醫療影像及報告實作指引
0.1.0 - DSTU0 ci-build

醫療影像及報告實作指引 - Local Development build (v0.1.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

Resource Profile: Observation Imaging result

Official URL: https://hapi.fhir.tw/fhir/StructureDefinition/Observation-Imaging-Result Version: 0.1.0
Active as of 2024-07-29 Computable Name: ObservationImagingResult

此Profile說明本IG如何進一步定義FHIR的Observation Resource以呈現影像報告中的Finding部分

Usage:

Formal Views of Profile Content

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

This structure is derived from Observation

NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation Observation
... identifier 0..* Identifier 此影像的業務用識別碼。[應填入於醫學影像報告檢查單號Accession No.]
.... type
..... coding
...... system 0..1 uri Identity of the terminology system
Required Pattern: https://hapi.fhir.tw/fhir/CodeSystem/ImageIdentifierType
...... code 0..1 code Symbol in syntax defined by the system
Required Pattern: ACSN
...... display 0..1 string Representation defined by the system
Required Pattern: Accession ID
..... text 0..1 string Plain text representation of the concept
Required Pattern: Accession No 檢查單號
.... system S 1..1 uri 機構識別碼（identifier）的命名空間（namespace）
.... value S 1..1 string 使用 Accession No
... status S 1..1 code registered | preliminary | final | amended +
... category 1..* CodeableConcept 概念（concept）－參照一個專門術語或只是純文字。
.... coding
..... system 0..1 uri Identity of the terminology system
Required Pattern: http://terminology.hl7.org/CodeSystem/observation-category
..... code 0..1 code Symbol in syntax defined by the system
Required Pattern: imaging
..... display 0..1 string Representation defined by the system
Required Pattern: Imaging
.... Slices for coding 0..* Coding 由專門術語系統（terminology system）定義的代碼
Slice: Unordered, Open by pattern:$this
..... coding:All Slices Content/Rules for all slices
...... system 0..1 uri 專門術語系統（terminology system）的識別
...... code 0..1 code 系統定義的語法之符號。[應填入於醫學影像報告醫令代碼Order Code]
...... display 0..1 string 由系統定義的表示法。[應填入於醫學影像報告醫令名稱Order Description]
..... coding:icd10-pcs-2023-b S 0..1 Coding Code defined by a terminology system
Binding: 臺灣健保署2023年中文版ICD-10-PCS-B-Imaging值集 (required)
...... system S 1..1 uri Identity of the terminology system
Required Pattern: https://hapi.fhir.tw/fhir/CodeSystem/icd-10-pcs-2023-tw-b
...... code S 1..1 code Symbol in syntax defined by the system
...... display S 1..1 string Representation defined by the system
..... coding:icd10-pcs-2023-c S 0..1 Coding Code defined by a terminology system
Binding: 臺灣健保署2023年中文版ICD-10-PCS-C-Nuclear Medicine 值集 (required)
...... system S 1..1 uri Identity of the terminology system
Required Pattern: https://hapi.fhir.tw/fhir/CodeSystem/icd-10-pcs-2023-tw-c
...... code S 1..1 code Symbol in syntax defined by the system
...... display S 1..1 string Representation defined by the system
..... coding:icd10-pcs-2023-d S 0..1 Coding Code defined by a terminology system
Binding: 臺灣健保署2023年中文版ICD-10-PCS-D-Radiation Therapy值集 (required)
...... system S 1..1 uri Identity of the terminology system
Required Pattern: https://hapi.fhir.tw/fhir/CodeSystem/icd-10-pcs-2023-tw-d
...... code S 1..1 code Symbol in syntax defined by the system
...... display S 1..1 string Representation defined by the system
... subject S 1..1 Reference(Patient | Group | Device | Location) 檢驗檢查有關的對象及（或）事物
... effective[x] S 1..1 dateTime, Period, Timing, instant 與臨床相關的時間／報告的時段。[應填入醫學影像報告確認報告時間Verification Time]
... Slices for value[x] 0..1 Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period Actual result
Slice: Unordered, Open by type:$this
.... value[x]:valueString S 0..1 string 影像報告Finding。[應填入醫學影像報告報告結果Records. Total]
... note S 0..* Annotation 醫師總結之建議。[應填入醫學影像報告報告建議Radiology Study Recommendation]
... component S 0..* BackboneElement 影像報告Finding，提供使用LOINC/SNOMED CT(若機構已有購買相關授權)。[應填入醫學影像報告報告結果Records. Total]

doco Documentation for this format

Terminology Bindings (Differential)

PathConformanceValueSetURI
Observation.code.coding:icd10-pcs-2023-brequiredICD10PCSB (a valid code from 臺灣2023年中文版ICD-10-PCS-B-Imaging)
https://hapi.fhir.tw/fhir/ValueSet/icd-10-pcs-2023-tw-b
from this IG
Observation.code.coding:icd10-pcs-2023-crequiredICD10PCSC (a valid code from 臺灣2023年中文版ICD-10-PCS-C-NuclearMedicine)
https://hapi.fhir.tw/fhir/ValueSet/icd-10-pcs-2023-tw-c
from this IG
Observation.code.coding:icd10-pcs-2023-drequiredICD10PCSD (a valid code from 臺灣2023年中文版ICD-10-PCS-D-RadiationTherapy)
https://hapi.fhir.tw/fhir/ValueSet/icd-10-pcs-2023-tw-d
from this IG
NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation C 0..* Observation Measurements and simple assertions
obs-6: dataAbsentReason SHALL only be present if Observation.value[x] is not present
obs-7: If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... identifier Σ 0..* Identifier 此影像的業務用識別碼。[應填入於醫學影像報告檢查單號Accession No.]
.... use ?!Σ 0..1 code usual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .

.... system SΣ 1..1 uri 機構識別碼（identifier）的命名空間（namespace）
Example General: http://www.acme.com/identifiers/patient
.... value SΣ 1..1 string 使用 Accession No
Example General: 123456
... category 1..* CodeableConcept 概念（concept）－參照一個專門術語或只是純文字。
Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.


... code Σ 1..1 CodeableConcept 概念（concept）－參照一個專門術語或只是純文字
Binding: LOINCCodes (example): Codes identifying names of simple observations.

.... Slices for coding Σ 0..* Coding 由專門術語系統（terminology system）定義的代碼
Slice: Unordered, Open by pattern:$this
..... coding:All Slices Content/Rules for all slices
...... system Σ 0..1 uri 專門術語系統（terminology system）的識別
...... code Σ 0..1 code 系統定義的語法之符號。[應填入於醫學影像報告醫令代碼Order Code]
...... display Σ 0..1 string 由系統定義的表示法。[應填入於醫學影像報告醫令名稱Order Description]
..... coding:icd10-pcs-2023-b SΣ 0..1 Coding Code defined by a terminology system
Binding: 臺灣健保署2023年中文版ICD-10-PCS-B-Imaging值集 (required)
...... system SΣ 1..1 uri Identity of the terminology system
Required Pattern: https://hapi.fhir.tw/fhir/CodeSystem/icd-10-pcs-2023-tw-b
...... code SΣ 1..1 code Symbol in syntax defined by the system
...... display SΣ 1..1 string Representation defined by the system
..... coding:icd10-pcs-2023-c SΣ 0..1 Coding Code defined by a terminology system
Binding: 臺灣健保署2023年中文版ICD-10-PCS-C-Nuclear Medicine 值集 (required)
...... system SΣ 1..1 uri Identity of the terminology system
Required Pattern: https://hapi.fhir.tw/fhir/CodeSystem/icd-10-pcs-2023-tw-c
...... code SΣ 1..1 code Symbol in syntax defined by the system
...... display SΣ 1..1 string Representation defined by the system
..... coding:icd10-pcs-2023-d SΣ 0..1 Coding Code defined by a terminology system
Binding: 臺灣健保署2023年中文版ICD-10-PCS-D-Radiation Therapy值集 (required)
...... system SΣ 1..1 uri Identity of the terminology system
Required Pattern: https://hapi.fhir.tw/fhir/CodeSystem/icd-10-pcs-2023-tw-d
...... code SΣ 1..1 code Symbol in syntax defined by the system
...... display SΣ 1..1 string Representation defined by the system
... subject SΣ 1..1 Reference(Patient | Group | Device | Location) 檢驗檢查有關的對象及（或）事物
... effective[x] SΣ 1..1 與臨床相關的時間／報告的時段。[應填入醫學影像報告確認報告時間Verification Time]
.... effectiveDateTime dateTime
.... effectivePeriod Period
.... effectiveTiming Timing
.... effectiveInstant instant
... Slices for value[x] ΣC 0..1 Actual result
Slice: Unordered, Open by type:$this
.... valueQuantity Quantity
.... valueCodeableConcept CodeableConcept
.... valueString string
.... valueBoolean boolean
.... valueInteger integer
.... valueRange Range
.... valueRatio Ratio
.... valueSampledData SampledData
.... valueTime time
.... valueDateTime dateTime
.... valuePeriod Period
.... value[x]:valueString SΣC 0..1 string 影像報告Finding。[應填入醫學影像報告報告結果Records. Total]
... note S 0..* Annotation 醫師總結之建議。[應填入醫學影像報告報告建議Radiology Study Recommendation]
... component SΣ 0..* BackboneElement 影像報告Finding，提供使用LOINC/SNOMED CT(若機構已有購買相關授權)。[應填入醫學影像報告報告結果Records. Total]
.... 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.


doco Documentation for this format

Terminology Bindings

PathConformanceValueSetURI
Observation.identifier.userequiredIdentifierUse
http://hl7.org/fhir/ValueSet/identifier-use|4.0.1
from the FHIR Standard
Observation.statusrequiredObservationStatus
http://hl7.org/fhir/ValueSet/observation-status|4.0.1
from the FHIR Standard
Observation.categorypreferredObservationCategoryCodes
http://hl7.org/fhir/ValueSet/observation-category
from the FHIR Standard
Observation.codeexampleLOINCCodes (a valid code from LOINC)
http://hl7.org/fhir/ValueSet/observation-codes
from the FHIR Standard
Observation.code.coding:icd10-pcs-2023-brequiredICD10PCSB (a valid code from 臺灣2023年中文版ICD-10-PCS-B-Imaging)
https://hapi.fhir.tw/fhir/ValueSet/icd-10-pcs-2023-tw-b
from this IG
Observation.code.coding:icd10-pcs-2023-crequiredICD10PCSC (a valid code from 臺灣2023年中文版ICD-10-PCS-C-NuclearMedicine)
https://hapi.fhir.tw/fhir/ValueSet/icd-10-pcs-2023-tw-c
from this IG
Observation.code.coding:icd10-pcs-2023-drequiredICD10PCSD (a valid code from 臺灣2023年中文版ICD-10-PCS-D-RadiationTherapy)
https://hapi.fhir.tw/fhir/ValueSet/icd-10-pcs-2023-tw-d
from this IG
Observation.component.codeexampleLOINCCodes (a valid code from LOINC)
http://hl7.org/fhir/ValueSet/observation-codes
from the FHIR Standard

Constraints

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()
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()
NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation C 0..* Observation Measurements and simple assertions
obs-6: dataAbsentReason SHALL only be present if Observation.value[x] is not present
obs-7: If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present
... 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 此影像的業務用識別碼。[應填入於醫學影像報告檢查單號Accession No.]
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... use ?!Σ 0..1 code usual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .

.... type Σ 0..1 CodeableConcept Description of identifier
Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... coding Σ 0..* Coding Code defined by a terminology system
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... system Σ 0..1 uri Identity of the terminology system
Required Pattern: https://hapi.fhir.tw/fhir/CodeSystem/ImageIdentifierType
...... version Σ 0..1 string Version of the system - if relevant
...... code Σ 0..1 code Symbol in syntax defined by the system
Required Pattern: ACSN
...... display Σ 0..1 string Representation defined by the system
Required Pattern: Accession ID
...... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
..... text Σ 0..1 string Plain text representation of the concept
Required Pattern: Accession No 檢查單號
.... system SΣ 1..1 uri 機構識別碼（identifier）的命名空間（namespace）
Example General: http://www.acme.com/identifiers/patient
.... value SΣ 1..1 string 使用 Accession No
Example General: 123456
.... period Σ 0..1 Period Time period when id is/was valid for use
.... assigner Σ 0..1 Reference(Organization) Organization that issued id (may be just text)
... basedOn Σ 0..* Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest) Fulfills plan, proposal or order
... partOf Σ 0..* Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy) Part of referenced event
... status ?!SΣ 1..1 code registered | preliminary | final | amended +
Binding: ObservationStatus (required): Codes providing the status of an observation.

... category 1..* CodeableConcept 概念（concept）－參照一個專門術語或只是純文字。
Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.


.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... coding Σ 0..* Coding Code defined by a terminology system
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... system Σ 0..1 uri Identity of the terminology system
Required Pattern: http://terminology.hl7.org/CodeSystem/observation-category
..... version Σ 0..1 string Version of the system - if relevant
..... code Σ 0..1 code Symbol in syntax defined by the system
Required Pattern: imaging
..... display Σ 0..1 string Representation defined by the system
Required Pattern: Imaging
..... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
.... text Σ 0..1 string Plain text representation of the concept
... code Σ 1..1 CodeableConcept 概念（concept）－參照一個專門術語或只是純文字
Binding: LOINCCodes (example): Codes identifying names of simple observations.

.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... Slices for coding Σ 0..* Coding 由專門術語系統（terminology system）定義的代碼
Slice: Unordered, Open by pattern:$this
..... coding:All Slices Content/Rules for all slices
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... system Σ 0..1 uri 專門術語系統（terminology system）的識別
...... version Σ 0..1 string Version of the system - if relevant
...... code Σ 0..1 code 系統定義的語法之符號。[應填入於醫學影像報告醫令代碼Order Code]
...... display Σ 0..1 string 由系統定義的表示法。[應填入於醫學影像報告醫令名稱Order Description]
...... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
..... coding:icd10-pcs-2023-b SΣ 0..1 Coding Code defined by a terminology system
Binding: 臺灣健保署2023年中文版ICD-10-PCS-B-Imaging值集 (required)
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... system SΣ 1..1 uri Identity of the terminology system
Required Pattern: https://hapi.fhir.tw/fhir/CodeSystem/icd-10-pcs-2023-tw-b
...... version Σ 0..1 string Version of the system - if relevant
...... code SΣ 1..1 code Symbol in syntax defined by the system
...... display SΣ 1..1 string Representation defined by the system
...... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
..... coding:icd10-pcs-2023-c SΣ 0..1 Coding Code defined by a terminology system
Binding: 臺灣健保署2023年中文版ICD-10-PCS-C-Nuclear Medicine 值集 (required)
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... system SΣ 1..1 uri Identity of the terminology system
Required Pattern: https://hapi.fhir.tw/fhir/CodeSystem/icd-10-pcs-2023-tw-c
...... version Σ 0..1 string Version of the system - if relevant
...... code SΣ 1..1 code Symbol in syntax defined by the system
...... display SΣ 1..1 string Representation defined by the system
...... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
..... coding:icd10-pcs-2023-d SΣ 0..1 Coding Code defined by a terminology system
Binding: 臺灣健保署2023年中文版ICD-10-PCS-D-Radiation Therapy值集 (required)
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... system SΣ 1..1 uri Identity of the terminology system
Required Pattern: https://hapi.fhir.tw/fhir/CodeSystem/icd-10-pcs-2023-tw-d
...... version Σ 0..1 string Version of the system - if relevant
...... code SΣ 1..1 code Symbol in syntax defined by the system
...... display SΣ 1..1 string Representation defined by the system
...... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
.... text Σ 0..1 string Plain text representation of the concept
... subject SΣ 1..1 Reference(Patient | Group | Device | Location) 檢驗檢查有關的對象及（或）事物
... focus Σ 0..* Reference(Resource) What the observation is about, when it is not about the subject of record
... encounter Σ 0..1 Reference(Encounter) Healthcare event during which this observation is made
... effective[x] SΣ 1..1 與臨床相關的時間／報告的時段。[應填入醫學影像報告確認報告時間Verification Time]
.... effectiveDateTime dateTime
.... effectivePeriod Period
.... effectiveTiming Timing
.... effectiveInstant instant
... 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 0..1 Actual result
Slice: Unordered, Open by type:$this
.... valueQuantity Quantity
.... valueCodeableConcept CodeableConcept
.... valueString string
.... valueBoolean boolean
.... valueInteger integer
.... valueRange Range
.... valueRatio Ratio
.... valueSampledData SampledData
.... valueTime time
.... valueDateTime dateTime
.... valuePeriod Period
.... value[x]:valueString SΣC 0..1 string 影像報告Finding。[應填入醫學影像報告報告結果Records. Total]
... dataAbsentReason C 0..1 CodeableConcept Why the result is missing
Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.

... interpretation 0..* CodeableConcept High, low, normal, etc.
Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.


... note S 0..* Annotation 醫師總結之建議。[應填入醫學影像報告報告建議Radiology Study Recommendation]
... 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
obs-3: Must have at least a low or a high or text
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... low C 0..1 SimpleQuantity Low Range, if relevant
.... high C 0..1 SimpleQuantity High Range, if relevant
.... type 0..1 CodeableConcept Reference range qualifier
Binding: ObservationReferenceRangeMeaningCodes (preferred): Code for the meaning of a reference range.

.... appliesTo 0..* CodeableConcept Reference range population
Binding: ObservationReferenceRangeAppliesToCodes (example): Codes identifying the population the reference range applies to.


.... age 0..1 Range Applicable age range, if relevant
.... text 0..1 string Text based reference range in an observation
... hasMember Σ 0..* Reference(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 SΣ 0..* BackboneElement 影像報告Finding，提供使用LOINC/SNOMED CT(若機構已有購買相關授權)。[應填入醫學影像報告報告結果Records. Total]
.... 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

PathConformanceValueSetURI
Observation.languagepreferredCommonLanguages
Additional Bindings Purpose
AllLanguages Max Binding
http://hl7.org/fhir/ValueSet/languages
from the FHIR Standard
Observation.identifier.userequiredIdentifierUse
http://hl7.org/fhir/ValueSet/identifier-use|4.0.1
from the FHIR Standard
Observation.identifier.typeextensibleIdentifier Type Codes
http://hl7.org/fhir/ValueSet/identifier-type
from the FHIR Standard
Observation.statusrequiredObservationStatus
http://hl7.org/fhir/ValueSet/observation-status|4.0.1
from the FHIR Standard
Observation.categorypreferredObservationCategoryCodes
http://hl7.org/fhir/ValueSet/observation-category
from the FHIR Standard
Observation.codeexampleLOINCCodes (a valid code from LOINC)
http://hl7.org/fhir/ValueSet/observation-codes
from the FHIR Standard
Observation.code.coding:icd10-pcs-2023-brequiredICD10PCSB (a valid code from 臺灣2023年中文版ICD-10-PCS-B-Imaging)
https://hapi.fhir.tw/fhir/ValueSet/icd-10-pcs-2023-tw-b
from this IG
Observation.code.coding:icd10-pcs-2023-crequiredICD10PCSC (a valid code from 臺灣2023年中文版ICD-10-PCS-C-NuclearMedicine)
https://hapi.fhir.tw/fhir/ValueSet/icd-10-pcs-2023-tw-c
from this IG
Observation.code.coding:icd10-pcs-2023-drequiredICD10PCSD (a valid code from 臺灣2023年中文版ICD-10-PCS-D-RadiationTherapy)
https://hapi.fhir.tw/fhir/ValueSet/icd-10-pcs-2023-tw-d
from this IG
Observation.dataAbsentReasonextensibleDataAbsentReason
http://hl7.org/fhir/ValueSet/data-absent-reason
from the FHIR Standard
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

Constraints

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()
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 Observation

Summary

Mandatory: 3 elements(11 nested mandatory elements)
Must-Support: 20 elements

Slices

This structure defines the following Slices:

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

Differential View

This structure is derived from Observation

NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation Observation
... identifier 0..* Identifier 此影像的業務用識別碼。[應填入於醫學影像報告檢查單號Accession No.]
.... type
..... coding
...... system 0..1 uri Identity of the terminology system
Required Pattern: https://hapi.fhir.tw/fhir/CodeSystem/ImageIdentifierType
...... code 0..1 code Symbol in syntax defined by the system
Required Pattern: ACSN
...... display 0..1 string Representation defined by the system
Required Pattern: Accession ID
..... text 0..1 string Plain text representation of the concept
Required Pattern: Accession No 檢查單號
.... system S 1..1 uri 機構識別碼（identifier）的命名空間（namespace）
.... value S 1..1 string 使用 Accession No
... status S 1..1 code registered | preliminary | final | amended +
... category 1..* CodeableConcept 概念（concept）－參照一個專門術語或只是純文字。
.... coding
..... system 0..1 uri Identity of the terminology system
Required Pattern: http://terminology.hl7.org/CodeSystem/observation-category
..... code 0..1 code Symbol in syntax defined by the system
Required Pattern: imaging
..... display 0..1 string Representation defined by the system
Required Pattern: Imaging
.... Slices for coding 0..* Coding 由專門術語系統（terminology system）定義的代碼
Slice: Unordered, Open by pattern:$this
..... coding:All Slices Content/Rules for all slices
...... system 0..1 uri 專門術語系統（terminology system）的識別
...... code 0..1 code 系統定義的語法之符號。[應填入於醫學影像報告醫令代碼Order Code]
...... display 0..1 string 由系統定義的表示法。[應填入於醫學影像報告醫令名稱Order Description]
..... coding:icd10-pcs-2023-b S 0..1 Coding Code defined by a terminology system
Binding: 臺灣健保署2023年中文版ICD-10-PCS-B-Imaging值集 (required)
...... system S 1..1 uri Identity of the terminology system
Required Pattern: https://hapi.fhir.tw/fhir/CodeSystem/icd-10-pcs-2023-tw-b
...... code S 1..1 code Symbol in syntax defined by the system
...... display S 1..1 string Representation defined by the system
..... coding:icd10-pcs-2023-c S 0..1 Coding Code defined by a terminology system
Binding: 臺灣健保署2023年中文版ICD-10-PCS-C-Nuclear Medicine 值集 (required)
...... system S 1..1 uri Identity of the terminology system
Required Pattern: https://hapi.fhir.tw/fhir/CodeSystem/icd-10-pcs-2023-tw-c
...... code S 1..1 code Symbol in syntax defined by the system
...... display S 1..1 string Representation defined by the system
..... coding:icd10-pcs-2023-d S 0..1 Coding Code defined by a terminology system
Binding: 臺灣健保署2023年中文版ICD-10-PCS-D-Radiation Therapy值集 (required)
...... system S 1..1 uri Identity of the terminology system
Required Pattern: https://hapi.fhir.tw/fhir/CodeSystem/icd-10-pcs-2023-tw-d
...... code S 1..1 code Symbol in syntax defined by the system
...... display S 1..1 string Representation defined by the system
... subject S 1..1 Reference(Patient | Group | Device | Location) 檢驗檢查有關的對象及（或）事物
... effective[x] S 1..1 dateTime, Period, Timing, instant 與臨床相關的時間／報告的時段。[應填入醫學影像報告確認報告時間Verification Time]
... Slices for value[x] 0..1 Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period Actual result
Slice: Unordered, Open by type:$this
.... value[x]:valueString S 0..1 string 影像報告Finding。[應填入醫學影像報告報告結果Records. Total]
... note S 0..* Annotation 醫師總結之建議。[應填入醫學影像報告報告建議Radiology Study Recommendation]
... component S 0..* BackboneElement 影像報告Finding，提供使用LOINC/SNOMED CT(若機構已有購買相關授權)。[應填入醫學影像報告報告結果Records. Total]

doco Documentation for this format

Terminology Bindings (Differential)

PathConformanceValueSetURI
Observation.code.coding:icd10-pcs-2023-brequiredICD10PCSB (a valid code from 臺灣2023年中文版ICD-10-PCS-B-Imaging)
https://hapi.fhir.tw/fhir/ValueSet/icd-10-pcs-2023-tw-b
from this IG
Observation.code.coding:icd10-pcs-2023-crequiredICD10PCSC (a valid code from 臺灣2023年中文版ICD-10-PCS-C-NuclearMedicine)
https://hapi.fhir.tw/fhir/ValueSet/icd-10-pcs-2023-tw-c
from this IG
Observation.code.coding:icd10-pcs-2023-drequiredICD10PCSD (a valid code from 臺灣2023年中文版ICD-10-PCS-D-RadiationTherapy)
https://hapi.fhir.tw/fhir/ValueSet/icd-10-pcs-2023-tw-d
from this IG

Key Elements View

NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation C 0..* Observation Measurements and simple assertions
obs-6: dataAbsentReason SHALL only be present if Observation.value[x] is not present
obs-7: If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... identifier Σ 0..* Identifier 此影像的業務用識別碼。[應填入於醫學影像報告檢查單號Accession No.]
.... use ?!Σ 0..1 code usual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .

.... system SΣ 1..1 uri 機構識別碼（identifier）的命名空間（namespace）
Example General: http://www.acme.com/identifiers/patient
.... value SΣ 1..1 string 使用 Accession No
Example General: 123456
... category 1..* CodeableConcept 概念（concept）－參照一個專門術語或只是純文字。
Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.


... code Σ 1..1 CodeableConcept 概念（concept）－參照一個專門術語或只是純文字
Binding: LOINCCodes (example): Codes identifying names of simple observations.

.... Slices for coding Σ 0..* Coding 由專門術語系統（terminology system）定義的代碼
Slice: Unordered, Open by pattern:$this
..... coding:All Slices Content/Rules for all slices
...... system Σ 0..1 uri 專門術語系統（terminology system）的識別
...... code Σ 0..1 code 系統定義的語法之符號。[應填入於醫學影像報告醫令代碼Order Code]
...... display Σ 0..1 string 由系統定義的表示法。[應填入於醫學影像報告醫令名稱Order Description]
..... coding:icd10-pcs-2023-b SΣ 0..1 Coding Code defined by a terminology system
Binding: 臺灣健保署2023年中文版ICD-10-PCS-B-Imaging值集 (required)
...... system SΣ 1..1 uri Identity of the terminology system
Required Pattern: https://hapi.fhir.tw/fhir/CodeSystem/icd-10-pcs-2023-tw-b
...... code SΣ 1..1 code Symbol in syntax defined by the system
...... display SΣ 1..1 string Representation defined by the system
..... coding:icd10-pcs-2023-c SΣ 0..1 Coding Code defined by a terminology system
Binding: 臺灣健保署2023年中文版ICD-10-PCS-C-Nuclear Medicine 值集 (required)
...... system SΣ 1..1 uri Identity of the terminology system
Required Pattern: https://hapi.fhir.tw/fhir/CodeSystem/icd-10-pcs-2023-tw-c
...... code SΣ 1..1 code Symbol in syntax defined by the system
...... display SΣ 1..1 string Representation defined by the system
..... coding:icd10-pcs-2023-d SΣ 0..1 Coding Code defined by a terminology system
Binding: 臺灣健保署2023年中文版ICD-10-PCS-D-Radiation Therapy值集 (required)
...... system SΣ 1..1 uri Identity of the terminology system
Required Pattern: https://hapi.fhir.tw/fhir/CodeSystem/icd-10-pcs-2023-tw-d
...... code SΣ 1..1 code Symbol in syntax defined by the system
...... display SΣ 1..1 string Representation defined by the system
... subject SΣ 1..1 Reference(Patient | Group | Device | Location) 檢驗檢查有關的對象及（或）事物
... effective[x] SΣ 1..1 與臨床相關的時間／報告的時段。[應填入醫學影像報告確認報告時間Verification Time]
.... effectiveDateTime dateTime
.... effectivePeriod Period
.... effectiveTiming Timing
.... effectiveInstant instant
... Slices for value[x] ΣC 0..1 Actual result
Slice: Unordered, Open by type:$this
.... valueQuantity Quantity
.... valueCodeableConcept CodeableConcept
.... valueString string
.... valueBoolean boolean
.... valueInteger integer
.... valueRange Range
.... valueRatio Ratio
.... valueSampledData SampledData
.... valueTime time
.... valueDateTime dateTime
.... valuePeriod Period
.... value[x]:valueString SΣC 0..1 string 影像報告Finding。[應填入醫學影像報告報告結果Records. Total]
... note S 0..* Annotation 醫師總結之建議。[應填入醫學影像報告報告建議Radiology Study Recommendation]
... component SΣ 0..* BackboneElement 影像報告Finding，提供使用LOINC/SNOMED CT(若機構已有購買相關授權)。[應填入醫學影像報告報告結果Records. Total]
.... 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.


doco Documentation for this format

Terminology Bindings

PathConformanceValueSetURI
Observation.identifier.userequiredIdentifierUse
http://hl7.org/fhir/ValueSet/identifier-use|4.0.1
from the FHIR Standard
Observation.statusrequiredObservationStatus
http://hl7.org/fhir/ValueSet/observation-status|4.0.1
from the FHIR Standard
Observation.categorypreferredObservationCategoryCodes
http://hl7.org/fhir/ValueSet/observation-category
from the FHIR Standard
Observation.codeexampleLOINCCodes (a valid code from LOINC)
http://hl7.org/fhir/ValueSet/observation-codes
from the FHIR Standard
Observation.code.coding:icd10-pcs-2023-brequiredICD10PCSB (a valid code from 臺灣2023年中文版ICD-10-PCS-B-Imaging)
https://hapi.fhir.tw/fhir/ValueSet/icd-10-pcs-2023-tw-b
from this IG
Observation.code.coding:icd10-pcs-2023-crequiredICD10PCSC (a valid code from 臺灣2023年中文版ICD-10-PCS-C-NuclearMedicine)
https://hapi.fhir.tw/fhir/ValueSet/icd-10-pcs-2023-tw-c
from this IG
Observation.code.coding:icd10-pcs-2023-drequiredICD10PCSD (a valid code from 臺灣2023年中文版ICD-10-PCS-D-RadiationTherapy)
https://hapi.fhir.tw/fhir/ValueSet/icd-10-pcs-2023-tw-d
from this IG
Observation.component.codeexampleLOINCCodes (a valid code from LOINC)
http://hl7.org/fhir/ValueSet/observation-codes
from the FHIR Standard

Constraints

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()
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()

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation C 0..* Observation Measurements and simple assertions
obs-6: dataAbsentReason SHALL only be present if Observation.value[x] is not present
obs-7: If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present
... 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 此影像的業務用識別碼。[應填入於醫學影像報告檢查單號Accession No.]
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... use ?!Σ 0..1 code usual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .

.... type Σ 0..1 CodeableConcept Description of identifier
Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... coding Σ 0..* Coding Code defined by a terminology system
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... system Σ 0..1 uri Identity of the terminology system
Required Pattern: https://hapi.fhir.tw/fhir/CodeSystem/ImageIdentifierType
...... version Σ 0..1 string Version of the system - if relevant
...... code Σ 0..1 code Symbol in syntax defined by the system
Required Pattern: ACSN
...... display Σ 0..1 string Representation defined by the system
Required Pattern: Accession ID
...... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
..... text Σ 0..1 string Plain text representation of the concept
Required Pattern: Accession No 檢查單號
.... system SΣ 1..1 uri 機構識別碼（identifier）的命名空間（namespace）
Example General: http://www.acme.com/identifiers/patient
.... value SΣ 1..1 string 使用 Accession No
Example General: 123456
.... period Σ 0..1 Period Time period when id is/was valid for use
.... assigner Σ 0..1 Reference(Organization) Organization that issued id (may be just text)
... basedOn Σ 0..* Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest) Fulfills plan, proposal or order
... partOf Σ 0..* Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy) Part of referenced event
... status ?!SΣ 1..1 code registered | preliminary | final | amended +
Binding: ObservationStatus (required): Codes providing the status of an observation.

... category 1..* CodeableConcept 概念（concept）－參照一個專門術語或只是純文字。
Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.


.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... coding Σ 0..* Coding Code defined by a terminology system
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... system Σ 0..1 uri Identity of the terminology system
Required Pattern: http://terminology.hl7.org/CodeSystem/observation-category
..... version Σ 0..1 string Version of the system - if relevant
..... code Σ 0..1 code Symbol in syntax defined by the system
Required Pattern: imaging
..... display Σ 0..1 string Representation defined by the system
Required Pattern: Imaging
..... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
.... text Σ 0..1 string Plain text representation of the concept
... code Σ 1..1 CodeableConcept 概念（concept）－參照一個專門術語或只是純文字
Binding: LOINCCodes (example): Codes identifying names of simple observations.

.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... Slices for coding Σ 0..* Coding 由專門術語系統（terminology system）定義的代碼
Slice: Unordered, Open by pattern:$this
..... coding:All Slices Content/Rules for all slices
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... system Σ 0..1 uri 專門術語系統（terminology system）的識別
...... version Σ 0..1 string Version of the system - if relevant
...... code Σ 0..1 code 系統定義的語法之符號。[應填入於醫學影像報告醫令代碼Order Code]
...... display Σ 0..1 string 由系統定義的表示法。[應填入於醫學影像報告醫令名稱Order Description]
...... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
..... coding:icd10-pcs-2023-b SΣ 0..1 Coding Code defined by a terminology system
Binding: 臺灣健保署2023年中文版ICD-10-PCS-B-Imaging值集 (required)
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... system SΣ 1..1 uri Identity of the terminology system
Required Pattern: https://hapi.fhir.tw/fhir/CodeSystem/icd-10-pcs-2023-tw-b
...... version Σ 0..1 string Version of the system - if relevant
...... code SΣ 1..1 code Symbol in syntax defined by the system
...... display SΣ 1..1 string Representation defined by the system
...... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
..... coding:icd10-pcs-2023-c SΣ 0..1 Coding Code defined by a terminology system
Binding: 臺灣健保署2023年中文版ICD-10-PCS-C-Nuclear Medicine 值集 (required)
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... system SΣ 1..1 uri Identity of the terminology system
Required Pattern: https://hapi.fhir.tw/fhir/CodeSystem/icd-10-pcs-2023-tw-c
...... version Σ 0..1 string Version of the system - if relevant
...... code SΣ 1..1 code Symbol in syntax defined by the system
...... display SΣ 1..1 string Representation defined by the system
...... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
..... coding:icd10-pcs-2023-d SΣ 0..1 Coding Code defined by a terminology system
Binding: 臺灣健保署2023年中文版ICD-10-PCS-D-Radiation Therapy值集 (required)
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... system SΣ 1..1 uri Identity of the terminology system
Required Pattern: https://hapi.fhir.tw/fhir/CodeSystem/icd-10-pcs-2023-tw-d
...... version Σ 0..1 string Version of the system - if relevant
...... code SΣ 1..1 code Symbol in syntax defined by the system
...... display SΣ 1..1 string Representation defined by the system
...... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
.... text Σ 0..1 string Plain text representation of the concept
... subject SΣ 1..1 Reference(Patient | Group | Device | Location) 檢驗檢查有關的對象及（或）事物
... focus Σ 0..* Reference(Resource) What the observation is about, when it is not about the subject of record
... encounter Σ 0..1 Reference(Encounter) Healthcare event during which this observation is made
... effective[x] SΣ 1..1 與臨床相關的時間／報告的時段。[應填入醫學影像報告確認報告時間Verification Time]
.... effectiveDateTime dateTime
.... effectivePeriod Period
.... effectiveTiming Timing
.... effectiveInstant instant
... 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 0..1 Actual result
Slice: Unordered, Open by type:$this
.... valueQuantity Quantity
.... valueCodeableConcept CodeableConcept
.... valueString string
.... valueBoolean boolean
.... valueInteger integer
.... valueRange Range
.... valueRatio Ratio
.... valueSampledData SampledData
.... valueTime time
.... valueDateTime dateTime
.... valuePeriod Period
.... value[x]:valueString SΣC 0..1 string 影像報告Finding。[應填入醫學影像報告報告結果Records. Total]
... dataAbsentReason C 0..1 CodeableConcept Why the result is missing
Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.

... interpretation 0..* CodeableConcept High, low, normal, etc.
Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.


... note S 0..* Annotation 醫師總結之建議。[應填入醫學影像報告報告建議Radiology Study Recommendation]
... 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
obs-3: Must have at least a low or a high or text
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... low C 0..1 SimpleQuantity Low Range, if relevant
.... high C 0..1 SimpleQuantity High Range, if relevant
.... type 0..1 CodeableConcept Reference range qualifier
Binding: ObservationReferenceRangeMeaningCodes (preferred): Code for the meaning of a reference range.

.... appliesTo 0..* CodeableConcept Reference range population
Binding: ObservationReferenceRangeAppliesToCodes (example): Codes identifying the population the reference range applies to.


.... age 0..1 Range Applicable age range, if relevant
.... text 0..1 string Text based reference range in an observation
... hasMember Σ 0..* Reference(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 SΣ 0..* BackboneElement 影像報告Finding，提供使用LOINC/SNOMED CT(若機構已有購買相關授權)。[應填入醫學影像報告報告結果Records. Total]
.... 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

PathConformanceValueSetURI
Observation.languagepreferredCommonLanguages
Additional Bindings Purpose
AllLanguages Max Binding
http://hl7.org/fhir/ValueSet/languages
from the FHIR Standard
Observation.identifier.userequiredIdentifierUse
http://hl7.org/fhir/ValueSet/identifier-use|4.0.1
from the FHIR Standard
Observation.identifier.typeextensibleIdentifier Type Codes
http://hl7.org/fhir/ValueSet/identifier-type
from the FHIR Standard
Observation.statusrequiredObservationStatus
http://hl7.org/fhir/ValueSet/observation-status|4.0.1
from the FHIR Standard
Observation.categorypreferredObservationCategoryCodes
http://hl7.org/fhir/ValueSet/observation-category
from the FHIR Standard
Observation.codeexampleLOINCCodes (a valid code from LOINC)
http://hl7.org/fhir/ValueSet/observation-codes
from the FHIR Standard
Observation.code.coding:icd10-pcs-2023-brequiredICD10PCSB (a valid code from 臺灣2023年中文版ICD-10-PCS-B-Imaging)
https://hapi.fhir.tw/fhir/ValueSet/icd-10-pcs-2023-tw-b
from this IG
Observation.code.coding:icd10-pcs-2023-crequiredICD10PCSC (a valid code from 臺灣2023年中文版ICD-10-PCS-C-NuclearMedicine)
https://hapi.fhir.tw/fhir/ValueSet/icd-10-pcs-2023-tw-c
from this IG
Observation.code.coding:icd10-pcs-2023-drequiredICD10PCSD (a valid code from 臺灣2023年中文版ICD-10-PCS-D-RadiationTherapy)
https://hapi.fhir.tw/fhir/ValueSet/icd-10-pcs-2023-tw-d
from this IG
Observation.dataAbsentReasonextensibleDataAbsentReason
http://hl7.org/fhir/ValueSet/data-absent-reason
from the FHIR Standard
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

Constraints

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()
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 Observation

Summary

Mandatory: 3 elements(11 nested mandatory elements)
Must-Support: 20 elements

Slices

This structure defines the following Slices:

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

 

Other representations of profile: CSV, Excel, Schematron