Release 4

This page is part of the FHIR Specification (v4.0.1: R4 - Mixed Normative and STU) in it's permanent home (it will always be available at this URL). The current version which supercedes this version is 5.0.0. For a full list of available versions, see the Directory of published versions . Page versions: R5 R4B R4 R3

10.1.27.2 StructureDefinition: HeadCircum

Orders and Observations Work Group Maturity Level: 5 Trial Use Use Context: Any

The official URL for this profile is: 

http://hl7.org/fhir/StructureDefinition/headcircum

FHIR Head Circumference Profile

This profile was published on Sat, Aug 11, 2018 00:00+1000 as a draft by Health Level Seven International (Orders and Observations Workgroup).

10.1.27.2.1 Formal Views of Profile Content

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

This structure is derived from observation-vitalsigns.

Summary

10.1.27.2.2 Complete Summary of the Mandatory Requirements

  1. One code in Observation.code which must have
    • a fixed Observation.code.coding.system='http ://loinc.org'
    • a fixed Observation.code.coding.code= '9843-4'
    • Other additional Codings are allowed in Observation.code- e.g. more specific LOINC Codes, SNOMED CT concepts, system specific codes. All codes SHALL have an system value
  2. Either one Observation.valueQuantity or, if there is no value, one code in Observation.DataAbsentReason
    • Each Observation.valueQuantity must have:
      • One numeric value in Observation.valueQuantity.value
      • a fixed Observation.valueQuantity.system="http://unitsofmeasure.org"
      • a UCUM unit code in Observation.valueQuantity.code = 'cm', or '[in_i]'

Mandatory: 3 elements (+4 nested mandatory elements)
Must-Support: 4 elements
Fixed Value: 3 elements

Slices

This structure defines the following Slices:

  • The element Observation.code.coding is sliced based on the values of value:code, value:system

This structure is derived from observation-vitalsigns.

Name Flags Card. Type Description & Constraints doco
.. Observation 0..*FHIR Head Circumference Profile
... code 1..1CodeableConcept Head Circumference
.... coding (Slice Definition) Slice: Unordered, Open by value:code, value:system
..... coding:HeadCircumCode 1..1Coding
...... system 1..1uri Fixed Value: http://loinc.org
...... code 1..1code Fixed Value: 9843-4
... valueQuantity 0..1Quantity
.... value S1..1decimal
.... unit S1..1string
.... system S1..1uri Fixed Value: http://unitsofmeasure.org
.... code S1..1code Coded responses from the common UCUM units for vital signs value set.
Binding: Body Length Units (required)

doco Documentation for this format
Name Flags Card. Type Description & Constraints doco
.. Observation I0..*FHIR Head Circumference Profile
... id Σ0..1string Logical id of this artifact
... meta ΣI0..1Meta Metadata about the resource
... implicitRules ?!ΣI0..1uri A set of rules under which this content was created
... language I0..1code Language of the resource content
Binding: Common Languages (preferred)
Max Binding: All Languages
... text I0..1Narrative Text summary of the resource, for human interpretation
... contained 0..*Resource Contained, inline Resources
... extension I0..*Extension Additional content defined by implementations
... modifierExtension ?!I0..*Extension Extensions that cannot be ignored
... identifier ΣI0..*Identifier Business Identifier for observation
... basedOn ΣI0..*Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest)Fulfills plan, proposal or order
... partOf ΣI0..*Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy)Part of referenced event
... status ?!SΣI1..1code registered | preliminary | final | amended +
Binding: ObservationStatus (required)
... category SI(Slice Definition) Classification of type of observation
Slice: Unordered, Open by value:coding.code, value:coding.system
Binding: Observation Category Codes (preferred )
.... category:VSCat SI1..1CodeableConcept Classification of type of observation
Binding: Observation Category Codes (preferred)
..... id 0..1string Unique id for inter-element referencing
..... extension I0..*Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... coding SΣI1..*Coding Code defined by a terminology system
...... id 0..1string Unique id for inter-element referencing
...... extension I0..*Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... system SΣI1..1uri Identity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category
...... version ΣI0..1string Version of the system - if relevant
...... code SΣI1..1code Symbol in syntax defined by the system
Fixed Value: vital-signs
...... display ΣI0..1string Representation defined by the system
...... userSelected ΣI0..1boolean If this coding was chosen directly by the user
..... text ΣI0..1string Plain text representation of the concept
... code SΣI1..1CodeableConcept Head Circumference
Binding: Vital Signs (extensible)
.... id 0..1string Unique id for inter-element referencing
.... extension I0..*Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... coding ΣI(Slice Definition) Code defined by a terminology system
Slice: Unordered, Open by value:code, value:system
..... coding:HeadCircumCode ΣI1..1Coding Code defined by a terminology system
...... id 0..1string Unique id for inter-element referencing
...... extension I0..*Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... system ΣI1..1uri Identity of the terminology system
Fixed Value: http://loinc.org
...... version ΣI0..1string Version of the system - if relevant
...... code ΣI1..1code Symbol in syntax defined by the system
Fixed Value: 9843-4
...... display ΣI0..1string Representation defined by the system
...... userSelected ΣI0..1boolean If this coding was chosen directly by the user
.... text ΣI0..1string Plain text representation of the concept
... subject SΣI1..1Reference(Patient)Who and/or what the observation is about
... focus ΣI0..*Reference(Resource)What the observation is about, when it is not about the subject of record
... encounter ΣI0..1Reference(Encounter)Healthcare event during which this observation is made
... effective[x] SΣI1..1Often just a dateTime for Vital Signs
vs-1: if Observation.effective[x] is dateTime and has a value then that value shall be precise to the day
.... effectiveDateTimedateTime
.... effectivePeriodPeriod
... issued ΣI0..1instant Date/Time this version was made available
... performer ΣI0..*Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson)Who is responsible for the observation
... value[x] SΣI(Slice Definition) Vital Signs value are recorded using the Quantity data type. For supporting observations such as Cuff size could use other datatypes such as CodeableConcept.
Slice: Unordered, Closed by type:$this
.... value[x]:valueQuantity SΣI0..1Quantity Vital Signs value are recorded using the Quantity data type. For supporting observations such as Cuff size could use other datatypes such as CodeableConcept.
..... id 0..1string Unique id for inter-element referencing
..... extension I0..*Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... value SΣI1..1decimal Numerical value (with implicit precision)
..... comparator ?!ΣI0..1code < | <= | >= | > - how to understand the value
Binding: QuantityComparator (required)
..... unit SΣI1..1string Unit representation
..... system SΣI1..1uri System that defines coded unit form
Fixed Value: http://unitsofmeasure.org
..... code SΣI1..1code Coded responses from the common UCUM units for vital signs value set.
Binding: Body Length Units (required)
... dataAbsentReason SI0..1CodeableConcept Why the result is missing
Binding: DataAbsentReason (extensible)
... interpretation I0..*CodeableConcept High, low, normal, etc.
Binding: Observation Interpretation Codes (extensible)
... note I0..*Annotation Comments about the observation
... bodySite I0..1CodeableConcept Observed body part
Binding: SNOMED CT Body Structures (example)
... method I0..1CodeableConcept How it was done
Binding: Observation Methods (example)
... specimen I0..1Reference(Specimen)Specimen used for this observation
... device I0..1Reference(Device | DeviceMetric)(Measurement) Device
... referenceRange I0..*BackboneElement Provides guide for interpretation
obs-3: Must have at least a low or a high or text
.... id 0..1string Unique id for inter-element referencing
.... extension I0..*Extension Additional content defined by implementations
.... modifierExtension ?!ΣI0..*Extension Extensions that cannot be ignored even if unrecognized
.... low I0..1SimpleQuantity Low Range, if relevant
.... high I0..1SimpleQuantity High Range, if relevant
.... type I0..1CodeableConcept Reference range qualifier
Binding: Observation Reference Range Meaning Codes (preferred)
.... appliesTo I0..*CodeableConcept Reference range population
Binding: Observation Reference Range Applies To Codes (example)
.... age I0..1Range Applicable age range, if relevant
.... text I0..1string Text based reference range in an observation
... hasMember ΣI0..*Reference(QuestionnaireResponse | MolecularSequence | Vital Signs Profile)Used when reporting vital signs panel components
... derivedFrom ΣI0..*Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | MolecularSequence | Vital Signs Profile)Related measurements the observation is made from
... component SΣI0..*BackboneElement Used when reporting systolic and diastolic blood pressure.
vs-3: If there is no a value a data absent reason must be present
.... id 0..1string Unique id for inter-element referencing
.... extension I0..*Extension Additional content defined by implementations
.... modifierExtension ?!ΣI0..*Extension Extensions that cannot be ignored even if unrecognized
.... code SΣI1..1CodeableConcept Type of component observation (code / type)
Binding: Vital Signs (extensible)
.... value[x] SΣI0..1Vital Sign Value recorded with UCUM
Binding: Vital Signs Units (required)
..... valueQuantityQuantity
..... valueCodeableConceptCodeableConcept
..... valueStringstring
..... valueBooleanboolean
..... valueIntegerinteger
..... valueRangeRange
..... valueRatioRatio
..... valueSampledDataSampledData
..... valueTimetime
..... valueDateTimedateTime
..... valuePeriodPeriod
.... dataAbsentReason SI0..1CodeableConcept Why the component result is missing
Binding: DataAbsentReason (extensible)
.... interpretation I0..*CodeableConcept High, low, normal, etc.
Binding: Observation Interpretation Codes (extensible)
.... referenceRange I0..*Unknown reference to #Observation.referenceRange
Provides guide for interpretation of component result

doco Documentation for this format 
<!-- observation-headcircum -->doco 
<Observation xmlns="http://hl7.org/fhir"
>
 <!-- from Element: extension -->
 <id><!-- 0..1 string  Logical id of this artifact --></id>
 <meta><!-- ?? 0..1 Meta  Metadata about the resource --></meta>
 <implicitRules value="[uri ]"/><!-- ?? 0..1 A set of rules under which this content was created -->
 <language value="[code ]"/><!-- ?? 0..1 Language of the resource content  -->
 <text><!-- ?? 0..1 Narrative  
 Text summary of the resource, for human interpretation --></text>
 <contained><!-- 0..* Resource  Contained, inline Resources --></contained>
 <modifierExtension><!-- ?? 0..* Extension  Extensions that cannot be ignored  --></modifierExtension>
 <identifier><!-- ?? 0..* Identifier  
 Business Identifier for observation --></identifier>
 <basedOn><!-- ?? 0..* Reference(CarePlan) Fulfills plan, proposal or order --></basedOn>
 <partOf><!-- ?? 0..* Reference(MedicationAdministration) Part of referenced event --></partOf>
 <status value="[code ]"/><!-- ?? 1..1 registered | preliminary | final | amended +  -->
 <-- category sliced by value:coding.code, value:coding.system in the specified orderOpen-->
 <category> ?? 1..1 CodeableConcept  <!-- ?? 1..1 Classification of type of observation -->
 <coding> ?? 1..* Coding  <!-- ?? 1..* Code defined by a terminology system -->
 <system value="[uri ]"/><!-- ?? 1..1 Identity of the terminology system -->
 <version value="[string ]"/><!-- ?? 0..1 Version of the system - if relevant -->
 <code value="[code ]"/><!-- ?? 1..1 Symbol in syntax defined by the system -->
 <display value="[string ]"/><!-- ?? 0..1 Representation defined by the system -->
 <userSelected value="[boolean ]"/><!-- ?? 0..1 If this coding was chosen directly by the user -->
 </coding>
 <text value="[string ]"/><!-- ?? 0..1 Plain text representation of the concept -->
 </category>
 <code> ?? 1..1 CodeableConcept  <!-- ?? 1..1 Head Circumference -->
 <-- coding sliced by value:code, value:system in the specified orderOpen-->
 <coding> ?? 1..1 Coding  <!-- ?? 1..1 Code defined by a terminology system -->
 <system value="[uri ]"/><!-- ?? 1..1 Identity of the terminology system -->
 <version value="[string ]"/><!-- ?? 0..1 Version of the system - if relevant -->
 <code value="[code ]"/><!-- ?? 1..1 Symbol in syntax defined by the system -->
 <display value="[string ]"/><!-- ?? 0..1 Representation defined by the system -->
 <userSelected value="[boolean ]"/><!-- ?? 0..1 If this coding was chosen directly by the user -->
 </coding>
 <text value="[string ]"/><!-- ?? 0..1 Plain text representation of the concept -->
 </code>
 <subject><!-- ?? 1..1 Reference(Patient) 
 Who and/or what the observation is about --></subject>
 <focus><!-- ?? 0..* Reference(Resource) 
 What the observation is about, when it is not about the subject of record --></focus>
 <encounter><!-- ?? 0..1 Reference(Encounter) 
 Healthcare event during which this observation is made --></encounter>
 <effective[x]><!-- ?? 1..1 dateTime|Period  
 Often just a dateTime for Vital Signs --></effective[x]>
 <issued value="[instant ]"/><!-- ?? 0..1 Date/Time this version was made available -->
 <performer><!-- ?? 0..* Reference(Practitioner) 
 Who is responsible for the observation --></performer>
 <-- valueQuantity sliced by type:$this in the specified orderClosed-->
 <valueQuantity> ?? 0..1 Quantity  <!-- ?? 0..1 Vital Signs value are recorded using the Quantity data type. For supporting observations such as Cuff size could use other datatypes such as CodeableConcept. -->
 <value value="[decimal ]"/><!-- ?? 1..1 Numerical value (with implicit precision) -->
 <comparator value="[code ]"/><!-- ?? 0..1 < | <= | >= | > - how to understand the value  -->
 <unit value="[string ]"/><!-- ?? 1..1 Unit representation -->
 <system value="[uri ]"/><!-- ?? 1..1 System that defines coded unit form -->
 <code value="[code ]"/><!-- ?? 1..1 Coded responses from the common UCUM units for vital signs value set.  -->
 </valueQuantity>
 <dataAbsentReason><!-- ?? 0..1 CodeableConcept  Why the result is missing  --></dataAbsentReason>
 <interpretation><!-- ?? 0..* CodeableConcept  High, low, normal, etc.  --></interpretation>
 <note><!-- ?? 0..* Annotation  Comments about the observation --></note>
 <bodySite><!-- ?? 0..1 CodeableConcept  Observed body part  --></bodySite>
 <method><!-- ?? 0..1 CodeableConcept  How it was done  --></method>
 <specimen><!-- ?? 0..1 Reference(Specimen) Specimen used for this observation --></specimen>
 <device><!-- ?? 0..1 Reference(Device) (Measurement) Device --></device>
 <referenceRange> ?? 0..* BackboneElement  <!-- ?? 0..* Provides guide for interpretation -->
 <modifierExtension><!-- ?? 0..* Extension  Extensions that cannot be ignored even if unrecognized  --></modifierExtension>
 <low><!-- ?? 0..1 Quantity  
 Low Range, if relevant --></low>
 <high><!-- ?? 0..1 Quantity  
 High Range, if relevant --></high>
 <type><!-- ?? 0..1 CodeableConcept  Reference range qualifier  --></type>
 <appliesTo><!-- ?? 0..* CodeableConcept  Reference range population  --></appliesTo>
 <age><!-- ?? 0..1 Range  
 Applicable age range, if relevant --></age>
 <text value="[string ]"/><!-- ?? 0..1 Text based reference range in an observation -->
 </referenceRange>
 <hasMember><!-- ?? 0..* Reference(QuestionnaireResponse) 
 Used when reporting vital signs panel components --></hasMember>
 <derivedFrom><!-- ?? 0..* Reference(DocumentReference) 
 Related measurements the observation is made from --></derivedFrom>
 <component> ?? 0..* BackboneElement  <!-- ?? 0..* Used when reporting systolic and diastolic blood pressure. -->
 <modifierExtension><!-- ?? 0..* Extension  Extensions that cannot be ignored even if unrecognized  --></modifierExtension>
 <code><!-- ?? 1..1 CodeableConcept  Type of component observation (code / type)  --></code>
 <value[x]><!-- ?? 0..1 Quantity|CodeableConcept|string|
 boolean|integer|Range|Ratio|SampledData|time|dateTime|Period  Vital Sign Value recorded with UCUM  --></value[x]>
 <dataAbsentReason><!-- ?? 0..1 CodeableConcept  Why the component result is missing  --></dataAbsentReason>
 <interpretation><!-- ?? 0..* CodeableConcept  High, low, normal, etc.  --></interpretation>
 <referenceRange><!-- See #Observation.referenceRange Provides guide for interpretation of component result --></referenceRange>
 </component>
</Observation>

{ // observation-headcircum
 // from Element: extension
 "meta" : { Meta  }, // C?Metadata about the resource
 "implicitRules" : "<uri >", // C?A set of rules under which this content was created
 "language" : "<code >", // C?Language of the resource content 
 "text" : { Narrative  }, // C?Text summary of the resource, for human interpretation
 "contained" : [{ Resource  }], //Contained, inline Resources
 "modifierExtension" : [{ Extension  }], // C?Extensions that cannot be ignored
 "identifier" : [{ Identifier  }], // C?Business Identifier for observation
 "basedOn" : [{ Reference (CarePlan ) }], // C?Fulfills plan, proposal or order
 "partOf" : [{ Reference (MedicationAdministration ) }], // C?Part of referenced event
 "status" : "<code >", // C? R! registered | preliminary | final | amended + 
 "category" : [ //  sliced by value:coding.code, value:coding.system in the specified order, Open 
 { // Classification of type of observation // C? R! 
 // from Element: extension
 "extension" : [ //  sliced by value:url in the specified order, Open ]
 "coding" : [{ Coding  }], // C? R! Code defined by a terminology system
 "text" : "<string >" // C?Plain text representation of the concept
 }
 ],
 "code" : { CodeableConcept  }, // C? R! Head Circumference 
 "subject" : { Reference (Patient ) }, // C? R! Who and/or what the observation is about
 "focus" : [{ Reference (Resource ) }], // C?What the observation is about, when it is not about the subject of record
 "encounter" : { Reference (Encounter ) }, // C?Healthcare event during which this observation is made
// value[x]: Often just a dateTime for Vital Signs. One of these 2:
 "effectiveDateTime" : "<dateTime >", // C? R! Often just a dateTime for Vital Signs
 "effectivePeriod" : { Period  }, // C? R! Often just a dateTime for Vital Signs
 "issued" : "<instant >", // C?Date/Time this version was made available
 "performer" : [{ Reference (Practitioner ) }], // C?Who is responsible for the observation
 "valueQuantity" : [ //  sliced by type:$this in the specified order, Closed 
 { // Vital Signs value are recorded using the Quantity data type. For supporting observations such as Cuff size could use other datatypes such as CodeableConcept. // C?
 // from Element: extension
 "extension" : [ //  sliced by value:url in the specified order, Open ]
 "value" : <decimal >, // C? R! Numerical value (with implicit precision)
 "comparator" : "<code >", // C?< | <= | >= | > - how to understand the value 
 "unit" : "<string >", // C? R! Unit representation
 "system" : "http://unitsofmeasure.org", // C? R! 
 "code" : "<code >" // C? R! Coded responses from the common UCUM units for vital signs value set. 
 }
 ],
 "dataAbsentReason" : { CodeableConcept  }, // C?Why the result is missing 
 "interpretation" : [{ CodeableConcept  }], // C?High, low, normal, etc. 
 "note" : [{ Annotation  }], // C?Comments about the observation
 "bodySite" : { CodeableConcept  }, // C?Observed body part 
 "method" : { CodeableConcept  }, // C?How it was done 
 "specimen" : { Reference (Specimen ) }, // C?Specimen used for this observation
 "device" : { Reference (Device ) }, // C?(Measurement) Device
 "referenceRange" : [{ BackboneElement  }], // C?Provides guide for interpretation
 "hasMember" : [{ Reference (QuestionnaireResponse ) }], // C?Used when reporting vital signs panel components
 "derivedFrom" : [{ Reference (DocumentReference ) }], // C?Related measurements the observation is made from
 "component" : [{ BackboneElement  }], // C?Used when reporting systolic and diastolic blood pressure.
 }

This structure is derived from observation-vitalsigns.

Summary

10.1.27.2.3 Complete Summary of the Mandatory Requirements

  1. One code in Observation.code which must have
    • a fixed Observation.code.coding.system='http ://loinc.org'
    • a fixed Observation.code.coding.code= '9843-4'
    • Other additional Codings are allowed in Observation.code- e.g. more specific LOINC Codes, SNOMED CT concepts, system specific codes. All codes SHALL have an system value
  2. Either one Observation.valueQuantity or, if there is no value, one code in Observation.DataAbsentReason
    • Each Observation.valueQuantity must have:
      • One numeric value in Observation.valueQuantity.value
      • a fixed Observation.valueQuantity.system="http://unitsofmeasure.org"
      • a UCUM unit code in Observation.valueQuantity.code = 'cm', or '[in_i]'

Mandatory: 3 elements (+4 nested mandatory elements)
Must-Support: 4 elements
Fixed Value: 3 elements

Slices

This structure defines the following Slices:

  • The element Observation.code.coding is sliced based on the values of value:code, value:system

Differential View

This structure is derived from observation-vitalsigns.

Name Flags Card. Type Description & Constraints doco
.. Observation 0..*FHIR Head Circumference Profile
... code 1..1CodeableConcept Head Circumference
.... coding (Slice Definition) Slice: Unordered, Open by value:code, value:system
..... coding:HeadCircumCode 1..1Coding
...... system 1..1uri Fixed Value: http://loinc.org
...... code 1..1code Fixed Value: 9843-4
... valueQuantity 0..1Quantity
.... value S1..1decimal
.... unit S1..1string
.... system S1..1uri Fixed Value: http://unitsofmeasure.org
.... code S1..1code Coded responses from the common UCUM units for vital signs value set.
Binding: Body Length Units (required)

doco Documentation for this format

Snapshot View

Name Flags Card. Type Description & Constraints doco
.. Observation I0..*FHIR Head Circumference Profile
... id Σ0..1string Logical id of this artifact
... meta ΣI0..1Meta Metadata about the resource
... implicitRules ?!ΣI0..1uri A set of rules under which this content was created
... language I0..1code Language of the resource content
Binding: Common Languages (preferred)
Max Binding: All Languages
... text I0..1Narrative Text summary of the resource, for human interpretation
... contained 0..*Resource Contained, inline Resources
... extension I0..*Extension Additional content defined by implementations
... modifierExtension ?!I0..*Extension Extensions that cannot be ignored
... identifier ΣI0..*Identifier Business Identifier for observation
... basedOn ΣI0..*Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest)Fulfills plan, proposal or order
... partOf ΣI0..*Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy)Part of referenced event
... status ?!SΣI1..1code registered | preliminary | final | amended +
Binding: ObservationStatus (required)
... category SI(Slice Definition) Classification of type of observation
Slice: Unordered, Open by value:coding.code, value:coding.system
Binding: Observation Category Codes (preferred )
.... category:VSCat SI1..1CodeableConcept Classification of type of observation
Binding: Observation Category Codes (preferred)
..... id 0..1string Unique id for inter-element referencing
..... extension I0..*Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... coding SΣI1..*Coding Code defined by a terminology system
...... id 0..1string Unique id for inter-element referencing
...... extension I0..*Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... system SΣI1..1uri Identity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category
...... version ΣI0..1string Version of the system - if relevant
...... code SΣI1..1code Symbol in syntax defined by the system
Fixed Value: vital-signs
...... display ΣI0..1string Representation defined by the system
...... userSelected ΣI0..1boolean If this coding was chosen directly by the user
..... text ΣI0..1string Plain text representation of the concept
... code SΣI1..1CodeableConcept Head Circumference
Binding: Vital Signs (extensible)
.... id 0..1string Unique id for inter-element referencing
.... extension I0..*Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... coding ΣI(Slice Definition) Code defined by a terminology system
Slice: Unordered, Open by value:code, value:system
..... coding:HeadCircumCode ΣI1..1Coding Code defined by a terminology system
...... id 0..1string Unique id for inter-element referencing
...... extension I0..*Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... system ΣI1..1uri Identity of the terminology system
Fixed Value: http://loinc.org
...... version ΣI0..1string Version of the system - if relevant
...... code ΣI1..1code Symbol in syntax defined by the system
Fixed Value: 9843-4
...... display ΣI0..1string Representation defined by the system
...... userSelected ΣI0..1boolean If this coding was chosen directly by the user
.... text ΣI0..1string Plain text representation of the concept
... subject SΣI1..1Reference(Patient)Who and/or what the observation is about
... focus ΣI0..*Reference(Resource)What the observation is about, when it is not about the subject of record
... encounter ΣI0..1Reference(Encounter)Healthcare event during which this observation is made
... effective[x] SΣI1..1Often just a dateTime for Vital Signs
vs-1: if Observation.effective[x] is dateTime and has a value then that value shall be precise to the day
.... effectiveDateTimedateTime
.... effectivePeriodPeriod
... issued ΣI0..1instant Date/Time this version was made available
... performer ΣI0..*Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson)Who is responsible for the observation
... value[x] SΣI(Slice Definition) Vital Signs value are recorded using the Quantity data type. For supporting observations such as Cuff size could use other datatypes such as CodeableConcept.
Slice: Unordered, Closed by type:$this
.... value[x]:valueQuantity SΣI0..1Quantity Vital Signs value are recorded using the Quantity data type. For supporting observations such as Cuff size could use other datatypes such as CodeableConcept.
..... id 0..1string Unique id for inter-element referencing
..... extension I0..*Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... value SΣI1..1decimal Numerical value (with implicit precision)
..... comparator ?!ΣI0..1code < | <= | >= | > - how to understand the value
Binding: QuantityComparator (required)
..... unit SΣI1..1string Unit representation
..... system SΣI1..1uri System that defines coded unit form
Fixed Value: http://unitsofmeasure.org
..... code SΣI1..1code Coded responses from the common UCUM units for vital signs value set.
Binding: Body Length Units (required)
... dataAbsentReason SI0..1CodeableConcept Why the result is missing
Binding: DataAbsentReason (extensible)
... interpretation I0..*CodeableConcept High, low, normal, etc.
Binding: Observation Interpretation Codes (extensible)
... note I0..*Annotation Comments about the observation
... bodySite I0..1CodeableConcept Observed body part
Binding: SNOMED CT Body Structures (example)
... method I0..1CodeableConcept How it was done
Binding: Observation Methods (example)
... specimen I0..1Reference(Specimen)Specimen used for this observation
... device I0..1Reference(Device | DeviceMetric)(Measurement) Device
... referenceRange I0..*BackboneElement Provides guide for interpretation
obs-3: Must have at least a low or a high or text
.... id 0..1string Unique id for inter-element referencing
.... extension I0..*Extension Additional content defined by implementations
.... modifierExtension ?!ΣI0..*Extension Extensions that cannot be ignored even if unrecognized
.... low I0..1SimpleQuantity Low Range, if relevant
.... high I0..1SimpleQuantity High Range, if relevant
.... type I0..1CodeableConcept Reference range qualifier
Binding: Observation Reference Range Meaning Codes (preferred)
.... appliesTo I0..*CodeableConcept Reference range population
Binding: Observation Reference Range Applies To Codes (example)
.... age I0..1Range Applicable age range, if relevant
.... text I0..1string Text based reference range in an observation
... hasMember ΣI0..*Reference(QuestionnaireResponse | MolecularSequence | Vital Signs Profile)Used when reporting vital signs panel components
... derivedFrom ΣI0..*Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | MolecularSequence | Vital Signs Profile)Related measurements the observation is made from
... component SΣI0..*BackboneElement Used when reporting systolic and diastolic blood pressure.
vs-3: If there is no a value a data absent reason must be present
.... id 0..1string Unique id for inter-element referencing
.... extension I0..*Extension Additional content defined by implementations
.... modifierExtension ?!ΣI0..*Extension Extensions that cannot be ignored even if unrecognized
.... code SΣI1..1CodeableConcept Type of component observation (code / type)
Binding: Vital Signs (extensible)
.... value[x] SΣI0..1Vital Sign Value recorded with UCUM
Binding: Vital Signs Units (required)
..... valueQuantityQuantity
..... valueCodeableConceptCodeableConcept
..... valueStringstring
..... valueBooleanboolean
..... valueIntegerinteger
..... valueRangeRange
..... valueRatioRatio
..... valueSampledDataSampledData
..... valueTimetime
..... valueDateTimedateTime
..... valuePeriodPeriod
.... dataAbsentReason SI0..1CodeableConcept Why the component result is missing
Binding: DataAbsentReason (extensible)
.... interpretation I0..*CodeableConcept High, low, normal, etc.
Binding: Observation Interpretation Codes (extensible)
.... referenceRange I0..*Unknown reference to #Observation.referenceRange
Provides guide for interpretation of component result

doco Documentation for this format

XML Template

<!-- observation-headcircum -->doco 
<Observation xmlns="http://hl7.org/fhir"
>
 <!-- from Element: extension -->
 <id><!-- 0..1 string  Logical id of this artifact --></id>
 <meta><!-- ?? 0..1 Meta  Metadata about the resource --></meta>
 <implicitRules value="[uri ]"/><!-- ?? 0..1 A set of rules under which this content was created -->
 <language value="[code ]"/><!-- ?? 0..1 Language of the resource content  -->
 <text><!-- ?? 0..1 Narrative  
 Text summary of the resource, for human interpretation --></text>
 <contained><!-- 0..* Resource  Contained, inline Resources --></contained>
 <modifierExtension><!-- ?? 0..* Extension  Extensions that cannot be ignored  --></modifierExtension>
 <identifier><!-- ?? 0..* Identifier  
 Business Identifier for observation --></identifier>
 <basedOn><!-- ?? 0..* Reference(CarePlan) Fulfills plan, proposal or order --></basedOn>
 <partOf><!-- ?? 0..* Reference(MedicationAdministration) Part of referenced event --></partOf>
 <status value="[code ]"/><!-- ?? 1..1 registered | preliminary | final | amended +  -->
 <-- category sliced by value:coding.code, value:coding.system in the specified orderOpen-->
 <category> ?? 1..1 CodeableConcept  <!-- ?? 1..1 Classification of type of observation -->
 <coding> ?? 1..* Coding  <!-- ?? 1..* Code defined by a terminology system -->
 <system value="[uri ]"/><!-- ?? 1..1 Identity of the terminology system -->
 <version value="[string ]"/><!-- ?? 0..1 Version of the system - if relevant -->
 <code value="[code ]"/><!-- ?? 1..1 Symbol in syntax defined by the system -->
 <display value="[string ]"/><!-- ?? 0..1 Representation defined by the system -->
 <userSelected value="[boolean ]"/><!-- ?? 0..1 If this coding was chosen directly by the user -->
 </coding>
 <text value="[string ]"/><!-- ?? 0..1 Plain text representation of the concept -->
 </category>
 <code> ?? 1..1 CodeableConcept  <!-- ?? 1..1 Head Circumference -->
 <-- coding sliced by value:code, value:system in the specified orderOpen-->
 <coding> ?? 1..1 Coding  <!-- ?? 1..1 Code defined by a terminology system -->
 <system value="[uri ]"/><!-- ?? 1..1 Identity of the terminology system -->
 <version value="[string ]"/><!-- ?? 0..1 Version of the system - if relevant -->
 <code value="[code ]"/><!-- ?? 1..1 Symbol in syntax defined by the system -->
 <display value="[string ]"/><!-- ?? 0..1 Representation defined by the system -->
 <userSelected value="[boolean ]"/><!-- ?? 0..1 If this coding was chosen directly by the user -->
 </coding>
 <text value="[string ]"/><!-- ?? 0..1 Plain text representation of the concept -->
 </code>
 <subject><!-- ?? 1..1 Reference(Patient) 
 Who and/or what the observation is about --></subject>
 <focus><!-- ?? 0..* Reference(Resource) 
 What the observation is about, when it is not about the subject of record --></focus>
 <encounter><!-- ?? 0..1 Reference(Encounter) 
 Healthcare event during which this observation is made --></encounter>
 <effective[x]><!-- ?? 1..1 dateTime|Period  
 Often just a dateTime for Vital Signs --></effective[x]>
 <issued value="[instant ]"/><!-- ?? 0..1 Date/Time this version was made available -->
 <performer><!-- ?? 0..* Reference(Practitioner) 
 Who is responsible for the observation --></performer>
 <-- valueQuantity sliced by type:$this in the specified orderClosed-->
 <valueQuantity> ?? 0..1 Quantity  <!-- ?? 0..1 Vital Signs value are recorded using the Quantity data type. For supporting observations such as Cuff size could use other datatypes such as CodeableConcept. -->
 <value value="[decimal ]"/><!-- ?? 1..1 Numerical value (with implicit precision) -->
 <comparator value="[code ]"/><!-- ?? 0..1 < | <= | >= | > - how to understand the value  -->
 <unit value="[string ]"/><!-- ?? 1..1 Unit representation -->
 <system value="[uri ]"/><!-- ?? 1..1 System that defines coded unit form -->
 <code value="[code ]"/><!-- ?? 1..1 Coded responses from the common UCUM units for vital signs value set.  -->
 </valueQuantity>
 <dataAbsentReason><!-- ?? 0..1 CodeableConcept  Why the result is missing  --></dataAbsentReason>
 <interpretation><!-- ?? 0..* CodeableConcept  High, low, normal, etc.  --></interpretation>
 <note><!-- ?? 0..* Annotation  Comments about the observation --></note>
 <bodySite><!-- ?? 0..1 CodeableConcept  Observed body part  --></bodySite>
 <method><!-- ?? 0..1 CodeableConcept  How it was done  --></method>
 <specimen><!-- ?? 0..1 Reference(Specimen) Specimen used for this observation --></specimen>
 <device><!-- ?? 0..1 Reference(Device) (Measurement) Device --></device>
 <referenceRange> ?? 0..* BackboneElement  <!-- ?? 0..* Provides guide for interpretation -->
 <modifierExtension><!-- ?? 0..* Extension  Extensions that cannot be ignored even if unrecognized  --></modifierExtension>
 <low><!-- ?? 0..1 Quantity  
 Low Range, if relevant --></low>
 <high><!-- ?? 0..1 Quantity  
 High Range, if relevant --></high>
 <type><!-- ?? 0..1 CodeableConcept  Reference range qualifier  --></type>
 <appliesTo><!-- ?? 0..* CodeableConcept  Reference range population  --></appliesTo>
 <age><!-- ?? 0..1 Range  
 Applicable age range, if relevant --></age>
 <text value="[string ]"/><!-- ?? 0..1 Text based reference range in an observation -->
 </referenceRange>
 <hasMember><!-- ?? 0..* Reference(QuestionnaireResponse) 
 Used when reporting vital signs panel components --></hasMember>
 <derivedFrom><!-- ?? 0..* Reference(DocumentReference) 
 Related measurements the observation is made from --></derivedFrom>
 <component> ?? 0..* BackboneElement  <!-- ?? 0..* Used when reporting systolic and diastolic blood pressure. -->
 <modifierExtension><!-- ?? 0..* Extension  Extensions that cannot be ignored even if unrecognized  --></modifierExtension>
 <code><!-- ?? 1..1 CodeableConcept  Type of component observation (code / type)  --></code>
 <value[x]><!-- ?? 0..1 Quantity|CodeableConcept|string|
 boolean|integer|Range|Ratio|SampledData|time|dateTime|Period  Vital Sign Value recorded with UCUM  --></value[x]>
 <dataAbsentReason><!-- ?? 0..1 CodeableConcept  Why the component result is missing  --></dataAbsentReason>
 <interpretation><!-- ?? 0..* CodeableConcept  High, low, normal, etc.  --></interpretation>
 <referenceRange><!-- See #Observation.referenceRange Provides guide for interpretation of component result --></referenceRange>
 </component>
</Observation>

JSON Template

{ // observation-headcircum
 // from Element: extension
 "meta" : { Meta  }, // C?Metadata about the resource
 "implicitRules" : "<uri >", // C?A set of rules under which this content was created
 "language" : "<code >", // C?Language of the resource content 
 "text" : { Narrative  }, // C?Text summary of the resource, for human interpretation
 "contained" : [{ Resource  }], //Contained, inline Resources
 "modifierExtension" : [{ Extension  }], // C?Extensions that cannot be ignored
 "identifier" : [{ Identifier  }], // C?Business Identifier for observation
 "basedOn" : [{ Reference (CarePlan ) }], // C?Fulfills plan, proposal or order
 "partOf" : [{ Reference (MedicationAdministration ) }], // C?Part of referenced event
 "status" : "<code >", // C? R! registered | preliminary | final | amended + 
 "category" : [ //  sliced by value:coding.code, value:coding.system in the specified order, Open 
 { // Classification of type of observation // C? R! 
 // from Element: extension
 "extension" : [ //  sliced by value:url in the specified order, Open ]
 "coding" : [{ Coding  }], // C? R! Code defined by a terminology system
 "text" : "<string >" // C?Plain text representation of the concept
 }
 ],
 "code" : { CodeableConcept  }, // C? R! Head Circumference 
 "subject" : { Reference (Patient ) }, // C? R! Who and/or what the observation is about
 "focus" : [{ Reference (Resource ) }], // C?What the observation is about, when it is not about the subject of record
 "encounter" : { Reference (Encounter ) }, // C?Healthcare event during which this observation is made
// value[x]: Often just a dateTime for Vital Signs. One of these 2:
 "effectiveDateTime" : "<dateTime >", // C? R! Often just a dateTime for Vital Signs
 "effectivePeriod" : { Period  }, // C? R! Often just a dateTime for Vital Signs
 "issued" : "<instant >", // C?Date/Time this version was made available
 "performer" : [{ Reference (Practitioner ) }], // C?Who is responsible for the observation
 "valueQuantity" : [ //  sliced by type:$this in the specified order, Closed 
 { // Vital Signs value are recorded using the Quantity data type. For supporting observations such as Cuff size could use other datatypes such as CodeableConcept. // C?
 // from Element: extension
 "extension" : [ //  sliced by value:url in the specified order, Open ]
 "value" : <decimal >, // C? R! Numerical value (with implicit precision)
 "comparator" : "<code >", // C?< | <= | >= | > - how to understand the value 
 "unit" : "<string >", // C? R! Unit representation
 "system" : "http://unitsofmeasure.org", // C? R! 
 "code" : "<code >" // C? R! Coded responses from the common UCUM units for vital signs value set. 
 }
 ],
 "dataAbsentReason" : { CodeableConcept  }, // C?Why the result is missing 
 "interpretation" : [{ CodeableConcept  }], // C?High, low, normal, etc. 
 "note" : [{ Annotation  }], // C?Comments about the observation
 "bodySite" : { CodeableConcept  }, // C?Observed body part 
 "method" : { CodeableConcept  }, // C?How it was done 
 "specimen" : { Reference (Specimen ) }, // C?Specimen used for this observation
 "device" : { Reference (Device ) }, // C?(Measurement) Device
 "referenceRange" : [{ BackboneElement  }], // C?Provides guide for interpretation
 "hasMember" : [{ Reference (QuestionnaireResponse ) }], // C?Used when reporting vital signs panel components
 "derivedFrom" : [{ Reference (DocumentReference ) }], // C?Related measurements the observation is made from
 "component" : [{ BackboneElement  }], // C?Used when reporting systolic and diastolic blood pressure.
 }

Alternate definitions: Master Definition (XML, JSON), Schematron

10.1.27.2.4 Terminology Bindings

Path Name Conformance ValueSet
Observation.language Common Languages preferred Common Languages
Observation.status ObservationStatus required ObservationStatus
Observation.category Observation Category Codes preferred Observation Category Codes
Observation.category Observation Category Codes preferred Observation Category Codes
Observation.code Vital Signs extensible Vital Signs
Observation.value[x].comparator QuantityComparator required QuantityComparator
Observation.value[x].code Body Length Units required Body Length Units
Observation.dataAbsentReason DataAbsentReason extensible DataAbsentReason
Observation.interpretation Observation Interpretation Codes extensible Observation Interpretation Codes
Observation.bodySite SNOMED CT Body Structures example SNOMED CT Body Structures
Observation.method Observation Methods example Observation Methods
Observation.referenceRange.type Observation Reference Range Meaning Codes preferred Observation Reference Range Meaning Codes
Observation.referenceRange.appliesTo Observation Reference Range Applies To Codes example Observation Reference Range Applies To Codes
Observation.component.code Vital Signs extensible Vital Signs
Observation.component.value[x] Vital Signs Units required Vital Signs Units
Observation.component.dataAbsentReason DataAbsentReason extensible DataAbsentReason
Observation.component.interpretation Observation Interpretation Codes extensible Observation Interpretation Codes

10.1.27.2.5 Constraints

Id Path Details Requirements
Rule vs-1 Observation.effective[x] if Observation.effective[x] is dateTime and has a value then that value shall be precise to the day
Expression : ($this as dateTime).toString().length() >= 8
Rule obs-3 Observation.referenceRange Must have at least a low or a high or text
Expression : low.exists() or high.exists() or text.exists()
Rule vs-3 Observation.component If there is no a value a data absent reason must be present
Expression : value.exists() or dataAbsentReason.exists()
.

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