Name	Flags	Card.	Type	Description & Constraints
Observation	C	0..*	USCoreVitalSignsProfile	US Core Vital Signs Profile This profile also complies with the profiles US Core Vital Signs Profile (6.1.0) and US Core Vital Signs Profile (7.0.0) dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated dom-5: If a resource is contained in another resource, it SHALL NOT have a security label dom-6: A resource should have narrative for robust management obs-6: dataAbsentReason SHALL only be present if Observation.value[x] is not present obs-7: If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present vs-2: If there is no component or hasMember element then either a value[x] or a data absent reason must be present.
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created ele-1: All FHIR elements must have a @value or children
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
extension:observation-deviceCode		0..1	(Complex)	A code representing the the type of device used for this observation. Should only be used if not implicit in the code found in `Observation.code` URL: http://hl7.org/fhir/StructureDefinition/observation-deviceCode ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
extension		0..0
url		1..1	uri	"http://hl7.org/fhir/StructureDefinition/observation-deviceCode"
value[x]	S	1..1	CodeableConcept	Value of extension Binding: VitalsMeasurementDevice FHIR (required): see mapping VF_VitalsMeasurementDevice ele-1: All FHIR elements must have a @value or children
extension:observation-bodyPosition		0..1	(Complex)	The body position during the observation URL: http://hl7.org/fhir/StructureDefinition/observation-bodyPosition ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
extension		0..0
url		1..1	uri	"http://hl7.org/fhir/StructureDefinition/observation-bodyPosition"
value[x]	S	1..1	CodeableConcept	Value of extension Binding: VitalsBodyPosition FHIR (required): see mapping VF_VitalsBodyPosition ele-1: All FHIR elements must have a @value or children
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
identifier	Σ	0..*	Identifier	Business Identifier for observation ele-1: All FHIR elements must have a @value or children
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known . ele-1: All FHIR elements must have a @value or children
system	SΣ	0..1	uri	The namespace for the identifier value ele-1: All FHIR elements must have a @value or children Required Pattern: http://va.gov/identifiers/$Sta3n/120.5
value	SΣ	0..1	string	The value that is unique ele-1: All FHIR elements must have a @value or children Example General: 123456
status	?!SΣC	1..1	code	registered | preliminary | final | amended + Binding: ObservationStatus (required) ele-1: All FHIR elements must have a @value or children vs-10-655: If (120.5-4) is null then fixed value #final vs-10-656: If (120.5-4) is not null then fixed value #entered-in-error
Slices for category	S	1..*	CodeableConcept	Classification of type of observation Slice: Unordered, Open by value:coding.code, value:coding.system Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories. ele-1: All FHIR elements must have a @value or children
category:VSCat	S	1..1	CodeableConcept	Classification of type of observation Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories. ele-1: All FHIR elements must have a @value or children Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category
code		1..1	code	Symbol in syntax defined by the system Fixed Value: vital-signs
coding	SΣ	1..*	Coding	Code defined by a terminology system ele-1: All FHIR elements must have a @value or children
system	SΣ	1..1	uri	Identity of the terminology system ele-1: All FHIR elements must have a @value or children Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category
code	SΣ	1..1	code	Symbol in syntax defined by the system ele-1: All FHIR elements must have a @value or children Fixed Value: vital-signs
code	SΣ	1..1	CodeableConcept	Coded Responses from C-CDA Vital Sign Results Binding: US Core Vital Signs ValueSet (extensible): The vital sign codes from the base FHIR and US Core Vital Signs. ele-1: All FHIR elements must have a @value or children
coding	SΣ	0..*	Coding	Code defined by a terminology system Binding: VitalsCodes FHIR (required): see mapping VF_VitalsCodes ele-1: All FHIR elements must have a @value or children
subject	SΣ	1..1	Reference(Patient)	Who and/or what the observation is about ele-1: All FHIR elements must have a @value or children
Slices for effective[x]	SΣC	1..1		Often just a dateTime for Vital Signs Slice: Unordered, Open by type:$this ele-1: All FHIR elements must have a @value or children vs-1: if Observation.effective[x] is dateTime and has a value then that value shall be precise to the day
effectiveDateTime			dateTime
effective[x]:effectiveDateTime	SΣC	0..1	dateTime	Often just a dateTime for Vital Signs ele-1: All FHIR elements must have a @value or children vs-1: if Observation.effective[x] is dateTime and has a value then that value shall be precise to the day
issued	SΣ	0..1	instant	Date/Time this version was made available ele-1: All FHIR elements must have a @value or children
performer	SΣ	0..*	Reference(Organization)	Who is responsible for the observation ele-1: All FHIR elements must have a @value or children
Slices for value[x]	SΣC	0..1		Vital Signs Value Slice: Unordered, Open by type:$this Binding: VitalSignsUnits (extensible): Common UCUM units for recording Vital Signs. ele-1: All FHIR elements must have a @value or children
valueQuantity			Quantity
value[x]:valueQuantity	SΣC	0..1	Quantity	Vital Signs Value Binding: VitalSignsUnits (extensible): Common UCUM units for recording Vital Signs. ele-1: All FHIR elements must have a @value or children
value	SΣC	0..1	decimal	Numerical value (with implicit precision) ele-1: All FHIR elements must have a @value or children vs-10-664: If VUID not = 4500634 then source value from (120.5-1.2)
comparator	?!Σ	0..1	code	< | <= | >= | > - how to understand the value Binding: QuantityComparator (required): How the Quantity should be understood and represented. ele-1: All FHIR elements must have a @value or children
code	SΣ	0..1	code	Coded form of the unit ele-1: All FHIR elements must have a @value or children
dataAbsentReason	SC	0..1	CodeableConcept	Why the result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing. ele-1: All FHIR elements must have a @value or children
bodySite	S	0..1	CodeableConcept	Observed body part Binding: VitalsBodySite FHIR (required): see mapping VF_VitalsBodySite ele-1: All FHIR elements must have a @value or children
method	S	0..1	CodeableConcept	How it was done Binding: VitalsMethod FHIR (required): see mapping VF_VitalsMethod ele-1: All FHIR elements must have a @value or children
Slices for component	SΣC	0..*	BackboneElement	Component observations Slice: Unordered, Open by pattern:code ele-1: All FHIR elements must have a @value or children vs-3: If there is no a value a data absent reason must be present
component:All Slices				Content/Rules for all slices
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
code	SΣ	1..1	CodeableConcept	Type of component observation (code / type) Binding: US Core Vital Signs ValueSet (extensible): The vital sign codes from the base FHIR and US Core Vital Signs. ele-1: All FHIR elements must have a @value or children
value[x]	SΣC	0..1		Vital Sign Component Value Binding: VitalSignsUnits (extensible): Common UCUM units for recording Vital Signs. ele-1: All FHIR elements must have a @value or children
valueQuantity			Quantity
dataAbsentReason	SC	0..1	CodeableConcept	Why the component result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing. ele-1: All FHIR elements must have a @value or children
component:va-pre-condition	SΣC	0..1	BackboneElement	Component observations ele-1: All FHIR elements must have a @value or children vs-3: If there is no a value a data absent reason must be present
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
code	SΣ	1..1	CodeableConcept	Type of component observation (code / type) Binding: US Core Vital Signs ValueSet (extensible): The vital sign codes from the base FHIR and US Core Vital Signs. ele-1: All FHIR elements must have a @value or children Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 104158-1
display		1..1	string	Representation defined by the system Fixed Value: Associated precondition - Reported
Slices for value[x]	SΣC	0..1		Vital Sign Component Value Slice: Unordered, Open by type:$this Binding: VitalSignsUnits (extensible): Common UCUM units for recording Vital Signs. ele-1: All FHIR elements must have a @value or children
valueQuantity			Quantity
value[x]:valueCodeableConcept	SΣC	0..1	CodeableConcept	Vital Sign Component Value Binding: VitalsPrecondition FHIR (required): see mapping VF_VitalsPrecondition ele-1: All FHIR elements must have a @value or children
dataAbsentReason	SC	0..1	CodeableConcept	Why the component result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing. ele-1: All FHIR elements must have a @value or children
component:va-pre-condition-device	SΣC	0..1	BackboneElement	Component observations ele-1: All FHIR elements must have a @value or children vs-3: If there is no a value a data absent reason must be present
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
code	SΣ	1..1	CodeableConcept	Type of component observation (code / type) Binding: US Core Vital Signs ValueSet (extensible): The vital sign codes from the base FHIR and US Core Vital Signs. ele-1: All FHIR elements must have a @value or children Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 104158-1
display		1..1	string	Representation defined by the system Fixed Value: Associated precondition - Reported
Slices for value[x]	SΣC	0..1		Vital Sign Component Value Slice: Unordered, Open by type:$this Binding: VitalSignsUnits (extensible): Common UCUM units for recording Vital Signs. ele-1: All FHIR elements must have a @value or children
valueQuantity			Quantity
value[x]:valueCodeableConcept	SΣC	0..1	CodeableConcept	Vital Sign Component Value Binding: VitalsQualifyingDevice FHIR (required): see mapping VF_VitalsQualifyingDevice ele-1: All FHIR elements must have a @value or children
dataAbsentReason	SC	0..1	CodeableConcept	Why the component result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing. ele-1: All FHIR elements must have a @value or children
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
Observation.extension:observation-deviceCode.value[x]	required	VitalsMeasurementDevice http://va.gov/fhir/ValueSet/VitalsMeasurementDevice from this IG
Observation.extension:observation-bodyPosition.value[x]	required	VitalsBodyPosition http://va.gov/fhir/ValueSet/VitalsBodyPosition from this IG
Observation.identifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 from the FHIR Standard
Observation.status	required	ObservationStatus http://hl7.org/fhir/ValueSet/observation-status|4.0.1 from the FHIR Standard
Observation.category	preferred	ObservationCategoryCodes http://hl7.org/fhir/ValueSet/observation-category from the FHIR Standard
Observation.category:VSCat	preferred	Pattern: vital-signs http://hl7.org/fhir/ValueSet/observation-category from the FHIR Standard
Observation.code	extensible	UsCoreVitalSigns http://hl7.org/fhir/us/core/ValueSet/us-core-vital-signs
Observation.code.coding	required	VitalsCodes http://va.gov/fhir/ValueSet/VitalsCodes from this IG
Observation.value[x]	extensible	VitalSignsUnits http://hl7.org/fhir/ValueSet/ucum-vitals-common|4.0.1 from the FHIR Standard
Observation.value[x]:valueQuantity	extensible	VitalSignsUnits http://hl7.org/fhir/ValueSet/ucum-vitals-common|4.0.1 from the FHIR Standard
Observation.value[x]:valueQuantity.comparator	required	QuantityComparator http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1 from the FHIR Standard
Observation.dataAbsentReason	extensible	DataAbsentReason http://hl7.org/fhir/ValueSet/data-absent-reason from the FHIR Standard
Observation.bodySite	required	VitalsBodySite http://va.gov/fhir/ValueSet/VitalsBodySite from this IG
Observation.method	required	VitalsMethod http://va.gov/fhir/ValueSet/VitalsMethod from this IG
Observation.component.code	extensible	UsCoreVitalSigns http://hl7.org/fhir/us/core/ValueSet/us-core-vital-signs
Observation.component.value[x]	extensible	VitalSignsUnits http://hl7.org/fhir/ValueSet/ucum-vitals-common|4.0.1 from the FHIR Standard
Observation.component.dataAbsentReason	extensible	DataAbsentReason http://hl7.org/fhir/ValueSet/data-absent-reason from the FHIR Standard
Observation.component:va-pre-condition.code	extensible	Pattern: LOINC Code 104158-1("Associated precondition - Reported") http://hl7.org/fhir/us/core/ValueSet/us-core-vital-signs
Observation.component:va-pre-condition.value[x]	extensible	VitalSignsUnits http://hl7.org/fhir/ValueSet/ucum-vitals-common|4.0.1 from the FHIR Standard
Observation.component:va-pre-condition.value[x]:valueCodeableConcept	required	VitalsPrecondition http://va.gov/fhir/ValueSet/VitalsPrecondition from this IG
Observation.component:va-pre-condition.dataAbsentReason	extensible	DataAbsentReason http://hl7.org/fhir/ValueSet/data-absent-reason from the FHIR Standard
Observation.component:va-pre-condition-device.code	extensible	Pattern: LOINC Code 104158-1("Associated precondition - Reported") http://hl7.org/fhir/us/core/ValueSet/us-core-vital-signs
Observation.component:va-pre-condition-device.value[x]	extensible	VitalSignsUnits http://hl7.org/fhir/ValueSet/ucum-vitals-common|4.0.1 from the FHIR Standard
Observation.component:va-pre-condition-device.value[x]:valueCodeableConcept	required	VitalsQualifyingDevice http://va.gov/fhir/ValueSet/VitalsQualifyingDevice from this IG
Observation.component:va-pre-condition-device.dataAbsentReason	extensible	DataAbsentReason http://hl7.org/fhir/ValueSet/data-absent-reason from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
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 or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).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()
dom-5	error	Observation	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Observation	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.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 Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present : value.empty() or component.code.where(coding.intersect(%resource.code.coding).exists()).empty()
vs-1	error	Observation.effective[x], Observation.effective[x]:effectiveDateTime	if Observation.effective[x] is dateTime and has a value then that value shall be precise to the day : $this is dateTime implies $this.toString().length() >= 10
vs-2	error	Observation	If there is no component or hasMember element then either a value[x] or a data absent reason must be present. : (component.empty() and hasMember.empty()) implies (dataAbsentReason.exists() or value.exists())
vs-3	error	Observation.component, Observation.component:va-pre-condition, Observation.component:va-pre-condition-device	If there is no a value a data absent reason must be present : value.exists() or dataAbsentReason.exists()
vs-10-655	warning	Observation.status	If (120.5-4) is null then fixed value #final : true
vs-10-656	warning	Observation.status	If (120.5-4) is not null then fixed value #entered-in-error : true
vs-10-664	warning	Observation.value[x]:valueQuantity.value	If VUID not = 4500634 then source value from (120.5-1.2) : true

Name	Flags	Card.	Type	Description & Constraints
Observation		0..*	USCoreVitalSignsProfile	US Core Vital Signs Profile This profile also complies with the profiles US Core Vital Signs Profile (6.1.0) and US Core Vital Signs Profile (7.0.0)
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:observation-deviceCode		0..1	(Complex)	A code representing the the type of device used for this observation. Should only be used if not implicit in the code found in `Observation.code` URL: http://hl7.org/fhir/StructureDefinition/observation-deviceCode
value[x]	S	1..1	CodeableConcept	Value of extension Binding: VitalsMeasurementDevice FHIR (required): see mapping VF_VitalsMeasurementDevice
extension:observation-bodyPosition		0..1	(Complex)	The body position during the observation URL: http://hl7.org/fhir/StructureDefinition/observation-bodyPosition
value[x]	S	1..1	CodeableConcept	Value of extension Binding: VitalsBodyPosition FHIR (required): see mapping VF_VitalsBodyPosition
identifier
system	S	0..1	uri	The namespace for the identifier value Required Pattern: http://va.gov/identifiers/$Sta3n/120.5
value	S	0..1	string	The value that is unique
status	C	1..1	code	registered | preliminary | final | amended + vs-10-655: If (120.5-4) is null then fixed value #final vs-10-656: If (120.5-4) is not null then fixed value #entered-in-error
Slices for category				Content/Rules for all slices
category:VSCat		1..1	CodeableConcept	Classification of type of observation Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category
code		1..1	code	Symbol in syntax defined by the system Fixed Value: vital-signs
code
coding	S	0..*	Coding	Code defined by a terminology system Binding: VitalsCodes FHIR (required): see mapping VF_VitalsCodes
subject		1..1	Reference(Patient)	Who and/or what the observation is about
Slices for effective[x]		1..1	dateTime, Period	Often just a dateTime for Vital Signs Slice: Unordered, Open by type:$this
effective[x]:effectiveDateTime	S	0..1	dateTime S	Often just a dateTime for Vital Signs
issued	S	0..1	instant	Date/Time this version was made available
performer	S	0..*	Reference(Organization)	Who is responsible for the observation
Slices for value[x]		0..1	Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period	Vital Signs Value Slice: Unordered, Open by type:$this
value[x]:valueQuantity		0..1	Quantity	Vital Signs Value
value	SC	0..1	decimal	Numerical value (with implicit precision) vs-10-664: If VUID not = 4500634 then source value from (120.5-1.2)
code	S	0..1	code	Coded form of the unit
bodySite	S	0..1	CodeableConcept	Observed body part Binding: VitalsBodySite FHIR (required): see mapping VF_VitalsBodySite
method	S	0..1	CodeableConcept	How it was done Binding: VitalsMethod FHIR (required): see mapping VF_VitalsMethod
Slices for component		0..*	BackboneElement	Component observations Slice: Unordered, Open by pattern:code
component:va-pre-condition		0..1	BackboneElement	Component observations
code		1..1	CodeableConcept	Type of component observation (code / type) Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 104158-1
display		1..1	string	Representation defined by the system Fixed Value: Associated precondition - Reported
Slices for value[x]		0..1	Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period	Vital Sign Component Value Slice: Unordered, Open by type:$this
value[x]:valueCodeableConcept	S	0..1	CodeableConcept	Vital Sign Component Value Binding: VitalsPrecondition FHIR (required): see mapping VF_VitalsPrecondition
component:va-pre-condition-device		0..1	BackboneElement	Component observations
code		1..1	CodeableConcept	Type of component observation (code / type) Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 104158-1
display		1..1	string	Representation defined by the system Fixed Value: Associated precondition - Reported
Slices for value[x]		0..1	Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period	Vital Sign Component Value Slice: Unordered, Open by type:$this
value[x]:valueCodeableConcept	S	0..1	CodeableConcept	Vital Sign Component Value Binding: VitalsQualifyingDevice FHIR (required): see mapping VF_VitalsQualifyingDevice
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
Observation.extension:observation-deviceCode.value[x]	required	VitalsMeasurementDevice http://va.gov/fhir/ValueSet/VitalsMeasurementDevice from this IG
Observation.extension:observation-bodyPosition.value[x]	required	VitalsBodyPosition http://va.gov/fhir/ValueSet/VitalsBodyPosition from this IG
Observation.code.coding	required	VitalsCodes http://va.gov/fhir/ValueSet/VitalsCodes from this IG
Observation.bodySite	required	VitalsBodySite http://va.gov/fhir/ValueSet/VitalsBodySite from this IG
Observation.method	required	VitalsMethod http://va.gov/fhir/ValueSet/VitalsMethod from this IG
Observation.component:va-pre-condition.value[x]:valueCodeableConcept	required	VitalsPrecondition http://va.gov/fhir/ValueSet/VitalsPrecondition from this IG
Observation.component:va-pre-condition-device.value[x]:valueCodeableConcept	required	VitalsQualifyingDevice http://va.gov/fhir/ValueSet/VitalsQualifyingDevice from this IG

Constraints

Id	Grade	Path(s)	Details	Requirements
vs-10-655	warning	Observation.status	If (120.5-4) is null then fixed value #final : true
vs-10-656	warning	Observation.status	If (120.5-4) is not null then fixed value #entered-in-error : true
vs-10-664	warning	Observation.value[x]:valueQuantity.value	If VUID not = 4500634 then source value from (120.5-1.2) : true

Name	Flags	Card.	Type	Description & Constraints
Observation	C	0..*	USCoreVitalSignsProfile	US Core Vital Signs Profile This profile also complies with the profiles US Core Vital Signs Profile (6.1.0) and US Core Vital Signs Profile (7.0.0) obs-6: dataAbsentReason SHALL only be present if Observation.value[x] is not present obs-7: If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present vs-2: If there is no component or hasMember element then either a value[x] or a data absent reason must be 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: CommonLanguages (preferred): 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
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:observation-deviceCode		0..1	(Complex)	A code representing the the type of device used for this observation. Should only be used if not implicit in the code found in `Observation.code` URL: http://hl7.org/fhir/StructureDefinition/observation-deviceCode
id		0..1	id	Unique id for inter-element referencing
extension		0..0
url		1..1	uri	"http://hl7.org/fhir/StructureDefinition/observation-deviceCode"
value[x]	S	1..1	CodeableConcept	Value of extension Binding: VitalsMeasurementDevice FHIR (required): see mapping VF_VitalsMeasurementDevice
extension:observation-bodyPosition		0..1	(Complex)	The body position during the observation URL: http://hl7.org/fhir/StructureDefinition/observation-bodyPosition
id		0..1	id	Unique id for inter-element referencing
extension		0..0
url		1..1	uri	"http://hl7.org/fhir/StructureDefinition/observation-bodyPosition"
value[x]	S	1..1	CodeableConcept	Value of extension Binding: VitalsBodyPosition FHIR (required): see mapping VF_VitalsBodyPosition
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	0..*	Identifier	Business Identifier for observation
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type	Σ	0..1	CodeableConcept	Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
system	SΣ	0..1	uri	The namespace for the identifier value Required Pattern: http://va.gov/identifiers/$Sta3n/120.5
value	SΣ	0..1	string	The value that is unique Example General: 123456
period	Σ	0..1	Period	Time period when id is/was valid for use
assigner	Σ	0..1	Reference(Organization)	Organization that issued id (may be just text)
basedOn	Σ	0..*	Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest)	Fulfills plan, proposal or order
partOf	Σ	0..*	Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy)	Part of referenced event
status	?!SΣC	1..1	code	registered | preliminary | final | amended + Binding: ObservationStatus (required) vs-10-655: If (120.5-4) is null then fixed value #final vs-10-656: If (120.5-4) is not null then fixed value #entered-in-error
Slices for category	S	1..*	CodeableConcept	Classification of type of observation Slice: Unordered, Open by value:coding.code, value:coding.system Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
category:VSCat	S	1..1	CodeableConcept	Classification of type of observation Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: vital-signs
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
coding	SΣ	1..*	Coding	Code defined by a terminology system
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	SΣ	1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category
version	Σ	0..1	string	Version of the system - if relevant
code	SΣ	1..1	code	Symbol in syntax defined by the system Fixed Value: vital-signs
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
code	SΣ	1..1	CodeableConcept	Coded Responses from C-CDA Vital Sign Results Binding: US Core Vital Signs ValueSet (extensible): The vital sign codes from the base FHIR and US Core Vital Signs.
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
coding	SΣ	0..*	Coding	Code defined by a terminology system Binding: VitalsCodes FHIR (required): see mapping VF_VitalsCodes
text	Σ	0..1	string	Plain text representation of the concept
subject	SΣ	1..1	Reference(Patient)	Who and/or what the observation is about
focus	Σ	0..*	Reference(Resource)	What the observation is about, when it is not about the subject of record
encounter	Σ	0..1	Reference(Encounter)	Healthcare event during which this observation is made
Slices for effective[x]	SΣC	1..1		Often just a dateTime for Vital Signs Slice: Unordered, Open by type:$this vs-1: if Observation.effective[x] is dateTime and has a value then that value shall be precise to the day
effectiveDateTime			dateTime S
effectivePeriod			Period
effective[x]:effectiveDateTime	SΣC	0..1	dateTime S	Often 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
issued	SΣ	0..1	instant	Date/Time this version was made available
performer	SΣ	0..*	Reference(Organization)	Who is responsible for the observation
Slices for value[x]	SΣC	0..1		Vital Signs Value Slice: Unordered, Open by type:$this Binding: VitalSignsUnits (extensible): Common UCUM units for recording Vital Signs.
valueQuantity			Quantity S
valueCodeableConcept			CodeableConcept
valueString			string
valueBoolean			boolean
valueInteger			integer
valueRange			Range
valueRatio			Ratio
valueSampledData			SampledData
valueTime			time
valueDateTime			dateTime
valuePeriod			Period
value[x]:valueQuantity	SΣC	0..1	Quantity S	Vital Signs Value Binding: VitalSignsUnits (extensible): Common UCUM units for recording Vital Signs.
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
value	SΣC	0..1	decimal	Numerical value (with implicit precision) vs-10-664: If VUID not = 4500634 then source value from (120.5-1.2)
comparator	?!Σ	0..1	code	< | <= | >= | > - how to understand the value Binding: QuantityComparator (required): How the Quantity should be understood and represented.
unit	Σ	0..1	string	Unit representation
system	ΣC	0..1	uri	System that defines coded unit form
code	SΣ	0..1	code	Coded form of the unit
dataAbsentReason	SC	0..1	CodeableConcept	Why the result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation		0..*	CodeableConcept	High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
note		0..*	Annotation	Comments about the observation
bodySite	S	0..1	CodeableConcept	Observed body part Binding: VitalsBodySite FHIR (required): see mapping VF_VitalsBodySite
method	S	0..1	CodeableConcept	How it was done Binding: VitalsMethod FHIR (required): see mapping VF_VitalsMethod
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	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
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: ObservationReferenceRangeMeaningCodes (preferred): Code for the meaning of a reference range.
appliesTo		0..*	CodeableConcept	Reference range population Binding: ObservationReferenceRangeAppliesToCodes (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
hasMember	Σ	0..*	Reference(QuestionnaireResponse | MolecularSequence | Vital Signs Profile)	Used when reporting vital signs panel components
derivedFrom	Σ	0..*	Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | MolecularSequence | Vital Signs Profile)	Related measurements the observation is made from
Slices for component	SΣC	0..*	BackboneElement	Component observations Slice: Unordered, Open by pattern:code vs-3: If there is no a value a data absent reason must be present
component:All Slices				Content/Rules for all slices
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	SΣ	1..1	CodeableConcept	Type of component observation (code / type) Binding: US Core Vital Signs ValueSet (extensible): The vital sign codes from the base FHIR and US Core Vital Signs.
value[x]	SΣC	0..1		Vital Sign Component Value Binding: VitalSignsUnits (extensible): Common UCUM units for recording Vital Signs.
valueQuantity			Quantity S
valueCodeableConcept			CodeableConcept
valueString			string
valueBoolean			boolean
valueInteger			integer
valueRange			Range
valueRatio			Ratio
valueSampledData			SampledData
valueTime			time
valueDateTime			dateTime
valuePeriod			Period
dataAbsentReason	SC	0..1	CodeableConcept	Why the component result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation		0..*	CodeableConcept	High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
referenceRange		0..*	See referenceRange (Observation)	Provides guide for interpretation of component result
component:va-pre-condition	SΣC	0..1	BackboneElement	Component observations vs-3: If there is no a value a data absent reason must be present
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	SΣ	1..1	CodeableConcept	Type of component observation (code / type) Binding: US Core Vital Signs ValueSet (extensible): The vital sign codes from the base FHIR and US Core Vital Signs. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 104158-1
display		1..1	string	Representation defined by the system Fixed Value: Associated precondition - Reported
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
Slices for value[x]	SΣC	0..1		Vital Sign Component Value Slice: Unordered, Open by type:$this Binding: VitalSignsUnits (extensible): Common UCUM units for recording Vital Signs.
valueQuantity			Quantity S
valueCodeableConcept			CodeableConcept
valueString			string
valueBoolean			boolean
valueInteger			integer
valueRange			Range
valueRatio			Ratio
valueSampledData			SampledData
valueTime			time
valueDateTime			dateTime
valuePeriod			Period
value[x]:valueCodeableConcept	SΣC	0..1	CodeableConcept	Vital Sign Component Value Binding: VitalsPrecondition FHIR (required): see mapping VF_VitalsPrecondition
dataAbsentReason	SC	0..1	CodeableConcept	Why the component result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation		0..*	CodeableConcept	High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
referenceRange		0..*	See referenceRange (Observation)	Provides guide for interpretation of component result
component:va-pre-condition-device	SΣC	0..1	BackboneElement	Component observations vs-3: If there is no a value a data absent reason must be present
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	SΣ	1..1	CodeableConcept	Type of component observation (code / type) Binding: US Core Vital Signs ValueSet (extensible): The vital sign codes from the base FHIR and US Core Vital Signs. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 104158-1
display		1..1	string	Representation defined by the system Fixed Value: Associated precondition - Reported
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
Slices for value[x]	SΣC	0..1		Vital Sign Component Value Slice: Unordered, Open by type:$this Binding: VitalSignsUnits (extensible): Common UCUM units for recording Vital Signs.
valueQuantity			Quantity S
valueCodeableConcept			CodeableConcept
valueString			string
valueBoolean			boolean
valueInteger			integer
valueRange			Range
valueRatio			Ratio
valueSampledData			SampledData
valueTime			time
valueDateTime			dateTime
valuePeriod			Period
value[x]:valueCodeableConcept	SΣC	0..1	CodeableConcept	Vital Sign Component Value Binding: VitalsQualifyingDevice FHIR (required): see mapping VF_VitalsQualifyingDevice
dataAbsentReason	SC	0..1	CodeableConcept	Why the component result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation		0..*	CodeableConcept	High, low, normal, etc. Binding: ObservationInterpretationCodes (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 / Code	URI
Observation.language	preferred	CommonLanguages http://hl7.org/fhir/ValueSet/languages from the FHIR Standard Additional Bindings Purpose AllLanguages Max Binding
Observation.extension:observation-deviceCode.value[x]	required	VitalsMeasurementDevice http://va.gov/fhir/ValueSet/VitalsMeasurementDevice from this IG
Observation.extension:observation-bodyPosition.value[x]	required	VitalsBodyPosition http://va.gov/fhir/ValueSet/VitalsBodyPosition from this IG
Observation.identifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 from the FHIR Standard
Observation.identifier.type	extensible	Identifier Type Codes http://hl7.org/fhir/ValueSet/identifier-type from the FHIR Standard
Observation.status	required	ObservationStatus http://hl7.org/fhir/ValueSet/observation-status|4.0.1 from the FHIR Standard
Observation.category	preferred	ObservationCategoryCodes http://hl7.org/fhir/ValueSet/observation-category from the FHIR Standard
Observation.category:VSCat	preferred	Pattern: vital-signs http://hl7.org/fhir/ValueSet/observation-category from the FHIR Standard
Observation.code	extensible	UsCoreVitalSigns http://hl7.org/fhir/us/core/ValueSet/us-core-vital-signs
Observation.code.coding	required	VitalsCodes http://va.gov/fhir/ValueSet/VitalsCodes from this IG
Observation.value[x]	extensible	VitalSignsUnits http://hl7.org/fhir/ValueSet/ucum-vitals-common|4.0.1 from the FHIR Standard
Observation.value[x]:valueQuantity	extensible	VitalSignsUnits http://hl7.org/fhir/ValueSet/ucum-vitals-common|4.0.1 from the FHIR Standard
Observation.value[x]:valueQuantity.comparator	required	QuantityComparator http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1 from the FHIR Standard
Observation.dataAbsentReason	extensible	DataAbsentReason http://hl7.org/fhir/ValueSet/data-absent-reason from the FHIR Standard
Observation.interpretation	extensible	ObservationInterpretationCodes http://hl7.org/fhir/ValueSet/observation-interpretation from the FHIR Standard
Observation.bodySite	required	VitalsBodySite http://va.gov/fhir/ValueSet/VitalsBodySite from this IG
Observation.method	required	VitalsMethod http://va.gov/fhir/ValueSet/VitalsMethod from this IG
Observation.referenceRange.type	preferred	ObservationReferenceRangeMeaningCodes http://hl7.org/fhir/ValueSet/referencerange-meaning from the FHIR Standard
Observation.referenceRange.appliesTo	example	ObservationReferenceRangeAppliesToCodes http://hl7.org/fhir/ValueSet/referencerange-appliesto from the FHIR Standard
Observation.component.code	extensible	UsCoreVitalSigns http://hl7.org/fhir/us/core/ValueSet/us-core-vital-signs
Observation.component.value[x]	extensible	VitalSignsUnits http://hl7.org/fhir/ValueSet/ucum-vitals-common|4.0.1 from the FHIR Standard
Observation.component.dataAbsentReason	extensible	DataAbsentReason http://hl7.org/fhir/ValueSet/data-absent-reason from the FHIR Standard
Observation.component.interpretation	extensible	ObservationInterpretationCodes http://hl7.org/fhir/ValueSet/observation-interpretation from the FHIR Standard
Observation.component:va-pre-condition.code	extensible	Pattern: LOINC Code 104158-1("Associated precondition - Reported") http://hl7.org/fhir/us/core/ValueSet/us-core-vital-signs
Observation.component:va-pre-condition.value[x]	extensible	VitalSignsUnits http://hl7.org/fhir/ValueSet/ucum-vitals-common|4.0.1 from the FHIR Standard
Observation.component:va-pre-condition.value[x]:valueCodeableConcept	required	VitalsPrecondition http://va.gov/fhir/ValueSet/VitalsPrecondition from this IG
Observation.component:va-pre-condition.dataAbsentReason	extensible	DataAbsentReason http://hl7.org/fhir/ValueSet/data-absent-reason from the FHIR Standard
Observation.component:va-pre-condition.interpretation	extensible	ObservationInterpretationCodes http://hl7.org/fhir/ValueSet/observation-interpretation from the FHIR Standard
Observation.component:va-pre-condition-device.code	extensible	Pattern: LOINC Code 104158-1("Associated precondition - Reported") http://hl7.org/fhir/us/core/ValueSet/us-core-vital-signs
Observation.component:va-pre-condition-device.value[x]	extensible	VitalSignsUnits http://hl7.org/fhir/ValueSet/ucum-vitals-common|4.0.1 from the FHIR Standard
Observation.component:va-pre-condition-device.value[x]:valueCodeableConcept	required	VitalsQualifyingDevice http://va.gov/fhir/ValueSet/VitalsQualifyingDevice from this IG
Observation.component:va-pre-condition-device.dataAbsentReason	extensible	DataAbsentReason http://hl7.org/fhir/ValueSet/data-absent-reason from the FHIR Standard
Observation.component:va-pre-condition-device.interpretation	extensible	ObservationInterpretationCodes http://hl7.org/fhir/ValueSet/observation-interpretation from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
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 or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).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()
dom-5	error	Observation	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Observation	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
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 Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present : value.empty() or component.code.where(coding.intersect(%resource.code.coding).exists()).empty()
vs-1	error	Observation.effective[x], Observation.effective[x]:effectiveDateTime	if Observation.effective[x] is dateTime and has a value then that value shall be precise to the day : $this is dateTime implies $this.toString().length() >= 10
vs-2	error	Observation	If there is no component or hasMember element then either a value[x] or a data absent reason must be present. : (component.empty() and hasMember.empty()) implies (dataAbsentReason.exists() or value.exists())
vs-3	error	Observation.component, Observation.component:va-pre-condition, Observation.component:va-pre-condition-device	If there is no a value a data absent reason must be present : value.exists() or dataAbsentReason.exists()
vs-10-655	warning	Observation.status	If (120.5-4) is null then fixed value #final : true
vs-10-656	warning	Observation.status	If (120.5-4) is not null then fixed value #entered-in-error : true
vs-10-664	warning	Observation.value[x]:valueQuantity.value	If VUID not = 4500634 then source value from (120.5-1.2) : true

Summary

Must-Support: 14 elements

Structures

This structure refers to these other structures:

• Patient (http://va.gov/fhir/StructureDefinition/Patient)
• Organization (http://va.gov/fhir/StructureDefinition/Organization)

Extensions

This structure refers to these extensions:

• http://hl7.org/fhir/StructureDefinition/observation-deviceCode
• http://hl7.org/fhir/StructureDefinition/observation-bodyPosition

Slices

This structure defines the following Slices:

• The element 1 is sliced based on the value of Observation.effective[x]
• The element 1 is sliced based on the value of Observation.value[x]
• The element 1 is sliced based on the value of Observation.component
• The element 1 is sliced based on the value of Observation.component.value[x]

Name	Flags	Card.	Type	Description & Constraints
Observation	C	0..*	USCoreVitalSignsProfile	US Core Vital Signs Profile This profile also complies with the profiles US Core Vital Signs Profile (6.1.0) and US Core Vital Signs Profile (7.0.0) dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated dom-5: If a resource is contained in another resource, it SHALL NOT have a security label dom-6: A resource should have narrative for robust management obs-6: dataAbsentReason SHALL only be present if Observation.value[x] is not present obs-7: If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present vs-2: If there is no component or hasMember element then either a value[x] or a data absent reason must be present.
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created ele-1: All FHIR elements must have a @value or children
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
extension:observation-deviceCode		0..1	(Complex)	A code representing the the type of device used for this observation. Should only be used if not implicit in the code found in `Observation.code` URL: http://hl7.org/fhir/StructureDefinition/observation-deviceCode ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
extension		0..0
url		1..1	uri	"http://hl7.org/fhir/StructureDefinition/observation-deviceCode"
value[x]	S	1..1	CodeableConcept	Value of extension Binding: VitalsMeasurementDevice FHIR (required): see mapping VF_VitalsMeasurementDevice ele-1: All FHIR elements must have a @value or children
extension:observation-bodyPosition		0..1	(Complex)	The body position during the observation URL: http://hl7.org/fhir/StructureDefinition/observation-bodyPosition ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
extension		0..0
url		1..1	uri	"http://hl7.org/fhir/StructureDefinition/observation-bodyPosition"
value[x]	S	1..1	CodeableConcept	Value of extension Binding: VitalsBodyPosition FHIR (required): see mapping VF_VitalsBodyPosition ele-1: All FHIR elements must have a @value or children
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
identifier	Σ	0..*	Identifier	Business Identifier for observation ele-1: All FHIR elements must have a @value or children
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known . ele-1: All FHIR elements must have a @value or children
system	SΣ	0..1	uri	The namespace for the identifier value ele-1: All FHIR elements must have a @value or children Required Pattern: http://va.gov/identifiers/$Sta3n/120.5
value	SΣ	0..1	string	The value that is unique ele-1: All FHIR elements must have a @value or children Example General: 123456
status	?!SΣC	1..1	code	registered | preliminary | final | amended + Binding: ObservationStatus (required) ele-1: All FHIR elements must have a @value or children vs-10-655: If (120.5-4) is null then fixed value #final vs-10-656: If (120.5-4) is not null then fixed value #entered-in-error
Slices for category	S	1..*	CodeableConcept	Classification of type of observation Slice: Unordered, Open by value:coding.code, value:coding.system Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories. ele-1: All FHIR elements must have a @value or children
category:VSCat	S	1..1	CodeableConcept	Classification of type of observation Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories. ele-1: All FHIR elements must have a @value or children Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category
code		1..1	code	Symbol in syntax defined by the system Fixed Value: vital-signs
coding	SΣ	1..*	Coding	Code defined by a terminology system ele-1: All FHIR elements must have a @value or children
system	SΣ	1..1	uri	Identity of the terminology system ele-1: All FHIR elements must have a @value or children Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category
code	SΣ	1..1	code	Symbol in syntax defined by the system ele-1: All FHIR elements must have a @value or children Fixed Value: vital-signs
code	SΣ	1..1	CodeableConcept	Coded Responses from C-CDA Vital Sign Results Binding: US Core Vital Signs ValueSet (extensible): The vital sign codes from the base FHIR and US Core Vital Signs. ele-1: All FHIR elements must have a @value or children
coding	SΣ	0..*	Coding	Code defined by a terminology system Binding: VitalsCodes FHIR (required): see mapping VF_VitalsCodes ele-1: All FHIR elements must have a @value or children
subject	SΣ	1..1	Reference(Patient)	Who and/or what the observation is about ele-1: All FHIR elements must have a @value or children
Slices for effective[x]	SΣC	1..1		Often just a dateTime for Vital Signs Slice: Unordered, Open by type:$this ele-1: All FHIR elements must have a @value or children vs-1: if Observation.effective[x] is dateTime and has a value then that value shall be precise to the day
effectiveDateTime			dateTime
effective[x]:effectiveDateTime	SΣC	0..1	dateTime	Often just a dateTime for Vital Signs ele-1: All FHIR elements must have a @value or children vs-1: if Observation.effective[x] is dateTime and has a value then that value shall be precise to the day
issued	SΣ	0..1	instant	Date/Time this version was made available ele-1: All FHIR elements must have a @value or children
performer	SΣ	0..*	Reference(Organization)	Who is responsible for the observation ele-1: All FHIR elements must have a @value or children
Slices for value[x]	SΣC	0..1		Vital Signs Value Slice: Unordered, Open by type:$this Binding: VitalSignsUnits (extensible): Common UCUM units for recording Vital Signs. ele-1: All FHIR elements must have a @value or children
valueQuantity			Quantity
value[x]:valueQuantity	SΣC	0..1	Quantity	Vital Signs Value Binding: VitalSignsUnits (extensible): Common UCUM units for recording Vital Signs. ele-1: All FHIR elements must have a @value or children
value	SΣC	0..1	decimal	Numerical value (with implicit precision) ele-1: All FHIR elements must have a @value or children vs-10-664: If VUID not = 4500634 then source value from (120.5-1.2)
comparator	?!Σ	0..1	code	< | <= | >= | > - how to understand the value Binding: QuantityComparator (required): How the Quantity should be understood and represented. ele-1: All FHIR elements must have a @value or children
code	SΣ	0..1	code	Coded form of the unit ele-1: All FHIR elements must have a @value or children
dataAbsentReason	SC	0..1	CodeableConcept	Why the result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing. ele-1: All FHIR elements must have a @value or children
bodySite	S	0..1	CodeableConcept	Observed body part Binding: VitalsBodySite FHIR (required): see mapping VF_VitalsBodySite ele-1: All FHIR elements must have a @value or children
method	S	0..1	CodeableConcept	How it was done Binding: VitalsMethod FHIR (required): see mapping VF_VitalsMethod ele-1: All FHIR elements must have a @value or children
Slices for component	SΣC	0..*	BackboneElement	Component observations Slice: Unordered, Open by pattern:code ele-1: All FHIR elements must have a @value or children vs-3: If there is no a value a data absent reason must be present
component:All Slices				Content/Rules for all slices
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
code	SΣ	1..1	CodeableConcept	Type of component observation (code / type) Binding: US Core Vital Signs ValueSet (extensible): The vital sign codes from the base FHIR and US Core Vital Signs. ele-1: All FHIR elements must have a @value or children
value[x]	SΣC	0..1		Vital Sign Component Value Binding: VitalSignsUnits (extensible): Common UCUM units for recording Vital Signs. ele-1: All FHIR elements must have a @value or children
valueQuantity			Quantity
dataAbsentReason	SC	0..1	CodeableConcept	Why the component result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing. ele-1: All FHIR elements must have a @value or children
component:va-pre-condition	SΣC	0..1	BackboneElement	Component observations ele-1: All FHIR elements must have a @value or children vs-3: If there is no a value a data absent reason must be present
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
code	SΣ	1..1	CodeableConcept	Type of component observation (code / type) Binding: US Core Vital Signs ValueSet (extensible): The vital sign codes from the base FHIR and US Core Vital Signs. ele-1: All FHIR elements must have a @value or children Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 104158-1
display		1..1	string	Representation defined by the system Fixed Value: Associated precondition - Reported
Slices for value[x]	SΣC	0..1		Vital Sign Component Value Slice: Unordered, Open by type:$this Binding: VitalSignsUnits (extensible): Common UCUM units for recording Vital Signs. ele-1: All FHIR elements must have a @value or children
valueQuantity			Quantity
value[x]:valueCodeableConcept	SΣC	0..1	CodeableConcept	Vital Sign Component Value Binding: VitalsPrecondition FHIR (required): see mapping VF_VitalsPrecondition ele-1: All FHIR elements must have a @value or children
dataAbsentReason	SC	0..1	CodeableConcept	Why the component result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing. ele-1: All FHIR elements must have a @value or children
component:va-pre-condition-device	SΣC	0..1	BackboneElement	Component observations ele-1: All FHIR elements must have a @value or children vs-3: If there is no a value a data absent reason must be present
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
code	SΣ	1..1	CodeableConcept	Type of component observation (code / type) Binding: US Core Vital Signs ValueSet (extensible): The vital sign codes from the base FHIR and US Core Vital Signs. ele-1: All FHIR elements must have a @value or children Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 104158-1
display		1..1	string	Representation defined by the system Fixed Value: Associated precondition - Reported
Slices for value[x]	SΣC	0..1		Vital Sign Component Value Slice: Unordered, Open by type:$this Binding: VitalSignsUnits (extensible): Common UCUM units for recording Vital Signs. ele-1: All FHIR elements must have a @value or children
valueQuantity			Quantity
value[x]:valueCodeableConcept	SΣC	0..1	CodeableConcept	Vital Sign Component Value Binding: VitalsQualifyingDevice FHIR (required): see mapping VF_VitalsQualifyingDevice ele-1: All FHIR elements must have a @value or children
dataAbsentReason	SC	0..1	CodeableConcept	Why the component result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing. ele-1: All FHIR elements must have a @value or children
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
Observation.extension:observation-deviceCode.value[x]	required	VitalsMeasurementDevice http://va.gov/fhir/ValueSet/VitalsMeasurementDevice from this IG
Observation.extension:observation-bodyPosition.value[x]	required	VitalsBodyPosition http://va.gov/fhir/ValueSet/VitalsBodyPosition from this IG
Observation.identifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 from the FHIR Standard
Observation.status	required	ObservationStatus http://hl7.org/fhir/ValueSet/observation-status|4.0.1 from the FHIR Standard
Observation.category	preferred	ObservationCategoryCodes http://hl7.org/fhir/ValueSet/observation-category from the FHIR Standard
Observation.category:VSCat	preferred	Pattern: vital-signs http://hl7.org/fhir/ValueSet/observation-category from the FHIR Standard
Observation.code	extensible	UsCoreVitalSigns http://hl7.org/fhir/us/core/ValueSet/us-core-vital-signs
Observation.code.coding	required	VitalsCodes http://va.gov/fhir/ValueSet/VitalsCodes from this IG
Observation.value[x]	extensible	VitalSignsUnits http://hl7.org/fhir/ValueSet/ucum-vitals-common|4.0.1 from the FHIR Standard
Observation.value[x]:valueQuantity	extensible	VitalSignsUnits http://hl7.org/fhir/ValueSet/ucum-vitals-common|4.0.1 from the FHIR Standard
Observation.value[x]:valueQuantity.comparator	required	QuantityComparator http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1 from the FHIR Standard
Observation.dataAbsentReason	extensible	DataAbsentReason http://hl7.org/fhir/ValueSet/data-absent-reason from the FHIR Standard
Observation.bodySite	required	VitalsBodySite http://va.gov/fhir/ValueSet/VitalsBodySite from this IG
Observation.method	required	VitalsMethod http://va.gov/fhir/ValueSet/VitalsMethod from this IG
Observation.component.code	extensible	UsCoreVitalSigns http://hl7.org/fhir/us/core/ValueSet/us-core-vital-signs
Observation.component.value[x]	extensible	VitalSignsUnits http://hl7.org/fhir/ValueSet/ucum-vitals-common|4.0.1 from the FHIR Standard
Observation.component.dataAbsentReason	extensible	DataAbsentReason http://hl7.org/fhir/ValueSet/data-absent-reason from the FHIR Standard
Observation.component:va-pre-condition.code	extensible	Pattern: LOINC Code 104158-1("Associated precondition - Reported") http://hl7.org/fhir/us/core/ValueSet/us-core-vital-signs
Observation.component:va-pre-condition.value[x]	extensible	VitalSignsUnits http://hl7.org/fhir/ValueSet/ucum-vitals-common|4.0.1 from the FHIR Standard
Observation.component:va-pre-condition.value[x]:valueCodeableConcept	required	VitalsPrecondition http://va.gov/fhir/ValueSet/VitalsPrecondition from this IG
Observation.component:va-pre-condition.dataAbsentReason	extensible	DataAbsentReason http://hl7.org/fhir/ValueSet/data-absent-reason from the FHIR Standard
Observation.component:va-pre-condition-device.code	extensible	Pattern: LOINC Code 104158-1("Associated precondition - Reported") http://hl7.org/fhir/us/core/ValueSet/us-core-vital-signs
Observation.component:va-pre-condition-device.value[x]	extensible	VitalSignsUnits http://hl7.org/fhir/ValueSet/ucum-vitals-common|4.0.1 from the FHIR Standard
Observation.component:va-pre-condition-device.value[x]:valueCodeableConcept	required	VitalsQualifyingDevice http://va.gov/fhir/ValueSet/VitalsQualifyingDevice from this IG
Observation.component:va-pre-condition-device.dataAbsentReason	extensible	DataAbsentReason http://hl7.org/fhir/ValueSet/data-absent-reason from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
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 or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).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()
dom-5	error	Observation	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Observation	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.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 Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present : value.empty() or component.code.where(coding.intersect(%resource.code.coding).exists()).empty()
vs-1	error	Observation.effective[x], Observation.effective[x]:effectiveDateTime	if Observation.effective[x] is dateTime and has a value then that value shall be precise to the day : $this is dateTime implies $this.toString().length() >= 10
vs-2	error	Observation	If there is no component or hasMember element then either a value[x] or a data absent reason must be present. : (component.empty() and hasMember.empty()) implies (dataAbsentReason.exists() or value.exists())
vs-3	error	Observation.component, Observation.component:va-pre-condition, Observation.component:va-pre-condition-device	If there is no a value a data absent reason must be present : value.exists() or dataAbsentReason.exists()
vs-10-655	warning	Observation.status	If (120.5-4) is null then fixed value #final : true
vs-10-656	warning	Observation.status	If (120.5-4) is not null then fixed value #entered-in-error : true
vs-10-664	warning	Observation.value[x]:valueQuantity.value	If VUID not = 4500634 then source value from (120.5-1.2) : true