Content defined by implementations
                              Comments

                              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                              Control0..*
                              TypeExtension
                              Alternate Namesextensions, user content
                              248. Observation.component:1MinuteAppearanceScore.modifierExtension
                              Definition

                              May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                              ShortExtensions that cannot be ignored
                              Comments

                              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                              Control0..*
                              TypeExtension
                              Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
                              Summarytrue
                              Alternate Namesextensions, user content, modifiers
                              250. Observation.component:1MinuteAppearanceScore.code
                              Definition

                              Describes what was observed. Sometimes this is called the observation "code".

                              ShortType of component observation (code / type)
                              Control1..1
                              BindingFor example codes, see LOINC Codes
                              (example to http://hl7.org/fhir/ValueSet/observation-codes)

                              Codes identifying names of simple observations.

                              TypeCodeableConcept
                              Summarytrue
                              Requirements

                              Knowing what kind of observation is being made is essential to understanding the observation.

                              Pattern Value{
                                "coding" : [{
                                  "system" : "http://loinc.org",
                                  "code" : "32406-1"
                                }]
                              }
                              252. Observation.component:1MinuteAppearanceScore.value[x]:valueCodeableConcept
                              Slice NamevalueCodeableConcept
                              Definition

                              The Apgar subscore for skin color/appearance.

                              ShortAppearanceScore
                              Comments

                              Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (these "yes/no" concepts can be mapped to the display name "true/false" or other mutually exclusive terms that may be needed"). The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (the name format is "'value' + the type name" with a capital on the first letter of the type).

                              Control0..1
                              BindingUnless not suitable, these codes SHALL be taken from HuidskleurScoreCodelijst
                              (extensible to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.12.16.4--20171231000000)

                              HuidskleurScoreCodelijst

                              TypeCodeableConcept
                              [x] NoteSee Choice of Data Types for further information about how to use [x]
                              Summarytrue
                              Requirements

                              An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.

                              Alternate NamesHuidskleurScore
                              254. Observation.component:1MinuteAppearanceScore.dataAbsentReason
                              Definition

                              Provides a reason why the expected value in the element Observation.value[x] is missing.

                              ShortWhy the component result is missing
                              Comments

                              "Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done". The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

                              Control0..1
                              This element is affected by the following invariants: obs-6
                              BindingUnless not suitable, these codes SHALL be taken from Observation Value Absent Reason
                              (extensible to http://hl7.org/fhir/ValueSet/observation-valueabsentreason)

                              Codes specifying why the result (Observation.value[x]) is missing.

                              TypeCodeableConcept
                              Requirements

                              For many results it is necessary to handle exceptional values in measurements.

                              256. Observation.component:1MinuteAppearanceScore.interpretation
                              Definition

                              The assessment made based on the result of the observation. Intended as a simple compact code often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result. Otherwise known as abnormal flag.

                              ShortHigh, low, normal, etc.
                              Comments

                              The component interpretation applies only to the individual component value. For an overall interpretation all components together use thes Observation.interpretation element.

                              Control0..1
                              BindingUnless not suitable, these codes SHALL be taken from Observation Interpretation Codes
                              (extensible to http://hl7.org/fhir/ValueSet/observation-interpretation)

                              Codes identifying interpretations of observations.

                              TypeCodeableConcept
                              Requirements

                              For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.

                              Alternate NamesAbnormal Flag
                              258. Observation.component:1MinuteAppearanceScore.referenceRange
                              Definition

                              Guidance on how to interpret the value by comparison to a normal or recommended range.

                              ShortProvides guide for interpretation of component result
                              Comments

                              Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.

                              Control0..*
                              TypeSee ttp://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange
                              Requirements

                              Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.

                              260. Observation.component:5MinuteAppearanceScore
                              Slice Name5MinuteAppearanceScore
                              Definition

                              Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.

                              ShortComponent results
                              Comments

                              For a discussion on the ways Observations can be assembled in groups together see Notes below.

                              Control0..1
                              TypeBackboneElement
                              Summarytrue
                              Requirements

                              Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
                              262. Observation.component:5MinuteAppearanceScore.id
                              Definition

                              unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                              Shortxml:id (or equivalent in JSON)
                              Control0..1
                              Typestring
                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                              XML FormatIn the XML format, this property is represented as an attribute.
                              264. Observation.component:5MinuteAppearanceScore.extension
                              Definition

                              May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                              ShortAdditional Content defined by implementations
                              Comments

                              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                              Control0..*
                              TypeExtension
                              Alternate Namesextensions, user content
                              266. Observation.component:5MinuteAppearanceScore.modifierExtension
                              Definition

                              May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                              ShortExtensions that cannot be ignored
                              Comments

                              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                              Control0..*
                              TypeExtension
                              Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
                              Summarytrue
                              Alternate Namesextensions, user content, modifiers
                              268. Observation.component:5MinuteAppearanceScore.code
                              Definition

                              Describes what was observed. Sometimes this is called the observation "code".

                              ShortType of component observation (code / type)
                              Control1..1
                              BindingFor example codes, see LOINC Codes
                              (example to http://hl7.org/fhir/ValueSet/observation-codes)

                              Codes identifying names of simple observations.

                              TypeCodeableConcept
                              Summarytrue
                              Requirements

                              Knowing what kind of observation is being made is essential to understanding the observation.

                              Pattern Value{
                                "coding" : [{
                                  "system" : "http://loinc.org",
                                  "code" : "32411-1"
                                }]
                              }
                              270. Observation.component:5MinuteAppearanceScore.value[x]:valueCodeableConcept
                              Slice NamevalueCodeableConcept
                              Definition

                              The Apgar subscore for skin color/appearance.

                              ShortAppearanceScore
                              Comments

                              Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (these "yes/no" concepts can be mapped to the display name "true/false" or other mutually exclusive terms that may be needed"). The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (the name format is "'value' + the type name" with a capital on the first letter of the type).

                              Control0..1
                              BindingUnless not suitable, these codes SHALL be taken from HuidskleurScoreCodelijst
                              (extensible to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.12.16.4--20171231000000)

                              HuidskleurScoreCodelijst

                              TypeCodeableConcept
                              [x] NoteSee Choice of Data Types for further information about how to use [x]
                              Summarytrue
                              Requirements

                              An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.

                              Alternate NamesHuidskleurScore
                              272. Observation.component:5MinuteAppearanceScore.dataAbsentReason
                              Definition

                              Provides a reason why the expected value in the element Observation.value[x] is missing.

                              ShortWhy the component result is missing
                              Comments

                              "Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done". The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

                              Control0..1
                              This element is affected by the following invariants: obs-6
                              BindingUnless not suitable, these codes SHALL be taken from Observation Value Absent Reason
                              (extensible to http://hl7.org/fhir/ValueSet/observation-valueabsentreason)

                              Codes specifying why the result (Observation.value[x]) is missing.

                              TypeCodeableConcept
                              Requirements

                              For many results it is necessary to handle exceptional values in measurements.

                              274. Observation.component:5MinuteAppearanceScore.interpretation
                              Definition

                              The assessment made based on the result of the observation. Intended as a simple compact code often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result. Otherwise known as abnormal flag.

                              ShortHigh, low, normal, etc.
                              Comments

                              The component interpretation applies only to the individual component value. For an overall interpretation all components together use thes Observation.interpretation element.

                              Control0..1
                              BindingUnless not suitable, these codes SHALL be taken from Observation Interpretation Codes
                              (extensible to http://hl7.org/fhir/ValueSet/observation-interpretation)

                              Codes identifying interpretations of observations.

                              TypeCodeableConcept
                              Requirements

                              For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.

                              Alternate NamesAbnormal Flag
                              276. Observation.component:5MinuteAppearanceScore.referenceRange
                              Definition

                              Guidance on how to interpret the value by comparison to a normal or recommended range.

                              ShortProvides guide for interpretation of component result
                              Comments

                              Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.

                              Control0..*
                              TypeSee ttp://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange
                              Requirements

                              Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.

                              278. Observation.component:10MinuteAppearanceScore
                              Slice Name10MinuteAppearanceScore
                              Definition

                              Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.

                              ShortComponent results
                              Comments

                              For a discussion on the ways Observations can be assembled in groups together see Notes below.

                              Control0..1
                              TypeBackboneElement
                              Summarytrue
                              Requirements

                              Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
                              280. Observation.component:10MinuteAppearanceScore.id
                              Definition

                              unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                              Shortxml:id (or equivalent in JSON)
                              Control0..1
                              Typestring
                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                              XML FormatIn the XML format, this property is represented as an attribute.
                              282. Observation.component:10MinuteAppearanceScore.extension
                              Definition

                              May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                              ShortAdditional Content defined by implementations
                              Comments

                              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                              Control0..*
                              TypeExtension
                              Alternate Namesextensions, user content
                              284. Observation.component:10MinuteAppearanceScore.modifierExtension
                              Definition

                              May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                              ShortExtensions that cannot be ignored
                              Comments

                              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                              Control0..*
                              TypeExtension
                              Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
                              Summarytrue
                              Alternate Namesextensions, user content, modifiers
                              286. Observation.component:10MinuteAppearanceScore.code
                              Definition

                              Describes what was observed. Sometimes this is called the observation "code".

                              ShortType of component observation (code / type)
                              Control1..1
                              BindingFor example codes, see LOINC Codes
                              (example to http://hl7.org/fhir/ValueSet/observation-codes)

                              Codes identifying names of simple observations.

                              TypeCodeableConcept
                              Summarytrue
                              Requirements

                              Knowing what kind of observation is being made is essential to understanding the observation.

                              Pattern Value{
                                "coding" : [{
                                  "system" : "http://loinc.org",
                                  "code" : "32401-2"
                                }]
                              }
                              288. Observation.component:10MinuteAppearanceScore.value[x]:valueCodeableConcept
                              Slice NamevalueCodeableConcept
                              Definition

                              The Apgar subscore for skin color/appearance.

                              ShortAppearanceScore
                              Comments

                              Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (these "yes/no" concepts can be mapped to the display name "true/false" or other mutually exclusive terms that may be needed"). The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (the name format is "'value' + the type name" with a capital on the first letter of the type).

                              Control0..1
                              BindingUnless not suitable, these codes SHALL be taken from HuidskleurScoreCodelijst
                              (extensible to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.12.16.4--20171231000000)

                              HuidskleurScoreCodelijst

                              TypeCodeableConcept
                              [x] NoteSee Choice of Data Types for further information about how to use [x]
                              Summarytrue
                              Requirements

                              An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.

                              Alternate NamesHuidskleurScore
                              290. Observation.component:10MinuteAppearanceScore.dataAbsentReason
                              Definition

                              Provides a reason why the expected value in the element Observation.value[x] is missing.

                              ShortWhy the component result is missing
                              Comments

                              "Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done". The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

                              Control0..1
                              This element is affected by the following invariants: obs-6
                              BindingUnless not suitable, these codes SHALL be taken from Observation Value Absent Reason
                              (extensible to http://hl7.org/fhir/ValueSet/observation-valueabsentreason)

                              Codes specifying why the result (Observation.value[x]) is missing.

                              TypeCodeableConcept
                              Requirements

                              For many results it is necessary to handle exceptional values in measurements.

                              292. Observation.component:10MinuteAppearanceScore.interpretation
                              Definition

                              The assessment made based on the result of the observation. Intended as a simple compact code often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result. Otherwise known as abnormal flag.

                              ShortHigh, low, normal, etc.
                              Comments

                              The component interpretation applies only to the individual component value. For an overall interpretation all components together use thes Observation.interpretation element.

                              Control0..1
                              BindingUnless not suitable, these codes SHALL be taken from Observation Interpretation Codes
                              (extensible to http://hl7.org/fhir/ValueSet/observation-interpretation)

                              Codes identifying interpretations of observations.

                              TypeCodeableConcept
                              Requirements

                              For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.

                              Alternate NamesAbnormal Flag
                              294. Observation.component:10MinuteAppearanceScore.referenceRange
                              Definition

                              Guidance on how to interpret the value by comparison to a normal or recommended range.

                              ShortProvides guide for interpretation of component result
                              Comments

                              Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.

                              Control0..*
                              TypeSee ttp://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange
                              Requirements

                              Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.

                              296. Observation.component:1MinutePulseScore
                              Slice Name1MinutePulseScore
                              Definition

                              Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.

                              ShortComponent results
                              Comments

                              For a discussion on the ways Observations can be assembled in groups together see Notes below.

                              Control0..1
                              TypeBackboneElement
                              Summarytrue
                              Requirements

                              Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
                              298. Observation.component:1MinutePulseScore.id
                              Definition

                              unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                              Shortxml:id (or equivalent in JSON)
                              Control0..1
                              Typestring
                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                              XML FormatIn the XML format, this property is represented as an attribute.
                              300. Observation.component:1MinutePulseScore.extension
                              Definition

                              May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                              ShortAdditional Content defined by implementations
                              Comments

                              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                              Control0..*
                              TypeExtension
                              Alternate Namesextensions, user content
                              302. Observation.component:1MinutePulseScore.modifierExtension
                              Definition

                              May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                              ShortExtensions that cannot be ignored
                              Comments

                              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                              Control0..*
                              TypeExtension
                              Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
                              Summarytrue
                              Alternate Namesextensions, user content, modifiers
                              304. Observation.component:1MinutePulseScore.code
                              Definition

                              Describes what was observed. Sometimes this is called the observation "code".

                              ShortType of component observation (code / type)
                              Control1..1
                              BindingFor example codes, see LOINC Codes
                              (example to http://hl7.org/fhir/ValueSet/observation-codes)

                              Codes identifying names of simple observations.

                              TypeCodeableConcept
                              Summarytrue
                              Requirements

                              Knowing what kind of observation is being made is essential to understanding the observation.

                              Pattern Value{
                                "coding" : [{
                                  "system" : "http://loinc.org",
                                  "code" : "32407-9"
                                }]
                              }
                              306. Observation.component:1MinutePulseScore.value[x]:valueCodeableConcept
                              Slice NamevalueCodeableConcept
                              Definition

                              The Apgar subscore for pulse.

                              ShortPulseScore
                              Comments

                              Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (these "yes/no" concepts can be mapped to the display name "true/false" or other mutually exclusive terms that may be needed"). The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (the name format is "'value' + the type name" with a capital on the first letter of the type).

                              Control0..1
                              BindingUnless not suitable, these codes SHALL be taken from HartslagScoreCodelijst
                              (extensible to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.12.16.2--20171231000000)

                              HartslagScoreCodelijst

                              TypeCodeableConcept
                              [x] NoteSee Choice of Data Types for further information about how to use [x]
                              Summarytrue
                              Requirements

                              An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.

                              Alternate NamesHartslagScore
                              308. Observation.component:1MinutePulseScore.dataAbsentReason
                              Definition

                              Provides a reason why the expected value in the element Observation.value[x] is missing.

                              ShortWhy the component result is missing
                              Comments

                              "Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done". The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

                              Control0..1
                              This element is affected by the following invariants: obs-6
                              BindingUnless not suitable, these codes SHALL be taken from Observation Value Absent Reason
                              (extensible to http://hl7.org/fhir/ValueSet/observation-valueabsentreason)

                              Codes specifying why the result (Observation.value[x]) is missing.

                              TypeCodeableConcept
                              Requirements

                              For many results it is necessary to handle exceptional values in measurements.

                              310. Observation.component:1MinutePulseScore.interpretation
                              Definition

                              The assessment made based on the result of the observation. Intended as a simple compact code often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result. Otherwise known as abnormal flag.

                              ShortHigh, low, normal, etc.
                              Comments

                              The component interpretation applies only to the individual component value. For an overall interpretation all components together use thes Observation.interpretation element.

                              Control0..1
                              BindingUnless not suitable, these codes SHALL be taken from Observation Interpretation Codes
                              (extensible to http://hl7.org/fhir/ValueSet/observation-interpretation)

                              Codes identifying interpretations of observations.

                              TypeCodeableConcept
                              Requirements

                              For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.

                              Alternate NamesAbnormal Flag
                              312. Observation.component:1MinutePulseScore.referenceRange
                              Definition

                              Guidance on how to interpret the value by comparison to a normal or recommended range.

                              ShortProvides guide for interpretation of component result
                              Comments

                              Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.

                              Control0..*
                              TypeSee ttp://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange
                              Requirements

                              Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.

                              314. Observation.component:5MinutePulseScore
                              Slice Name5MinutePulseScore
                              Definition

                              Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.

                              ShortComponent results
                              Comments

                              For a discussion on the ways Observations can be assembled in groups together see Notes below.

                              Control0..1
                              TypeBackboneElement
                              Summarytrue
                              Requirements

                              Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
                              316. Observation.component:5MinutePulseScore.id
                              Definition

                              unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                              Shortxml:id (or equivalent in JSON)
                              Control0..1
                              Typestring
                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                              XML FormatIn the XML format, this property is represented as an attribute.
                              318. Observation.component:5MinutePulseScore.extension
                              Definition

                              May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                              ShortAdditional Content defined by implementations
                              Comments

                              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                              Control0..*
                              TypeExtension
                              Alternate Namesextensions, user content
                              320. Observation.component:5MinutePulseScore.modifierExtension
                              Definition

                              May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                              ShortExtensions that cannot be ignored
                              Comments

                              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                              Control0..*
                              TypeExtension
                              Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
                              Summarytrue
                              Alternate Namesextensions, user content, modifiers
                              322. Observation.component:5MinutePulseScore.code
                              Definition

                              Describes what was observed. Sometimes this is called the observation "code".

                              ShortType of component observation (code / type)
                              Control1..1
                              BindingFor example codes, see LOINC Codes
                              (example to http://hl7.org/fhir/ValueSet/observation-codes)

                              Codes identifying names of simple observations.

                              TypeCodeableConcept
                              Summarytrue
                              Requirements

                              Knowing what kind of observation is being made is essential to understanding the observation.

                              Pattern Value{
                                "coding" : [{
                                  "system" : "http://loinc.org",
                                  "code" : "32412-9"
                                }]
                              }
                              324. Observation.component:5MinutePulseScore.value[x]:valueCodeableConcept
                              Slice NamevalueCodeableConcept
                              Definition

                              The Apgar subscore for pulse.

                              ShortPulseScore
                              Comments

                              Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (these "yes/no" concepts can be mapped to the display name "true/false" or other mutually exclusive terms that may be needed"). The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (the name format is "'value' + the type name" with a capital on the first letter of the type).

                              Control0..1
                              BindingUnless not suitable, these codes SHALL be taken from HartslagScoreCodelijst
                              (extensible to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.12.16.2--20171231000000)

                              HartslagScoreCodelijst

                              TypeCodeableConcept
                              [x] NoteSee Choice of Data Types for further information about how to use [x]
                              Summarytrue
                              Requirements

                              An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.

                              Alternate NamesHartslagScore
                              326. Observation.component:5MinutePulseScore.dataAbsentReason
                              Definition

                              Provides a reason why the expected value in the element Observation.value[x] is missing.

                              ShortWhy the component result is missing
                              Comments

                              "Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done". The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

                              Control0..1
                              This element is affected by the following invariants: obs-6
                              BindingUnless not suitable, these codes SHALL be taken from Observation Value Absent Reason
                              (extensible to http://hl7.org/fhir/ValueSet/observation-valueabsentreason)

                              Codes specifying why the result (Observation.value[x]) is missing.

                              TypeCodeableConcept
                              Requirements

                              For many results it is necessary to handle exceptional values in measurements.

                              328. Observation.component:5MinutePulseScore.interpretation
                              Definition

                              The assessment made based on the result of the observation. Intended as a simple compact code often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result. Otherwise known as abnormal flag.

                              ShortHigh, low, normal, etc.
                              Comments

                              The component interpretation applies only to the individual component value. For an overall interpretation all components together use thes Observation.interpretation element.

                              Control0..1
                              BindingUnless not suitable, these codes SHALL be taken from Observation Interpretation Codes
                              (extensible to http://hl7.org/fhir/ValueSet/observation-interpretation)

                              Codes identifying interpretations of observations.

                              TypeCodeableConcept
                              Requirements

                              For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.

                              Alternate NamesAbnormal Flag
                              330. Observation.component:5MinutePulseScore.referenceRange
                              Definition

                              Guidance on how to interpret the value by comparison to a normal or recommended range.

                              ShortProvides guide for interpretation of component result
                              Comments

                              Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.

                              Control0..*
                              TypeSee ttp://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange
                              Requirements

                              Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.

                              332. Observation.component:10MinutePulseScore
                              Slice Name10MinutePulseScore
                              Definition

                              Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.

                              ShortComponent results
                              Comments

                              For a discussion on the ways Observations can be assembled in groups together see Notes below.

                              Control0..1
                              TypeBackboneElement
                              Summarytrue
                              Requirements

                              Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
                              334. Observation.component:10MinutePulseScore.id
                              Definition

                              unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                              Shortxml:id (or equivalent in JSON)
                              Control0..1
                              Typestring
                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                              XML FormatIn the XML format, this property is represented as an attribute.
                              336. Observation.component:10MinutePulseScore.extension
                              Definition

                              May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                              ShortAdditional Content defined by implementations
                              Comments

                              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                              Control0..*
                              TypeExtension
                              Alternate Namesextensions, user content
                              338. Observation.component:10MinutePulseScore.modifierExtension
                              Definition

                              May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                              ShortExtensions that cannot be ignored
                              Comments

                              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                              Control0..*
                              TypeExtension
                              Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
                              Summarytrue
                              Alternate Namesextensions, user content, modifiers
                              340. Observation.component:10MinutePulseScore.code
                              Definition

                              Describes what was observed. Sometimes this is called the observation "code".

                              ShortType of component observation (code / type)
                              Control1..1
                              BindingFor example codes, see LOINC Codes
                              (example to http://hl7.org/fhir/ValueSet/observation-codes)

                              Codes identifying names of simple observations.

                              TypeCodeableConcept
                              Summarytrue
                              Requirements

                              Knowing what kind of observation is being made is essential to understanding the observation.

                              Pattern Value{
                                "coding" : [{
                                  "system" : "http://loinc.org",
                                  "code" : "32402-0"
                                }]
                              }
                              342. Observation.component:10MinutePulseScore.value[x]:valueCodeableConcept
                              Slice NamevalueCodeableConcept
                              Definition

                              The Apgar subscore for pulse.

                              ShortPulseScore
                              Comments

                              Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (these "yes/no" concepts can be mapped to the display name "true/false" or other mutually exclusive terms that may be needed"). The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (the name format is "'value' + the type name" with a capital on the first letter of the type).

                              Control0..1
                              BindingUnless not suitable, these codes SHALL be taken from HartslagScoreCodelijst
                              (extensible to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.12.16.2--20171231000000)

                              HartslagScoreCodelijst

                              TypeCodeableConcept
                              [x] NoteSee Choice of Data Types for further information about how to use [x]
                              Summarytrue
                              Requirements

                              An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.

                              Alternate NamesHartslagScore
                              344. Observation.component:10MinutePulseScore.dataAbsentReason
                              Definition

                              Provides a reason why the expected value in the element Observation.value[x] is missing.

                              ShortWhy the component result is missing
                              Comments

                              "Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done". The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

                              Control0..1
                              This element is affected by the following invariants: obs-6
                              BindingUnless not suitable, these codes SHALL be taken from Observation Value Absent Reason
                              (extensible to http://hl7.org/fhir/ValueSet/observation-valueabsentreason)

                              Codes specifying why the result (Observation.value[x]) is missing.

                              TypeCodeableConcept
                              Requirements

                              For many results it is necessary to handle exceptional values in measurements.

                              346. Observation.component:10MinutePulseScore.interpretation
                              Definition

                              The assessment made based on the result of the observation. Intended as a simple compact code often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result. Otherwise known as abnormal flag.

                              ShortHigh, low, normal, etc.
                              Comments

                              The component interpretation applies only to the individual component value. For an overall interpretation all components together use thes Observation.interpretation element.

                              Control0..1
                              BindingUnless not suitable, these codes SHALL be taken from Observation Interpretation Codes
                              (extensible to http://hl7.org/fhir/ValueSet/observation-interpretation)

                              Codes identifying interpretations of observations.

                              TypeCodeableConcept
                              Requirements

                              For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.

                              Alternate NamesAbnormal Flag
                              348. Observation.component:10MinutePulseScore.referenceRange
                              Definition

                              Guidance on how to interpret the value by comparison to a normal or recommended range.

                              ShortProvides guide for interpretation of component result
                              Comments

                              Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.

                              Control0..*
                              TypeSee ttp://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange
                              Requirements

                              Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.

                              350. Observation.component:1MinuteGrimaceScore
                              Slice Name1MinuteGrimaceScore
                              Definition

                              Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.

                              ShortComponent results
                              Comments

                              For a discussion on the ways Observations can be assembled in groups together see Notes below.

                              Control0..1
                              TypeBackboneElement
                              Summarytrue
                              Requirements

                              Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
                              352. Observation.component:1MinuteGrimaceScore.id
                              Definition

                              unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                              Shortxml:id (or equivalent in JSON)
                              Control0..1
                              Typestring
                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                              XML FormatIn the XML format, this property is represented as an attribute.
                              354. Observation.component:1MinuteGrimaceScore.extension
                              Definition

                              May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                              ShortAdditional Content defined by implementations
                              Comments

                              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                              Control0..*
                              TypeExtension
                              Alternate Namesextensions, user content
                              356. Observation.component:1MinuteGrimaceScore.modifierExtension
                              Definition

                              May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                              ShortExtensions that cannot be ignored
                              Comments

                              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                              Control0..*
                              TypeExtension
                              Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
                              Summarytrue
                              Alternate Namesextensions, user content, modifiers
                              358. Observation.component:1MinuteGrimaceScore.code
                              Definition

                              Describes what was observed. Sometimes this is called the observation "code".

                              ShortType of component observation (code / type)
                              Control1..1
                              BindingFor example codes, see LOINC Codes
                              (example to http://hl7.org/fhir/ValueSet/observation-codes)

                              Codes identifying names of simple observations.

                              TypeCodeableConcept
                              Summarytrue
                              Requirements

                              Knowing what kind of observation is being made is essential to understanding the observation.

                              Pattern Value{
                                "coding" : [{
                                  "system" : "http://loinc.org",
                                  "code" : "32409-5"
                                }]
                              }
                              360. Observation.component:1MinuteGrimaceScore.value[x]:valueCodeableConcept
                              Slice NamevalueCodeableConcept
                              Definition

                              The Apgar subscore for grimace.

                              ShortGrimaceScore
                              Comments

                              Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (these "yes/no" concepts can be mapped to the display name "true/false" or other mutually exclusive terms that may be needed"). The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (the name format is "'value' + the type name" with a capital on the first letter of the type).

                              Control0..1
                              BindingUnless not suitable, these codes SHALL be taken from ReflexenScoreCodelijst
                              (extensible to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.12.16.5--20171231000000)

                              ReflexenScoreCodelijst

                              TypeCodeableConcept
                              [x] NoteSee Choice of Data Types for further information about how to use [x]
                              Summarytrue
                              Requirements

                              An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.

                              Alternate NamesReflexenScore
                              362. Observation.component:1MinuteGrimaceScore.dataAbsentReason
                              Definition

                              Provides a reason why the expected value in the element Observation.value[x] is missing.

                              ShortWhy the component result is missing
                              Comments

                              "Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done". The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

                              Control0..1
                              This element is affected by the following invariants: obs-6
                              BindingUnless not suitable, these codes SHALL be taken from Observation Value Absent Reason
                              (extensible to http://hl7.org/fhir/ValueSet/observation-valueabsentreason)

                              Codes specifying why the result (Observation.value[x]) is missing.

                              TypeCodeableConcept
                              Requirements

                              For many results it is necessary to handle exceptional values in measurements.

                              364. Observation.component:1MinuteGrimaceScore.interpretation
                              Definition

                              The assessment made based on the result of the observation. Intended as a simple compact code often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result. Otherwise known as abnormal flag.

                              ShortHigh, low, normal, etc.
                              Comments

                              The component interpretation applies only to the individual component value. For an overall interpretation all components together use thes Observation.interpretation element.

                              Control0..1
                              BindingUnless not suitable, these codes SHALL be taken from Observation Interpretation Codes
                              (extensible to http://hl7.org/fhir/ValueSet/observation-interpretation)

                              Codes identifying interpretations of observations.

                              TypeCodeableConcept
                              Requirements

                              For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.

                              Alternate NamesAbnormal Flag
                              366. Observation.component:1MinuteGrimaceScore.referenceRange
                              Definition

                              Guidance on how to interpret the value by comparison to a normal or recommended range.

                              ShortProvides guide for interpretation of component result
                              Comments

                              Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.

                              Control0..*
                              TypeSee ttp://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange
                              Requirements

                              Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.

                              368. Observation.component:5MinuteGrimaceScore
                              Slice Name5MinuteGrimaceScore
                              Definition

                              Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.

                              ShortComponent results
                              Comments

                              For a discussion on the ways Observations can be assembled in groups together see Notes below.

                              Control0..1
                              TypeBackboneElement
                              Summarytrue
                              Requirements

                              Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
                              370. Observation.component:5MinuteGrimaceScore.id
                              Definition

                              unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                              Shortxml:id (or equivalent in JSON)
                              Control0..1
                              Typestring
                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                              XML FormatIn the XML format, this property is represented as an attribute.
                              372. Observation.component:5MinuteGrimaceScore.extension
                              Definition

                              May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                              ShortAdditional Content defined by implementations
                              Comments

                              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                              Control0..*
                              TypeExtension
                              Alternate Namesextensions, user content
                              374. Observation.component:5MinuteGrimaceScore.modifierExtension
                              Definition

                              May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                              ShortExtensions that cannot be ignored
                              Comments

                              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                              Control0..*
                              TypeExtension
                              Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
                              Summarytrue
                              Alternate Namesextensions, user content, modifiers
                              376. Observation.component:5MinuteGrimaceScore.code
                              Definition

                              Describes what was observed. Sometimes this is called the observation "code".

                              ShortType of component observation (code / type)
                              Control1..1
                              BindingFor example codes, see LOINC Codes
                              (example to http://hl7.org/fhir/ValueSet/observation-codes)

                              Codes identifying names of simple observations.

                              TypeCodeableConcept
                              Summarytrue
                              Requirements

                              Knowing what kind of observation is being made is essential to understanding the observation.

                              Pattern Value{
                                "coding" : [{
                                  "system" : "http://loinc.org",
                                  "code" : "32414-5"
                                }]
                              }
                              378. Observation.component:5MinuteGrimaceScore.value[x]:valueCodeableConcept
                              Slice NamevalueCodeableConcept
                              Definition

                              The Apgar subscore for grimace.

                              ShortGrimaceScore
                              Comments

                              Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (these "yes/no" concepts can be mapped to the display name "true/false" or other mutually exclusive terms that may be needed"). The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (the name format is "'value' + the type name" with a capital on the first letter of the type).

                              Control0..1
                              BindingUnless not suitable, these codes SHALL be taken from ReflexenScoreCodelijst
                              (extensible to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.12.16.5--20171231000000)

                              ReflexenScoreCodelijst

                              TypeCodeableConcept
                              [x] NoteSee Choice of Data Types for further information about how to use [x]
                              Summarytrue
                              Requirements

                              An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.

                              Alternate NamesReflexenScore
                              380. Observation.component:5MinuteGrimaceScore.dataAbsentReason
                              Definition

                              Provides a reason why the expected value in the element Observation.value[x] is missing.

                              ShortWhy the component result is missing
                              Comments

                              "Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done". The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

                              Control0..1
                              This element is affected by the following invariants: obs-6
                              BindingUnless not suitable, these codes SHALL be taken from Observation Value Absent Reason
                              (extensible to http://hl7.org/fhir/ValueSet/observation-valueabsentreason)

                              Codes specifying why the result (Observation.value[x]) is missing.

                              TypeCodeableConcept
                              Requirements

                              For many results it is necessary to handle exceptional values in measurements.

                              382. Observation.component:5MinuteGrimaceScore.interpretation
                              Definition

                              The assessment made based on the result of the observation. Intended as a simple compact code often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result. Otherwise known as abnormal flag.

                              ShortHigh, low, normal, etc.
                              Comments

                              The component interpretation applies only to the individual component value. For an overall interpretation all components together use thes Observation.interpretation element.

                              Control0..1
                              BindingUnless not suitable, these codes SHALL be taken from Observation Interpretation Codes
                              (extensible to http://hl7.org/fhir/ValueSet/observation-interpretation)

                              Codes identifying interpretations of observations.

                              TypeCodeableConcept
                              Requirements

                              For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.

                              Alternate NamesAbnormal Flag
                              384. Observation.component:5MinuteGrimaceScore.referenceRange
                              Definition

                              Guidance on how to interpret the value by comparison to a normal or recommended range.

                              ShortProvides guide for interpretation of component result
                              Comments

                              Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.

                              Control0..*
                              TypeSee ttp://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange
                              Requirements

                              Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.

                              386. Observation.component:10MinuteGrimaceScore
                              Slice Name10MinuteGrimaceScore
                              Definition

                              Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.

                              ShortComponent results
                              Comments

                              For a discussion on the ways Observations can be assembled in groups together see Notes below.

                              Control0..1
                              TypeBackboneElement
                              Summarytrue
                              Requirements

                              Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
                              388. Observation.component:10MinuteGrimaceScore.id
                              Definition

                              unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                              Shortxml:id (or equivalent in JSON)
                              Control0..1
                              Typestring
                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                              XML FormatIn the XML format, this property is represented as an attribute.
                              390. Observation.component:10MinuteGrimaceScore.extension
                              Definition

                              May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                              ShortAdditional Content defined by implementations
                              Comments

                              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                              Control0..*
                              TypeExtension
                              Alternate Namesextensions, user content
                              392. Observation.component:10MinuteGrimaceScore.modifierExtension
                              Definition

                              May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                              ShortExtensions that cannot be ignored
                              Comments

                              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                              Control0..*
                              TypeExtension
                              Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
                              Summarytrue
                              Alternate Namesextensions, user content, modifiers
                              394. Observation.component:10MinuteGrimaceScore.code
                              Definition

                              Describes what was observed. Sometimes this is called the observation "code".

                              ShortType of component observation (code / type)
                              Control1..1
                              BindingFor example codes, see LOINC Codes
                              (example to http://hl7.org/fhir/ValueSet/observation-codes)

                              Codes identifying names of simple observations.

                              TypeCodeableConcept
                              Summarytrue
                              Requirements

                              Knowing what kind of observation is being made is essential to understanding the observation.

                              Pattern Value{
                                "coding" : [{
                                  "system" : "http://loinc.org",
                                  "code" : "32404-6"
                                }]
                              }
                              396. Observation.component:10MinuteGrimaceScore.value[x]:valueCodeableConcept
                              Slice NamevalueCodeableConcept
                              Definition

                              The Apgar subscore for grimace.

                              ShortGrimaceScore
                              Comments

                              Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (these "yes/no" concepts can be mapped to the display name "true/false" or other mutually exclusive terms that may be needed"). The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (the name format is "'value' + the type name" with a capital on the first letter of the type).

                              Control0..1
                              BindingUnless not suitable, these codes SHALL be taken from ReflexenScoreCodelijst
                              (extensible to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.12.16.5--20171231000000)

                              ReflexenScoreCodelijst

                              TypeCodeableConcept
                              [x] NoteSee Choice of Data Types for further information about how to use [x]
                              Summarytrue
                              Requirements

                              An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.

                              Alternate NamesReflexenScore
                              398. Observation.component:10MinuteGrimaceScore.dataAbsentReason
                              Definition

                              Provides a reason why the expected value in the element Observation.value[x] is missing.

                              ShortWhy the component result is missing
                              Comments

                              "Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done". The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

                              Control0..1
                              This element is affected by the following invariants: obs-6
                              BindingUnless not suitable, these codes SHALL be taken from Observation Value Absent Reason
                              (extensible to http://hl7.org/fhir/ValueSet/observation-valueabsentreason)

                              Codes specifying why the result (Observation.value[x]) is missing.

                              TypeCodeableConcept
                              Requirements

                              For many results it is necessary to handle exceptional values in measurements.

                              400. Observation.component:10MinuteGrimaceScore.interpretation
                              Definition

                              The assessment made based on the result of the observation. Intended as a simple compact code often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result. Otherwise known as abnormal flag.

                              ShortHigh, low, normal, etc.
                              Comments

                              The component interpretation applies only to the individual component value. For an overall interpretation all components together use thes Observation.interpretation element.

                              Control0..1
                              BindingUnless not suitable, these codes SHALL be taken from Observation Interpretation Codes
                              (extensible to http://hl7.org/fhir/ValueSet/observation-interpretation)

                              Codes identifying interpretations of observations.

                              TypeCodeableConcept
                              Requirements

                              For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.

                              Alternate NamesAbnormal Flag
                              402. Observation.component:10MinuteGrimaceScore.referenceRange
                              Definition

                              Guidance on how to interpret the value by comparison to a normal or recommended range.

                              ShortProvides guide for interpretation of component result
                              Comments

                              Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.

                              Control0..*
                              TypeSee ttp://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange
                              Requirements

                              Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.

                              404. Observation.component:1MinuteMuscleToneScore
                              Slice Name1MinuteMuscleToneScore
                              Definition

                              Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.

                              ShortComponent results
                              Comments

                              For a discussion on the ways Observations can be assembled in groups together see Notes below.

                              Control0..1
                              TypeBackboneElement
                              Summarytrue
                              Requirements

                              Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
                              406. Observation.component:1MinuteMuscleToneScore.id
                              Definition

                              unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                              Shortxml:id (or equivalent in JSON)
                              Control0..1
                              Typestring
                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                              XML FormatIn the XML format, this property is represented as an attribute.
                              408. Observation.component:1MinuteMuscleToneScore.extension
                              Definition

                              May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                              ShortAdditional Content defined by implementations
                              Comments

                              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                              Control0..*
                              TypeExtension
                              Alternate Namesextensions, user content
                              410. Observation.component:1MinuteMuscleToneScore.modifierExtension
                              Definition

                              May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                              ShortExtensions that cannot be ignored
                              Comments

                              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                              Control0..*
                              TypeExtension
                              Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
                              Summarytrue
                              Alternate Namesextensions, user content, modifiers
                              412. Observation.component:1MinuteMuscleToneScore.code
                              Definition

                              Describes what was observed. Sometimes this is called the observation "code".

                              ShortType of component observation (code / type)
                              Control1..1
                              BindingFor example codes, see LOINC Codes
                              (example to http://hl7.org/fhir/ValueSet/observation-codes)

                              Codes identifying names of simple observations.

                              TypeCodeableConcept
                              Summarytrue
                              Requirements

                              Knowing what kind of observation is being made is essential to understanding the observation.

                              Pattern Value{
                                "coding" : [{
                                  "system" : "http://loinc.org",
                                  "code" : "32408-7"
                                }]
                              }
                              414. Observation.component:1MinuteMuscleToneScore.value[x]:valueCodeableConcept
                              Slice NamevalueCodeableConcept
                              Definition

                              The Apgar subscore for activity/muscle tone.

                              ShortMusleToneScore
                              Comments

                              Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (these "yes/no" concepts can be mapped to the display name "true/false" or other mutually exclusive terms that may be needed"). The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (the name format is "'value' + the type name" with a capital on the first letter of the type).

                              Control0..1
                              BindingUnless not suitable, these codes SHALL be taken from SpierspanningScoreCodelijst
                              (extensible to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.12.16.3--20171231000000)

                              SpierspanningScoreCodelijst

                              TypeCodeableConcept
                              [x] NoteSee Choice of Data Types for further information about how to use [x]
                              Summarytrue
                              Requirements

                              An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.

                              Alternate NamesSpierspanningScore
                              416. Observation.component:1MinuteMuscleToneScore.dataAbsentReason
                              Definition

                              Provides a reason why the expected value in the element Observation.value[x] is missing.

                              ShortWhy the component result is missing
                              Comments

                              "Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done". The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

                              Control0..1
                              This element is affected by the following invariants: obs-6
                              BindingUnless not suitable, these codes SHALL be taken from Observation Value Absent Reason
                              (extensible to http://hl7.org/fhir/ValueSet/observation-valueabsentreason)

                              Codes specifying why the result (Observation.value[x]) is missing.

                              TypeCodeableConcept
                              Requirements

                              For many results it is necessary to handle exceptional values in measurements.

                              418. Observation.component:1MinuteMuscleToneScore.interpretation
                              Definition

                              The assessment made based on the result of the observation. Intended as a simple compact code often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result. Otherwise known as abnormal flag.

                              ShortHigh, low, normal, etc.
                              Comments

                              The component interpretation applies only to the individual component value. For an overall interpretation all components together use thes Observation.interpretation element.

                              Control0..1
                              BindingUnless not suitable, these codes SHALL be taken from Observation Interpretation Codes
                              (extensible to http://hl7.org/fhir/ValueSet/observation-interpretation)

                              Codes identifying interpretations of observations.

                              TypeCodeableConcept
                              Requirements

                              For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.

                              Alternate NamesAbnormal Flag
                              420. Observation.component:1MinuteMuscleToneScore.referenceRange
                              Definition

                              Guidance on how to interpret the value by comparison to a normal or recommended range.

                              ShortProvides guide for interpretation of component result
                              Comments

                              Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.

                              Control0..*
                              TypeSee ttp://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange
                              Requirements

                              Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.

                              422. Observation.component:5MinuteMuscleToneScore
                              Slice Name5MinuteMuscleToneScore
                              Definition

                              Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.

                              ShortComponent results
                              Comments

                              For a discussion on the ways Observations can be assembled in groups together see Notes below.

                              Control0..1
                              TypeBackboneElement
                              Summarytrue
                              Requirements

                              Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
                              424. Observation.component:5MinuteMuscleToneScore.id
                              Definition

                              unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                              Shortxml:id (or equivalent in JSON)
                              Control0..1
                              Typestring
                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                              XML FormatIn the XML format, this property is represented as an attribute.
                              426. Observation.component:5MinuteMuscleToneScore.extension
                              Definition

                              May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                              ShortAdditional Content defined by implementations
                              Comments

                              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                              Control0..*
                              TypeExtension
                              Alternate Namesextensions, user content
                              428. Observation.component:5MinuteMuscleToneScore.modifierExtension
                              Definition

                              May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                              ShortExtensions that cannot be ignored
                              Comments

                              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                              Control0..*
                              TypeExtension
                              Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
                              Summarytrue
                              Alternate Namesextensions, user content, modifiers
                              430. Observation.component:5MinuteMuscleToneScore.code
                              Definition

                              Describes what was observed. Sometimes this is called the observation "code".

                              ShortType of component observation (code / type)
                              Control1..1
                              BindingFor example codes, see LOINC Codes
                              (example to http://hl7.org/fhir/ValueSet/observation-codes)

                              Codes identifying names of simple observations.

                              TypeCodeableConcept
                              Summarytrue
                              Requirements

                              Knowing what kind of observation is being made is essential to understanding the observation.

                              Pattern Value{
                                "coding" : [{
                                  "system" : "http://loinc.org",
                                  "code" : "32413-7"
                                }]
                              }
                              432. Observation.component:5MinuteMuscleToneScore.value[x]:valueCodeableConcept
                              Slice NamevalueCodeableConcept
                              Definition

                              The Apgar subscore for activity/muscle tone.

                              ShortMusleToneScore
                              Comments

                              Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (these "yes/no" concepts can be mapped to the display name "true/false" or other mutually exclusive terms that may be needed"). The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (the name format is "'value' + the type name" with a capital on the first letter of the type).

                              Control0..1
                              BindingUnless not suitable, these codes SHALL be taken from SpierspanningScoreCodelijst
                              (extensible to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.12.16.3--20171231000000)

                              SpierspanningScoreCodelijst

                              TypeCodeableConcept
                              [x] NoteSee Choice of Data Types for further information about how to use [x]
                              Summarytrue
                              Requirements

                              An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.

                              Alternate NamesSpierspanningScore
                              434. Observation.component:5MinuteMuscleToneScore.dataAbsentReason
                              Definition

                              Provides a reason why the expected value in the element Observation.value[x] is missing.

                              ShortWhy the component result is missing
                              Comments

                              "Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done". The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

                              Control0..1
                              This element is affected by the following invariants: obs-6
                              BindingUnless not suitable, these codes SHALL be taken from Observation Value Absent Reason
                              (extensible to http://hl7.org/fhir/ValueSet/observation-valueabsentreason)

                              Codes specifying why the result (Observation.value[x]) is missing.

                              TypeCodeableConcept
                              Requirements

                              For many results it is necessary to handle exceptional values in measurements.

                              436. Observation.component:5MinuteMuscleToneScore.interpretation
                              Definition

                              The assessment made based on the result of the observation. Intended as a simple compact code often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result. Otherwise known as abnormal flag.

                              ShortHigh, low, normal, etc.
                              Comments

                              The component interpretation applies only to the individual component value. For an overall interpretation all components together use thes Observation.interpretation element.

                              Control0..1
                              BindingUnless not suitable, these codes SHALL be taken from Observation Interpretation Codes
                              (extensible to http://hl7.org/fhir/ValueSet/observation-interpretation)

                              Codes identifying interpretations of observations.

                              TypeCodeableConcept
                              Requirements

                              For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.

                              Alternate NamesAbnormal Flag
                              438. Observation.component:5MinuteMuscleToneScore.referenceRange
                              Definition

                              Guidance on how to interpret the value by comparison to a normal or recommended range.

                              ShortProvides guide for interpretation of component result
                              Comments

                              Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.

                              Control0..*
                              TypeSee ttp://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange
                              Requirements

                              Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.

                              440. Observation.component:10MinuteMuscleToneScore
                              Slice Name10MinuteMuscleToneScore
                              Definition

                              Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.

                              ShortComponent results
                              Comments

                              For a discussion on the ways Observations can be assembled in groups together see Notes below.

                              Control0..1
                              TypeBackboneElement
                              Summarytrue
                              Requirements

                              Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
                              442. Observation.component:10MinuteMuscleToneScore.id
                              Definition

                              unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                              Shortxml:id (or equivalent in JSON)
                              Control0..1
                              Typestring
                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                              XML FormatIn the XML format, this property is represented as an attribute.
                              444. Observation.component:10MinuteMuscleToneScore.extension
                              Definition

                              May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                              ShortAdditional Content defined by implementations
                              Comments

                              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                              Control0..*
                              TypeExtension
                              Alternate Namesextensions, user content
                              446. Observation.component:10MinuteMuscleToneScore.modifierExtension
                              Definition

                              May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                              ShortExtensions that cannot be ignored
                              Comments

                              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                              Control0..*
                              TypeExtension
                              Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
                              Summarytrue
                              Alternate Namesextensions, user content, modifiers
                              448. Observation.component:10MinuteMuscleToneScore.code
                              Definition

                              Describes what was observed. Sometimes this is called the observation "code".

                              ShortType of component observation (code / type)
                              Control1..1
                              BindingFor example codes, see LOINC Codes
                              (example to http://hl7.org/fhir/ValueSet/observation-codes)

                              Codes identifying names of simple observations.

                              TypeCodeableConcept
                              Summarytrue
                              Requirements

                              Knowing what kind of observation is being made is essential to understanding the observation.

                              Pattern Value{
                                "coding" : [{
                                  "system" : "http://loinc.org",
                                  "code" : "32403-8"
                                }]
                              }
                              450. Observation.component:10MinuteMuscleToneScore.value[x]:valueCodeableConcept
                              Slice NamevalueCodeableConcept
                              Definition

                              The Apgar subscore for activity/muscle tone.

                              ShortMusleToneScore
                              Comments

                              Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (these "yes/no" concepts can be mapped to the display name "true/false" or other mutually exclusive terms that may be needed"). The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (the name format is "'value' + the type name" with a capital on the first letter of the type).

                              Control0..1
                              BindingUnless not suitable, these codes SHALL be taken from SpierspanningScoreCodelijst
                              (extensible to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.12.16.3--20171231000000)

                              SpierspanningScoreCodelijst

                              TypeCodeableConcept
                              [x] NoteSee Choice of Data Types for further information about how to use [x]
                              Summarytrue
                              Requirements

                              An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.

                              Alternate NamesSpierspanningScore
                              452. Observation.component:10MinuteMuscleToneScore.dataAbsentReason
                              Definition

                              Provides a reason why the expected value in the element Observation.value[x] is missing.

                              ShortWhy the component result is missing
                              Comments

                              "Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done". The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

                              Control0..1
                              This element is affected by the following invariants: obs-6
                              BindingUnless not suitable, these codes SHALL be taken from Observation Value Absent Reason
                              (extensible to http://hl7.org/fhir/ValueSet/observation-valueabsentreason)

                              Codes specifying why the result (Observation.value[x]) is missing.

                              TypeCodeableConcept
                              Requirements

                              For many results it is necessary to handle exceptional values in measurements.

                              454. Observation.component:10MinuteMuscleToneScore.interpretation
                              Definition

                              The assessment made based on the result of the observation. Intended as a simple compact code often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result. Otherwise known as abnormal flag.

                              ShortHigh, low, normal, etc.
                              Comments

                              The component interpretation applies only to the individual component value. For an overall interpretation all components together use thes Observation.interpretation element.

                              Control0..1
                              BindingUnless not suitable, these codes SHALL be taken from Observation Interpretation Codes
                              (extensible to http://hl7.org/fhir/ValueSet/observation-interpretation)

                              Codes identifying interpretations of observations.

                              TypeCodeableConcept
                              Requirements

                              For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.

                              Alternate NamesAbnormal Flag
                              456. Observation.component:10MinuteMuscleToneScore.referenceRange
                              Definition

                              Guidance on how to interpret the value by comparison to a normal or recommended range.

                              ShortProvides guide for interpretation of component result
                              Comments

                              Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.

                              Control0..*
                              TypeSee ttp://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange
                              Requirements

                              Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.