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Orders and Observations Work Group Maturity Level : 5 N   Trial Use Normative (from v4.1.0) Security Category : Patient Compartments : Device , Encounter , Patient , Practitioner , RelatedPerson

Detailed Descriptions for the elements in the Observation resource.

Observation
Element Id Observation
Definition

Measurements and simple assertions made about a patient, device or other subject.

Control Cardinality 1..1 0..*
Type DomainResource
Requirements

Observations are a key aspect of healthcare. This resource is used to capture those that do not require more sophisticated mechanisms.

Alternate Names Vital Signs; Measurement; Results; Tests
Comments

Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc. Other resources are used to provide context for observations such as lab laboratory reports, etc.

Invariants
Defined on this element
obs-6 : Rule dataAbsentReason SHALL only be present if Observation.value[x] is not present ( expression : dataAbsentReason.empty() or value.empty(), xpath: not(exists(f:dataAbsentReason)) or (not(exists(*[starts-with(local-name(.), 'value')])))) value.empty()
obs-7 : Rule If code Observation.code is the same as a component code an Observation.component.code then the value element associated with the code SHALL NOT be present ( expression : value.empty() or code!=component.code, xpath: not(exists(f:*[starts-with(local-name(.), 'value')])) or not(count(for $coding in f:code/f:coding return parent::*/f:component/f:code/f:coding[f:code/@value=$coding/f:code/@value and f:system/@value=$coding/f:system/@value])=0)) component.code.where(coding.intersect(%resource.code.coding).exists()).empty()
Observation.identifier
Element Id Observation.identifier
Definition

A unique identifier assigned to this observation.

Note This is a business identifer, identifier, not a resource identifier (see discussion )
Control Cardinality 0..*
Type Identifier
Requirements

Allows observations to be distinguished and referenced.

Summary true
Observation.basedOn
Element Id Observation.basedOn
Definition

A plan, proposal or order that is fulfilled in whole or in part by this event. For example, a MedicationRequest may require a patient to have laboratory test performed before it is dispensed.

Control Cardinality 0..*
Type Reference ( CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ProcedureRequest | ReferralRequest ServiceRequest )
Patterns Reference(CarePlan,DeviceRequest,ImmunizationRecommendation,MedicationRequest,NutritionOrder,ServiceRequest): Common patterns = Request
Requirements

Allows tracing of authorization for the event and tracking whether proposals/recommendations were acted upon.

Alternate Names Fulfills
Summary true
Observation.partOf
Element Id Observation.partOf
Definition

A larger event of which this particular Observation is a component or step. For example, an observation as part of a procedure.

Cardinality 0..*
Type Reference ( MedicationAdministration | MedicationDispense | MedicationUsage | Procedure | Immunization | ImagingStudy )
Patterns Reference(MedicationAdministration,MedicationDispense,MedicationUsage,Procedure,Immunization,ImagingStudy): Common patterns = Event
Alternate Names Container
Summary true
Comments

To link an Observation to an Encounter use encounter . See the Notes below for guidance on referencing another Observation.

Observation.status
Element Id Observation.status
Definition

The status of the result value.

Control Cardinality 1..1
Terminology Binding ObservationStatus ( Required )
Type code
Is Modifier true (Reason: This element is labeled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid)
Requirements

Need to track the status of individual results. Some results are finalized before the whole report is finalized.

Summary true
Comments

This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.

Observation.category
Element Id Observation.category
Definition

A code that classifies the general type of observation being made.

Control Cardinality 0..*
Terminology Binding Observation Category Codes ( Preferred )
Type CodeableConcept
Requirements

Used for filtering what observations are retrieved and displayed.

Comments

In addition to the required category valueset, this element allows various categorization schemes based on the owner’s owner’s definition of the category and effectively multiple categories can be used at once. The level of granularity is defined by the category concepts in the value set.

Observation.code
Element Id Observation.code
Definition

Describes what was observed. Sometimes this is called the observation "name".

Control Cardinality 1..1
Terminology Binding LOINC Codes ( Example )
Type CodeableConcept
Requirements

Knowing what kind of observation is being made is essential to understanding the observation.

Alternate Names Name
Summary true
Comments

All code-value and, if present, component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

Observation.subject
Element Id Observation.subject
Definition

The patient, or group of patients, location, or device whose characteristics (direct or indirect) are described by the this observation is about and into whose record the observation is placed. Comments: Indirect characteristics may be those If the actual focus of the observation is different from the subject (or a specimen, fetus, donor, other observer (for example a relative sample of, part, or EMT), region of the subject), the focus element or any observation made about the subject. code itself specifies the actual focus of the observation.

Control Cardinality 0..1
Type Reference ( Patient | Group | Device | Location )
Patterns Reference(Patient,Group,Device,Location): Common patterns = Participant
Requirements

Observations have no value if you don't know who or what they're about.

Summary true
Comments

One would expect this element to be a cardinality of 1..1. The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.

Observation.focus
Element Id Observation.focus
Definition

If The actual focus of an observation when it is not the target patient of record representing something or someone associated with the patient such as a spouse, parent, fetus, or donor. For example, fetus observations in a mother's record. The focus of an observation is different than could also be an existing condition, an intervention, the subject, subject's diet, another observation of the general extension observation-focal-subject . may subject, or a body structure such as tumor or implanted device. An example use case would be used. However, using the distinction between Observation resource to capture whether the patient's own value for mother is trained to change her child's tracheostomy tube. In this example, the child is the patient of record and the mother is the focus.

Cardinality 0..*
Type Reference ( Any )
Summary true
Comments

Typically, an observation versus that of is made about the fetus, subject - a patient, or the donor group of patients, location, or blood product unit, etc., are often device - and the distinction between the subject and what is directly measured for an observation is specified in the observation code. code itself ( e.g., "Blood Glucose") and does not need to be represented separately using this element. Use specimen if a reference to a specimen is required. If a code is required instead of a resource use either bodysite for bodysites or the standard extension focusCode .

Observation.context Observation.encounter
Element Id Observation.encounter
Definition

The healthcare event (e.g. a patient and healthcare provider interaction) during which this observation is made.

Control Cardinality 0..1
Type Reference ( Encounter | EpisodeOfCare )
Requirements

For some observations it may be important to know the link between an observation and a particular encounter.

Alternate Names Encounter Context
Summary true
Comments

This will typically be the encounter the event occurred within, but some events may be initiated prior to or after the official completion of an encounter or episode but still be tied to the context of the encounter or episode (e.g. pre-admission lab laboratory tests).

Observation.effective[x]
Element Id Observation.effective[x]
Definition

The time or time-period the observed value is asserted as being true. For biological subjects - e.g. human patients - this is usually called the "physiologically relevant time". This is usually either the time of the procedure or of specimen collection, but very often the source of the date/time is not known, only the date/time itself.

Control Cardinality 0..1
Type dateTime | Period | Timing | instant
[x] Note See Choice of Data Types for further information about how to use [x]
Requirements

Knowing when an observation was deemed true is important to its relevance as well as determining trends.

Alternate Names Occurrence
Summary true
Comments

At least a date should be present unless this observation is a historical report. For recording imprecise or "fuzzy" times (For example, a blood glucose measurement taken "after breakfast") use the Timing datatype which allow the measurement to be tied to regular life events.

Observation.issued
Element Id Observation.issued
Definition

The date and time this version of the observation was made available to providers, typically after the results have been reviewed and verified.

Control Cardinality 0..1
Type instant
Summary true
Comments

Updated when For Observations that don’t require review and verification, it may be the result is updated. same as the lastUpdated time of the resource itself. For Observations that do require review and verification for certain updates, it might not be the same as the lastUpdated time of the resource itself due to a non-clinically significant update that doesn’t require the new version to be reviewed and verified again.

Observation.performer
Element Id Observation.performer
Definition

Who was responsible for asserting the observed value as "true".

Control Cardinality 0..*
Type Reference ( Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson )
Patterns Reference(Practitioner,PractitionerRole,Organization,CareTeam,Patient,RelatedPerson): Common patterns = Participant
Requirements

May give a degree of confidence in the observation and also indicates where follow-up questions should be directed.

Summary true
Observation.value[x]
Element Id Observation.value[x]
Definition

The information determined as a result of making the observation, if the information has a simple value.

Control Cardinality 0..1
Type Quantity | CodeableConcept | string | boolean | integer | Range | Ratio | SampledData | Attachment | time | dateTime | Period
[x] Note See Choice of Data Types for further information about how to use [x]
Requirements

An observation exists to have a value, though it may might not if it is in error, or if it represents a group of observations.

Summary true
Comments

Normally, an An observation will have either may have; 1) a single value or here, 2) both a value and a set of related observations. A few observations (e.g. Apgar score) may have both or component values, or 3) only a value and set of related observations (for an Apgar score, the observations from which the measure is derived). or component values. If a value is present, the datatype for this element should be determined by Observation.code. This element has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueString, valueBoolean, valueRange, valueRatio, valueSampledData, valueAttachment, valueTime, valueDateTime, or valuePeriod. (The name format is "'value' + the type name" A CodeableConcept with just a capital on the first letter text would be used instead of a string if the type). If the data element is field was usually coded coded, or if the type associated with the Observation.value Observation.code defines a coded value, use CodeableConcept instead of string datatype even if the value is uncoded text. A value set is bound to the ValueCodeableConcept element. value. For further discussion and examples additional guidance, see the notes Notes section below.

Invariants
Affect this element
obs-7 : Rule If code Observation.code is the same as a component code an Observation.component.code then the value element associated with the code SHALL NOT be present ( expression : value.empty() or code!=component.code, xpath: not(exists(f:*[starts-with(local-name(.), 'value')])) or not(count(for $coding in f:code/f:coding return parent::*/f:component/f:code/f:coding[f:code/@value=$coding/f:code/@value and f:system/@value=$coding/f:system/@value])=0)) component.code.where(coding.intersect(%resource.code.coding).exists()).empty()
Observation.dataAbsentReason
Element Id Observation.dataAbsentReason
Definition

Provides a reason why the expected value in the element Observation.value[x] is missing.

Control Cardinality 0..1
Terminology Binding Observation Value Absent Reason DataAbsentReason ( Extensible )
Type CodeableConcept
Requirements

For many results it is necessary to handle exceptional values in measurements.

Comments

Null or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "specimen unsatisfactory".

The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Note that an observation may only be reported if there are values to report. For example differential cell counts values may be reported only when > 0. Because of these options, use-case agreements are required to interpret general observations for null or exceptional values.

Invariants
Affect this element
obs-6 : Rule dataAbsentReason SHALL only be present if Observation.value[x] is not present ( expression : dataAbsentReason.empty() or value.empty(), xpath: not(exists(f:dataAbsentReason)) or (not(exists(*[starts-with(local-name(.), 'value')])))) value.empty()
Observation.interpretation
Element Id Observation.interpretation
Definition

The A categorical assessment made based on the result of the observation. Intended as a simple compact code often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result. Otherwise known as abnormal flag. an observation value. For example, high, low, normal.

Control Cardinality 0..1 0..*
Terminology Binding Observation Interpretation Codes ( Extensible )
Type CodeableConcept
Requirements

For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.

Alternate Names Abnormal Flag
Comments

Historically used for laboratory results (known as 'abnormal flag' ), its use extends to other use cases where coded interpretations are relevant. Often reported as one or more simple compact codes this element is often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result.

Observation.comment Observation.note
Element Id Observation.note
Definition

May include statements about significant, unexpected or unreliable values, or information Comments about the source of the value where this may be relevant to the interpretation of observation or the result. results.

Control Cardinality 0..1 0..*
Type string Annotation
Requirements

Need to be able to provide free text additional information.

Comments

May include general statements about the observation, or statements about significant, unexpected or unreliable results values, or information about its source when relevant to its interpretation.

Observation.bodySite
Element Id Observation.bodySite
Definition

Indicates the site on the subject's body where the observation was made (i.e. the target site).

Control Cardinality 0..1
Terminology Binding SNOMED CT Body Structures ( Example )
Type CodeableConcept
Comments

Only used if not implicit in code found in Observation.code. In many systems, this may be represented as a related observation instead of an inline component.

If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use the standard extension body-site-instance bodySite .

Observation.method
Element Id Observation.method
Definition

Indicates the mechanism used to perform the observation.

Control Cardinality 0..1
Terminology Binding Observation Methods ( Example )
Type CodeableConcept
Requirements

In some cases, method can impact results and is thus used for determining whether results can be compared or determining significance of results.

Comments

Only used if not implicit in code for Observation.code.

Observation.specimen
Element Id Observation.specimen
Definition

The specimen that was used when this observation was made.

Control Cardinality 0..1
Type Reference ( Specimen )
Comments

Should only be used if not implicit in code found in Observation.code . Observations are not made on specimens themselves; they are made on a subject, but in many cases by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).

Observation.device
Element Id Observation.device
Definition

The device used to generate the observation data.

Control Cardinality 0..1
Type Reference ( Device | DeviceMetric )
Patterns Reference(Device,DeviceMetric): No common pattern
Comments

An extension should be used if further typing of the device Note that this is needed. Devices used not meant to support obtaining an observation can represent a device involved in the transmission of the result, e.g., a gateway. Such devices may be represented documented using either an extension or through the Observation.related element. Provenance resource where relevant.

Observation.referenceRange
Element Id Observation.referenceRange
Definition

Guidance on how to interpret the value by comparison to a normal or recommended range. Multiple reference ranges are interpreted as an "OR". In other words, to represent two distinct target populations, two referenceRange elements would be used.

Control Cardinality 0..*
Requirements

Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.

Comments

Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may might not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.

Invariants
Defined on this element
obs-3 : Rule Must have at least a low or a high or text ( expression : low.exists() or high.exists() or text.exists(), xpath: (exists(f:low) or exists(f:high)or exists(f:text))) text.exists()
Observation.referenceRange.low
Element Id Observation.referenceRange.low
Definition

The value of the low bound of the reference range. The low bound of the reference range endpoint is inclusive of the value (e.g. reference range is >=5 - <=9). If the low bound is omitted, it is assumed to be meaningless (e.g. reference range is <=2.3).

Control Cardinality 0..1
Type SimpleQuantity
Invariants
Affect this element
obs-3 : Rule Must have at least a low or a high or text ( expression : low.exists() or high.exists() or text.exists(), xpath: (exists(f:low) or exists(f:high)or exists(f:text))) text.exists()
Observation.referenceRange.high
Element Id Observation.referenceRange.high
Definition

The value of the high bound of the reference range. The high bound of the reference range endpoint is inclusive of the value (e.g. reference range is >=5 - <=9). If the high bound is omitted, it is assumed to be meaningless (e.g. reference range is >= 2.3).

Control Cardinality 0..1
Type SimpleQuantity
Invariants
Affect this element
obs-3 : Rule Must have at least a low or a high or text ( expression : low.exists() or high.exists() or text.exists(), xpath: (exists(f:low) or exists(f:high)or exists(f:text))) text.exists()
Observation.referenceRange.type
Element Id Observation.referenceRange.type
Definition

Codes to indicate the what part of the targeted reference population it applies to. For example, the normal or therapeutic range.

Control Cardinality 0..1
Terminology Binding Observation Reference Range Meaning Codes ( Extensible Preferred )
Type CodeableConcept
Requirements

Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc, etc., - for proper interpretation.

Comments

This SHOULD be populated if there is more than one range. If this element is not present then the normal range is assumed.

Observation.referenceRange.appliesTo
Element Id Observation.referenceRange.appliesTo
Definition

Codes to indicate the target population this reference range applies to. For example, a reference range may be based on the normal population or a particular sex or race. Multiple appliesTo are interpreted as an "AND" of the target populations. For example, to represent a target population of African American females, both a code of female and a code for African American would be used.

Control Cardinality 0..*
Terminology Binding Observation Reference Range Applies To Codes ( Example )
Type CodeableConcept
Requirements

Need to be able to identify the target population for proper interpretation.

Comments

This SHOULD be populated if there is more than one range. If this element is not present then the normal population is assumed.

Observation.referenceRange.age
Element Id Observation.referenceRange.age
Definition

The age at which this reference range is applicable. This is a neonatal age (e.g. number of weeks at term) if the meaning says so.

Control Cardinality 0..1
Type Range
Requirements

Some analytes vary greatly over age.

Observation.referenceRange.text
Element Id Observation.referenceRange.text
Definition

Text based reference range in an observation which may be used when a quantitative range is not appropriate for an observation. An example would be a reference value of "Negative" or a list or table of 'normals'. "normals".

Control Cardinality 0..1
Type string
Observation.related Observation.hasMember
Element Id Observation.hasMember
Definition

A reference to another resource (usually another Observation) whose relationship This observation is defined by a group observation (e.g. a battery, a panel of tests, a set of vital sign measurements) that includes the relationship type code. target as a member of the group.

Control Cardinality 0..*
Requirements Type Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and a set of related observations or sometimes a Reference ( Observation | QuestionnaireResponse from which the measure is derived. | MolecularSequence )
Patterns Reference(Observation,QuestionnaireResponse,MolecularSequence): No common pattern
Summary true
Comments

When using this element, an observation will typically have either a value or a set of related resources, although both may be present in some cases. For a discussion on the ways Observations can assembled in groups together together, see Notes below . below. Note that a system may calculate results from QuestionnaireResponse into a final score and represent the score as an Observation.

Observation.related.type Observation.derivedFrom
Element Id Observation.derivedFrom
Definition

A code specifying the kind of relationship that exists with the The target resource. resource that represents a measurement from which this observation value is derived. For example, a calculated anion gap or a fetal measurement based on an ultrasound image.

Control Cardinality 0..1 0..*
Terminology Binding Type ObservationRelationshipType Reference ( Required DocumentReference | ImagingStudy | Media | QuestionnaireResponse | Observation | MolecularSequence )
Type Patterns code Reference(DocumentReference,ImagingStudy,Media,QuestionnaireResponse,Observation,MolecularSequence): No common pattern
Requirements A relationship type SHOULD be provided. Summary true
Comments

The "derived-from" type is All the only logical choice when referencing reference choices that are listed in this element can represent clinical observations and other measurements that may be the QuestionnaireAnswer resource. source for a derived value. The most common reference will be another Observation. For a discussion on the ways Observations can assembled in groups together, see Notes below.

Observation.related.target Observation.component
Definition A reference to the observation or QuestionnaireResponse resource that is related to this observation. Control 1..1 Type Element Id Reference ( Observation | QuestionnaireResponse | Sequence ) Observation.component
Definition

Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.

Control Cardinality 0..*
Requirements

Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

Summary true
Comments

For a discussion on the ways Observations can be assembled in groups together see Notes below.

Observation.component.code
Element Id Observation.component.code
Definition

Describes what was observed. Sometimes this is called the observation "code".

Control Cardinality 1..1
Terminology Binding LOINC Codes ( Example )
Type CodeableConcept
Requirements

Knowing what kind of observation is being made is essential to understanding the observation.

Summary true
Comments

All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

Observation.component.value[x]
Element Id Observation.component.value[x]
Definition

The information determined as a result of making the observation, if the information has a simple value.

Control Cardinality 0..1
Type Quantity | CodeableConcept | string | boolean | integer | Range | Ratio | SampledData | Attachment | time | dateTime | Period
[x] Note See Choice of Data Types for further information about how to use [x]
Requirements

An observation exists to have a value, though it may might not if it is in error, or if it represents a group of observations.

Summary true
Comments

Normally, an Used when observation will have either a single value or has a set of related component observations. A few observations (e.g. Apgar score) An observation may have both a value and related observations (for (e.g. an Apgar score, the score) and component observations (the observations from which the measure is Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (these "yes/no" concepts can be mapped to the display name "true/false" or other mutually exclusive terms that may be needed"). The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (the name format is "'value' + the type name" with a capital on the first letter of additional guidance, see the type). Notes section below.

Observation.component.dataAbsentReason
Element Id Observation.component.dataAbsentReason
Definition

Provides a reason why the expected value in the element Observation.value[x] Observation.component.value[x] is missing.

Control Cardinality 0..1
Terminology Binding Observation Value Absent Reason DataAbsentReason ( Extensible )
Type CodeableConcept
Requirements

For many results it is necessary to handle exceptional values in measurements.

Comments

"Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done".

The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

Invariants
Affect this element
obs-6 : Rule dataAbsentReason SHALL only be present if Observation.value[x] is not present ( expression : dataAbsentReason.empty() or value.empty(), xpath: not(exists(f:dataAbsentReason)) or (not(exists(*[starts-with(local-name(.), 'value')])))) value.empty()
Observation.component.interpretation
Element Id Observation.component.interpretation
Definition

The A categorical assessment made based on the result of the observation. Intended as a simple compact code often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result. Otherwise known as abnormal flag. an observation value. For example, high, low, normal.

Control Cardinality 0..1 0..*
Terminology Binding Observation Interpretation Codes ( Extensible )
Type CodeableConcept
Requirements

For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.

Alternate Names Abnormal Flag
Comments

The component interpretation applies only Historically used for laboratory results (known as 'abnormal flag' ), its use extends to the individual component value. For an overall interpretation all components together other use thes Observation.interpretation element. cases where coded interpretations are relevant. Often reported as one or more simple compact codes this element is often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result.

Observation.component.referenceRange
Element Id Observation.component.referenceRange
Definition

Guidance on how to interpret the value by comparison to a normal or recommended range.

Control Cardinality 0..*
Type See Observation.referenceRange
Requirements

Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.

Comments

Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may might not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.