US Veterans Health Administration FHIR Map Set Implementation Guide
1.6.49 - 250701 United States of America flag

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Resource Profile: Decision Precision Plus Observation[smoking]

Official URL: http://va.gov/fhir/StructureDefinition/DecisionPrecisionPlusObservationsmoking Version: 1.6.49
Draft as of 2025-06-13 Computable Name: DecisionPrecisionPlusObservationsmoking

This StructureDefinition contains the maps for VistA file V HEALTH FACTORS (9000010.23) to us-core-smokingstatus.

​See also the FHIR Shorthand.

Use Case Overview

Use Case: Decision Precision Plus«us-core-smokingstatus»DecisionPrecisionPlusObservationsmokingencounter«us-core-observation-social-history»DecisionPrecisionPlusObservationsocialencounterEncounterOutpatient

Usages:

Formal Views of Profile Content

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

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Observation C 0..* USCoreSmokingStatusProfile(5.0.1) Measurements and simple assertions
Constraints: obs-6, obs-7
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... status ?!SΣ 1..1 code registered | preliminary | final | amended +
Binding: US Core Status for Smoking Status Observation (required)
Required Pattern: final
.... coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
..... code 1..1 code Symbol in syntax defined by the system
Fixed Value: social-history
.... category:SocialHistory S 1..1 CodeableConcept Classification of type of observation
Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.

Required Pattern: At least the following
..... coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
...... system 1..1 uri Identity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category
...... code 1..1 code Symbol in syntax defined by the system
Fixed Value: social-history
... code SΣC 1..1 CodeableConcept Smoking Status
Binding: US Core Smoking Status Observation Codes (extensible)
Constraints: dppo-39-2222-1
... subject SΣ 1..1 Reference(US Core Patient Profile(5.0.1)) Who and/or what the observation is about
... encounter SΣ 0..1 Reference(Encounter: Outpatient) Healthcare event during which this observation is made
... Slices for effective[x] Σ 1..1 dateTime Clinically relevant time/time-period for observation
Slice: Unordered, Closed by type:$this
.... effective[x]:effectiveDateTime SΣ 1..1 dateTime Clinically relevant time/time-period for observation
... Slices for value[x] ΣC 1..1 CodeableConcept Actual result
Slice: Unordered, Closed by type:$this
.... value[x]:valueCodeableConcept SΣC 1..1 CodeableConcept Coded Responses from Smoking Status Value Set
Binding: DPPLungCancerScreeningFind FHIR (required): see mapping VF_DPPLungCancerScreeningFind
Constraints: dppo-39-2222
... dataAbsentReason SC 0..1 CodeableConcept Why the result is missing
Binding: DPPLungCancerScreeningDec FHIR (required): see mapping VF_DPPLungCancerScreeningDec
Constraints: dppo-39-2232
... note S 0..* Annotation Comments about the observation

doco Documentation for this format

Terminology Bindings

Constraints

PathConformanceValueSet / CodeURI
Observation.statusrequiredPattern Value: final
http://hl7.org/fhir/us/core/ValueSet/us-core-observation-smoking-status-status
Observation.categorypreferredPattern Value: social-history
http://hl7.org/fhir/ValueSet/observation-category
From the FHIR Standard
Observation.category:SocialHistorypreferredPattern Value: social-history
http://hl7.org/fhir/ValueSet/observation-category
From the FHIR Standard
Observation.codeextensibleUSCoreSmokingStatusObservationCodes
http://hl7.org/fhir/us/core/ValueSet/us-core-smoking-status-observation-codes
Observation.value[x]:valueCodeableConceptrequiredDPPLungCancerScreeningFind
http://va.gov/fhir/ValueSet/DPPLungCancerScreeningFind
From this IG
Observation.dataAbsentReasonrequiredDPPLungCancerScreeningDec
http://va.gov/fhir/ValueSet/DPPLungCancerScreeningDec
From this IG
IdGradePath(s)DetailsRequirements
dom-2errorObservationIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorObservationIf the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource
: contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4errorObservationIf a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
: contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5errorObservationIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practiceObservationA resource should have narrative for robust management
: text.`div`.exists()
dppo-39-2222best practiceObservation.value[x]:valueCodeableConceptIf VF_DPPLungCancerScreeningFind then terminologyMaps (9000010.23-.01) using VF_DPPLungCancerScreeningFind
: true
dppo-39-2232best practiceObservation.dataAbsentReasonIf In VF_DPPLungCancerScreeningDec then terminologyMaps (9000010.23-.01) using VF_DPPLungCancerScreeningDec
: true
dppo-39-2222-1best practiceObservation.codeIf VF_DPPLungCancerScreeningFind then fixed value http://loinc.org#72166-2 "Tobacco smoking status NHIS"
: true
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()
obs-6errorObservationdataAbsentReason SHALL only be present if Observation.value[x] is not present
: dataAbsentReason.empty() or value.empty()
obs-7errorObservationIf Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present
: value.empty() or component.code.where(coding.intersect(%resource.code.coding).exists()).empty()

This structure is derived from USCoreSmokingStatusProfile

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Observation 0..* USCoreSmokingStatusProfile(5.0.1) Measurements and simple assertions
... status 1..1 code registered | preliminary | final | amended +
Required Pattern: final
... category 1..* CodeableConcept Classification of type of observation
Required Pattern: At least the following
.... coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
..... code 1..1 code Symbol in syntax defined by the system
Fixed Value: social-history
... code C 1..1 CodeableConcept Smoking Status
Constraints: dppo-39-2222-1
... Slices for effective[x] Content/Rules for all slices
.... effective[x]:effectiveDateTime 1..1 dateTime Clinically relevant time/time-period for observation
... Slices for value[x] Content/Rules for all slices
.... value[x]:valueCodeableConcept C 1..1 CodeableConcept Coded Responses from Smoking Status Value Set
Binding: DPPLungCancerScreeningFind FHIR (required): see mapping VF_DPPLungCancerScreeningFind
Constraints: dppo-39-2222
... dataAbsentReason SC 0..1 CodeableConcept Why the result is missing
Binding: DPPLungCancerScreeningDec FHIR (required): see mapping VF_DPPLungCancerScreeningDec
Constraints: dppo-39-2232
... note S 0..* Annotation Comments about the observation

doco Documentation for this format

Terminology Bindings (Differential)

PathConformanceValueSetURI
Observation.value[x]:valueCodeableConceptrequiredDPPLungCancerScreeningFind
http://va.gov/fhir/ValueSet/DPPLungCancerScreeningFind
From this IG
Observation.dataAbsentReasonrequiredDPPLungCancerScreeningDec
http://va.gov/fhir/ValueSet/DPPLungCancerScreeningDec
From this IG

Constraints

IdGradePath(s)DetailsRequirements
dppo-39-2222best practiceObservation.value[x]:valueCodeableConceptIf VF_DPPLungCancerScreeningFind then terminologyMaps (9000010.23-.01) using VF_DPPLungCancerScreeningFind
: true
dppo-39-2232best practiceObservation.dataAbsentReasonIf In VF_DPPLungCancerScreeningDec then terminologyMaps (9000010.23-.01) using VF_DPPLungCancerScreeningDec
: true
dppo-39-2222-1best practiceObservation.codeIf VF_DPPLungCancerScreeningFind then fixed value http://loinc.org#72166-2 "Tobacco smoking status NHIS"
: true
NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Observation C 0..* USCoreSmokingStatusProfile(5.0.1) Measurements and simple assertions
Constraints: obs-6, obs-7
... id Σ 0..1 id Logical id of this artifact
... meta Σ 0..1 Meta Metadata about the resource
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... language 0..1 code Language of the resource content
Binding: CommonLanguages (preferred): A human language.
Additional BindingsPurpose
AllLanguages Max Binding
... text 0..1 Narrative Text summary of the resource, for human interpretation
... contained 0..* Resource Contained, inline Resources
... extension 0..* Extension Additional content defined by implementations
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... identifier Σ 0..* Identifier Business Identifier for observation
... basedOn Σ 0..* Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest) Fulfills plan, proposal or order
... partOf Σ 0..* Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy) Part of referenced event
... status ?!SΣ 1..1 code registered | preliminary | final | amended +
Binding: US Core Status for Smoking Status Observation (required)
Required Pattern: final
... Slices for category S 1..* CodeableConcept Classification of type of observation
Slice: Unordered, Open by pattern:$this
Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.

Required Pattern: At least the following
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
..... system 0..1 uri Identity of the terminology system
..... version 0..1 string Version of the system - if relevant
..... code 1..1 code Symbol in syntax defined by the system
Fixed Value: social-history
..... display 0..1 string Representation defined by the system
..... userSelected 0..1 boolean If this coding was chosen directly by the user
.... text 0..1 string Plain text representation of the concept
.... category:SocialHistory S 1..1 CodeableConcept Classification of type of observation
Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.

Required Pattern: At least the following
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
..... coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
...... system 1..1 uri Identity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category
...... version 0..1 string Version of the system - if relevant
...... code 1..1 code Symbol in syntax defined by the system
Fixed Value: social-history
...... display 0..1 string Representation defined by the system
...... userSelected 0..1 boolean If this coding was chosen directly by the user
..... text 0..1 string Plain text representation of the concept
... code SΣC 1..1 CodeableConcept Smoking Status
Binding: US Core Smoking Status Observation Codes (extensible)
Constraints: dppo-39-2222-1
... subject SΣ 1..1 Reference(US Core Patient Profile(5.0.1)) Who and/or what the observation is about
... focus Σ 0..* Reference(Resource) What the observation is about, when it is not about the subject of record
... encounter SΣ 0..1 Reference(Encounter: Outpatient) Healthcare event during which this observation is made
... Slices for effective[x] Σ 1..1 dateTime Clinically relevant time/time-period for observation
Slice: Unordered, Closed by type:$this
.... effective[x]:effectiveDateTime SΣ 1..1 dateTime Clinically relevant time/time-period for observation
... issued Σ 0..1 instant Date/Time this version was made available
... performer Σ 0..* Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson) Who is responsible for the observation
... Slices for value[x] ΣC 1..1 CodeableConcept Actual result
Slice: Unordered, Closed by type:$this
.... value[x]:valueCodeableConcept SΣC 1..1 CodeableConcept Coded Responses from Smoking Status Value Set
Binding: DPPLungCancerScreeningFind FHIR (required): see mapping VF_DPPLungCancerScreeningFind
Constraints: dppo-39-2222
... dataAbsentReason SC 0..1 CodeableConcept Why the result is missing
Binding: DPPLungCancerScreeningDec FHIR (required): see mapping VF_DPPLungCancerScreeningDec
Constraints: dppo-39-2232
... interpretation 0..* CodeableConcept High, low, normal, etc.
Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
... note S 0..* Annotation Comments about the observation
... bodySite 0..1 CodeableConcept Observed body part
Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
... method 0..1 CodeableConcept How it was done
Binding: ObservationMethods (example): Methods for simple observations.
... specimen 0..1 Reference(Specimen) Specimen used for this observation
... device 0..1 Reference(Device | DeviceMetric) (Measurement) Device
... referenceRange C 0..* BackboneElement Provides guide for interpretation
Constraints: obs-3
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... low C 0..1 SimpleQuantity Low Range, if relevant
.... high C 0..1 SimpleQuantity High Range, if relevant
.... type 0..1 CodeableConcept Reference range qualifier
Binding: ObservationReferenceRangeMeaningCodes (preferred): Code for the meaning of a reference range.
.... appliesTo 0..* CodeableConcept Reference range population
Binding: ObservationReferenceRangeAppliesToCodes (example): Codes identifying the population the reference range applies to.
.... age 0..1 Range Applicable age range, if relevant
.... text 0..1 string Text based reference range in an observation
... hasMember Σ 0..* Reference(Observation | QuestionnaireResponse | MolecularSequence) Related resource that belongs to the Observation group
... derivedFrom Σ 0..* Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | Observation | MolecularSequence) Related measurements the observation is made from
... component Σ 0..* BackboneElement Component results
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... code Σ 1..1 CodeableConcept Type of component observation (code / type)
Binding: LOINCCodes (example): Codes identifying names of simple observations.
.... value[x] Σ 0..1 Actual component result
..... valueQuantity Quantity
..... valueCodeableConcept CodeableConcept
..... valueString string
..... valueBoolean boolean
..... valueInteger integer
..... valueRange Range
..... valueRatio Ratio
..... valueSampledData SampledData
..... valueTime time
..... valueDateTime dateTime
..... valuePeriod Period
.... dataAbsentReason C 0..1 CodeableConcept Why the component result is missing
Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
.... interpretation 0..* CodeableConcept High, low, normal, etc.
Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
.... referenceRange 0..* See referenceRange (Observation) Provides guide for interpretation of component result

doco Documentation for this format

Terminology Bindings

Constraints

PathConformanceValueSet / CodeURI
Observation.languagepreferredCommonLanguages
http://hl7.org/fhir/ValueSet/languages
From the FHIR Standard
Additional Bindings Purpose
AllLanguages Max Binding
Observation.statusrequiredPattern Value: final
http://hl7.org/fhir/us/core/ValueSet/us-core-observation-smoking-status-status
Observation.categorypreferredPattern Value: social-history
http://hl7.org/fhir/ValueSet/observation-category
From the FHIR Standard
Observation.category:SocialHistorypreferredPattern Value: social-history
http://hl7.org/fhir/ValueSet/observation-category
From the FHIR Standard
Observation.codeextensibleUSCoreSmokingStatusObservationCodes
http://hl7.org/fhir/us/core/ValueSet/us-core-smoking-status-observation-codes
Observation.value[x]:valueCodeableConceptrequiredDPPLungCancerScreeningFind
http://va.gov/fhir/ValueSet/DPPLungCancerScreeningFind
From this IG
Observation.dataAbsentReasonrequiredDPPLungCancerScreeningDec
http://va.gov/fhir/ValueSet/DPPLungCancerScreeningDec
From this IG
Observation.interpretationextensibleObservationInterpretationCodes
http://hl7.org/fhir/ValueSet/observation-interpretation
From the FHIR Standard
Observation.bodySiteexampleSNOMEDCTBodyStructures
http://hl7.org/fhir/ValueSet/body-site
From the FHIR Standard
Observation.methodexampleObservationMethods
http://hl7.org/fhir/ValueSet/observation-methods
From the FHIR Standard
Observation.referenceRange.typepreferredObservationReferenceRangeMeaningCodes
http://hl7.org/fhir/ValueSet/referencerange-meaning
From the FHIR Standard
Observation.referenceRange.appliesToexampleObservationReferenceRangeAppliesToCodes
http://hl7.org/fhir/ValueSet/referencerange-appliesto
From the FHIR Standard
Observation.component.codeexampleLOINCCodes(a valid code from LOINC)
http://hl7.org/fhir/ValueSet/observation-codes
From the FHIR Standard
Observation.component.dataAbsentReasonextensibleDataAbsentReason
http://hl7.org/fhir/ValueSet/data-absent-reason
From the FHIR Standard
Observation.component.interpretationextensibleObservationInterpretationCodes
http://hl7.org/fhir/ValueSet/observation-interpretation
From the FHIR Standard
IdGradePath(s)DetailsRequirements
dom-2errorObservationIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorObservationIf the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource
: contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4errorObservationIf a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
: contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5errorObservationIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practiceObservationA resource should have narrative for robust management
: text.`div`.exists()
dppo-39-2222best practiceObservation.value[x]:valueCodeableConceptIf VF_DPPLungCancerScreeningFind then terminologyMaps (9000010.23-.01) using VF_DPPLungCancerScreeningFind
: true
dppo-39-2232best practiceObservation.dataAbsentReasonIf In VF_DPPLungCancerScreeningDec then terminologyMaps (9000010.23-.01) using VF_DPPLungCancerScreeningDec
: true
dppo-39-2222-1best practiceObservation.codeIf VF_DPPLungCancerScreeningFind then fixed value http://loinc.org#72166-2 "Tobacco smoking status NHIS"
: true
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()
obs-3errorObservation.referenceRangeMust have at least a low or a high or text
: low.exists() or high.exists() or text.exists()
obs-6errorObservationdataAbsentReason SHALL only be present if Observation.value[x] is not present
: dataAbsentReason.empty() or value.empty()
obs-7errorObservationIf Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present
: value.empty() or component.code.where(coding.intersect(%resource.code.coding).exists()).empty()

This structure is derived from USCoreSmokingStatusProfile

Summary

Must-Support: 3 elements

Structures

This structure refers to these other structures:

Key Elements View

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Observation C 0..* USCoreSmokingStatusProfile(5.0.1) Measurements and simple assertions
Constraints: obs-6, obs-7
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... status ?!SΣ 1..1 code registered | preliminary | final | amended +
Binding: US Core Status for Smoking Status Observation (required)
Required Pattern: final
.... coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
..... code 1..1 code Symbol in syntax defined by the system
Fixed Value: social-history
.... category:SocialHistory S 1..1 CodeableConcept Classification of type of observation
Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.

Required Pattern: At least the following
..... coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
...... system 1..1 uri Identity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category
...... code 1..1 code Symbol in syntax defined by the system
Fixed Value: social-history
... code SΣC 1..1 CodeableConcept Smoking Status
Binding: US Core Smoking Status Observation Codes (extensible)
Constraints: dppo-39-2222-1
... subject SΣ 1..1 Reference(US Core Patient Profile(5.0.1)) Who and/or what the observation is about
... encounter SΣ 0..1 Reference(Encounter: Outpatient) Healthcare event during which this observation is made
... Slices for effective[x] Σ 1..1 dateTime Clinically relevant time/time-period for observation
Slice: Unordered, Closed by type:$this
.... effective[x]:effectiveDateTime SΣ 1..1 dateTime Clinically relevant time/time-period for observation
... Slices for value[x] ΣC 1..1 CodeableConcept Actual result
Slice: Unordered, Closed by type:$this
.... value[x]:valueCodeableConcept SΣC 1..1 CodeableConcept Coded Responses from Smoking Status Value Set
Binding: DPPLungCancerScreeningFind FHIR (required): see mapping VF_DPPLungCancerScreeningFind
Constraints: dppo-39-2222
... dataAbsentReason SC 0..1 CodeableConcept Why the result is missing
Binding: DPPLungCancerScreeningDec FHIR (required): see mapping VF_DPPLungCancerScreeningDec
Constraints: dppo-39-2232
... note S 0..* Annotation Comments about the observation

doco Documentation for this format

Terminology Bindings

Constraints

PathConformanceValueSet / CodeURI
Observation.statusrequiredPattern Value: final
http://hl7.org/fhir/us/core/ValueSet/us-core-observation-smoking-status-status
Observation.categorypreferredPattern Value: social-history
http://hl7.org/fhir/ValueSet/observation-category
From the FHIR Standard
Observation.category:SocialHistorypreferredPattern Value: social-history
http://hl7.org/fhir/ValueSet/observation-category
From the FHIR Standard
Observation.codeextensibleUSCoreSmokingStatusObservationCodes
http://hl7.org/fhir/us/core/ValueSet/us-core-smoking-status-observation-codes
Observation.value[x]:valueCodeableConceptrequiredDPPLungCancerScreeningFind
http://va.gov/fhir/ValueSet/DPPLungCancerScreeningFind
From this IG
Observation.dataAbsentReasonrequiredDPPLungCancerScreeningDec
http://va.gov/fhir/ValueSet/DPPLungCancerScreeningDec
From this IG
IdGradePath(s)DetailsRequirements
dom-2errorObservationIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorObservationIf the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource
: contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4errorObservationIf a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
: contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5errorObservationIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practiceObservationA resource should have narrative for robust management
: text.`div`.exists()
dppo-39-2222best practiceObservation.value[x]:valueCodeableConceptIf VF_DPPLungCancerScreeningFind then terminologyMaps (9000010.23-.01) using VF_DPPLungCancerScreeningFind
: true
dppo-39-2232best practiceObservation.dataAbsentReasonIf In VF_DPPLungCancerScreeningDec then terminologyMaps (9000010.23-.01) using VF_DPPLungCancerScreeningDec
: true
dppo-39-2222-1best practiceObservation.codeIf VF_DPPLungCancerScreeningFind then fixed value http://loinc.org#72166-2 "Tobacco smoking status NHIS"
: true
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()
obs-6errorObservationdataAbsentReason SHALL only be present if Observation.value[x] is not present
: dataAbsentReason.empty() or value.empty()
obs-7errorObservationIf Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present
: value.empty() or component.code.where(coding.intersect(%resource.code.coding).exists()).empty()

Differential View

This structure is derived from USCoreSmokingStatusProfile

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Observation 0..* USCoreSmokingStatusProfile(5.0.1) Measurements and simple assertions
... status 1..1 code registered | preliminary | final | amended +
Required Pattern: final
... category 1..* CodeableConcept Classification of type of observation
Required Pattern: At least the following
.... coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
..... code 1..1 code Symbol in syntax defined by the system
Fixed Value: social-history
... code C 1..1 CodeableConcept Smoking Status
Constraints: dppo-39-2222-1
... Slices for effective[x] Content/Rules for all slices
.... effective[x]:effectiveDateTime 1..1 dateTime Clinically relevant time/time-period for observation
... Slices for value[x] Content/Rules for all slices
.... value[x]:valueCodeableConcept C 1..1 CodeableConcept Coded Responses from Smoking Status Value Set
Binding: DPPLungCancerScreeningFind FHIR (required): see mapping VF_DPPLungCancerScreeningFind
Constraints: dppo-39-2222
... dataAbsentReason SC 0..1 CodeableConcept Why the result is missing
Binding: DPPLungCancerScreeningDec FHIR (required): see mapping VF_DPPLungCancerScreeningDec
Constraints: dppo-39-2232
... note S 0..* Annotation Comments about the observation

doco Documentation for this format

Terminology Bindings (Differential)

PathConformanceValueSetURI
Observation.value[x]:valueCodeableConceptrequiredDPPLungCancerScreeningFind
http://va.gov/fhir/ValueSet/DPPLungCancerScreeningFind
From this IG
Observation.dataAbsentReasonrequiredDPPLungCancerScreeningDec
http://va.gov/fhir/ValueSet/DPPLungCancerScreeningDec
From this IG

Constraints

IdGradePath(s)DetailsRequirements
dppo-39-2222best practiceObservation.value[x]:valueCodeableConceptIf VF_DPPLungCancerScreeningFind then terminologyMaps (9000010.23-.01) using VF_DPPLungCancerScreeningFind
: true
dppo-39-2232best practiceObservation.dataAbsentReasonIf In VF_DPPLungCancerScreeningDec then terminologyMaps (9000010.23-.01) using VF_DPPLungCancerScreeningDec
: true
dppo-39-2222-1best practiceObservation.codeIf VF_DPPLungCancerScreeningFind then fixed value http://loinc.org#72166-2 "Tobacco smoking status NHIS"
: true

Snapshot View

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Observation C 0..* USCoreSmokingStatusProfile(5.0.1) Measurements and simple assertions
Constraints: obs-6, obs-7
... id Σ 0..1 id Logical id of this artifact
... meta Σ 0..1 Meta Metadata about the resource
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... language 0..1 code Language of the resource content
Binding: CommonLanguages (preferred): A human language.
Additional BindingsPurpose
AllLanguages Max Binding
... text 0..1 Narrative Text summary of the resource, for human interpretation
... contained 0..* Resource Contained, inline Resources
... extension 0..* Extension Additional content defined by implementations
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... identifier Σ 0..* Identifier Business Identifier for observation
... basedOn Σ 0..* Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest) Fulfills plan, proposal or order
... partOf Σ 0..* Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy) Part of referenced event
... status ?!SΣ 1..1 code registered | preliminary | final | amended +
Binding: US Core Status for Smoking Status Observation (required)
Required Pattern: final
... Slices for category S 1..* CodeableConcept Classification of type of observation
Slice: Unordered, Open by pattern:$this
Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.

Required Pattern: At least the following
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
..... system 0..1 uri Identity of the terminology system
..... version 0..1 string Version of the system - if relevant
..... code 1..1 code Symbol in syntax defined by the system
Fixed Value: social-history
..... display 0..1 string Representation defined by the system
..... userSelected 0..1 boolean If this coding was chosen directly by the user
.... text 0..1 string Plain text representation of the concept
.... category:SocialHistory S 1..1 CodeableConcept Classification of type of observation
Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.

Required Pattern: At least the following
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
..... coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
...... system 1..1 uri Identity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category
...... version 0..1 string Version of the system - if relevant
...... code 1..1 code Symbol in syntax defined by the system
Fixed Value: social-history
...... display 0..1 string Representation defined by the system
...... userSelected 0..1 boolean If this coding was chosen directly by the user
..... text 0..1 string Plain text representation of the concept
... code SΣC 1..1 CodeableConcept Smoking Status
Binding: US Core Smoking Status Observation Codes (extensible)
Constraints: dppo-39-2222-1
... subject SΣ 1..1 Reference(US Core Patient Profile(5.0.1)) Who and/or what the observation is about
... focus Σ 0..* Reference(Resource) What the observation is about, when it is not about the subject of record
... encounter SΣ 0..1 Reference(Encounter: Outpatient) Healthcare event during which this observation is made
... Slices for effective[x] Σ 1..1 dateTime Clinically relevant time/time-period for observation
Slice: Unordered, Closed by type:$this
.... effective[x]:effectiveDateTime SΣ 1..1 dateTime Clinically relevant time/time-period for observation
... issued Σ 0..1 instant Date/Time this version was made available
... performer Σ 0..* Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson) Who is responsible for the observation
... Slices for value[x] ΣC 1..1 CodeableConcept Actual result
Slice: Unordered, Closed by type:$this
.... value[x]:valueCodeableConcept SΣC 1..1 CodeableConcept Coded Responses from Smoking Status Value Set
Binding: DPPLungCancerScreeningFind FHIR (required): see mapping VF_DPPLungCancerScreeningFind
Constraints: dppo-39-2222
... dataAbsentReason SC 0..1 CodeableConcept Why the result is missing
Binding: DPPLungCancerScreeningDec FHIR (required): see mapping VF_DPPLungCancerScreeningDec
Constraints: dppo-39-2232
... interpretation 0..* CodeableConcept High, low, normal, etc.
Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
... note S 0..* Annotation Comments about the observation
... bodySite 0..1 CodeableConcept Observed body part
Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
... method 0..1 CodeableConcept How it was done
Binding: ObservationMethods (example): Methods for simple observations.
... specimen 0..1 Reference(Specimen) Specimen used for this observation
... device 0..1 Reference(Device | DeviceMetric) (Measurement) Device
... referenceRange C 0..* BackboneElement Provides guide for interpretation
Constraints: obs-3
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... low C 0..1 SimpleQuantity Low Range, if relevant
.... high C 0..1 SimpleQuantity High Range, if relevant
.... type 0..1 CodeableConcept Reference range qualifier
Binding: ObservationReferenceRangeMeaningCodes (preferred): Code for the meaning of a reference range.
.... appliesTo 0..* CodeableConcept Reference range population
Binding: ObservationReferenceRangeAppliesToCodes (example): Codes identifying the population the reference range applies to.
.... age 0..1 Range Applicable age range, if relevant
.... text 0..1 string Text based reference range in an observation
... hasMember Σ 0..* Reference(Observation | QuestionnaireResponse | MolecularSequence) Related resource that belongs to the Observation group
... derivedFrom Σ 0..* Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | Observation | MolecularSequence) Related measurements the observation is made from
... component Σ 0..* BackboneElement Component results
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... code Σ 1..1 CodeableConcept Type of component observation (code / type)
Binding: LOINCCodes (example): Codes identifying names of simple observations.
.... value[x] Σ 0..1 Actual component result
..... valueQuantity Quantity
..... valueCodeableConcept CodeableConcept
..... valueString string
..... valueBoolean boolean
..... valueInteger integer
..... valueRange Range
..... valueRatio Ratio
..... valueSampledData SampledData
..... valueTime time
..... valueDateTime dateTime
..... valuePeriod Period
.... dataAbsentReason C 0..1 CodeableConcept Why the component result is missing
Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
.... interpretation 0..* CodeableConcept High, low, normal, etc.
Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
.... referenceRange 0..* See referenceRange (Observation) Provides guide for interpretation of component result

doco Documentation for this format

Terminology Bindings

Constraints

PathConformanceValueSet / CodeURI
Observation.languagepreferredCommonLanguages
http://hl7.org/fhir/ValueSet/languages
From the FHIR Standard
Additional Bindings Purpose
AllLanguages Max Binding
Observation.statusrequiredPattern Value: final
http://hl7.org/fhir/us/core/ValueSet/us-core-observation-smoking-status-status
Observation.categorypreferredPattern Value: social-history
http://hl7.org/fhir/ValueSet/observation-category
From the FHIR Standard
Observation.category:SocialHistorypreferredPattern Value: social-history
http://hl7.org/fhir/ValueSet/observation-category
From the FHIR Standard
Observation.codeextensibleUSCoreSmokingStatusObservationCodes
http://hl7.org/fhir/us/core/ValueSet/us-core-smoking-status-observation-codes
Observation.value[x]:valueCodeableConceptrequiredDPPLungCancerScreeningFind
http://va.gov/fhir/ValueSet/DPPLungCancerScreeningFind
From this IG
Observation.dataAbsentReasonrequiredDPPLungCancerScreeningDec
http://va.gov/fhir/ValueSet/DPPLungCancerScreeningDec
From this IG
Observation.interpretationextensibleObservationInterpretationCodes
http://hl7.org/fhir/ValueSet/observation-interpretation
From the FHIR Standard
Observation.bodySiteexampleSNOMEDCTBodyStructures
http://hl7.org/fhir/ValueSet/body-site
From the FHIR Standard
Observation.methodexampleObservationMethods
http://hl7.org/fhir/ValueSet/observation-methods
From the FHIR Standard
Observation.referenceRange.typepreferredObservationReferenceRangeMeaningCodes
http://hl7.org/fhir/ValueSet/referencerange-meaning
From the FHIR Standard
Observation.referenceRange.appliesToexampleObservationReferenceRangeAppliesToCodes
http://hl7.org/fhir/ValueSet/referencerange-appliesto
From the FHIR Standard
Observation.component.codeexampleLOINCCodes(a valid code from LOINC)
http://hl7.org/fhir/ValueSet/observation-codes
From the FHIR Standard
Observation.component.dataAbsentReasonextensibleDataAbsentReason
http://hl7.org/fhir/ValueSet/data-absent-reason
From the FHIR Standard
Observation.component.interpretationextensibleObservationInterpretationCodes
http://hl7.org/fhir/ValueSet/observation-interpretation
From the FHIR Standard
IdGradePath(s)DetailsRequirements
dom-2errorObservationIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorObservationIf the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource
: contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4errorObservationIf a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
: contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5errorObservationIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practiceObservationA resource should have narrative for robust management
: text.`div`.exists()
dppo-39-2222best practiceObservation.value[x]:valueCodeableConceptIf VF_DPPLungCancerScreeningFind then terminologyMaps (9000010.23-.01) using VF_DPPLungCancerScreeningFind
: true
dppo-39-2232best practiceObservation.dataAbsentReasonIf In VF_DPPLungCancerScreeningDec then terminologyMaps (9000010.23-.01) using VF_DPPLungCancerScreeningDec
: true
dppo-39-2222-1best practiceObservation.codeIf VF_DPPLungCancerScreeningFind then fixed value http://loinc.org#72166-2 "Tobacco smoking status NHIS"
: true
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()
obs-3errorObservation.referenceRangeMust have at least a low or a high or text
: low.exists() or high.exists() or text.exists()
obs-6errorObservationdataAbsentReason SHALL only be present if Observation.value[x] is not present
: dataAbsentReason.empty() or value.empty()
obs-7errorObservationIf Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present
: value.empty() or component.code.where(coding.intersect(%resource.code.coding).exists()).empty()

This structure is derived from USCoreSmokingStatusProfile

Summary

Must-Support: 3 elements

Structures

This structure refers to these other structures:

 

Other representations of profile: CSV, Excel, Schematron