sd-mii-icu-koerpertemperatur-rektal
type: StructureDefinition
node role: treeRoot
id:
  v: sd-mii-icu-koerpertemperatur-rektal
text:
  status:
    v: extensions
  div:
    v: Generated Narrative: StructureDefinition sd-mii-icu-koerpertemperatur-rektal Name Flags Card. Type Description & Constraints<img src="[binary]" alt="doco" style="background-color: inherit"/> Observation 0..* ISiKKoerperkerntemperatur Measurements and simple assertions #xD; code #xD; coding 5..* Coding Coding #xD; Slices for coding Content/Rules for all slices #xD; coding:snomed 1..1 ISiKSnomedCTCoding SNOMED CT Kodierung Required Pattern: At least the following #xD; system 1..1 uri Identity of the terminology system Fixed Value: http://snomed.info/sct #xD; code 1..1 code Symbol in syntax defined by the system Fixed Value: 307047009 #xD; coding:specific-loinc 1..1 Coding Code defined by a terminology system Required Pattern: At least the following #xD; system 1..1 uri Identity of the terminology system Fixed Value: http://loinc.org #xD; code 1..1 code Symbol in syntax defined by the system Fixed Value: 8332-9 #xD; coding:specific-IEEE-11073 S 1..1 Coding Coding Required Pattern: At least the following #xD; system 1..1 uri Identity of the terminology system Fixed Value: urn:iso:std:iso:11073:10101 #xD; code 1..1 code Symbol in syntax defined by the system Fixed Value: 188420 #xD; bodySite 0..1 CodeableConcept Observed body part Required Pattern: At least the following #xD; coding 1..* Coding Code defined by a terminology system Fixed Value: (Complex) #xD; system 1..1 uri Identity of the terminology system Fixed Value: http://snomed.info/sct #xD; code 1..1 code Symbol in syntax defined by the system Fixed Value: 34402009 #xD; <img src="[binary]" alt="doco" style="background-color: inherit"/> Documentation for this format
url:
  v: https://gematik.de/fhir/isik/StructureDefinition/sd-mii-icu-koerpertemperatur-rektal
  l: sd-mii-icu-koerpertemperatur-rektal
version:
  v: 6.0.0-rc
name:
  v: SD_MII_ICU_Koerpertemperatur_Rektal
title:
  v: SD MII ICU Koerpertemperatur rektal
status:
  v: active
experimental:
  v: false
date:
  v: 2026-04-02
description:
  v: Dieses Profil bietet eine spezialisierte Abbildung der geschätzten KörperKERNtemperatur gemessen rektal in der Akutmedizin.
fhir version:
  v: 4.0.1
kind:
  v: resource
abstract:
  v: false
type:
  v: Observation
  l: Observation
base definition:
  v: https://gematik.de/fhir/isik/StructureDefinition/ISiKKoerperkerntemperatur
  l: ISiKKoerperkerntemperatur
derivation:
  v: constraint
snapshot:
  extension:
    url:
      v: http://hl7.org/fhir/tools/StructureDefinition/snapshot-base-version
      l: snapshot-base-version
    value: String
      v: 6.0.0-rc
  element:
    id:
      v: Observation
    path:
      v: Observation
    short:
      v: Measurements and simple assertions
    definition:
      v: Measurements and simple assertions made about a patient, device or other subject.
    comment:
      v: Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc. Other resources are used to provide context for observations such as laboratory reports, etc.
    alias:
      v: Vital Signs
    alias:
      v: Measurement
    alias:
      v: Results
    alias:
      v: Tests
    min:
      v: 0
    max:
      v: *
    base:
      path:
        v: Observation
      min:
        v: 0
      max:
        v: *
    constraint:
      key:
        v: dom-2
      severity:
        v: error
      human:
        v: If the resource is contained in another resource, it SHALL NOT contain nested Resources
      expression:
        v: contained.contained.empty()
      xpath:
        v: not(parent::f:contained and f:contained)
      source:
        v: http://hl7.org/fhir/StructureDefinition/DomainResource
        l: DomainResource
    constraint:
      key:
        v: dom-3
      severity:
        v: error
      human:
        v: 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
      expression:
        v: 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()
      xpath:
        v: not(exists(for $id in f:contained/*/f:id/@value return $contained[not(parent::*/descendant::f:reference/@value=concat('#', $contained/*/id/@value) or descendant::f:reference[@value='#'])]))
      source:
        v: http://hl7.org/fhir/StructureDefinition/DomainResource
        l: DomainResource
    constraint:
      key:
        v: dom-4
      severity:
        v: error
      human:
        v: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
      expression:
        v: contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
      xpath:
        v: not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))
      source:
        v: http://hl7.org/fhir/StructureDefinition/DomainResource
        l: DomainResource
    constraint:
      key:
        v: dom-5
      severity:
        v: error
      human:
        v: If a resource is contained in another resource, it SHALL NOT have a security label
      expression:
        v: contained.meta.security.empty()
      xpath:
        v: not(exists(f:contained/*/f:meta/f:security))
      source:
        v: http://hl7.org/fhir/StructureDefinition/DomainResource
        l: DomainResource
    constraint:
      extension:
        value: Boolean
      extension:
        value: Markdown
      key:
        v: dom-6
      severity:
        v: warning
      human:
        v: A resource should have narrative for robust management
      expression:
        v: text.`div`.exists()
      xpath:
        v: exists(f:text/h:div)
      source:
        v: http://hl7.org/fhir/StructureDefinition/DomainResource
        l: DomainResource
    constraint:
      key:
        v: obs-6
      severity:
        v: error
      human:
        v: dataAbsentReason SHALL only be present if Observation.value[x] is not present
      expression:
        v: dataAbsentReason.empty() or value.empty()
      xpath:
        v: not(exists(f:dataAbsentReason)) or (not(exists(*[starts-with(local-name(.), 'value')])))
      source:
        v: http://fhir.de/StructureDefinition/observation-de-vitalsign
        l: observation-de-vitalsign
    constraint:
      key:
        v: obs-7
      severity:
        v: error
      human:
        v: If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present
      expression:
        v: value.empty() or component.code.where(coding.intersect(%resource.code.coding).exists()).empty()
      xpath:
        v: not(f:*[starts-with(local-name(.), 'value')] and (for $coding in f:code/f:coding return f:component/f:code/f:coding[f:code/@value=$coding/f:code/@value] [f:system/@value=$coding/f:system/@value]))
      source:
        v: http://fhir.de/StructureDefinition/observation-de-vitalsign
        l: observation-de-vitalsign
    constraint:
      key:
        v: vs-de-2
      severity:
        v: error
      human:
        v: If there is no component or hasMember element then either a value[x] or a data absent reason must be present
      expression:
        v: (component.empty() and hasMember.empty()) implies (dataAbsentReason.exists() or value.exists())
      source:
        v: http://fhir.de/StructureDefinition/observation-de-vitalsign
        l: observation-de-vitalsign
    is modifier:
      v: false
    is summary:
      v: false
    mapping:
      identity:
        v: rim
      map:
        v: Entity. Role, or Act
    mapping:
      identity:
        v: workflow

Boolean
v: true

Markdown
v: When a resource has no narrative, only systems that fully understand the data can display the resource to a human safely. Including a human readable representation in the resource makes for a much more robust eco-system and cheaper handling of resources by intermediary systems. Some ecosystems restrict distribution of resources to only those systems that do fully understand the resources, and as a consequence implementers may believe that the narrative is superfluous. However experience shows that such eco-systems often open up to new participants over time.

v: Event

identity:
  v: sct-concept
map:
  v: < 363787002 |Observable entity|

identity:
  v: v2
map:
  v: OBX

identity:
  v: rim
map:
  v: Observation[classCode=OBS, moodCode=EVN]

id:
  v: Observation.id
path:
  v: Observation.id
short:
  v: serverseitige, interne ID des Datensatzes
definition:
  v: The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
comment:
  v: **bedingtes Pflichtfeld/bedingtes MS:** Alle von einem Server bereitgestellten Ressourcen MÜSSEN über eine `id` verfügen. Von Clients erzeugte Ressourcen, die im Kontext einer CREATE-Interaktion übermittelt werden, MÜSSEN NICHT über eine `id`verfügen.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Resource.id
  min:
    v: 0
  max:
    v: 1
type:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type
      l: structuredefinition-fhir-type
    value: Url
      v: id
      l: id
  code:
    v: http://hl7.org/fhirpath/System.String
    l: System.String
must support:
  v: true
is modifier:
  v: false
is summary:
  v: true

id:
  v: Observation.meta
path:
  v: Observation.meta
short:
  v: Metadata about the resource
definition:
  v: The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Resource.meta
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: Meta
    l: Meta
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
is modifier:
  v: false
is summary:
  v: true

id:
  v: Observation.meta.id
path:
  v: Observation.meta.id
representation:
  v: xmlAttr
short:
  v: Unique id for inter-element referencing
definition:
  v: Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Element.id
  min:
    v: 0
  max:
    v: 1
type:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type
      l: structuredefinition-fhir-type
    value: Url
      v: string
      l: string
  code:
    v: http://hl7.org/fhirpath/System.String
    l: System.String
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: n/a

id:
  v: Observation.meta.extension
path:
  v: Observation.meta.extension
slicing:
  discriminator:
    type:
      v: value
    path:
      v: url
  description:
    v: Extensions are always sliced by (at least) url
  rules:
    v: open
short:
  v: Additional content defined by implementations
definition:
  v: May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
comment:
  v: There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
alias:
  v: extensions
alias:
  v: user content
min:
  v: 0
max:
  v: *
base:
  path:
    v: Element.extension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
    l: Extension
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
  xpath:
    v: exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])
  source:
    v: http://hl7.org/fhir/StructureDefinition/Extension
    l: Extension
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: n/a

id:
  v: Observation.meta.versionId
path:
  v: Observation.meta.versionId
short:
  v: Eindeutiger Name der serverseitigen Version des Datensatzes
definition:
  v: The version specific identifier, as it appears in the version portion of the URL. This value changes when the resource is created, updated, or deleted.
comment:
  v: Alle von einem Server bereitgestellten Ressourcen SOLLEN über eine `versionID` verfügen. Von Clients erzeugte Ressourcen, die im Kontext einer CREATE-Interaktion übermittelt werden, MÜSSEN NICHT über eine `versionID`verfügen.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Meta.versionId
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: id
    l: id
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
is modifier:
  v: false
is summary:
  v: true

id:
  v: Observation.meta.lastUpdated
path:
  v: Observation.meta.lastUpdated
short:
  v: Zeitpunkt der letzten Änderung
definition:
  v: When the resource last changed - e.g. when the version changed.
comment:
  v: Alle von einem Server bereitgestellten Ressourcen SOLLEN über ein `lastUpdate` verfügen. Von Clients erzeugte Ressourcen, die im Kontext einer CREATE-Interaktion übermittelt werden, MÜSSEN NICHT über ein `lastUpdate`verfügen.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Meta.lastUpdated
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: instant
    l: instant
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
is modifier:
  v: false
is summary:
  v: true

id:
  v: Observation.meta.source
path:
  v: Observation.meta.source
short:
  v: Identifies where the resource comes from
definition:
  v: A uri that identifies the source system of the resource. This provides a minimal amount of [Provenance](http://hl7.org/fhir/R4/provenance.html#) information that can be used to track or differentiate the source of information in the resource. The source may identify another FHIR server, document, message, database, etc.
comment:
  v: In the provenance resource, this corresponds to Provenance.entity.what[x]. The exact use of the source (and the implied Provenance.entity.role) is left to implementer discretion. Only one nominated source is allowed; for additional provenance details, a full Provenance resource should be used. This element can be used to indicate where the current master source of a resource that has a canonical URL if the resource is no longer hosted at the canonical URL.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Meta.source
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: uri
    l: uri
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
is modifier:
  v: false
is summary:
  v: true

id:
  v: Observation.meta.profile
path:
  v: Observation.meta.profile
short:
  v: Profiles this resource claims to conform to
definition:
  v: A list of profiles (references to [StructureDefinition](http://hl7.org/fhir/R4/structuredefinition.html#) resources) that this resource claims to conform to. The URL is a reference to [StructureDefinition.url](http://hl7.org/fhir/R4/structuredefinition-definitions.html#StructureDefinition.url).
comment:
  v: It is up to the server and/or other infrastructure of policy to determine whether/how these claims are verified and/or updated over time. The list of profile URLs is a set.
min:
  v: 0
max:
  v: *
base:
  path:
    v: Meta.profile
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: canonical
    l: canonical
  target profile:
    v: http://hl7.org/fhir/StructureDefinition/StructureDefinition|4.0.1
    l: http://hl7.org/fhir/StructureDefinition/StructureDefinition
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
is modifier:
  v: false
is summary:
  v: true

id:
  v: Observation.meta.security
path:
  v: Observation.meta.security
short:
  v: Security Labels applied to this resource
definition:
  v: Security labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure.
comment:
  v: The security labels can be updated without changing the stated version of the resource. The list of security labels is a set. Uniqueness is based the system/code, and version and display are ignored.
min:
  v: 0
max:
  v: *
base:
  path:
    v: Meta.security
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Coding
    l: Coding
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
is modifier:
  v: false
is summary:
  v: true
binding:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName
      l: elementdefinition-bindingName
    value: String
      v: SecurityLabels
  strength:
    v: extensible
  description:
    v: Security Labels from the Healthcare Privacy and Security Classification System.
  value set:
    v: http://hl7.org/fhir/ValueSet/security-labels|4.0.1
    l: http://hl7.org/fhir/ValueSet/security-labels

id:
  v: Observation.meta.tag
path:
  v: Observation.meta.tag
short:
  v: Tags applied to this resource
definition:
  v: Tags applied to this resource. Tags are intended to be used to identify and relate resources to process and workflow, and applications are not required to consider the tags when interpreting the meaning of a resource.
comment:
  v: The tags can be updated without changing the stated version of the resource. The list of tags is a set. Uniqueness is based the system/code, and version and display are ignored.
min:
  v: 0
max:
  v: *
base:
  path:
    v: Meta.tag
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Coding
    l: Coding
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
is modifier:
  v: false
is summary:
  v: true
binding:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName
      l: elementdefinition-bindingName
    value: String
      v: Tags
  strength:
    v: example
  description:
    v: Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".
  value set:
    v: http://hl7.org/fhir/ValueSet/common-tags|4.0.1
    l: http://hl7.org/fhir/ValueSet/common-tags

id:
  v: Observation.implicitRules
path:
  v: Observation.implicitRules
short:
  v: Verweis auf die Regeln, nach denen die Ressource erstellt wurde
definition:
  v: A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.
comment:
  v: Begründung Constraint: In ISiK existiert kein Use-Case für dieses Element. Da es sich um ein Modifying Element handelt, wird es daher ausgeschlossen. Darüber hinaus werden die Regeln als URI vorgehalten. Dies führt dazu, dass sich hinter der URI eine beliebige Menge an Regeln befinden kann; wodurch nicht sichergestellt werden kann, dass alle Clients die Regeln korrekt interpretieren können.
min:
  v: 0
max:
  v: 0
base:
  path:
    v: Resource.implicitRules
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: uri
    l: uri
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
is modifier:
  v: true
is modifier reason:
  v: This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
is summary:
  v: true

id:
  v: Observation.language
path:
  v: Observation.language
short:
  v: Language of the resource content
definition:
  v: The base language in which the resource is written.
comment:
  v: Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Resource.language
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: code
    l: code
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
is modifier:
  v: false
is summary:
  v: false
binding:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet
      l: elementdefinition-maxValueSet
    value: Canonical
      v: http://hl7.org/fhir/ValueSet/all-languages
      l: all-languages
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName
      l: elementdefinition-bindingName
    value: String
      v: Language
  strength:
    v: preferred
  description:
    v: A human language.
  value set:
    v: http://hl7.org/fhir/ValueSet/languages
    l: languages

id:
  v: Observation.text
path:
  v: Observation.text
short:
  v: Text summary of the resource, for human interpretation
definition:
  v: A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.
comment:
  v: Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.
alias:
  v: narrative
alias:
  v: html
alias:
  v: xhtml
alias:
  v: display
min:
  v: 0
max:
  v: 1
base:
  path:
    v: DomainResource.text
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: Narrative
    l: Narrative
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: Act.text?

id:
  v: Observation.contained
path:
  v: Observation.contained
short:
  v: Contained, inline Resources
definition:
  v: These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.
comment:
  v: This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.
alias:
  v: inline resources
alias:
  v: anonymous resources
alias:
  v: contained resources
min:
  v: 0
max:
  v: *
base:
  path:
    v: DomainResource.contained
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Resource
    l: Resource
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: N/A

id:
  v: Observation.extension
path:
  v: Observation.extension
short:
  v: Additional content defined by implementations
definition:
  v: May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
comment:
  v: There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
alias:
  v: extensions
alias:
  v: user content
min:
  v: 0
max:
  v: *
base:
  path:
    v: DomainResource.extension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
    l: Extension
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
  xpath:
    v: exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])
  source:
    v: http://hl7.org/fhir/StructureDefinition/Extension
    l: Extension
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: N/A

id:
  v: Observation.modifierExtension
path:
  v: Observation.modifierExtension
short:
  v: Extensions that cannot be ignored
definition:
  v: May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
comment:
  v: There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
requirements:
  v: Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).
alias:
  v: extensions
alias:
  v: user content
min:
  v: 0
max:
  v: *
base:
  path:
    v: DomainResource.modifierExtension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
    l: Extension
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
  xpath:
    v: exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])
  source:
    v: http://hl7.org/fhir/StructureDefinition/Extension
    l: Extension
is modifier:
  v: true
is modifier reason:
  v: Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: N/A

id:
  v: Observation.identifier
path:
  v: Observation.identifier
short:
  v: Business Identifier for observation
definition:
  v: A unique identifier assigned to this observation.
requirements:
  v: Allows observations to be distinguished and referenced.
min:
  v: 0
max:
  v: *
base:
  path:
    v: Observation.identifier
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Identifier
    l: Identifier
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
is modifier:
  v: false
is summary:
  v: true
mapping:
  identity:
    v: workflow
  map:
    v: Event.identifier
mapping:
  identity:
    v: w5
  map:
    v: FiveWs.identifier
mapping:
  identity:
    v: v2
  map:
    v: OBX.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.
mapping:
  identity:
    v: rim
  map:
    v: id

id:
  v: Observation.basedOn
path:
  v: Observation.basedOn
short:
  v: Fulfills plan, proposal or order
definition:
  v: A plan, proposal or order that is fulfilled in whole or in part by this event. For example, a MedicationRequest may require a patient to have laboratory test performed before it is dispensed.
requirements:
  v: Allows tracing of authorization for the event and tracking whether proposals/recommendations were acted upon.
alias:
  v: Fulfills
min:
  v: 0
max:
  v: *
base:
  path:
    v: Observation.basedOn
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Reference
    l: Reference
  target profile:
    v: http://hl7.org/fhir/StructureDefinition/CarePlan
    l: CarePlan
  target profile:
    v: http://hl7.org/fhir/StructureDefinition/DeviceRequest
    l: DeviceRequest
  target profile:
    v: http://hl7.org/fhir/StructureDefinition/ImmunizationRecommendation
    l: ImmunizationRecommendation
  target profile:
    v: http://hl7.org/fhir/StructureDefinition/MedicationRequest
    l: MedicationRequest
  target profile:
    v: http://hl7.org/fhir/StructureDefinition/NutritionOrder
    l: NutritionOrder
  target profile:
    v: http://hl7.org/fhir/StructureDefinition/ServiceRequest
    l: ServiceRequest
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
is modifier:
  v: false
is summary:
  v: true
mapping:
  identity:
    v: workflow
  map:
    v: Event.basedOn
mapping:
  identity:
    v: v2
  map:
    v: ORC
mapping:
  identity:
    v: rim
  map:
    v: .inboundRelationship[typeCode=COMP].source[moodCode=EVN]

id:
  v: Observation.partOf
path:
  v: Observation.partOf
short:
  v: Part of referenced event
definition:
  v: A larger event of which this particular Observation is a component or step. For example, an observation as part of a procedure.
comment:
  v: To link an Observation to an Encounter use `encounter`. See the [Notes](http://hl7.org/fhir/R4/observation.html#obsgrouping) below for guidance on referencing another Observation.
alias:
  v: Container
min:
  v: 0
max:
  v: *
base:
  path:
    v: Observation.partOf
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Reference
    l: Reference
  target profile:
    v: http://hl7.org/fhir/StructureDefinition/MedicationAdministration
    l: MedicationAdministration
  target profile:
    v: http://hl7.org/fhir/StructureDefinition/MedicationDispense
    l: MedicationDispense
  target profile:
    v: http://hl7.org/fhir/StructureDefinition/MedicationStatement
    l: MedicationStatement
  target profile:
    v: http://hl7.org/fhir/StructureDefinition/Procedure
    l: Procedure
  target profile:
    v: http://hl7.org/fhir/StructureDefinition/Immunization
    l: Immunization
  target profile:
    v: http://hl7.org/fhir/StructureDefinition/ImagingStudy
    l: ImagingStudy
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
is modifier:
  v: false
is summary:
  v: true
mapping:
  identity:
    v: workflow
  map:
    v: Event.partOf
mapping:
  identity:
    v: v2
  map:
    v: Varies by domain
mapping:
  identity:
    v: rim
  map:
    v: .outboundRelationship[typeCode=FLFS].target

id:
  v: Observation.status
extension:
  url:
    v: http://hl7.org/fhir/StructureDefinition/structuredefinition-display-hint
    l: structuredefinition-display-hint
  value: String
    v: default: final
path:
  v: Observation.status
short:
  v: Untersuchungsstatus
definition:
  v: The status of the result value.
comment:
  v: **WICHTIGER Hinweis für Implementierer:** * Alle server-seitigen Implementierungen MÜSSEN in der Lage sein, die systemintern möglichen Statuswerte korrekt in FHIR abzubilden, mindestens jedoch `final`. * Alle client-seitigen Implementierungen MÜSSEN in der Lage sein, sämtliche Status-Codes zu interpretieren und dem Anwender in angemessener Form darstellen zu können, beispielsweise durch Ausblenden/Durchstreichen von Ressourcen mit dem status `entered-in-error` und Ausgrauen von Ressourcen, die einen Plan- oder Entwurfs-Status haben.
requirements:
  v: Need to track the status of individual results. Some results are finalized before the whole report is finalized.
min:
  v: 1
max:
  v: 1
base:
  path:
    v: Observation.status
  min:
    v: 1
  max:
    v: 1
type:
  code:
    v: code
    l: code
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
must support:
  v: true
is modifier:
  v: true
is modifier reason:
  v: This element is labeled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
is summary:
  v: true
binding:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName
      l: elementdefinition-bindingName
    value: String
      v: ObservationStatus
  strength:
    v: required
  description:
    v: Codes providing the status of an observation.
  value set:
    v: http://hl7.org/fhir/ValueSet/observation-status|4.0.1
    l: http://hl7.org/fhir/ValueSet/observation-status
mapping:
  identity:
    v: workflow
  map:
    v: Event.status
mapping:
  identity:
    v: w5
  map:
    v: FiveWs.status
mapping:
  identity:
    v: sct-concept
  map:
    v: < 445584004 |Report by finality status|
mapping:
  identity:
    v: v2
  map:
    v: OBX-11
mapping:
  identity:
    v: rim
  map:
    v: status Amended & Final are differentiated by whether it is the subject of a ControlAct event with a type of "revise"

id:
  v: Observation.category
path:
  v: Observation.category
slicing:
  discriminator:
    type:
      v: pattern
    path:
      v: $this
  rules:
    v: open
short:
  v: Untersuchungskategorie
definition:
  v: A code that classifies the general type of observation being made.
comment:
  v: Motivation MS: Dieses Feld erlaubt die Sortierung und Abfrage anhand der Kategorie der Untersuchung
requirements:
  v: Used for filtering what observations are retrieved and displayed.
min:
  v: 1
max:
  v: *
base:
  path:
    v: Observation.category
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: CodeableConcept
    l: CodeableConcept
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
must support:
  v: true
is modifier:
  v: false
is summary:
  v: false
binding:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName
      l: elementdefinition-bindingName
    value: String
      v: ObservationCategory
  strength:
    v: preferred
  description:
    v: Codes for high level observation categories.
  value set:
    v: http://hl7.org/fhir/ValueSet/observation-category
    l: observation-category
mapping:
  identity:
    v: w5
  map:
    v: FiveWs.class
mapping:
  identity:
    v: rim
  map:
    v: .outboundRelationship[typeCode="COMP].target[classCode="LIST", moodCode="EVN"].code

id:
  v: Observation.category:VSCat
path:
  v: Observation.category
slice name:
  v: VSCat
short:
  v: Vitalparameterkategorie
definition:
  v: A code that classifies the general type of observation being made.
comment:
  v: Motivation MS: Die Kategorie 'vital-signs' dient der Kategorisierung von Vitalparametern
requirements:
  v: Used for filtering what observations are retrieved and displayed.
min:
  v: 1
max:
  v: 1
base:
  path:
    v: Observation.category
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: CodeableConcept
    l: CodeableConcept
pattern: CodeableConcept
  coding:
    system:
      v: http://terminology.hl7.org/CodeSystem/observation-category
      l: observation-category
    code:
      v: vital-signs
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
must support:
  v: true
is modifier:
  v: false
is summary:
  v: false
binding:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName
      l: elementdefinition-bindingName
    value: String
      v: ObservationCategory
  strength:
    v: preferred
  description:
    v: Codes for high level observation categories.
  value set:
    v: http://hl7.org/fhir/ValueSet/observation-category
    l: observation-category
mapping:
  identity:
    v: w5
  map:
    v: FiveWs.class
mapping:
  identity:
    v: rim
  map:
    v: .outboundRelationship[typeCode="COMP].target[classCode="LIST", moodCode="EVN"].code

id:
  v: Observation.code
path:
  v: Observation.code
short:
  v: Code
definition:
  v: Describes what was observed. Sometimes this is called the observation "name".
comment:
  v: Motivation MS: Die Observation wird anhand des Codes identifiziert.
requirements:
  v: Knowing what kind of observation is being made is essential to understanding the observation.
alias:
  v: Name
min:
  v: 1
max:
  v: 1
base:
  path:
    v: Observation.code
  min:
    v: 1
  max:
    v: 1
type:
  code:
    v: CodeableConcept
    l: CodeableConcept
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
must support:
  v: true
is modifier:
  v: false
is summary:
  v: true
binding:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName
      l: elementdefinition-bindingName
    value: String
      v: ObservationCode
  strength:
    v: example
  description:
    v: Codes identifying names of simple observations.
  value set:
    v: http://hl7.org/fhir/ValueSet/observation-codes
    l: observation-codes
mapping:
  identity:
    v: workflow
  map:
    v: Event.code
mapping:
  identity:
    v: w5
  map:
    v: FiveWs.what[x]
mapping:
  identity:
    v: sct-concept
  map:
    v: < 363787002 |Observable entity| OR < 386053000 |Evaluation procedure|
mapping:
  identity:
    v: v2
  map:
    v: OBX-3
mapping:
  identity:
    v: rim
  map:
    v: code
mapping:
  identity:
    v: sct-attr
  map:
    v: 116680003 |Is a|

id:
  v: Observation.code.id
path:
  v: Observation.code.id
representation:
  v: xmlAttr
short:
  v: Unique id for inter-element referencing
definition:
  v: Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Element.id
  min:
    v: 0
  max:
    v: 1
type:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type
      l: structuredefinition-fhir-type
    value: Url
      v: string
      l: string
  code:
    v: http://hl7.org/fhirpath/System.String
    l: System.String
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: n/a

id:
  v: Observation.code.extension
path:
  v: Observation.code.extension
slicing:
  discriminator:
    type:
      v: value
    path:
      v: url
  description:
    v: Extensions are always sliced by (at least) url
  rules:
    v: open
short:
  v: Additional content defined by implementations
definition:
  v: May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
comment:
  v: There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
alias:
  v: extensions
alias:
  v: user content
min:
  v: 0
max:
  v: *
base:
  path:
    v: Element.extension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
    l: Extension
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
  xpath:
    v: exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])
  source:
    v: http://hl7.org/fhir/StructureDefinition/Extension
    l: Extension
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: n/a

id:
  v: Observation.code.coding
path:
  v: Observation.code.coding
slicing:
  discriminator:
    type:
      v: pattern
    path:
      v: $this
  rules:
    v: open
short:
  v: Coding
definition:
  v: A reference to a code defined by a terminology system.
comment:
  v: Motivation MS: Semantische Kodierung
requirements:
  v: Allows for alternative encodings within a code system, and translations to other code systems.
min:
  v: 5
max:
  v: *
base:
  path:
    v: CodeableConcept.coding
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Coding
    l: Coding
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
must support:
  v: true
is modifier:
  v: false
is summary:
  v: true
mapping:
  identity:
    v: v2
  map:
    v: C*E.1-8, C*E.10-22
mapping:
  identity:
    v: rim
  map:
    v: union(., ./translation)
mapping:
  identity:
    v: orim
  map:
    v: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding

id:
  v: Observation.code.coding:loinc
path:
  v: Observation.code.coding
slice name:
  v: loinc
short:
  v: LOINC Kodierung
definition:
  v: A reference to a code defined by a terminology system.
comment:
  v: Motivation MS: Kodierung des Vitalparameters mittels LOINC.
requirements:
  v: Allows for alternative encodings within a code system, and translations to other code systems.
min:
  v: 1
max:
  v: 1
base:
  path:
    v: CodeableConcept.coding
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Coding
    l: Coding
  profile:
    v: https://gematik.de/fhir/isik/StructureDefinition/ISiKLoincCoding
    l: ISiKLoincCoding
pattern: Coding
  type: https://loinc.org/rdf/8310-5
  system:
    v: http://loinc.org
    l: loinc.org
  code:
    v: 8310-5
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
must support:
  v: true
is modifier:
  v: false
is summary:
  v: true
mapping:
  identity:
    v: v2
  map:
    v: C*E.1-8, C*E.10-22
mapping:
  identity:
    v: rim
  map:
    v: union(., ./translation)
mapping:
  identity:
    v: orim
  map:
    v: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding

id:
  v: Observation.code.coding:loinc.id
path:
  v: Observation.code.coding.id
representation:
  v: xmlAttr
short:
  v: Unique id for inter-element referencing
definition:
  v: Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Element.id
  min:
    v: 0
  max:
    v: 1
type:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type
      l: structuredefinition-fhir-type
    value: Url
      v: string
      l: string
  code:
    v: http://hl7.org/fhirpath/System.String
    l: System.String
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: n/a

id:
  v: Observation.code.coding:loinc.extension
path:
  v: Observation.code.coding.extension
slicing:
  discriminator:
    type:
      v: value
    path:
      v: url
  description:
    v: Extensions are always sliced by (at least) url
  rules:
    v: open
short:
  v: Additional content defined by implementations
definition:
  v: May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
comment:
  v: There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
alias:
  v: extensions
alias:
  v: user content
min:
  v: 0
max:
  v: *
base:
  path:
    v: Element.extension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
    l: Extension
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
  xpath:
    v: exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])
  source:
    v: http://hl7.org/fhir/StructureDefinition/Extension
    l: Extension
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: n/a

id:
  v: Observation.code.coding:loinc.system
path:
  v: Observation.code.coding.system
short:
  v: Identity of the terminology system
definition:
  v: The identification of the code system that defines the meaning of the symbol in the code.
comment:
  v: The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.
requirements:
  v: Need to be unambiguous about the source of the definition of the symbol.
min:
  v: 1
max:
  v: 1
base:
  path:
    v: Coding.system
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: uri
    l: uri
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
is modifier:
  v: false
is summary:
  v: true
mapping:
  identity:
    v: v2
  map:
    v: C*E.3
mapping:
  identity:
    v: rim
  map:
    v: ./codeSystem
mapping:
  identity:
    v: orim
  map:
    v: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem

id:
  v: Observation.code.coding:loinc.version
path:
  v: Observation.code.coding.version
short:
  v: Version of the system - if relevant
definition:
  v: The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.
comment:
  v: Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Coding.version
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: string
    l: string
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
is modifier:
  v: false
is summary:
  v: true
mapping:
  identity:
    v: v2
  map:
    v: C*E.7
mapping:
  identity:
    v: rim
  map:
    v: ./codeSystemVersion
mapping:
  identity:
    v: orim
  map:
    v: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion

id:
  v: Observation.code.coding:loinc.code
path:
  v: Observation.code.coding.code
short:
  v: Symbol in syntax defined by the system
definition:
  v: A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).
requirements:
  v: Need to refer to a particular code in the system.
min:
  v: 1
max:
  v: 1
base:
  path:
    v: Coding.code
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: code
    l: code
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
is modifier:
  v: false
is summary:
  v: true
mapping:
  identity:
    v: v2
  map:
    v: C*E.1
mapping:
  identity:
    v: rim
  map:
    v: ./code
mapping:
  identity:
    v: orim
  map:
    v: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code

id:
  v: Observation.code.coding:loinc.display
extension:
  url:
    v: http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable
    l: elementdefinition-translatable
  value: Boolean
    v: true
path:
  v: Observation.code.coding.display
short:
  v: Representation defined by the system
definition:
  v: A representation of the meaning of the code in the system, following the rules of the system.
requirements:
  v: Need to be able to carry a human-readable meaning of the code for readers that do not know the system.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Coding.display
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: string
    l: string
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
is modifier:
  v: false
is summary:
  v: true
mapping:
  identity:
    v: v2
  map:
    v: C*E.2 - but note this is not well followed
mapping:
  identity:
    v: rim
  map:
    v: CV.displayName
mapping:
  identity:
    v: orim
  map:
    v: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName

id:
  v: Observation.code.coding:loinc.userSelected
path:
  v: Observation.code.coding.userSelected
short:
  v: If this coding was chosen directly by the user
definition:
  v: Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).
comment:
  v: Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.
requirements:
  v: This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Coding.userSelected
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: boolean
    l: boolean
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
is modifier:
  v: false
is summary:
  v: true
mapping:
  identity:
    v: v2
  map:
    v: Sometimes implied by being first
mapping:
  identity:
    v: rim
  map:
    v: CD.codingRationale
mapping:
  identity:
    v: orim
  map:
    v: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]

id:
  v: Observation.code.coding:snomed
path:
  v: Observation.code.coding
slice name:
  v: snomed
short:
  v: SNOMED CT Kodierung
definition:
  v: A reference to a code defined by a terminology system.
comment:
  v: Motivation MS: Kodierung des Vitalparameters mittels SNOMED CT.
requirements:
  v: Allows for alternative encodings within a code system, and translations to other code systems.
min:
  v: 1
max:
  v: 1
base:
  path:
    v: CodeableConcept.coding
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Coding
    l: Coding
  profile:
    v: https://gematik.de/fhir/isik/StructureDefinition/ISiKSnomedCTCoding
    l: ISiKSnomedCTCoding
pattern: Coding
  type: http://snomed.info/id/307047009
  system:
    v: http://snomed.info/sct
    l: sct
  code:
    v: 307047009
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
must support:
  v: true
is modifier:
  v: false
is summary:
  v: true
binding:
  strength:
    v: required
  value set:
    v: https://gematik.de/fhir/isik/ValueSet/ISiKKernTempSctVS
    l: ISiKKernTempSctVS
mapping:
  identity:
    v: v2
  map:
    v: C*E.1-8, C*E.10-22
mapping:
  identity:
    v: rim
  map:
    v: union(., ./translation)
mapping:
  identity:
    v: orim
  map:
    v: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding

id:
  v: Observation.code.coding:snomed.id
path:
  v: Observation.code.coding.id
representation:
  v: xmlAttr
short:
  v: Unique id for inter-element referencing
definition:
  v: Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Element.id
  min:
    v: 0
  max:
    v: 1
type:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type
      l: structuredefinition-fhir-type
    value: Url
      v: string
      l: string
  code:
    v: http://hl7.org/fhirpath/System.String
    l: System.String
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: n/a

id:
  v: Observation.code.coding:snomed.extension
path:
  v: Observation.code.coding.extension
slicing:
  discriminator:
    type:
      v: value
    path:
      v: url
  description:
    v: Extensions are always sliced by (at least) url
  rules:
    v: open
short:
  v: Additional content defined by implementations
definition:
  v: May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
comment:
  v: There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
alias:
  v: extensions
alias:
  v: user content
min:
  v: 0
max:
  v: *
base:
  path:
    v: Element.extension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
    l: Extension
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
  xpath:
    v: exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])
  source:
    v: http://hl7.org/fhir/StructureDefinition/Extension
    l: Extension
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: n/a

id:
  v: Observation.code.coding:snomed.system
path:
  v: Observation.code.coding.system
short:
  v: Identity of the terminology system
definition:
  v: The identification of the code system that defines the meaning of the symbol in the code.
comment:
  v: The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.
requirements:
  v: Need to be unambiguous about the source of the definition of the symbol.
min:
  v: 1
max:
  v: 1
base:
  path:
    v: Coding.system
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: uri
    l: uri
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
is modifier:
  v: false
is summary:
  v: true
mapping:
  identity:
    v: v2
  map:
    v: C*E.3
mapping:
  identity:
    v: rim
  map:
    v: ./codeSystem
mapping:
  identity:
    v: orim
  map:
    v: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem

id:
  v: Observation.code.coding:snomed.version
path:
  v: Observation.code.coding.version
short:
  v: Version of the system - if relevant
definition:
  v: The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.
comment:
  v: Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Coding.version
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: string
    l: string
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
is modifier:
  v: false
is summary:
  v: true
mapping:
  identity:
    v: v2
  map:
    v: C*E.7
mapping:
  identity:
    v: rim
  map:
    v: ./codeSystemVersion
mapping:
  identity:
    v: orim
  map:
    v: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion

id:
  v: Observation.code.coding:snomed.code
path:
  v: Observation.code.coding.code
short:
  v: Symbol in syntax defined by the system
definition:
  v: A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).
requirements:
  v: Need to refer to a particular code in the system.
min:
  v: 1
max:
  v: 1
base:
  path:
    v: Coding.code
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: code
    l: code
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
is modifier:
  v: false
is summary:
  v: true
mapping:
  identity:
    v: v2
  map:
    v: C*E.1
mapping:
  identity:
    v: rim
  map:
    v: ./code
mapping:
  identity:
    v: orim
  map:
    v: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code

id:
  v: Observation.code.coding:snomed.display
extension:
  url:
    v: http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable
    l: elementdefinition-translatable
  value: Boolean
    v: true
path:
  v: Observation.code.coding.display
short:
  v: Representation defined by the system
definition:
  v: A representation of the meaning of the code in the system, following the rules of the system.
requirements:
  v: Need to be able to carry a human-readable meaning of the code for readers that do not know the system.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Coding.display
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: string
    l: string
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
is modifier:
  v: false
is summary:
  v: true
mapping:
  identity:
    v: v2
  map:
    v: C*E.2 - but note this is not well followed
mapping:
  identity:
    v: rim
  map:
    v: CV.displayName
mapping:
  identity:
    v: orim
  map:
    v: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName

id:
  v: Observation.code.coding:snomed.userSelected
path:
  v: Observation.code.coding.userSelected
short:
  v: If this coding was chosen directly by the user
definition:
  v: Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).
comment:
  v: Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.
requirements:
  v: This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Coding.userSelected
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: boolean
    l: boolean
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
is modifier:
  v: false
is summary:
  v: true
mapping:
  identity:
    v: v2
  map:
    v: Sometimes implied by being first
mapping:
  identity:
    v: rim
  map:
    v: CD.codingRationale
mapping:
  identity:
    v: orim
  map:
    v: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]

id:
  v: Observation.code.coding:IEEE11073
path:
  v: Observation.code.coding
slice name:
  v: IEEE11073
short:
  v: Code defined by a terminology system
definition:
  v: A reference to a code defined by a terminology system.
comment:
  v: Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
requirements:
  v: Allows for alternative encodings within a code system, and translations to other code systems.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: CodeableConcept.coding
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Coding
    l: Coding
pattern: Coding
  system:
    v: urn:iso:std:iso:11073:10101
    l: 10101
  code:
    v: 150364
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
is modifier:
  v: false
is summary:
  v: true
mapping:
  identity:
    v: v2
  map:
    v: C*E.1-8, C*E.10-22
mapping:
  identity:
    v: rim
  map:
    v: union(., ./translation)
mapping:
  identity:
    v: orim
  map:
    v: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding

id:
  v: Observation.code.coding:coretemp-IEEE11073
path:
  v: Observation.code.coding
slice name:
  v: coretemp-IEEE11073
short:
  v: Code defined by a terminology system
definition:
  v: A reference to a code defined by a terminology system.
comment:
  v: Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
requirements:
  v: Allows for alternative encodings within a code system, and translations to other code systems.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: CodeableConcept.coding
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Coding
    l: Coding
pattern: Coding
  system:
    v: urn:iso:std:iso:11073:10101
    l: 10101
  code:
    v: 150368
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
is modifier:
  v: false
is summary:
  v: true
mapping:
  identity:
    v: v2
  map:
    v: C*E.1-8, C*E.10-22
mapping:
  identity:
    v: rim
  map:
    v: union(., ./translation)
mapping:
  identity:
    v: orim
  map:
    v: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding

id:
  v: Observation.code.coding:coretemp-loinc
path:
  v: Observation.code.coding
slice name:
  v: coretemp-loinc
short:
  v: Code defined by a terminology system
definition:
  v: A reference to a code defined by a terminology system.
comment:
  v: Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
requirements:
  v: Allows for alternative encodings within a code system, and translations to other code systems.
min:
  v: 1
max:
  v: 1
base:
  path:
    v: CodeableConcept.coding
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Coding
    l: Coding
pattern: Coding
  type: https://loinc.org/rdf/8329-5
  system:
    v: http://loinc.org
    l: loinc.org
  code:
    v: 8329-5
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
is modifier:
  v: false
is summary:
  v: true
mapping:
  identity:
    v: v2
  map:
    v: C*E.1-8, C*E.10-22
mapping:
  identity:
    v: rim
  map:
    v: union(., ./translation)
mapping:
  identity:
    v: orim
  map:
    v: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding

id:
  v: Observation.code.coding:specific-loinc
path:
  v: Observation.code.coding
slice name:
  v: specific-loinc
short:
  v: Code defined by a terminology system
definition:
  v: A reference to a code defined by a terminology system.
comment:
  v: Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
requirements:
  v: Allows for alternative encodings within a code system, and translations to other code systems.
min:
  v: 1
max:
  v: 1
base:
  path:
    v: CodeableConcept.coding
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Coding
    l: Coding
pattern: Coding
  type: https://loinc.org/rdf/8332-9
  system:
    v: http://loinc.org
    l: loinc.org
  code:
    v: 8332-9
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
is modifier:
  v: false
is summary:
  v: true
binding:
  strength:
    v: required
  value set:
    v: https://gematik.de/fhir/isik/ValueSet/ISiKSpecificKernTempLoincVS
    l: ISiKSpecificKernTempLoincVS
mapping:
  identity:
    v: v2
  map:
    v: C*E.1-8, C*E.10-22
mapping:
  identity:
    v: rim
  map:
    v: union(., ./translation)
mapping:
  identity:
    v: orim
  map:
    v: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding

id:
  v: Observation.code.coding:specific-IEEE-11073
path:
  v: Observation.code.coding
slice name:
  v: specific-IEEE-11073
short:
  v: Coding
definition:
  v: A reference to a code defined by a terminology system.
comment:
  v: Motivation MS: Semantische Kodierung
requirements:
  v: Allows for alternative encodings within a code system, and translations to other code systems.
min:
  v: 1
max:
  v: 1
base:
  path:
    v: CodeableConcept.coding
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Coding
    l: Coding
pattern: Coding
  system:
    v: urn:iso:std:iso:11073:10101
    l: 10101
  code:
    v: 188420
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
must support:
  v: true
is modifier:
  v: false
is summary:
  v: true
mapping:
  identity:
    v: v2
  map:
    v: C*E.1-8, C*E.10-22
mapping:
  identity:
    v: rim
  map:
    v: union(., ./translation)
mapping:
  identity:
    v: orim
  map:
    v: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding

id:
  v: Observation.code.text
extension:
  url:
    v: http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable
    l: elementdefinition-translatable
  value: Boolean
    v: true
path:
  v: Observation.code.text
short:
  v: Plain text representation of the concept
definition:
  v: A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.
comment:
  v: Very often the text is the same as a displayName of one of the codings.
requirements:
  v: The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: CodeableConcept.text
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: string
    l: string
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
is modifier:
  v: false
is summary:
  v: true
mapping:
  identity:
    v: v2
  map:
    v: C*E.9. But note many systems use C*E.2 for this
mapping:
  identity:
    v: rim
  map:
    v: ./originalText[mediaType/code="text/plain"]/data
mapping:
  identity:
    v: orim
  map:
    v: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText

id:
  v: Observation.subject
path:
  v: Observation.subject
short:
  v: Patient
definition:
  v: The patient, or group of patients, location, or device this observation is about and into whose record the observation is placed. If the actual focus of the observation is different from the subject (or a sample of, part, or region of the subject), the `focus` element or the `code` itself specifies the actual focus of the observation.
comment:
  v: **Motivation MS:** Die Verlinkung auf eine Patienten-Ressource dient der technischen Zuordnung der Dokumentation zu einem Patienten und ermöglicht wichtige API-Funktionen wie verkettete Suche, (Reverse-)Include etc. Im ISik Kontext MUSS die referenzierte Ressource konform zu [ISiKPatient](https://gematik.de/fhir/isik/StructureDefinition/ISiKPatient) sein. Jenseits von ISiK KÖNNEN weitere Instanzen mit anderen Profilen referenziert werden.
requirements:
  v: Observations have no value if you don't know who or what they're about.
min:
  v: 1
max:
  v: 1
base:
  path:
    v: Observation.subject
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: Reference
    l: Reference
  target profile:
    v: http://hl7.org/fhir/StructureDefinition/Patient
    l: Patient
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
must support:
  v: true
is modifier:
  v: false
is summary:
  v: true
mapping:
  identity:
    v: workflow
  map:
    v: Event.subject
mapping:
  identity:
    v: w5
  map:
    v: FiveWs.subject[x]
mapping:
  identity:
    v: v2
  map:
    v: PID-3
mapping:
  identity:
    v: rim
  map:
    v: participation[typeCode=RTGT]
mapping:
  identity:
    v: w5
  map:
    v: FiveWs.subject

id:
  v: Observation.focus
path:
  v: Observation.focus
short:
  v: What the observation is about, when it is not about the subject of record
definition:
  v: The actual focus of an observation when it is not the patient of record representing something or someone associated with the patient such as a spouse, parent, fetus, or donor. For example, fetus observations in a mother's record. The focus of an observation could also be an existing condition, an intervention, the subject's diet, another observation of the subject, or a body structure such as tumor or implanted device. An example use case would be using the Observation resource to capture whether the mother is trained to change her child's tracheostomy tube. In this example, the child is the patient of record and the mother is the focus.
comment:
  v: Typically, an observation is made about the subject - a patient, or group of patients, location, or device - and the distinction between the subject and what is directly measured for an observation is specified in the observation code itself ( e.g., "Blood Glucose") and does not need to be represented separately using this element. Use `specimen` if a reference to a specimen is required. If a code is required instead of a resource use either `bodysite` for bodysites or the standard extension [focusCode](http://hl7.org/fhir/R4/extension-observation-focuscode.html).
min:
  v: 0
max:
  v: *
base:
  path:
    v: Observation.focus
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Reference
    l: Reference
  target profile:
    v: http://hl7.org/fhir/StructureDefinition/Resource
    l: Resource
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
is modifier:
  v: false
is summary:
  v: true
mapping:
  identity:
    v: w5
  map:
    v: FiveWs.subject[x]
mapping:
  identity:
    v: v2
  map:
    v: OBX-3
mapping:
  identity:
    v: rim
  map:
    v: participation[typeCode=SBJ]
mapping:
  identity:
    v: w5
  map:
    v: FiveWs.subject

id:
  v: Observation.encounter
path:
  v: Observation.encounter
short:
  v: Aufenthaltsbezug
definition:
  v: The healthcare event (e.g. a patient and healthcare provider interaction) during which this observation is made.
comment:
  v: Motivation MS: Der Behandlungskontext ist für die Interpretation der Untersuchungsergebnisse relevant
requirements:
  v: For some observations it may be important to know the link between an observation and a particular encounter.
alias:
  v: Context
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Observation.encounter
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: Reference
    l: Reference
  target profile:
    v: http://hl7.org/fhir/StructureDefinition/Encounter
    l: Encounter
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
must support:
  v: true
is modifier:
  v: false
is summary:
  v: true
mapping:
  identity:
    v: workflow
  map:
    v: Event.context
mapping:
  identity:
    v: w5
  map:
    v: FiveWs.context
mapping:
  identity:
    v: v2
  map:
    v: PV1
mapping:
  identity:
    v: rim
  map:
    v: inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN]

id:
  v: Observation.encounter.id
path:
  v: Observation.encounter.id
representation:
  v: xmlAttr
short:
  v: Unique id for inter-element referencing
definition:
  v: Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Element.id
  min:
    v: 0
  max:
    v: 1
type:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type
      l: structuredefinition-fhir-type
    value: Url
      v: string
      l: string
  code:
    v: http://hl7.org/fhirpath/System.String
    l: System.String
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: n/a

id:
  v: Observation.encounter.extension
path:
  v: Observation.encounter.extension
slicing:
  discriminator:
    type:
      v: value
    path:
      v: url
  description:
    v: Extensions are always sliced by (at least) url
  rules:
    v: open
short:
  v: Additional content defined by implementations
definition:
  v: May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
comment:
  v: There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
alias:
  v: extensions
alias:
  v: user content
min:
  v: 0
max:
  v: *
base:
  path:
    v: Element.extension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
    l: Extension
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
  xpath:
    v: exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])
  source:
    v: http://hl7.org/fhir/StructureDefinition/Extension
    l: Extension
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: n/a

id:
  v: Observation.encounter.reference
path:
  v: Observation.encounter.reference
short:
  v: Encounter-Link
definition:
  v: A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.
comment:
  v: **Begründung Pflichtfeld:** Die Verlinkung auf eine Encounter-Ressource dient der technischen Zuordnung der Dokumentation zu einem Aufenthalt und ermöglicht wichtige API-Funktionen wie verkettete Suche, (Reverse-)Include etc. **WICHTIGER Hinweis für Implementierer:** Die Zuordnung MUSS auf einen Encounter der Ebene "Abteilungskontakt" (siehe hierzu Basismodul > UseCases > Abbildung des Konstruktes "Fall") erfolgen. Bei der Auswahl des Encounters ist zu beachten, dass unter einer (Abrechnungs-)"Fallnummer" (hier: `Encounter.account`) unter Umständen mehrere Encounter gruppiert sein können (z.B. stationärer Besuch mit mehreren vor- und nachstationären Aufenthalten.) Im ISik Kontext MUSS die referenzierte Ressource konform zu [ISiKKontaktGesundheitseinrichtung](https://gematik.de/fhir/isik/StructureDefinition/ISiKKontaktGesundheitseinrichtung) sein. Jenseits von ISiK KÖNNEN weitere Instanzen mit anderen Profilen referenziert werden.
min:
  v: 1
max:
  v: 1
base:
  path:
    v: Reference.reference
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: string
    l: string
condition:
  v: ref-1
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
must support:
  v: true
is modifier:
  v: false
is summary:
  v: true
mapping:
  identity:
    v: rim
  map:
    v: N/A

id:
  v: Observation.encounter.type
path:
  v: Observation.encounter.type
short:
  v: Type the reference refers to (e.g. "Patient")
definition:
  v: The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).
comment:
  v: This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Reference.type
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: uri
    l: uri
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
is modifier:
  v: false
is summary:
  v: true
binding:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName
      l: elementdefinition-bindingName
    value: String
      v: FHIRResourceTypeExt
  strength:
    v: extensible
  description:
    v: Aa resource (or, for logical models, the URI of the logical model).
  value set:
    v: http://hl7.org/fhir/ValueSet/resource-types|4.0.1
    l: http://hl7.org/fhir/ValueSet/resource-types
mapping:
  identity:
    v: rim
  map:
    v: N/A

id:
  v: Observation.encounter.identifier
path:
  v: Observation.encounter.identifier
short:
  v: Logical reference, when literal reference is not known
definition:
  v: An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.
comment:
  v: When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Reference.identifier
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: Identifier
    l: Identifier
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
is modifier:
  v: false
is summary:
  v: true
mapping:
  identity:
    v: rim
  map:
    v: .identifier

id:
  v: Observation.encounter.display
extension:
  url:
    v: http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable
    l: elementdefinition-translatable
  value: Boolean
    v: true
path:
  v: Observation.encounter.display
short:
  v: Text alternative for the resource
definition:
  v: Plain text narrative that identifies the resource in addition to the resource reference.
comment:
  v: This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Reference.display
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: string
    l: string
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
is modifier:
  v: false
is summary:
  v: true
mapping:
  identity:
    v: rim
  map:
    v: N/A

id:
  v: Observation.effective[x]
path:
  v: Observation.effective[x]
short:
  v: Datum und Uhrzeit der Untersuchung
definition:
  v: The time or time-period the observed value is asserted as being true. For biological subjects - e.g. human patients - this is usually called the "physiologically relevant time". This is usually either the time of the procedure or of specimen collection, but very often the source of the date/time is not known, only the date/time itself.
comment:
  v: Motivation MS: Das Datum und die Uhrzeit der Untersuchung sind für die Interpretation der Untersuchungsergebnisse relevant
requirements:
  v: Knowing when an observation was deemed true is important to its relevance as well as determining trends.
alias:
  v: Occurrence
min:
  v: 1
max:
  v: 1
base:
  path:
    v: Observation.effective[x]
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: dateTime
    l: dateTime
type:
  code:
    v: Period
    l: Period
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
constraint:
  key:
    v: vs-de-1
  severity:
    v: error
  human:
    v: If Observation.effective[x] has a value then that value shall be precise to the day
  expression:
    v: (($this is dateTime) implies ($this as dateTime).toString().length() >= 10) and ($this.start.exists() implies ($this.start as dateTime).toString().length() >= 10) and ($this.end.exists() implies ($this.end as dateTime).toString().length() >= 10)
  source:
    v: http://fhir.de/StructureDefinition/observation-de-vitalsign
    l: observation-de-vitalsign
must support:
  v: true
is modifier:
  v: false
is summary:
  v: true
mapping:
  identity:
    v: workflow
  map:
    v: Event.occurrence[x]
mapping:
  identity:
    v: w5
  map:
    v: FiveWs.done[x]
mapping:
  identity:
    v: v2
  map:
    v: OBX-14, and/or OBX-19 after v2.4 (depends on who observation made)
mapping:
  identity:
    v: rim
  map:
    v: effectiveTime

id:
  v: Observation.issued
path:
  v: Observation.issued
short:
  v: Date/Time this version was made available
definition:
  v: The date and time this version of the observation was made available to providers, typically after the results have been reviewed and verified.
comment:
  v: For Observations that don’t require review and verification, it may be the same as the [`lastUpdated` ](http://hl7.org/fhir/R4/resource-definitions.html#Meta.lastUpdated) time of the resource itself. For Observations that do require review and verification for certain updates, it might not be the same as the `lastUpdated` time of the resource itself due to a non-clinically significant update that doesn’t require the new version to be reviewed and verified again.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Observation.issued
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: instant
    l: instant
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
is modifier:
  v: false
is summary:
  v: true
mapping:
  identity:
    v: w5
  map:
    v: FiveWs.recorded
mapping:
  identity:
    v: v2
  map:
    v: OBR.22 (or MSH.7), or perhaps OBX-19 (depends on who observation made)
mapping:
  identity:
    v: rim
  map:
    v: participation[typeCode=AUT].time

id:
  v: Observation.performer
path:
  v: Observation.performer
short:
  v: Untersuchender
definition:
  v: Who was responsible for asserting the observed value as "true".
comment:
  v: Motivation MS: Dieses Feld stellt präzisierende Angaben zum Zweck der Qualitätsbewertung bereit
requirements:
  v: May give a degree of confidence in the observation and also indicates where follow-up questions should be directed.
min:
  v: 0
max:
  v: *
base:
  path:
    v: Observation.performer
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Reference
    l: Reference
  target profile:
    v: http://hl7.org/fhir/StructureDefinition/Practitioner
    l: Practitioner
  target profile:
    v: http://hl7.org/fhir/StructureDefinition/PractitionerRole
    l: PractitionerRole
  target profile:
    v: http://hl7.org/fhir/StructureDefinition/Organization
    l: Organization
  target profile:
    v: http://hl7.org/fhir/StructureDefinition/CareTeam
    l: CareTeam
  target profile:
    v: http://hl7.org/fhir/StructureDefinition/Patient
    l: Patient
  target profile:
    v: http://hl7.org/fhir/StructureDefinition/RelatedPerson
    l: RelatedPerson
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
must support:
  v: true
is modifier:
  v: false
is summary:
  v: true
mapping:
  identity:
    v: workflow
  map:
    v: Event.performer.actor
mapping:
  identity:
    v: w5
  map:
    v: FiveWs.actor
mapping:
  identity:
    v: v2
  map:
    v: OBX.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'
mapping:
  identity:
    v: rim
  map:
    v: participation[typeCode=PRF]

id:
  v: Observation.value[x]
path:
  v: Observation.value[x]
slicing:
  discriminator:
    type:
      v: type
    path:
      v: $this
  ordered:
    v: false
  rules:
    v: closed
short:
  v: Untersuchungsergebnis
definition:
  v: The information determined as a result of making the observation, if the information has a simple value.
comment:
  v: Motivation MS: Der Wert des Vitalparameters ist das zentrale Ergebnis der Untersuchung
requirements:
  v: An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Observation.value[x]
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: Quantity
    l: Quantity
type:
  code:
    v: CodeableConcept
    l: CodeableConcept
type:
  code:
    v: string
    l: string
type:
  code:
    v: boolean
    l: boolean
type:
  code:
    v: integer
    l: integer
type:
  code:
    v: Range
    l: Range
type:
  code:
    v: Ratio
    l: Ratio
type:
  code:
    v: SampledData
    l: SampledData
type:
  code:
    v: time
    l: time
type:
  code:
    v: dateTime
    l: dateTime
type:
  code:
    v: Period
    l: Period
condition:
  v: obs-7
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
must support:
  v: true
is modifier:
  v: false
is summary:
  v: true
mapping:
  identity:
    v: sct-concept
  map:
    v: < 441742003 |Evaluation finding|
mapping:
  identity:
    v: v2
  map:
    v: OBX.2, OBX.5, OBX.6
mapping:
  identity:
    v: rim
  map:
    v: value
mapping:
  identity:
    v: sct-attr
  map:
    v: 363714003 |Interprets|

id:
  v: Observation.value[x]:valueQuantity
path:
  v: Observation.value[x]
slice name:
  v: valueQuantity
short:
  v: quantitatives Untersuchungsergebnis
definition:
  v: The information determined as a result of making the observation, if the information has a simple value.
comment:
  v: Motivation MS: valueQuantity muss für VitalSigns unterstützt werden
requirements:
  v: An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Observation.value[x]
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: Quantity
    l: Quantity
pattern: Quantity
  system:
    v: http://unitsofmeasure.org
    l: unitsofmeasure.org
  code:
    v: Cel
condition:
  v: obs-7
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
must support:
  v: true
is modifier:
  v: false
is summary:
  v: true
mapping:
  identity:
    v: sct-concept
  map:
    v: < 441742003 |Evaluation finding|
mapping:
  identity:
    v: v2
  map:
    v: OBX.2, OBX.5, OBX.6
mapping:
  identity:
    v: rim
  map:
    v: value
mapping:
  identity:
    v: sct-attr
  map:
    v: 363714003 |Interprets|

id:
  v: Observation.value[x]:valueQuantity.id
path:
  v: Observation.value[x].id
representation:
  v: xmlAttr
short:
  v: Unique id for inter-element referencing
definition:
  v: Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Element.id
  min:
    v: 0
  max:
    v: 1
type:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type
      l: structuredefinition-fhir-type
    value: Url
      v: string
      l: string
  code:
    v: http://hl7.org/fhirpath/System.String
    l: System.String
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: n/a

id:
  v: Observation.value[x]:valueQuantity.extension
path:
  v: Observation.value[x].extension
slicing:
  discriminator:
    type:
      v: value
    path:
      v: url
  description:
    v: Extensions are always sliced by (at least) url
  rules:
    v: open
short:
  v: Additional content defined by implementations
definition:
  v: May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
comment:
  v: There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
alias:
  v: extensions
alias:
  v: user content
min:
  v: 0
max:
  v: *
base:
  path:
    v: Element.extension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
    l: Extension
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
  xpath:
    v: exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])
  source:
    v: http://hl7.org/fhir/StructureDefinition/Extension
    l: Extension
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: n/a

id:
  v: Observation.value[x]:valueQuantity.value
path:
  v: Observation.value[x].value
short:
  v: Wert
definition:
  v: The value of the measured amount. The value includes an implicit precision in the presentation of the value.
comment:
  v: Motivation MS: Eine Quantity soll einen Wert enthalten
requirements:
  v: Precision is handled implicitly in almost all cases of measurement.
min:
  v: 1
max:
  v: 1
base:
  path:
    v: Quantity.value
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: decimal
    l: decimal
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
must support:
  v: true
is modifier:
  v: false
is summary:
  v: true
mapping:
  identity:
    v: v2
  map:
    v: SN.2 / CQ - N/A
mapping:
  identity:
    v: rim
  map:
    v: PQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value

id:
  v: Observation.value[x]:valueQuantity.comparator
path:
  v: Observation.value[x].comparator
short:
  v: < | <= | >= | > - how to understand the value
definition:
  v: How the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is "<" , then the real value is < stated value.
requirements:
  v: Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Quantity.comparator
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: code
    l: code
meaning when missing:
  v: If there is no comparator, then there is no modification of the value
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
is modifier:
  v: true
is modifier reason:
  v: This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value
is summary:
  v: true
binding:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName
      l: elementdefinition-bindingName
    value: String
      v: QuantityComparator
  strength:
    v: required
  description:
    v: How the Quantity should be understood and represented.
  value set:
    v: http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1
    l: http://hl7.org/fhir/ValueSet/quantity-comparator
mapping:
  identity:
    v: v2
  map:
    v: SN.1 / CQ.1
mapping:
  identity:
    v: rim
  map:
    v: IVL properties

id:
  v: Observation.value[x]:valueQuantity.unit
extension:
  url:
    v: http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable
    l: elementdefinition-translatable
  value: Boolean
    v: true
path:
  v: Observation.value[x].unit
short:
  v: Einheit
definition:
  v: A human-readable form of the unit.
comment:
  v: Motivation MS: Eine Quantity soll eine Einheit enthalten
requirements:
  v: There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.
min:
  v: 1
max:
  v: 1
base:
  path:
    v: Quantity.unit
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: string
    l: string
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
must support:
  v: true
is modifier:
  v: false
is summary:
  v: true
mapping:
  identity:
    v: v2
  map:
    v: (see OBX.6 etc.) / CQ.2
mapping:
  identity:
    v: rim
  map:
    v: PQ.unit

id:
  v: Observation.value[x]:valueQuantity.system
path:
  v: Observation.value[x].system
short:
  v: CodeSystem aus dem die Einheit stammt
definition:
  v: The identification of the system that provides the coded form of the unit.
comment:
  v: Motivation MS: Eine Quantity soll ein System, mit dem die Einheit kodiert wird, enthalten
requirements:
  v: Need to know the system that defines the coded form of the unit.
min:
  v: 1
max:
  v: 1
base:
  path:
    v: Quantity.system
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: uri
    l: uri
pattern: Uri
  v: http://unitsofmeasure.org
  l: unitsofmeasure.org
condition:
  v: qty-3
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
must support:
  v: true
is modifier:
  v: false
is summary:
  v: true
mapping:
  identity:
    v: v2
  map:
    v: (see OBX.6 etc.) / CQ.2
mapping:
  identity:
    v: rim
  map:
    v: CO.codeSystem, PQ.translation.codeSystem

id:
  v: Observation.value[x]:valueQuantity.code
path:
  v: Observation.value[x].code
short:
  v: Code der Einheit
definition:
  v: A computer processable form of the unit in some unit representation system.
comment:
  v: Motivation MS: Eine Quantity soll einen Code der die Einheit kodiert enthalten
requirements:
  v: Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest.
min:
  v: 1
max:
  v: 1
base:
  path:
    v: Quantity.code
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: code
    l: code
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
must support:
  v: true
is modifier:
  v: false
is summary:
  v: true
binding:
  strength:
    v: required
  value set:
    v: http://fhir.de/ValueSet/UcumVitalsCommonDE
    l: UcumVitalsCommonDE
mapping:
  identity:
    v: v2
  map:
    v: (see OBX.6 etc.) / CQ.2
mapping:
  identity:
    v: rim
  map:
    v: PQ.code, MO.currency, PQ.translation.code

id:
  v: Observation.dataAbsentReason
path:
  v: Observation.dataAbsentReason
short:
  v: Grund für fehlende Untersuchungsergebnisse
definition:
  v: Provides a reason why the expected value in the element Observation.value[x] is missing.
comment:
  v: Motivation MS: Dieses Feld erlaubt die Angabe von Gründen für fehlende Untersuchungsergebnisse
requirements:
  v: For many results it is necessary to handle exceptional values in measurements.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Observation.dataAbsentReason
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: CodeableConcept
    l: CodeableConcept
condition:
  v: obs-6
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
must support:
  v: true
is modifier:
  v: false
is summary:
  v: false
binding:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName
      l: elementdefinition-bindingName
    value: String
      v: ObservationValueAbsentReason
  strength:
    v: extensible
  description:
    v: Codes specifying why the result (`Observation.value[x]`) is missing.
  value set:
    v: http://hl7.org/fhir/ValueSet/data-absent-reason
    l: data-absent-reason
mapping:
  identity:
    v: v2
  map:
    v: N/A
mapping:
  identity:
    v: rim
  map:
    v: value.nullFlavor

id:
  v: Observation.interpretation
path:
  v: Observation.interpretation
short:
  v: High, low, normal, etc.
definition:
  v: A categorical assessment of an observation value. For example, high, low, normal.
comment:
  v: Historically used for laboratory results (known as 'abnormal flag' ), its use extends to other use cases where coded interpretations are relevant. Often reported as one or more simple compact codes this element is often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result.
requirements:
  v: For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.
alias:
  v: Abnormal Flag
min:
  v: 0
max:
  v: *
base:
  path:
    v: Observation.interpretation
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: CodeableConcept
    l: CodeableConcept
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
is modifier:
  v: false
is summary:
  v: false
binding:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName
      l: elementdefinition-bindingName
    value: String
      v: ObservationInterpretation
  strength:
    v: extensible
  description:
    v: Codes identifying interpretations of observations.
  value set:
    v: http://hl7.org/fhir/ValueSet/observation-interpretation
    l: observation-interpretation
mapping:
  identity:
    v: sct-concept
  map:
    v: < 260245000 |Findings values|
mapping:
  identity:
    v: v2
  map:
    v: OBX-8
mapping:
  identity:
    v: rim
  map:
    v: interpretationCode
mapping:
  identity:
    v: sct-attr
  map:
    v: 363713009 |Has interpretation|

id:
  v: Observation.note
path:
  v: Observation.note
short:
  v: Comments about the observation
definition:
  v: Comments about the observation or the results.
comment:
  v: May include general statements about the observation, or statements about significant, unexpected or unreliable results values, or information about its source when relevant to its interpretation.
requirements:
  v: Need to be able to provide free text additional information.
min:
  v: 0
max:
  v: *
base:
  path:
    v: Observation.note
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Annotation
    l: Annotation
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: v2
  map:
    v: NTE.3 (partner NTE to OBX, or sometimes another (child?) OBX)
mapping:
  identity:
    v: rim
  map:
    v: subjectOf.observationEvent[code="annotation"].value

id:
  v: Observation.bodySite
path:
  v: Observation.bodySite
short:
  v: Observed body part
definition:
  v: Indicates the site on the subject's body where the observation was made (i.e. the target site).
comment:
  v: Only used if not implicit in code found in Observation.code. In many systems, this may be represented as a related observation instead of an inline component. If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use the standard extension[ bodySite](http://hl7.org/fhir/R4/extension-bodysite.html).
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Observation.bodySite
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: CodeableConcept
    l: CodeableConcept
pattern: CodeableConcept
  coding: http://snomed.info/id/34402009
    system:
      v: http://snomed.info/sct
      l: sct
    code:
      v: 34402009
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
is modifier:
  v: false
is summary:
  v: false
binding:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName
      l: elementdefinition-bindingName
    value: String
      v: BodySite
  strength:
    v: example
  description:
    v: Codes describing anatomical locations. May include laterality.
  value set:
    v: http://hl7.org/fhir/ValueSet/body-site
    l: body-site
mapping:
  identity:
    v: sct-concept
  map:
    v: < 123037004 |Body structure|
mapping:
  identity:
    v: v2
  map:
    v: OBX-20
mapping:
  identity:
    v: rim
  map:
    v: targetSiteCode
mapping:
  identity:
    v: sct-attr
  map:
    v: 718497002 |Inherent location|

id:
  v: Observation.method
path:
  v: Observation.method
short:
  v: Untersuchungsmethode
definition:
  v: Indicates the mechanism used to perform the observation.
comment:
  v: **Einschränkung der übergreifenden MS-Definition:** Verfügt ein bestätigungsrelevantes System nicht über die Datenstruktur zur Hinterlegung der Untersuchungsmethode, so MUSS dieses System die Information NICHT abbilden Motivation zum eingeschränkten MS: Dieses Feld stellt präzisierende Angaben zum Zweck der Qualitätsbewertung bereit. Allerdings rechtfertigt der Stand der Umsetzung in gängigen Systemen eine Implementierungspflicht (MS) für die Schnittstelle nicht.
requirements:
  v: In some cases, method can impact results and is thus used for determining whether results can be compared or determining significance of results.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Observation.method
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: CodeableConcept
    l: CodeableConcept
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
must support:
  v: true
is modifier:
  v: false
is summary:
  v: false
binding:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName
      l: elementdefinition-bindingName
    value: String
      v: ObservationMethod
  strength:
    v: example
  description:
    v: Methods for simple observations.
  value set:
    v: http://hl7.org/fhir/ValueSet/observation-methods
    l: observation-methods
mapping:
  identity:
    v: v2
  map:
    v: OBX-17
mapping:
  identity:
    v: rim
  map:
    v: methodCode

id:
  v: Observation.specimen
path:
  v: Observation.specimen
short:
  v: Specimen used for this observation
definition:
  v: The specimen that was used when this observation was made.
comment:
  v: Should only be used if not implicit in code found in `Observation.code`. Observations are not made on specimens themselves; they are made on a subject, but in many cases by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Observation.specimen
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: Reference
    l: Reference
  target profile:
    v: http://hl7.org/fhir/StructureDefinition/Specimen
    l: Specimen
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: sct-concept
  map:
    v: < 123038009 |Specimen|
mapping:
  identity:
    v: v2
  map:
    v: SPM segment
mapping:
  identity:
    v: rim
  map:
    v: participation[typeCode=SPC].specimen
mapping:
  identity:
    v: sct-attr
  map:
    v: 704319004 |Inherent in|

id:
  v: Observation.device
path:
  v: Observation.device
short:
  v: Gerät
definition:
  v: The device used to generate the observation data.
comment:
  v: **Einschränkung der übergreifenden MS-Definition:** Verfügt ein bestätigungsrelevantes System nicht über die Datenstruktur zur Hinterlegung des Geräts, mittels dessen der Parameter erhoben worden ist, so MUSS dieses System die Information NICHT abbilden. Motivation zum eingeschränkten MS: Dieses Feld stellt präzisierende Angaben zum Zweck der Qualitätsbewertung bereit. Allerdings rechtfertigt der Stand der Umsetzung in gängigen Systemen eine Implementierungspflicht (MS) für die Schnittstelle nicht.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Observation.device
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: Reference
    l: Reference
  target profile:
    v: http://hl7.org/fhir/StructureDefinition/Device
    l: Device
  target profile:
    v: http://hl7.org/fhir/StructureDefinition/DeviceMetric
    l: DeviceMetric
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
must support:
  v: true
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: sct-concept
  map:
    v: < 49062001 |Device|
mapping:
  identity:
    v: v2
  map:
    v: OBX-17 / PRT -10
mapping:
  identity:
    v: rim
  map:
    v: participation[typeCode=DEV]
mapping:
  identity:
    v: sct-attr
  map:
    v: 424226004 |Using device|

id:
  v: Observation.referenceRange
path:
  v: Observation.referenceRange
short:
  v: Provides guide for interpretation
definition:
  v: Guidance on how to interpret the value by comparison to a normal or recommended range. Multiple reference ranges are interpreted as an "OR". In other words, to represent two distinct target populations, two `referenceRange` elements would be used.
comment:
  v: Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this might not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.
requirements:
  v: Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.
min:
  v: 0
max:
  v: *
base:
  path:
    v: Observation.referenceRange
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: BackboneElement
    l: BackboneElement
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
constraint:
  key:
    v: obs-3
  severity:
    v: error
  human:
    v: Must have at least a low or a high or text
  expression:
    v: low.exists() or high.exists() or text.exists()
  xpath:
    v: (exists(f:low) or exists(f:high)or exists(f:text))
  source:
    v: http://fhir.de/StructureDefinition/observation-de-vitalsign-koerpertemperatur
    l: observation-de-vitalsign-koerpertemperatur
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: v2
  map:
    v: OBX.7
mapping:
  identity:
    v: rim
  map:
    v: outboundRelationship[typeCode=REFV]/target[classCode=OBS, moodCode=EVN]

id:
  v: Observation.referenceRange.id
path:
  v: Observation.referenceRange.id
representation:
  v: xmlAttr
short:
  v: Unique id for inter-element referencing
definition:
  v: Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Element.id
  min:
    v: 0
  max:
    v: 1
type:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type
      l: structuredefinition-fhir-type
    value: Url
      v: string
      l: string
  code:
    v: http://hl7.org/fhirpath/System.String
    l: System.String
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: n/a

id:
  v: Observation.referenceRange.extension
path:
  v: Observation.referenceRange.extension
short:
  v: Additional content defined by implementations
definition:
  v: May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
comment:
  v: There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
alias:
  v: extensions
alias:
  v: user content
min:
  v: 0
max:
  v: *
base:
  path:
    v: Element.extension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
    l: Extension
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
  xpath:
    v: exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])
  source:
    v: http://hl7.org/fhir/StructureDefinition/Extension
    l: Extension
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: n/a

id:
  v: Observation.referenceRange.modifierExtension
path:
  v: Observation.referenceRange.modifierExtension
short:
  v: Extensions that cannot be ignored even if unrecognized
definition:
  v: May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
comment:
  v: There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
requirements:
  v: Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).
alias:
  v: extensions
alias:
  v: user content
alias:
  v: modifiers
min:
  v: 0
max:
  v: *
base:
  path:
    v: BackboneElement.modifierExtension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
    l: Extension
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
  xpath:
    v: exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])
  source:
    v: http://hl7.org/fhir/StructureDefinition/Extension
    l: Extension
is modifier:
  v: true
is modifier reason:
  v: Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
is summary:
  v: true
mapping:
  identity:
    v: rim
  map:
    v: N/A

id:
  v: Observation.referenceRange.low
path:
  v: Observation.referenceRange.low
short:
  v: Low Range, if relevant
definition:
  v: The value of the low bound of the reference range. The low bound of the reference range endpoint is inclusive of the value (e.g. reference range is >=5 - <=9). If the low bound is omitted, it is assumed to be meaningless (e.g. reference range is <=2.3).
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Observation.referenceRange.low
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: Quantity
    l: Quantity
  profile:
    v: http://hl7.org/fhir/StructureDefinition/SimpleQuantity
    l: SimpleQuantity
condition:
  v: obs-3
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: v2
  map:
    v: OBX-7
mapping:
  identity:
    v: rim
  map:
    v: value:IVL_PQ.low

id:
  v: Observation.referenceRange.high
path:
  v: Observation.referenceRange.high
short:
  v: High Range, if relevant
definition:
  v: The value of the high bound of the reference range. The high bound of the reference range endpoint is inclusive of the value (e.g. reference range is >=5 - <=9). If the high bound is omitted, it is assumed to be meaningless (e.g. reference range is >= 2.3).
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Observation.referenceRange.high
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: Quantity
    l: Quantity
  profile:
    v: http://hl7.org/fhir/StructureDefinition/SimpleQuantity
    l: SimpleQuantity
condition:
  v: obs-3
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: v2
  map:
    v: OBX-7
mapping:
  identity:
    v: rim
  map:
    v: value:IVL_PQ.high

id:
  v: Observation.referenceRange.type
path:
  v: Observation.referenceRange.type
short:
  v: Reference range qualifier
definition:
  v: Codes to indicate the what part of the targeted reference population it applies to. For example, the normal or therapeutic range.
comment:
  v: This SHOULD be populated if there is more than one range. If this element is not present then the normal range is assumed.
requirements:
  v: Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc., - for proper interpretation.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Observation.referenceRange.type
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: CodeableConcept
    l: CodeableConcept
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
is modifier:
  v: false
is summary:
  v: false
binding:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName
      l: elementdefinition-bindingName
    value: String
      v: ObservationRangeMeaning
  strength:
    v: preferred
  description:
    v: Code for the meaning of a reference range.
  value set:
    v: http://hl7.org/fhir/ValueSet/referencerange-meaning
    l: referencerange-meaning
mapping:
  identity:
    v: sct-concept
  map:
    v: < 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|
mapping:
  identity:
    v: v2
  map:
    v: OBX-10
mapping:
  identity:
    v: rim
  map:
    v: interpretationCode

id:
  v: Observation.referenceRange.appliesTo
path:
  v: Observation.referenceRange.appliesTo
short:
  v: Reference range population
definition:
  v: Codes to indicate the target population this reference range applies to. For example, a reference range may be based on the normal population or a particular sex or race. Multiple `appliesTo` are interpreted as an "AND" of the target populations. For example, to represent a target population of African American females, both a code of female and a code for African American would be used.
comment:
  v: This SHOULD be populated if there is more than one range. If this element is not present then the normal population is assumed.
requirements:
  v: Need to be able to identify the target population for proper interpretation.
min:
  v: 0
max:
  v: *
base:
  path:
    v: Observation.referenceRange.appliesTo
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: CodeableConcept
    l: CodeableConcept
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
is modifier:
  v: false
is summary:
  v: false
binding:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName
      l: elementdefinition-bindingName
    value: String
      v: ObservationRangeType
  strength:
    v: example
  description:
    v: Codes identifying the population the reference range applies to.
  value set:
    v: http://hl7.org/fhir/ValueSet/referencerange-appliesto
    l: referencerange-appliesto
mapping:
  identity:
    v: sct-concept
  map:
    v: < 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|
mapping:
  identity:
    v: v2
  map:
    v: OBX-10
mapping:
  identity:
    v: rim
  map:
    v: interpretationCode

id:
  v: Observation.referenceRange.age
path:
  v: Observation.referenceRange.age
short:
  v: Applicable age range, if relevant
definition:
  v: The age at which this reference range is applicable. This is a neonatal age (e.g. number of weeks at term) if the meaning says so.
requirements:
  v: Some analytes vary greatly over age.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Observation.referenceRange.age
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: Range
    l: Range
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: outboundRelationship[typeCode=PRCN].targetObservationCriterion[code="age"].value

id:
  v: Observation.referenceRange.text
path:
  v: Observation.referenceRange.text
short:
  v: Text based reference range in an observation
definition:
  v: Text based reference range in an observation which may be used when a quantitative range is not appropriate for an observation. An example would be a reference value of "Negative" or a list or table of "normals".
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Observation.referenceRange.text
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: string
    l: string
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: v2
  map:
    v: OBX-7
mapping:
  identity:
    v: rim
  map:
    v: value:ST

id:
  v: Observation.hasMember
path:
  v: Observation.hasMember
short:
  v: Related resource that belongs to the Observation group
definition:
  v: This observation is a group observation (e.g. a battery, a panel of tests, a set of vital sign measurements) that includes the target as a member of the group.
comment:
  v: When using this element, an observation will typically have either a value or a set of related resources, although both may be present in some cases. For a discussion on the ways Observations can assembled in groups together, see [Notes](http://hl7.org/fhir/R4/observation.html#obsgrouping) below. Note that a system may calculate results from [QuestionnaireResponse](http://hl7.org/fhir/R4/questionnaireresponse.html) into a final score and represent the score as an Observation.
min:
  v: 0
max:
  v: *
base:
  path:
    v: Observation.hasMember
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Reference
    l: Reference
  target profile:
    v: http://hl7.org/fhir/StructureDefinition/Observation
    l: Observation
  target profile:
    v: http://hl7.org/fhir/StructureDefinition/QuestionnaireResponse
    l: QuestionnaireResponse
  target profile:
    v: http://hl7.org/fhir/StructureDefinition/MolecularSequence
    l: MolecularSequence
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
is modifier:
  v: false
is summary:
  v: true
mapping:
  identity:
    v: v2
  map:
    v: Relationships established by OBX-4 usage
mapping:
  identity:
    v: rim
  map:
    v: outBoundRelationship

id:
  v: Observation.derivedFrom
path:
  v: Observation.derivedFrom
short:
  v: Related measurements the observation is made from
definition:
  v: The target resource that represents a measurement from which this observation value is derived. For example, a calculated anion gap or a fetal measurement based on an ultrasound image.
comment:
  v: All the reference choices that are listed in this element can represent clinical observations and other measurements that may be the source for a derived value. The most common reference will be another Observation. For a discussion on the ways Observations can assembled in groups together, see [Notes](http://hl7.org/fhir/R4/observation.html#obsgrouping) below.
min:
  v: 0
max:
  v: *
base:
  path:
    v: Observation.derivedFrom
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Reference
    l: Reference
  target profile:
    v: http://hl7.org/fhir/StructureDefinition/DocumentReference
    l: DocumentReference
  target profile:
    v: http://hl7.org/fhir/StructureDefinition/ImagingStudy
    l: ImagingStudy
  target profile:
    v: http://hl7.org/fhir/StructureDefinition/Media
    l: Media
  target profile:
    v: http://hl7.org/fhir/StructureDefinition/QuestionnaireResponse
    l: QuestionnaireResponse
  target profile:
    v: http://hl7.org/fhir/StructureDefinition/Observation
    l: Observation
  target profile:
    v: http://hl7.org/fhir/StructureDefinition/MolecularSequence
    l: MolecularSequence
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
is modifier:
  v: false
is summary:
  v: true
mapping:
  identity:
    v: v2
  map:
    v: Relationships established by OBX-4 usage
mapping:
  identity:
    v: rim
  map:
    v: .targetObservation

id:
  v: Observation.component
path:
  v: Observation.component
short:
  v: Component results
definition:
  v: Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.
comment:
  v: For a discussion on the ways Observations can be assembled in groups together see [Notes](http://hl7.org/fhir/R4/observation.html#notes) below.
requirements:
  v: Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.
min:
  v: 0
max:
  v: *
base:
  path:
    v: Observation.component
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: BackboneElement
    l: BackboneElement
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
constraint:
  key:
    v: vs-de-3
  severity:
    v: error
  human:
    v: If there is no a value a data absent reason must be present
  expression:
    v: value.exists() xor dataAbsentReason.exists()
  source:
    v: http://fhir.de/StructureDefinition/observation-de-vitalsign
    l: observation-de-vitalsign
is modifier:
  v: false
is summary:
  v: true
mapping:
  identity:
    v: v2
  map:
    v: containment by OBX-4?
mapping:
  identity:
    v: rim
  map:
    v: outBoundRelationship[typeCode=COMP]

id:
  v: Observation.component.id
path:
  v: Observation.component.id
representation:
  v: xmlAttr
short:
  v: Unique id for inter-element referencing
definition:
  v: Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Element.id
  min:
    v: 0
  max:
    v: 1
type:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type
      l: structuredefinition-fhir-type
    value: Url
      v: string
      l: string
  code:
    v: http://hl7.org/fhirpath/System.String
    l: System.String
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: n/a

id:
  v: Observation.component.extension
path:
  v: Observation.component.extension
short:
  v: Additional content defined by implementations
definition:
  v: May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
comment:
  v: There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
alias:
  v: extensions
alias:
  v: user content
min:
  v: 0
max:
  v: *
base:
  path:
    v: Element.extension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
    l: Extension
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
  xpath:
    v: exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])
  source:
    v: http://hl7.org/fhir/StructureDefinition/Extension
    l: Extension
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: n/a

id:
  v: Observation.component.modifierExtension
path:
  v: Observation.component.modifierExtension
short:
  v: Extensions that cannot be ignored even if unrecognized
definition:
  v: May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
comment:
  v: There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
requirements:
  v: Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).
alias:
  v: extensions
alias:
  v: user content
alias:
  v: modifiers
min:
  v: 0
max:
  v: *
base:
  path:
    v: BackboneElement.modifierExtension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
    l: Extension
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
  xpath:
    v: exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])
  source:
    v: http://hl7.org/fhir/StructureDefinition/Extension
    l: Extension
is modifier:
  v: true
is modifier reason:
  v: Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
is summary:
  v: true
mapping:
  identity:
    v: rim
  map:
    v: N/A

id:
  v: Observation.component.code
path:
  v: Observation.component.code
short:
  v: Type of component observation (code / type)
definition:
  v: Describes what was observed. Sometimes this is called the observation "code".
comment:
  v: *All* code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.
requirements:
  v: Knowing what kind of observation is being made is essential to understanding the observation.
min:
  v: 1
max:
  v: 1
base:
  path:
    v: Observation.component.code
  min:
    v: 1
  max:
    v: 1
type:
  code:
    v: CodeableConcept
    l: CodeableConcept
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
is modifier:
  v: false
is summary:
  v: true
binding:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName
      l: elementdefinition-bindingName
    value: String
      v: ObservationCode
  strength:
    v: example
  description:
    v: Codes identifying names of simple observations.
  value set:
    v: http://hl7.org/fhir/ValueSet/observation-codes
    l: observation-codes
mapping:
  identity:
    v: w5
  map:
    v: FiveWs.what[x]
mapping:
  identity:
    v: sct-concept
  map:
    v: < 363787002 |Observable entity| OR < 386053000 |Evaluation procedure|
mapping:
  identity:
    v: v2
  map:
    v: OBX-3
mapping:
  identity:
    v: rim
  map:
    v: code

id:
  v: Observation.component.value[x]
path:
  v: Observation.component.value[x]
slicing:
  discriminator:
    type:
      v: type
    path:
      v: $this
  ordered:
    v: false
  rules:
    v: open
short:
  v: Actual component result
definition:
  v: The information determined as a result of making the observation, if the information has a simple value.
comment:
  v: Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the [Notes section](http://hl7.org/fhir/R4/observation.html#notes) below.
requirements:
  v: An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Observation.component.value[x]
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: Quantity
    l: Quantity
type:
  code:
    v: CodeableConcept
    l: CodeableConcept
type:
  code:
    v: string
    l: string
type:
  code:
    v: boolean
    l: boolean
type:
  code:
    v: integer
    l: integer
type:
  code:
    v: Range
    l: Range
type:
  code:
    v: Ratio
    l: Ratio
type:
  code:
    v: SampledData
    l: SampledData
type:
  code:
    v: time
    l: time
type:
  code:
    v: dateTime
    l: dateTime
type:
  code:
    v: Period
    l: Period
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
is modifier:
  v: false
is summary:
  v: true
mapping:
  identity:
    v: sct-concept
  map:
    v: 363714003 |Interprets| < 441742003 |Evaluation finding|
mapping:
  identity:
    v: v2
  map:
    v: OBX.2, OBX.5, OBX.6
mapping:
  identity:
    v: rim
  map:
    v: value
mapping:
  identity:
    v: sct-attr
  map:
    v: 363714003 |Interprets|

id:
  v: Observation.component.value[x]:valueQuantity
path:
  v: Observation.component.value[x]
slice name:
  v: valueQuantity
short:
  v: Actual component result
definition:
  v: The information determined as a result of making the observation, if the information has a simple value.
comment:
  v: Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the [Notes section](http://hl7.org/fhir/R4/observation.html#notes) below.
requirements:
  v: An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Observation.component.value[x]
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: Quantity
    l: Quantity
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
is modifier:
  v: false
is summary:
  v: true
mapping:
  identity:
    v: sct-concept
  map:
    v: 363714003 |Interprets| < 441742003 |Evaluation finding|
mapping:
  identity:
    v: v2
  map:
    v: OBX.2, OBX.5, OBX.6
mapping:
  identity:
    v: rim
  map:
    v: value
mapping:
  identity:
    v: sct-attr
  map:
    v: 363714003 |Interprets|

id:
  v: Observation.component.value[x]:valueQuantity.id
path:
  v: Observation.component.value[x].id
representation:
  v: xmlAttr
short:
  v: Unique id for inter-element referencing
definition:
  v: Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Element.id
  min:
    v: 0
  max:
    v: 1
type:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type
      l: structuredefinition-fhir-type
    value: Url
      v: string
      l: string
  code:
    v: http://hl7.org/fhirpath/System.String
    l: System.String
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: n/a

id:
  v: Observation.component.value[x]:valueQuantity.extension
path:
  v: Observation.component.value[x].extension
slicing:
  discriminator:
    type:
      v: value
    path:
      v: url
  description:
    v: Extensions are always sliced by (at least) url
  rules:
    v: open
short:
  v: Additional content defined by implementations
definition:
  v: May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
comment:
  v: There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
alias:
  v: extensions
alias:
  v: user content
min:
  v: 0
max:
  v: *
base:
  path:
    v: Element.extension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
    l: Extension
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
  xpath:
    v: exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])
  source:
    v: http://hl7.org/fhir/StructureDefinition/Extension
    l: Extension
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: n/a

id:
  v: Observation.component.value[x]:valueQuantity.value
path:
  v: Observation.component.value[x].value
short:
  v: Numerical value (with implicit precision)
definition:
  v: The value of the measured amount. The value includes an implicit precision in the presentation of the value.
comment:
  v: The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).
requirements:
  v: Precision is handled implicitly in almost all cases of measurement.
min:
  v: 1
max:
  v: 1
base:
  path:
    v: Quantity.value
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: decimal
    l: decimal
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
is modifier:
  v: false
is summary:
  v: true
mapping:
  identity:
    v: v2
  map:
    v: SN.2 / CQ - N/A
mapping:
  identity:
    v: rim
  map:
    v: PQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value

id:
  v: Observation.component.value[x]:valueQuantity.comparator
path:
  v: Observation.component.value[x].comparator
short:
  v: < | <= | >= | > - how to understand the value
definition:
  v: How the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is "<" , then the real value is < stated value.
requirements:
  v: Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Quantity.comparator
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: code
    l: code
meaning when missing:
  v: If there is no comparator, then there is no modification of the value
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
is modifier:
  v: true
is modifier reason:
  v: This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value
is summary:
  v: true
binding:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName
      l: elementdefinition-bindingName
    value: String
      v: QuantityComparator
  strength:
    v: required
  description:
    v: How the Quantity should be understood and represented.
  value set:
    v: http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1
    l: http://hl7.org/fhir/ValueSet/quantity-comparator
mapping:
  identity:
    v: v2
  map:
    v: SN.1 / CQ.1
mapping:
  identity:
    v: rim
  map:
    v: IVL properties

id:
  v: Observation.component.value[x]:valueQuantity.unit
extension:
  url:
    v: http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable
    l: elementdefinition-translatable
  value: Boolean
    v: true
path:
  v: Observation.component.value[x].unit
short:
  v: Unit representation
definition:
  v: A human-readable form of the unit.
requirements:
  v: There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.
min:
  v: 1
max:
  v: 1
base:
  path:
    v: Quantity.unit
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: string
    l: string
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
is modifier:
  v: false
is summary:
  v: true
mapping:
  identity:
    v: v2
  map:
    v: (see OBX.6 etc.) / CQ.2
mapping:
  identity:
    v: rim
  map:
    v: PQ.unit

id:
  v: Observation.component.value[x]:valueQuantity.system
path:
  v: Observation.component.value[x].system
short:
  v: System that defines coded unit form
definition:
  v: The identification of the system that provides the coded form of the unit.
requirements:
  v: Need to know the system that defines the coded form of the unit.
min:
  v: 1
max:
  v: 1
base:
  path:
    v: Quantity.system
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: uri
    l: uri
pattern: Uri
  v: http://unitsofmeasure.org
  l: unitsofmeasure.org
condition:
  v: qty-3
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
is modifier:
  v: false
is summary:
  v: true
mapping:
  identity:
    v: v2
  map:
    v: (see OBX.6 etc.) / CQ.2
mapping:
  identity:
    v: rim
  map:
    v: CO.codeSystem, PQ.translation.codeSystem

id:
  v: Observation.component.value[x]:valueQuantity.code
path:
  v: Observation.component.value[x].code
short:
  v: Coded form of the unit
definition:
  v: A computer processable form of the unit in some unit representation system.
comment:
  v: The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system.
requirements:
  v: Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest.
min:
  v: 1
max:
  v: 1
base:
  path:
    v: Quantity.code
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: code
    l: code
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
is modifier:
  v: false
is summary:
  v: true
mapping:
  identity:
    v: v2
  map:
    v: (see OBX.6 etc.) / CQ.2
mapping:
  identity:
    v: rim
  map:
    v: PQ.code, MO.currency, PQ.translation.code

id:
  v: Observation.component.dataAbsentReason
path:
  v: Observation.component.dataAbsentReason
short:
  v: Why the component result is missing
definition:
  v: Provides a reason why the expected value in the element Observation.component.value[x] is missing.
comment:
  v: "Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done". The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.
requirements:
  v: For many results it is necessary to handle exceptional values in measurements.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Observation.component.dataAbsentReason
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: CodeableConcept
    l: CodeableConcept
condition:
  v: obs-6
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
is modifier:
  v: false
is summary:
  v: false
binding:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName
      l: elementdefinition-bindingName
    value: String
      v: ObservationValueAbsentReason
  strength:
    v: extensible
  description:
    v: Codes specifying why the result (`Observation.value[x]`) is missing.
  value set:
    v: http://hl7.org/fhir/ValueSet/data-absent-reason
    l: data-absent-reason
mapping:
  identity:
    v: v2
  map:
    v: N/A
mapping:
  identity:
    v: rim
  map:
    v: value.nullFlavor

id:
  v: Observation.component.interpretation
path:
  v: Observation.component.interpretation
short:
  v: High, low, normal, etc.
definition:
  v: A categorical assessment of an observation value. For example, high, low, normal.
comment:
  v: Historically used for laboratory results (known as 'abnormal flag' ), its use extends to other use cases where coded interpretations are relevant. Often reported as one or more simple compact codes this element is often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result.
requirements:
  v: For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.
alias:
  v: Abnormal Flag
min:
  v: 0
max:
  v: *
base:
  path:
    v: Observation.component.interpretation
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: CodeableConcept
    l: CodeableConcept
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
is modifier:
  v: false
is summary:
  v: false
binding:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName
      l: elementdefinition-bindingName
    value: String
      v: ObservationInterpretation
  strength:
    v: extensible
  description:
    v: Codes identifying interpretations of observations.
  value set:
    v: http://hl7.org/fhir/ValueSet/observation-interpretation
    l: observation-interpretation
mapping:
  identity:
    v: sct-concept
  map:
    v: < 260245000 |Findings values|
mapping:
  identity:
    v: v2
  map:
    v: OBX-8
mapping:
  identity:
    v: rim
  map:
    v: interpretationCode
mapping:
  identity:
    v: sct-attr
  map:
    v: 363713009 |Has interpretation|

id:
  v: Observation.component.referenceRange
path:
  v: Observation.component.referenceRange
short:
  v: Provides guide for interpretation of component result
definition:
  v: Guidance on how to interpret the value by comparison to a normal or recommended range.
comment:
  v: Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this might not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.
requirements:
  v: Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.
min:
  v: 0
max:
  v: *
base:
  path:
    v: Observation.component.referenceRange
  min:
    v: 0
  max:
    v: *
content reference:
  v: http://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange
  l: Observation.referenceRange
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: v2
  map:
    v: OBX.7
mapping:
  identity:
    v: rim
  map:
    v: outboundRelationship[typeCode=REFV]/target[classCode=OBS, moodCode=EVN]

element:
  id:
    v: Observation
  path:
    v: Observation
element:
  id:
    v: Observation.code.coding
  path:
    v: Observation.code.coding
  min:
    v: 5
element:
  id:
    v: Observation.code.coding:snomed
  path:
    v: Observation.code.coding
  slice name:
    v: snomed
  min:
    v: 1
  max:
    v: 1
  pattern: Coding
    type: http://snomed.info/id/307047009
    system:
      v: http://snomed.info/sct
      l: sct
    code:
      v: 307047009
element:
  id:
    v: Observation.code.coding:specific-loinc
  path:
    v: Observation.code.coding
  slice name:
    v: specific-loinc
  min:
    v: 1
  pattern: Coding
    type: https://loinc.org/rdf/8332-9
    system:
      v: http://loinc.org
      l: loinc.org
    code:
      v: 8332-9
element:
  id:
    v: Observation.code.coding:specific-IEEE-11073
  path:
    v: Observation.code.coding
  slice name:
    v: specific-IEEE-11073
  min:
    v: 1
  max:
    v: 1
  pattern: Coding
    system:
      v: urn:iso:std:iso:11073:10101
      l: 10101
    code:
      v: 188420
  must support:
    v: true
element:
  id:
    v: Observation.bodySite
  path:
    v: Observation.bodySite
  pattern: CodeableConcept
    coding: http://snomed.info/id/34402009
      system:
        v: http://snomed.info/sct
        l: sct
      code:
        v: 34402009