US Veterans Health Administration FHIR Map Set Implementation Guide
1.3.1 - 250401 United States of America flag

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Resource Profile: LabObservation - Mappings

Active as of 2025-03-31

Mappings for the LabObservation resource profile.

Scroll down for the Raw FHIR, CDW & SDA mappings (if any).

Note that the CDW and SDA mappings are derived from a look-up based on the VistA source mappings in CDW and VPR SDA.

Mapping Sources

Use Case: Lab Observation (Source)PATIENT (2)63LABORATORY REFERENCELAB DATA (63).01LRDFN

Raw Mappings

key status direction source mapApproach mapCase FHIR Path subPath mapValue mapParameter mapComment FHIR URL | Ver
843 for review V2F fixed value Observation.category[Laboratory] http://terminology.hl7.org/CodeSystem/observation-category#laboratory http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-lab | 5.0.1
844 for review V2F PATIENT - LABORATORY REFERENCE > LAB DATA - LRDFN (2-63 > 63-.01) reference Observation.subject /Patient Pointer from PATIENT (2) http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-lab | 5.0.1

Mappings for Veterans Health Information Systems Technology and Architecture (VistA) ()

LabObservation
Observation
   category (Laboratory)843: fixed value = http://terminology.hl7.org/CodeSystem/observation-category#laboratory
   subject844: reference based on PATIENT - LABORATORY REFERENCE > LAB DATA - LRDFN (2-63 > 63-.01)

Pointer from PATIENT (2)

Mappings for Clinical Data Warehouse (CDW) ()

LabObservation
Observation
   subjectMicro.AntibioticSensitivity.LRDFN,Micro.AntibioticSensitivityComment.LRDFN,Micro.BacteriologyReports.LRDFN,Micro.MicroAntibioticLevel.LRDFN,Micro.MicroAudit.LRDFN,Micro.Microbiology.LRDFN,Micro.MicroOrderedTest.LRDFN,Micro.MicroSterilityResults.LRDFN,Micro.MycobacteriologyReports.LRDFN,Micro.Mycology.LRDFN,Micro.MycologyReports.LRDFN,Micro.Parasitology.LRDFN,Micro.ParasitologyReports.LRDFN,Micro.ParasitologyStage.LRDFN,Micro.Virology.LRDFN,Micro.VirologyReports.LRDFN,Pathology.Autopsy.LRDFN,Pathology.CytoOrganTissueFunction.StaffIEN,SStaff.SMicroOrderedTest.LRDFN

Mappings for Summary Document Architecure (SDA) ()

LabObservation
Observation
   subjectPatient.Extension[PatientExtension].VeteranLrdfn

Mappings for Workflow Pattern (http://hl7.org/fhir/workflow)

LabObservation
ObservationEvent
   identifierEvent.identifier
   basedOnEvent.basedOn
   partOfEvent.partOf
   statusEvent.status
   codeEvent.code
   subjectEvent.subject
   encounterEvent.context
   effective[x]Event.occurrence[x]
   performerEvent.performer.actor

Mappings for SNOMED CT Concept Domain Binding (http://snomed.info/conceptdomain)

LabObservation
Observation< 363787002 |Observable entity|
   status< 445584004 |Report by finality status|
   code< 363787002 |Observable entity| OR < 386053000 |Evaluation procedure|
   value[x]< 441742003 |Evaluation finding|
   interpretation< 260245000 |Findings values|
   bodySite< 123037004 |Body structure|
   specimen< 123038009 |Specimen|
   device< 49062001 |Device|
   referenceRange
      type< 260245000 |Findings values| OR < 365860008 |General clinical state finding| OR < 250171008 |Clinical history or observation findings| OR < 415229000 |Racial group| OR < 365400002 |Finding of puberty stage| OR < 443938003 |Procedure carried out on subject|
      appliesTo< 260245000 |Findings values| OR < 365860008 |General clinical state finding| OR < 250171008 |Clinical history or observation findings| OR < 415229000 |Racial group| OR < 365400002 |Finding of puberty stage| OR < 443938003 |Procedure carried out on subject|
   component
      code< 363787002 |Observable entity| OR < 386053000 |Evaluation procedure|
      value[x]363714003 |Interprets| < 441742003 |Evaluation finding|
      interpretation< 260245000 |Findings values|

Mappings for HL7 v2 Mapping (http://hl7.org/v2)

LabObservation
ObservationOBX
   identifierOBX.21 For OBX segments from systems without OBX-21 support a combination of ORC/OBR and OBX must be negotiated between trading partners to uniquely identify the OBX segment. Depending on how V2 has been implemented each of these may be an option: 1) OBR-3 + OBX-3 + OBX-4 or 2) OBR-3 + OBR-4 + OBX-3 + OBX-4 or 2) some other way to uniquely ID the OBR/ORC + OBX-3 + OBX-4.
   basedOnORC
   partOfVaries by domain
   statusOBX-11
   codeOBX-3
   subjectPID-3
   focusOBX-3
   encounterPV1
   effective[x]OBX-14, and/or OBX-19 after v2.4 (depends on who observation made)
   issuedOBR.22 (or MSH.7), or perhaps OBX-19 (depends on who observation made)
   performerOBX.15 / (Practitioner) OBX-16, PRT-5:PRT-4='RO' / (Device) OBX-18 , PRT-10:PRT-4='EQUIP' / (Organization) OBX-23, PRT-8:PRT-4='PO'
   value[x]OBX.2, OBX.5, OBX.6
   dataAbsentReasonN/A
   interpretationOBX-8
   noteNTE.3 (partner NTE to OBX, or sometimes another (child?) OBX)
   bodySiteOBX-20
   methodOBX-17
   specimenSPM segment
   deviceOBX-17 / PRT -10
   referenceRangeOBX.7
      lowOBX-7
      highOBX-7
      typeOBX-10
      appliesToOBX-10
      textOBX-7
   hasMemberRelationships established by OBX-4 usage
   derivedFromRelationships established by OBX-4 usage
   componentcontainment by OBX-4?
      codeOBX-3
      value[x]OBX.2, OBX.5, OBX.6
      dataAbsentReasonN/A
      interpretationOBX-8
      referenceRangeOBX.7

Mappings for RIM Mapping (http://hl7.org/v3)

LabObservation
ObservationEntity. Role, or Act, Observation[classCode=OBS, moodCode=EVN]
   textAct.text?
   containedN/A
   extensionN/A
   modifierExtensionN/A
   identifierid
   basedOn.inboundRelationship[typeCode=COMP].source[moodCode=EVN]
   partOf.outboundRelationship[typeCode=FLFS].target
   statusstatus Amended & Final are differentiated by whether it is the subject of a ControlAct event with a type of "revise"
   category.outboundRelationship[typeCode="COMP].target[classCode="LIST", moodCode="EVN"].code
   category (Laboratory).outboundRelationship[typeCode="COMP].target[classCode="LIST", moodCode="EVN"].code
   codecode
   subjectparticipation[typeCode=RTGT]
   focusparticipation[typeCode=SBJ]
   encounterinboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN]
   effective[x]effectiveTime
   issuedparticipation[typeCode=AUT].time
   performerparticipation[typeCode=PRF]
   value[x]value
   dataAbsentReasonvalue.nullFlavor
   interpretationinterpretationCode
   notesubjectOf.observationEvent[code="annotation"].value
   bodySitetargetSiteCode
   methodmethodCode
   specimenparticipation[typeCode=SPC].specimen
   deviceparticipation[typeCode=DEV]
   referenceRangeoutboundRelationship[typeCode=REFV]/target[classCode=OBS, moodCode=EVN]
      idn/a
      extensionn/a
      modifierExtensionN/A
      lowvalue:IVL_PQ.low
      highvalue:IVL_PQ.high
      typeinterpretationCode
      appliesTointerpretationCode
      ageoutboundRelationship[typeCode=PRCN].targetObservationCriterion[code="age"].value
      textvalue:ST
   hasMemberoutBoundRelationship
   derivedFrom.targetObservation
   componentoutBoundRelationship[typeCode=COMP]
      idn/a
      extensionn/a
      modifierExtensionN/A
      codecode
      value[x]value
      dataAbsentReasonvalue.nullFlavor
      interpretationinterpretationCode
      referenceRangeoutboundRelationship[typeCode=REFV]/target[classCode=OBS, moodCode=EVN]

Mappings for FiveWs Pattern Mapping (http://hl7.org/fhir/fivews)

LabObservation
Observation
   identifierFiveWs.identifier
   statusFiveWs.status
   categoryFiveWs.class
   category (Laboratory)FiveWs.class
   codeFiveWs.what[x]
   subjectFiveWs.subject[x], FiveWs.subject
   focusFiveWs.subject[x], FiveWs.subject
   encounterFiveWs.context
   effective[x]FiveWs.done[x]
   issuedFiveWs.recorded
   performerFiveWs.actor
   component
      codeFiveWs.what[x]

Mappings for SNOMED CT Attribute Binding (http://snomed.org/attributebinding)

LabObservation
Observation
   code116680003 |Is a|
   value[x]363714003 |Interprets|
   interpretation363713009 |Has interpretation|
   bodySite718497002 |Inherent location|
   specimen704319004 |Inherent in|
   device424226004 |Using device|
   component
      value[x]363714003 |Interprets|
      interpretation363713009 |Has interpretation|