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

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Resource Profile: HCIM Stoma

Stoma is defined by the Dutch Health and Care Information models (Dutch: Zorginformatiebouwsteen or ZIB) version 3.2, release 2017.

A stoma is an unnatural, surgically created opening connecting a body cavity with the outside world. A stoma is created e.g. as an exit opening for feces or urine in the event that they cannot leave the body naturally. In the case of a tracheostomy, the stoma is intended to facilitate breathing if that is no longer possible via the oral, nasal and throat cavity.

Information on present stomas is recorded to inform other health professionals. This information is of importance in determining the care required for the patient. In a transfer situation, the information offers the option to realize continuity of care by organizing specific expertise and materials in advance, for example.

Usage:

• Refer to this Resource Profile: Stoma reference for Observation resources
• Examples for this Resource Profile: Observation/zib-stoma-01, Observation/zib-stoma-02 and Observation/zib-stoma-bladderfunction-01

Formal Views of Profile Content

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

• Differential Table
• Key Elements Table
• Snapshot Table
• Statistics/References
• All

This structure is derived from Observation

Name	Flags	Card.	Type	Description & Constraints
Observation		0..*	Observation	Stoma
identifier		0..*	Identifier	Business Identifier for observation
code
Slices for coding		0..*	Coding	Code defined by a terminology system Slice: Unordered, Open by value:code
coding:stomaCode		0..*	Coding	Code defined by a terminology system
system		0..1	uri	Identity of the terminology system Fixed Value: http://snomed.info/sct
code		0..1	code	Symbol in syntax defined by the system Fixed Value: 245857005
display		0..1	string	Representation defined by the system
subject		0..1	Reference(nl-core-patient)	Who and/or what this is about
effectiveDateTime:effectiveDateTime		0..1	dateTime	CreationDate
performer		0..*	Reference(nl-core-organization | nl-core-patient | nl-core-practitioner | nl-core-relatedperson)	Who is responsible for the observation
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
practitionerRole		0..1	Reference(nl-core-practitionerrole)	Optional Extensions Element URL: http://nictiz.nl/fhir/StructureDefinition/practitionerrole-reference
valueCodeableConcept:valueCodeableConcept		1..1	CodeableConcept	Stoma type Binding: StomaTypeCodelijst (extensible): Stoma type code list Example Zib example of double-barrelled colostomy: {"coding":[{"system":"http://snomed.info/sct","code":"261072008","display":"double-barrelled colostomy"}]}
comment		0..1	string	Comment
bodySite		0..1	CodeableConcept	AnatomicalLocation Binding: StomaAnatomischeLocatieCodelijst (extensible): Codes describing anatomical locations for a stoma
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
Laterality		0..1	(Complex)	Laterality URL: http://nictiz.nl/fhir/StructureDefinition/BodySite-Qualifier
valueCodeableConcept:valueCodeableConcept		0..1	CodeableConcept	BodySite qualifier Binding: StomaLateraliteitCodelijst (extensible): StomaLateralityCodelist
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
Observation.valueCodeableConcept:valueCodeableConcept	extensible	StomaTypeCodelijst http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.5.2.1--20171231000000 from this IG
Observation.bodySite	extensible	StomaAnatomischeLocatieCodelijst http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.5.2.2--20171231000000 from this IG
Observation.bodySite.extension:Laterality.valueCodeableConcept:valueCodeableConcept	extensible	StomaLateraliteitCodelijst http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.5.2.3--20171231000000 from this IG

Name	Flags	Card.	Type	Description & Constraints
Observation	C	0..*	Observation	Stoma obs-7: If code is the same as a component code then the value element associated with the code SHALL NOT be present obs-6: dataAbsentReason SHALL only be present if Observation.value[x] is not present
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	0..*	Identifier	Business Identifier for observation
status	?!Σ	1..1	code	registered | preliminary | final | amended + Binding: ObservationStatus (required): Codes providing the status of an observation.
code	Σ	1..1	CodeableConcept	Type of observation (code / type) Binding: LOINC Codes (example): Codes identifying names of simple observations.
Slices for coding	Σ	0..*	Coding	Code defined by a terminology system Slice: Unordered, Open by value:code
coding:stomaCode	Σ	0..*	Coding	Code defined by a terminology system
system	Σ	0..1	uri	Identity of the terminology system Fixed Value: http://snomed.info/sct
code	Σ	0..1	code	Symbol in syntax defined by the system Fixed Value: 245857005
display	Σ	0..1	string	Representation defined by the system
subject	Σ	0..1	Reference(nl-core-patient)	Who and/or what this is about
Slices for effective[x]	Σ	0..1	dateTime	Clinically relevant time/time-period for observation Slice: Unordered, Closed by type:$this
effective[x]:effectiveDateTime	Σ	0..1	dateTime	CreationDate
performer	Σ	0..*	Reference(nl-core-organization | nl-core-patient | nl-core-practitioner | nl-core-relatedperson)	Who is responsible for the observation
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
practitionerRole		0..1	Reference(nl-core-practitionerrole)	Optional Extensions Element URL: http://nictiz.nl/fhir/StructureDefinition/practitionerrole-reference
Slices for value[x]	ΣC	1..1	CodeableConcept	Actual result Slice: Unordered, Closed by type:$this
value[x]:valueCodeableConcept	ΣC	1..1	CodeableConcept	Stoma type Binding: StomaTypeCodelijst (extensible): Stoma type code list Example Zib example of double-barrelled colostomy: {"coding":[{"system":"http://snomed.info/sct","code":"261072008","display":"double-barrelled colostomy"}]}
comment		0..1	string	Comment
bodySite		0..1	CodeableConcept	AnatomicalLocation Binding: StomaAnatomischeLocatieCodelijst (extensible): Codes describing anatomical locations for a stoma
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
Laterality		0..1	(Complex)	Laterality URL: http://nictiz.nl/fhir/StructureDefinition/BodySite-Qualifier
url		1..1	uri	"http://nictiz.nl/fhir/StructureDefinition/BodySite-Qualifier"
Slices for value[x]		0..1	CodeableConcept	Value of extension Slice: Unordered, Closed by type:$this
value[x]:valueCodeableConcept		0..1	CodeableConcept	BodySite qualifier Binding: StomaLateraliteitCodelijst (extensible): StomaLateralityCodelist
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
Observation.status	required	ObservationStatus http://hl7.org/fhir/ValueSet/observation-status from the FHIR Standard
Observation.code	example	LOINC Codes (a valid code from LOINC) http://hl7.org/fhir/ValueSet/observation-codes from the FHIR Standard
Observation.value[x]:valueCodeableConcept	extensible	StomaTypeCodelijst http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.5.2.1--20171231000000 from this IG
Observation.bodySite	extensible	StomaAnatomischeLocatieCodelijst http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.5.2.2--20171231000000 from this IG
Observation.bodySite.extension:Laterality.value[x]:valueCodeableConcept	extensible	StomaLateraliteitCodelijst http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.5.2.3--20171231000000 from this IG

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-1	error	Observation	If the resource is contained in another resource, it SHALL NOT contain any narrative : contained.text.empty()
dom-2	error	Observation	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Observation	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource : contained.where(('#'+id in %resource.descendants().reference).not()).empty()
dom-4	error	Observation	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
obs-6	error	Observation	dataAbsentReason SHALL only be present if Observation.value[x] is not present : dataAbsentReason.empty() or value.empty()
obs-7	error	Observation	If 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()

Name	Flags	Card.	Type	Description & Constraints
Observation	C	0..*	Observation	Stoma obs-7: If code is the same as a component code then the value element associated with the code SHALL NOT be present obs-6: dataAbsentReason SHALL only be present if Observation.value[x] is not present
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: Common Languages (extensible): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
extension		0..*	Extension	Additional Content defined by implementations
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	0..*	Identifier	Business Identifier for observation
basedOn	Σ	0..*	Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ProcedureRequest | ReferralRequest)	Fulfills plan, proposal or order
status	?!Σ	1..1	code	registered | preliminary | final | amended + Binding: ObservationStatus (required): Codes providing the status of an observation.
category		0..*	CodeableConcept	Classification of type of observation Binding: Observation Category Codes (preferred): Codes for high level observation categories.
code	Σ	1..1	CodeableConcept	Type of observation (code / type) Binding: LOINC Codes (example): Codes identifying names of simple observations.
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
Slices for coding	Σ	0..*	Coding	Code defined by a terminology system Slice: Unordered, Open by value:code
coding:stomaCode	Σ	0..*	Coding	Code defined by a terminology system
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
system	Σ	0..1	uri	Identity of the terminology system Fixed Value: http://snomed.info/sct
version	Σ	0..1	string	Version of the system - if relevant
code	Σ	0..1	code	Symbol in syntax defined by the system Fixed Value: 245857005
display	Σ	0..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
text	Σ	0..1	string	Plain text representation of the concept
subject	Σ	0..1	Reference(nl-core-patient)	Who and/or what this is about
context		0..1	Reference(Encounter | EpisodeOfCare)	Healthcare event during which this observation is made
Slices for effective[x]	Σ	0..1	dateTime	Clinically relevant time/time-period for observation Slice: Unordered, Closed by type:$this
effective[x]:effectiveDateTime	Σ	0..1	dateTime	CreationDate
issued	Σ	0..1	instant	Date/Time this was made available
performer	Σ	0..*	Reference(nl-core-organization | nl-core-patient | nl-core-practitioner | nl-core-relatedperson)	Who is responsible for the observation
id		0..1	string	xml:id (or equivalent in JSON)
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
practitionerRole		0..1	Reference(nl-core-practitionerrole)	Optional Extensions Element URL: http://nictiz.nl/fhir/StructureDefinition/practitionerrole-reference
reference	ΣC	0..1	string	Literal reference, Relative, internal or absolute URL
identifier	Σ	0..1	Identifier	Logical reference, when literal reference is not known
display	Σ	0..1	string	Text alternative for the resource
Slices for value[x]	ΣC	1..1	CodeableConcept	Actual result Slice: Unordered, Closed by type:$this
value[x]:valueCodeableConcept	ΣC	1..1	CodeableConcept	Stoma type Binding: StomaTypeCodelijst (extensible): Stoma type code list Example Zib example of double-barrelled colostomy: {"coding":[{"system":"http://snomed.info/sct","code":"261072008","display":"double-barrelled colostomy"}]}
dataAbsentReason	C	0..1	CodeableConcept	Why the result is missing Binding: Observation Value Absent Reason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation		0..1	CodeableConcept	High, low, normal, etc. Binding: Observation Interpretation Codes (extensible): Codes identifying interpretations of observations.
comment		0..1	string	Comment
bodySite		0..1	CodeableConcept	AnatomicalLocation Binding: StomaAnatomischeLocatieCodelijst (extensible): Codes describing anatomical locations for a stoma
id		0..1	string	xml:id (or equivalent in JSON)
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
Laterality		0..1	(Complex)	Laterality URL: http://nictiz.nl/fhir/StructureDefinition/BodySite-Qualifier
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
url		1..1	uri	"http://nictiz.nl/fhir/StructureDefinition/BodySite-Qualifier"
Slices for value[x]		0..1	CodeableConcept	Value of extension Slice: Unordered, Closed by type:$this
value[x]:valueCodeableConcept		0..1	CodeableConcept	BodySite qualifier Binding: StomaLateraliteitCodelijst (extensible): StomaLateralityCodelist
coding	Σ	0..*	Coding	Code defined by a terminology system
text	Σ	0..1	string	Plain text representation of the concept
method		0..1	CodeableConcept	How it was done Binding: Observation Methods (example): Methods for simple observations.
specimen		0..1	Reference(Specimen)	Specimen used for this observation
device		0..1	Reference(Device | DeviceMetric)	(Measurement) Device
referenceRange	C	0..*	BackboneElement	Provides guide for interpretation obs-3: Must have at least a low or a high or text
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
low	C	0..1	SimpleQuantity	Low Range, if relevant
high	C	0..1	SimpleQuantity	High Range, if relevant
type		0..1	CodeableConcept	Reference range qualifier Binding: Observation Reference Range Meaning Codes (extensible): Code for the meaning of a reference range.
appliesTo		0..*	CodeableConcept	Reference range population Binding: Observation Reference Range Applies To Codes (example): Codes identifying the population the reference range applies to.
age		0..1	Range	Applicable age range, if relevant
text		0..1	string	Text based reference range in an observation
related	Σ	0..*	BackboneElement	Resource related to this observation
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
type		0..1	code	has-member | derived-from | sequel-to | replaces | qualified-by | interfered-by Binding: ObservationRelationshipType (required): Codes specifying how two observations are related.
target		1..1	Reference(Observation | QuestionnaireResponse | Sequence)	Resource that is related to this one
component	Σ	0..*	BackboneElement	Component results
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
code	Σ	1..1	CodeableConcept	Type of component observation (code / type) Binding: LOINC Codes (example): Codes identifying names of simple observations.
value[x]	Σ	0..1		Actual component result
valueQuantity			Quantity
valueCodeableConcept			CodeableConcept
valueString			string
valueRange			Range
valueRatio			Ratio
valueSampledData			SampledData
valueAttachment			Attachment
valueTime			time
valueDateTime			dateTime
valuePeriod			Period
dataAbsentReason	C	0..1	CodeableConcept	Why the component result is missing Binding: Observation Value Absent Reason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation		0..1	CodeableConcept	High, low, normal, etc. Binding: Observation Interpretation Codes (extensible): Codes identifying interpretations of observations.
referenceRange		0..*	See referenceRange (Observation)	Provides guide for interpretation of component result
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
Observation.language	extensible	Common Languages Additional Bindings Purpose AllLanguages Max Binding http://hl7.org/fhir/ValueSet/languages from the FHIR Standard
Observation.status	required	ObservationStatus http://hl7.org/fhir/ValueSet/observation-status from the FHIR Standard
Observation.category	preferred	Observation Category Codes http://hl7.org/fhir/ValueSet/observation-category from the FHIR Standard
Observation.code	example	LOINC Codes (a valid code from LOINC) http://hl7.org/fhir/ValueSet/observation-codes from the FHIR Standard
Observation.value[x]:valueCodeableConcept	extensible	StomaTypeCodelijst http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.5.2.1--20171231000000 from this IG
Observation.dataAbsentReason	extensible	Observation Value Absent Reason http://hl7.org/fhir/ValueSet/observation-valueabsentreason from the FHIR Standard
Observation.interpretation	extensible	Observation Interpretation Codes http://hl7.org/fhir/ValueSet/observation-interpretation from the FHIR Standard
Observation.bodySite	extensible	StomaAnatomischeLocatieCodelijst http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.5.2.2--20171231000000 from this IG
Observation.bodySite.extension:Laterality.value[x]:valueCodeableConcept	extensible	StomaLateraliteitCodelijst http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.5.2.3--20171231000000 from this IG
Observation.method	example	Observation Methods http://hl7.org/fhir/ValueSet/observation-methods from the FHIR Standard
Observation.referenceRange.type	extensible	Observation Reference Range Meaning Codes http://hl7.org/fhir/ValueSet/referencerange-meaning from the FHIR Standard
Observation.referenceRange.appliesTo	example	Observation Reference Range Applies To Codes http://hl7.org/fhir/ValueSet/referencerange-appliesto from the FHIR Standard
Observation.related.type	required	ObservationRelationshipType http://hl7.org/fhir/ValueSet/observation-relationshiptypes from the FHIR Standard
Observation.component.code	example	LOINC Codes (a valid code from LOINC) http://hl7.org/fhir/ValueSet/observation-codes from the FHIR Standard
Observation.component.dataAbsentReason	extensible	Observation Value Absent Reason http://hl7.org/fhir/ValueSet/observation-valueabsentreason from the FHIR Standard
Observation.component.interpretation	extensible	Observation Interpretation Codes http://hl7.org/fhir/ValueSet/observation-interpretation from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-1	error	Observation	If the resource is contained in another resource, it SHALL NOT contain any narrative : contained.text.empty()
dom-2	error	Observation	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Observation	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource : contained.where(('#'+id in %resource.descendants().reference).not()).empty()
dom-4	error	Observation	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() | (children().count() > id.count())
obs-3	error	Observation.referenceRange	Must have at least a low or a high or text : low.exists() or high.exists() or text.exists()
obs-6	error	Observation	dataAbsentReason SHALL only be present if Observation.value[x] is not present : dataAbsentReason.empty() or value.empty()
obs-7	error	Observation	If code is the same as a component code then the value element associated with the code SHALL NOT be present : value.empty() or component.code.where( (coding.code = %resource.code.coding.code) and (coding.system = %resource.code.coding.system)).empty()

This structure is derived from Observation

Summary

Mandatory: 1 element
Fixed: 2 elements

Structures

This structure refers to these other structures:

• nl-core-patient (http://fhir.nl/fhir/StructureDefinition/nl-core-patient)
• nl-core-organization (http://fhir.nl/fhir/StructureDefinition/nl-core-organization)
• nl-core-practitioner (http://fhir.nl/fhir/StructureDefinition/nl-core-practitioner)
• nl-core-relatedperson (http://fhir.nl/fhir/StructureDefinition/nl-core-relatedperson)

Extensions

This structure refers to these extensions:

• http://nictiz.nl/fhir/StructureDefinition/practitionerrole-reference
• http://nictiz.nl/fhir/StructureDefinition/BodySite-Qualifier

Slices

This structure defines the following Slices:

• The element 1 is sliced based on the value of Observation.code.coding

Differential View

This structure is derived from Observation

Name	Flags	Card.	Type	Description & Constraints
Observation		0..*	Observation	Stoma
identifier		0..*	Identifier	Business Identifier for observation
code
Slices for coding		0..*	Coding	Code defined by a terminology system Slice: Unordered, Open by value:code
coding:stomaCode		0..*	Coding	Code defined by a terminology system
system		0..1	uri	Identity of the terminology system Fixed Value: http://snomed.info/sct
code		0..1	code	Symbol in syntax defined by the system Fixed Value: 245857005
display		0..1	string	Representation defined by the system
subject		0..1	Reference(nl-core-patient)	Who and/or what this is about
effectiveDateTime:effectiveDateTime		0..1	dateTime	CreationDate
performer		0..*	Reference(nl-core-organization | nl-core-patient | nl-core-practitioner | nl-core-relatedperson)	Who is responsible for the observation
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
practitionerRole		0..1	Reference(nl-core-practitionerrole)	Optional Extensions Element URL: http://nictiz.nl/fhir/StructureDefinition/practitionerrole-reference
valueCodeableConcept:valueCodeableConcept		1..1	CodeableConcept	Stoma type Binding: StomaTypeCodelijst (extensible): Stoma type code list Example Zib example of double-barrelled colostomy: {"coding":[{"system":"http://snomed.info/sct","code":"261072008","display":"double-barrelled colostomy"}]}
comment		0..1	string	Comment
bodySite		0..1	CodeableConcept	AnatomicalLocation Binding: StomaAnatomischeLocatieCodelijst (extensible): Codes describing anatomical locations for a stoma
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
Laterality		0..1	(Complex)	Laterality URL: http://nictiz.nl/fhir/StructureDefinition/BodySite-Qualifier
valueCodeableConcept:valueCodeableConcept		0..1	CodeableConcept	BodySite qualifier Binding: StomaLateraliteitCodelijst (extensible): StomaLateralityCodelist
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
Observation.valueCodeableConcept:valueCodeableConcept	extensible	StomaTypeCodelijst http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.5.2.1--20171231000000 from this IG
Observation.bodySite	extensible	StomaAnatomischeLocatieCodelijst http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.5.2.2--20171231000000 from this IG
Observation.bodySite.extension:Laterality.valueCodeableConcept:valueCodeableConcept	extensible	StomaLateraliteitCodelijst http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.5.2.3--20171231000000 from this IG

Key Elements View

Name	Flags	Card.	Type	Description & Constraints
Observation	C	0..*	Observation	Stoma obs-7: If code is the same as a component code then the value element associated with the code SHALL NOT be present obs-6: dataAbsentReason SHALL only be present if Observation.value[x] is not present
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	0..*	Identifier	Business Identifier for observation
status	?!Σ	1..1	code	registered | preliminary | final | amended + Binding: ObservationStatus (required): Codes providing the status of an observation.
code	Σ	1..1	CodeableConcept	Type of observation (code / type) Binding: LOINC Codes (example): Codes identifying names of simple observations.
Slices for coding	Σ	0..*	Coding	Code defined by a terminology system Slice: Unordered, Open by value:code
coding:stomaCode	Σ	0..*	Coding	Code defined by a terminology system
system	Σ	0..1	uri	Identity of the terminology system Fixed Value: http://snomed.info/sct
code	Σ	0..1	code	Symbol in syntax defined by the system Fixed Value: 245857005
display	Σ	0..1	string	Representation defined by the system
subject	Σ	0..1	Reference(nl-core-patient)	Who and/or what this is about
Slices for effective[x]	Σ	0..1	dateTime	Clinically relevant time/time-period for observation Slice: Unordered, Closed by type:$this
effective[x]:effectiveDateTime	Σ	0..1	dateTime	CreationDate
performer	Σ	0..*	Reference(nl-core-organization | nl-core-patient | nl-core-practitioner | nl-core-relatedperson)	Who is responsible for the observation
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
practitionerRole		0..1	Reference(nl-core-practitionerrole)	Optional Extensions Element URL: http://nictiz.nl/fhir/StructureDefinition/practitionerrole-reference
Slices for value[x]	ΣC	1..1	CodeableConcept	Actual result Slice: Unordered, Closed by type:$this
value[x]:valueCodeableConcept	ΣC	1..1	CodeableConcept	Stoma type Binding: StomaTypeCodelijst (extensible): Stoma type code list Example Zib example of double-barrelled colostomy: {"coding":[{"system":"http://snomed.info/sct","code":"261072008","display":"double-barrelled colostomy"}]}
comment		0..1	string	Comment
bodySite		0..1	CodeableConcept	AnatomicalLocation Binding: StomaAnatomischeLocatieCodelijst (extensible): Codes describing anatomical locations for a stoma
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
Laterality		0..1	(Complex)	Laterality URL: http://nictiz.nl/fhir/StructureDefinition/BodySite-Qualifier
url		1..1	uri	"http://nictiz.nl/fhir/StructureDefinition/BodySite-Qualifier"
Slices for value[x]		0..1	CodeableConcept	Value of extension Slice: Unordered, Closed by type:$this
value[x]:valueCodeableConcept		0..1	CodeableConcept	BodySite qualifier Binding: StomaLateraliteitCodelijst (extensible): StomaLateralityCodelist
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
Observation.status	required	ObservationStatus http://hl7.org/fhir/ValueSet/observation-status from the FHIR Standard
Observation.code	example	LOINC Codes (a valid code from LOINC) http://hl7.org/fhir/ValueSet/observation-codes from the FHIR Standard
Observation.value[x]:valueCodeableConcept	extensible	StomaTypeCodelijst http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.5.2.1--20171231000000 from this IG
Observation.bodySite	extensible	StomaAnatomischeLocatieCodelijst http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.5.2.2--20171231000000 from this IG
Observation.bodySite.extension:Laterality.value[x]:valueCodeableConcept	extensible	StomaLateraliteitCodelijst http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.5.2.3--20171231000000 from this IG

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-1	error	Observation	If the resource is contained in another resource, it SHALL NOT contain any narrative : contained.text.empty()
dom-2	error	Observation	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Observation	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource : contained.where(('#'+id in %resource.descendants().reference).not()).empty()
dom-4	error	Observation	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
obs-6	error	Observation	dataAbsentReason SHALL only be present if Observation.value[x] is not present : dataAbsentReason.empty() or value.empty()
obs-7	error	Observation	If code is the same as a component code then the value element associated with the code SHALL NOT be present : value.empty() or component.code.where( (coding.code = %resource.code.coding.code) and (coding.system = %resource.code.coding.system)).empty()

Snapshot View

Name	Flags	Card.	Type	Description & Constraints
Observation	C	0..*	Observation	Stoma obs-7: If code is the same as a component code then the value element associated with the code SHALL NOT be present obs-6: dataAbsentReason SHALL only be present if Observation.value[x] is not present
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: Common Languages (extensible): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
extension		0..*	Extension	Additional Content defined by implementations
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	0..*	Identifier	Business Identifier for observation
basedOn	Σ	0..*	Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ProcedureRequest | ReferralRequest)	Fulfills plan, proposal or order
status	?!Σ	1..1	code	registered | preliminary | final | amended + Binding: ObservationStatus (required): Codes providing the status of an observation.
category		0..*	CodeableConcept	Classification of type of observation Binding: Observation Category Codes (preferred): Codes for high level observation categories.
code	Σ	1..1	CodeableConcept	Type of observation (code / type) Binding: LOINC Codes (example): Codes identifying names of simple observations.
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
Slices for coding	Σ	0..*	Coding	Code defined by a terminology system Slice: Unordered, Open by value:code
coding:stomaCode	Σ	0..*	Coding	Code defined by a terminology system
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
system	Σ	0..1	uri	Identity of the terminology system Fixed Value: http://snomed.info/sct
version	Σ	0..1	string	Version of the system - if relevant
code	Σ	0..1	code	Symbol in syntax defined by the system Fixed Value: 245857005
display	Σ	0..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
text	Σ	0..1	string	Plain text representation of the concept
subject	Σ	0..1	Reference(nl-core-patient)	Who and/or what this is about
context		0..1	Reference(Encounter | EpisodeOfCare)	Healthcare event during which this observation is made
Slices for effective[x]	Σ	0..1	dateTime	Clinically relevant time/time-period for observation Slice: Unordered, Closed by type:$this
effective[x]:effectiveDateTime	Σ	0..1	dateTime	CreationDate
issued	Σ	0..1	instant	Date/Time this was made available
performer	Σ	0..*	Reference(nl-core-organization | nl-core-patient | nl-core-practitioner | nl-core-relatedperson)	Who is responsible for the observation
id		0..1	string	xml:id (or equivalent in JSON)
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
practitionerRole		0..1	Reference(nl-core-practitionerrole)	Optional Extensions Element URL: http://nictiz.nl/fhir/StructureDefinition/practitionerrole-reference
reference	ΣC	0..1	string	Literal reference, Relative, internal or absolute URL
identifier	Σ	0..1	Identifier	Logical reference, when literal reference is not known
display	Σ	0..1	string	Text alternative for the resource
Slices for value[x]	ΣC	1..1	CodeableConcept	Actual result Slice: Unordered, Closed by type:$this
value[x]:valueCodeableConcept	ΣC	1..1	CodeableConcept	Stoma type Binding: StomaTypeCodelijst (extensible): Stoma type code list Example Zib example of double-barrelled colostomy: {"coding":[{"system":"http://snomed.info/sct","code":"261072008","display":"double-barrelled colostomy"}]}
dataAbsentReason	C	0..1	CodeableConcept	Why the result is missing Binding: Observation Value Absent Reason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation		0..1	CodeableConcept	High, low, normal, etc. Binding: Observation Interpretation Codes (extensible): Codes identifying interpretations of observations.
comment		0..1	string	Comment
bodySite		0..1	CodeableConcept	AnatomicalLocation Binding: StomaAnatomischeLocatieCodelijst (extensible): Codes describing anatomical locations for a stoma
id		0..1	string	xml:id (or equivalent in JSON)
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
Laterality		0..1	(Complex)	Laterality URL: http://nictiz.nl/fhir/StructureDefinition/BodySite-Qualifier
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
url		1..1	uri	"http://nictiz.nl/fhir/StructureDefinition/BodySite-Qualifier"
Slices for value[x]		0..1	CodeableConcept	Value of extension Slice: Unordered, Closed by type:$this
value[x]:valueCodeableConcept		0..1	CodeableConcept	BodySite qualifier Binding: StomaLateraliteitCodelijst (extensible): StomaLateralityCodelist
coding	Σ	0..*	Coding	Code defined by a terminology system
text	Σ	0..1	string	Plain text representation of the concept
method		0..1	CodeableConcept	How it was done Binding: Observation Methods (example): Methods for simple observations.
specimen		0..1	Reference(Specimen)	Specimen used for this observation
device		0..1	Reference(Device | DeviceMetric)	(Measurement) Device
referenceRange	C	0..*	BackboneElement	Provides guide for interpretation obs-3: Must have at least a low or a high or text
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
low	C	0..1	SimpleQuantity	Low Range, if relevant
high	C	0..1	SimpleQuantity	High Range, if relevant
type		0..1	CodeableConcept	Reference range qualifier Binding: Observation Reference Range Meaning Codes (extensible): Code for the meaning of a reference range.
appliesTo		0..*	CodeableConcept	Reference range population Binding: Observation Reference Range Applies To Codes (example): Codes identifying the population the reference range applies to.
age		0..1	Range	Applicable age range, if relevant
text		0..1	string	Text based reference range in an observation
related	Σ	0..*	BackboneElement	Resource related to this observation
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
type		0..1	code	has-member | derived-from | sequel-to | replaces | qualified-by | interfered-by Binding: ObservationRelationshipType (required): Codes specifying how two observations are related.
target		1..1	Reference(Observation | QuestionnaireResponse | Sequence)	Resource that is related to this one
component	Σ	0..*	BackboneElement	Component results
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
code	Σ	1..1	CodeableConcept	Type of component observation (code / type) Binding: LOINC Codes (example): Codes identifying names of simple observations.
value[x]	Σ	0..1		Actual component result
valueQuantity			Quantity
valueCodeableConcept			CodeableConcept
valueString			string
valueRange			Range
valueRatio			Ratio
valueSampledData			SampledData
valueAttachment			Attachment
valueTime			time
valueDateTime			dateTime
valuePeriod			Period
dataAbsentReason	C	0..1	CodeableConcept	Why the component result is missing Binding: Observation Value Absent Reason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation		0..1	CodeableConcept	High, low, normal, etc. Binding: Observation Interpretation Codes (extensible): Codes identifying interpretations of observations.
referenceRange		0..*	See referenceRange (Observation)	Provides guide for interpretation of component result
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
Observation.language	extensible	Common Languages Additional Bindings Purpose AllLanguages Max Binding http://hl7.org/fhir/ValueSet/languages from the FHIR Standard
Observation.status	required	ObservationStatus http://hl7.org/fhir/ValueSet/observation-status from the FHIR Standard
Observation.category	preferred	Observation Category Codes http://hl7.org/fhir/ValueSet/observation-category from the FHIR Standard
Observation.code	example	LOINC Codes (a valid code from LOINC) http://hl7.org/fhir/ValueSet/observation-codes from the FHIR Standard
Observation.value[x]:valueCodeableConcept	extensible	StomaTypeCodelijst http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.5.2.1--20171231000000 from this IG
Observation.dataAbsentReason	extensible	Observation Value Absent Reason http://hl7.org/fhir/ValueSet/observation-valueabsentreason from the FHIR Standard
Observation.interpretation	extensible	Observation Interpretation Codes http://hl7.org/fhir/ValueSet/observation-interpretation from the FHIR Standard
Observation.bodySite	extensible	StomaAnatomischeLocatieCodelijst http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.5.2.2--20171231000000 from this IG
Observation.bodySite.extension:Laterality.value[x]:valueCodeableConcept	extensible	StomaLateraliteitCodelijst http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.5.2.3--20171231000000 from this IG
Observation.method	example	Observation Methods http://hl7.org/fhir/ValueSet/observation-methods from the FHIR Standard
Observation.referenceRange.type	extensible	Observation Reference Range Meaning Codes http://hl7.org/fhir/ValueSet/referencerange-meaning from the FHIR Standard
Observation.referenceRange.appliesTo	example	Observation Reference Range Applies To Codes http://hl7.org/fhir/ValueSet/referencerange-appliesto from the FHIR Standard
Observation.related.type	required	ObservationRelationshipType http://hl7.org/fhir/ValueSet/observation-relationshiptypes from the FHIR Standard
Observation.component.code	example	LOINC Codes (a valid code from LOINC) http://hl7.org/fhir/ValueSet/observation-codes from the FHIR Standard
Observation.component.dataAbsentReason	extensible	Observation Value Absent Reason http://hl7.org/fhir/ValueSet/observation-valueabsentreason from the FHIR Standard
Observation.component.interpretation	extensible	Observation Interpretation Codes http://hl7.org/fhir/ValueSet/observation-interpretation from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-1	error	Observation	If the resource is contained in another resource, it SHALL NOT contain any narrative : contained.text.empty()
dom-2	error	Observation	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Observation	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource : contained.where(('#'+id in %resource.descendants().reference).not()).empty()
dom-4	error	Observation	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() | (children().count() > id.count())
obs-3	error	Observation.referenceRange	Must have at least a low or a high or text : low.exists() or high.exists() or text.exists()
obs-6	error	Observation	dataAbsentReason SHALL only be present if Observation.value[x] is not present : dataAbsentReason.empty() or value.empty()
obs-7	error	Observation	If code is the same as a component code then the value element associated with the code SHALL NOT be present : value.empty() or component.code.where( (coding.code = %resource.code.coding.code) and (coding.system = %resource.code.coding.system)).empty()

This structure is derived from Observation

Summary

Mandatory: 1 element
Fixed: 2 elements

Structures

This structure refers to these other structures:

• nl-core-patient (http://fhir.nl/fhir/StructureDefinition/nl-core-patient)
• nl-core-organization (http://fhir.nl/fhir/StructureDefinition/nl-core-organization)
• nl-core-practitioner (http://fhir.nl/fhir/StructureDefinition/nl-core-practitioner)
• nl-core-relatedperson (http://fhir.nl/fhir/StructureDefinition/nl-core-relatedperson)

Extensions

This structure refers to these extensions:

• http://nictiz.nl/fhir/StructureDefinition/practitionerrole-reference
• http://nictiz.nl/fhir/StructureDefinition/BodySite-Qualifier

Slices

This structure defines the following Slices:

• The element 1 is sliced based on the value of Observation.code.coding

Other representations of profile: CSV, Excel, Schematron