Escopo e Uso

O recurso Observation é um recurso de evento na perspectiva do fluxo de trabalho FHIR. Observações são elementos centrais na assistência à saúde, usados para apoiar diagnósticos, monitorar progresso, determinar padrões e até capturar características demográficas. A maioria das observações são simples pares nome/valor com alguns metadados, mas algumas agrupam outras observações logicamente ou são observações multicomponentes. No Brasil esse recurso foi utilizado em dois perfis para aplicar em dois casos de uso:**BRMedidaObservada, estruturado e BRObservationText, mais simples, para se fazer inserções textuais sobre observações mais simples. O Resumo do Atendimento Clínico (RAC) da RNDS usa o BRMedidaObservada e o Sumario do Paciente iPeS extrai informações desse perfil para apresentá-lo de forma estruturada no visualizador do Sumário

Exemplos de Uso

• Sinais vitais como peso corporal, pressão arterial e temperatura
• Dados laboratoriais como glicose no sangue ou taxa de filtração glomerular estimada
• Resultados de imagem como densidade óssea ou medidas fetais
• Achados clínicos como sensibilidade abdominal
• Medições de dispositivos como dados de ECG ou oximetria de pulso
• Ferramentas de avaliação clínica como APGAR ou Escala de Coma de Glasgow
• Características pessoais como cor dos olhos
• Histórico social como uso de tabaco, suporte familiar ou estado cognitivo
• Características centrais como estado de gravidez ou declaração de óbito.

Perfis Centrais para Observation

Os seguintes perfis centrais foram definidos para o recurso Observation FHIR R4. Implementações que usarem este recurso ao expressar conceitos específicos do perfil como dados estruturados, elas DEVEM conformar-se aos seguintes perfis, para estar em conformidade com o padrão FHIR R4:

• Sinais vitais: O perfil FHIR Vital Signs define expectativas mínimas para o recurso Observation registrar, buscar e recuperar sinais vitais (por exemplo, temperatura, pressão arterial, taxa de respiração, etc.) associados a um paciente.

No entanto, a RNDS utiliza um único recurso BRMedidaObservada, que tem um ValueSet derivado do LOINC, o brtTipoobservacao que contém todo o tipo de informação de observações realizadas no atendimento clínico e nesse showcase será utilizada a versão atual do RAC. No RAC são capturadas as seguintes medidas descritivas

Código de Medições

29463-7: Peso Corporal 8480-6: Pressão Arterial Sistólica 8462-4: Pressão Arterial Diastólica 8280-0: Circunferência Abdominal 9843-4: Perímetro Cefálico 8302-2: Altura

Limites e Relacionamentos

No seu núcleo, o recurso Observation permite expressar um par nome-valor ou uma coleção estruturada de pares nome-valor. Como tal, pode suportar a transmissão de qualquer tipo de informação desejada. No entanto, essa não é sua intenção. Observation é destinado a capturar medições e avaliações subjetivas em um ponto no tempo.

O recurso DiagnosticReport fornece um contexto clínico ou de fluxo de trabalho para um conjunto de observações e o recurso Observation é referenciado por DiagnosticReport para representar dados laboratoriais, de imagem e outros dados clínicos e diagnósticos para formar um relatório completo.

Uso Indevido

Este recurso não deve ser utilizado para representar diagnósticos ou condições clínicas diretamente. Para isso, deve-se usar o recurso Condition.

Identificadores

Cada observação deve ter um identificador único que pode ser usado para referenciá-la de forma inequívoca.

Extensões

Este recurso pode ser estendido para incluir informações adicionais que não são cobertas pelos elementos padrão.

• Key Elements Table
• Differential Table
• Snapshot Table
• Statistics/References
• All

Nome	Bandeiras	Card.	Tipo	Descrição e condicionalismos    Filter: Condicionantes Obrigações Vínculos
Observation	C	0..*	Observation	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	?!Σ	1..1	code	registered | preliminary | final | amended + Vínculo: ObservationStatus (required): Codes providing the status of an observation.
code	Σ	1..1	CodeableConcept	Type of observation (code / type) Vínculo: LOINCCodes (preferred): Codes identifying names of simple observations.
subject	Σ	1..1	Reference(Paciente)	Who and/or what the observation is about
encounter	Σ	0..1	Reference(Contato Assistencial)	Healthcare event during which this observation is made
bodySite		0..1	CodeableConcept	Observed body part Vínculo: https://terminologia.saude.gov.br/fhir/ValueSet/BRLocalAfericao (preferred)
method		0..1	CodeableConcept	How it was done Vínculo: https://terminologia.saude.gov.br/fhir/ValueSet/BRPosicaoIndividuo (preferred)
Documentação para este formato

Terminologia Ligações

Caminho	Conformidade	Conjunto de valores	URI
Observation.status	required	ObservationStatus http://hl7.org/fhir/ValueSet/observation-status|4.0.1 From a norma FHIR
Observation.code	preferred	LOINCCodes(a valid code from LOINC) http://hl7.org/fhir/ValueSet/observation-codes From a norma FHIR
Observation.bodySite	preferred	https://terminologia.saude.gov.br/fhir/ValueSet/BRLocalAfericao https://terminologia.saude.gov.br/fhir/ValueSet/BRLocalAfericao
Observation.method	preferred	https://terminologia.saude.gov.br/fhir/ValueSet/BRPosicaoIndividuo https://terminologia.saude.gov.br/fhir/ValueSet/BRPosicaoIndividuo

Restrições

Id	Grau	Caminho(s)	Detalhes	Requisitos
dom-2	error	Observation	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Observation	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Observation	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Observation	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Observation	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
obs-6	error	Observation	dataAbsentReason SHALL only be present if Observation.value[x] is not present : dataAbsentReason.empty() or value.empty()
obs-7	error	Observation	If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present : value.empty() or component.code.where(coding.intersect(%resource.code.coding).exists()).empty()

This structure is derived from Observation

Nome	Bandeiras	Card.	Tipo	Descrição e condicionalismos    Filter: Condicionantes Obrigações Vínculos
Observation			Observation
identifier		0..0
basedOn		0..0
partOf		0..0
code		1..1	CodeableConcept	Type of observation (code / type) Vínculo: LOINCCodes (preferred): Codes identifying names of simple observations.
subject		1..1	Reference(Paciente)	Who and/or what the observation is about
type		0..0
identifier		0..0
display		0..0
focus		0..0
encounter		0..1	Reference(Contato Assistencial)	Healthcare event during which this observation is made
type		0..0
identifier		0..0
display		0..0
issued		0..0
performer		0..0
value[x]		0..0
dataAbsentReason		0..0
interpretation		0..0
bodySite		0..1	CodeableConcept	Observed body part Vínculo: https://terminologia.saude.gov.br/fhir/ValueSet/BRLocalAfericao (preferred)
method		0..1	CodeableConcept	How it was done Vínculo: https://terminologia.saude.gov.br/fhir/ValueSet/BRPosicaoIndividuo (preferred)
referenceRange		0..0
hasMember		0..0
derivedFrom		0..0
component
interpretation		0..0
Documentação para este formato

Terminologia Ligações (Diferencial)

Caminho	Conformidade	Conjunto de valores	URI
Observation.code	preferred	LOINCCodes(a valid code from LOINC) http://hl7.org/fhir/ValueSet/observation-codes From a norma FHIR
Observation.bodySite	preferred	https://terminologia.saude.gov.br/fhir/ValueSet/BRLocalAfericao https://terminologia.saude.gov.br/fhir/ValueSet/BRLocalAfericao
Observation.method	preferred	https://terminologia.saude.gov.br/fhir/ValueSet/BRPosicaoIndividuo https://terminologia.saude.gov.br/fhir/ValueSet/BRPosicaoIndividuo

Nome	Bandeiras	Card.	Tipo	Descrição e condicionalismos    Filter: Condicionantes Obrigações Vínculos
Observation	C	0..*	Observation	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 Vínculo: CommonLanguages (preferred): A human language. Vínculos adicionais Objetivo AllLanguages Vínculo máximo
text		0..1	Narrative	Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained		0..*	Resource	Contained, inline Resources
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
status	?!Σ	1..1	code	registered | preliminary | final | amended + Vínculo: ObservationStatus (required): Codes providing the status of an observation.
category		0..*	CodeableConcept	Classification of type of observation Vínculo: ObservationCategoryCodes (preferred): Codes for high level observation categories.
code	Σ	1..1	CodeableConcept	Type of observation (code / type) Vínculo: LOINCCodes (preferred): Codes identifying names of simple observations.
subject	Σ	1..1	Reference(Paciente)	Who and/or what the observation is about
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Fatia: Não ordenado, Aberto por value:url
reference	ΣC	0..1	string	Literal reference, Relative, internal or absolute URL
encounter	Σ	0..1	Reference(Contato Assistencial)	Healthcare event during which this observation is made
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Fatia: Não ordenado, Aberto por value:url
reference	ΣC	0..1	string	Literal reference, Relative, internal or absolute URL
effective[x]	Σ	0..1		Clinically relevant time/time-period for observation
effectiveDateTime			dateTime
effectivePeriod			Period
effectiveTiming			Timing
effectiveInstant			instant
note		0..*	Annotation	Comments about the observation
bodySite		0..1	CodeableConcept	Observed body part Vínculo: https://terminologia.saude.gov.br/fhir/ValueSet/BRLocalAfericao (preferred)
method		0..1	CodeableConcept	How it was done Vínculo: https://terminologia.saude.gov.br/fhir/ValueSet/BRPosicaoIndividuo (preferred)
specimen		0..1	Reference(Specimen)	Specimen used for this observation
device		0..1	Reference(Device | DeviceMetric)	(Measurement) Device
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) Vínculo: 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 Vínculo: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
referenceRange		0..*	Ver referenceRange (Observation)	Provides guide for interpretation of component result
Documentação para este formato

Terminologia Ligações

Caminho	Conformidade	Conjunto de valores	URI
Observation.language	preferred	CommonLanguages http://hl7.org/fhir/ValueSet/languages From a norma FHIR Vínculos adicionais Objetivo AllLanguages Vínculo máximo
Observation.status	required	ObservationStatus http://hl7.org/fhir/ValueSet/observation-status|4.0.1 From a norma FHIR
Observation.category	preferred	ObservationCategoryCodes http://hl7.org/fhir/ValueSet/observation-category From a norma FHIR
Observation.code	preferred	LOINCCodes(a valid code from LOINC) http://hl7.org/fhir/ValueSet/observation-codes From a norma FHIR
Observation.bodySite	preferred	https://terminologia.saude.gov.br/fhir/ValueSet/BRLocalAfericao https://terminologia.saude.gov.br/fhir/ValueSet/BRLocalAfericao
Observation.method	preferred	https://terminologia.saude.gov.br/fhir/ValueSet/BRPosicaoIndividuo https://terminologia.saude.gov.br/fhir/ValueSet/BRPosicaoIndividuo
Observation.referenceRange.type	preferred	ObservationReferenceRangeMeaningCodes http://hl7.org/fhir/ValueSet/referencerange-meaning From a norma FHIR
Observation.referenceRange.appliesTo	example	ObservationReferenceRangeAppliesToCodes http://hl7.org/fhir/ValueSet/referencerange-appliesto From a norma FHIR
Observation.component.code	example	LOINCCodes(a valid code from LOINC) http://hl7.org/fhir/ValueSet/observation-codes From a norma FHIR
Observation.component.dataAbsentReason	extensible	DataAbsentReason http://hl7.org/fhir/ValueSet/data-absent-reason From a norma FHIR

Restrições

Id	Grau	Caminho(s)	Detalhes	Requisitos
dom-2	error	Observation	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Observation	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Observation	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Observation	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Observation	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
obs-6	error	Observation	dataAbsentReason SHALL only be present if Observation.value[x] is not present : dataAbsentReason.empty() or value.empty()
obs-7	error	Observation	If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present : value.empty() or component.code.where(coding.intersect(%resource.code.coding).exists()).empty()

Key Elements View

Nome	Bandeiras	Card.	Tipo	Descrição e condicionalismos    Filter: Condicionantes Obrigações Vínculos
Observation	C	0..*	Observation	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	?!Σ	1..1	code	registered | preliminary | final | amended + Vínculo: ObservationStatus (required): Codes providing the status of an observation.
code	Σ	1..1	CodeableConcept	Type of observation (code / type) Vínculo: LOINCCodes (preferred): Codes identifying names of simple observations.
subject	Σ	1..1	Reference(Paciente)	Who and/or what the observation is about
encounter	Σ	0..1	Reference(Contato Assistencial)	Healthcare event during which this observation is made
bodySite		0..1	CodeableConcept	Observed body part Vínculo: https://terminologia.saude.gov.br/fhir/ValueSet/BRLocalAfericao (preferred)
method		0..1	CodeableConcept	How it was done Vínculo: https://terminologia.saude.gov.br/fhir/ValueSet/BRPosicaoIndividuo (preferred)
Documentação para este formato

Terminologia Ligações

Caminho	Conformidade	Conjunto de valores	URI
Observation.status	required	ObservationStatus http://hl7.org/fhir/ValueSet/observation-status|4.0.1 From a norma FHIR
Observation.code	preferred	LOINCCodes(a valid code from LOINC) http://hl7.org/fhir/ValueSet/observation-codes From a norma FHIR
Observation.bodySite	preferred	https://terminologia.saude.gov.br/fhir/ValueSet/BRLocalAfericao https://terminologia.saude.gov.br/fhir/ValueSet/BRLocalAfericao
Observation.method	preferred	https://terminologia.saude.gov.br/fhir/ValueSet/BRPosicaoIndividuo https://terminologia.saude.gov.br/fhir/ValueSet/BRPosicaoIndividuo

Restrições

Id	Grau	Caminho(s)	Detalhes	Requisitos
dom-2	error	Observation	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Observation	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Observation	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Observation	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Observation	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
obs-6	error	Observation	dataAbsentReason SHALL only be present if Observation.value[x] is not present : dataAbsentReason.empty() or value.empty()
obs-7	error	Observation	If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present : value.empty() or component.code.where(coding.intersect(%resource.code.coding).exists()).empty()

Differential View

This structure is derived from Observation

Nome	Bandeiras	Card.	Tipo	Descrição e condicionalismos    Filter: Condicionantes Obrigações Vínculos
Observation			Observation
identifier		0..0
basedOn		0..0
partOf		0..0
code		1..1	CodeableConcept	Type of observation (code / type) Vínculo: LOINCCodes (preferred): Codes identifying names of simple observations.
subject		1..1	Reference(Paciente)	Who and/or what the observation is about
type		0..0
identifier		0..0
display		0..0
focus		0..0
encounter		0..1	Reference(Contato Assistencial)	Healthcare event during which this observation is made
type		0..0
identifier		0..0
display		0..0
issued		0..0
performer		0..0
value[x]		0..0
dataAbsentReason		0..0
interpretation		0..0
bodySite		0..1	CodeableConcept	Observed body part Vínculo: https://terminologia.saude.gov.br/fhir/ValueSet/BRLocalAfericao (preferred)
method		0..1	CodeableConcept	How it was done Vínculo: https://terminologia.saude.gov.br/fhir/ValueSet/BRPosicaoIndividuo (preferred)
referenceRange		0..0
hasMember		0..0
derivedFrom		0..0
component
interpretation		0..0
Documentação para este formato

Terminologia Ligações (Diferencial)

Caminho	Conformidade	Conjunto de valores	URI
Observation.code	preferred	LOINCCodes(a valid code from LOINC) http://hl7.org/fhir/ValueSet/observation-codes From a norma FHIR
Observation.bodySite	preferred	https://terminologia.saude.gov.br/fhir/ValueSet/BRLocalAfericao https://terminologia.saude.gov.br/fhir/ValueSet/BRLocalAfericao
Observation.method	preferred	https://terminologia.saude.gov.br/fhir/ValueSet/BRPosicaoIndividuo https://terminologia.saude.gov.br/fhir/ValueSet/BRPosicaoIndividuo

Snapshot View

Nome	Bandeiras	Card.	Tipo	Descrição e condicionalismos    Filter: Condicionantes Obrigações Vínculos
Observation	C	0..*	Observation	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 Vínculo: CommonLanguages (preferred): A human language. Vínculos adicionais Objetivo AllLanguages Vínculo máximo
text		0..1	Narrative	Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained		0..*	Resource	Contained, inline Resources
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
status	?!Σ	1..1	code	registered | preliminary | final | amended + Vínculo: ObservationStatus (required): Codes providing the status of an observation.
category		0..*	CodeableConcept	Classification of type of observation Vínculo: ObservationCategoryCodes (preferred): Codes for high level observation categories.
code	Σ	1..1	CodeableConcept	Type of observation (code / type) Vínculo: LOINCCodes (preferred): Codes identifying names of simple observations.
subject	Σ	1..1	Reference(Paciente)	Who and/or what the observation is about
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Fatia: Não ordenado, Aberto por value:url
reference	ΣC	0..1	string	Literal reference, Relative, internal or absolute URL
encounter	Σ	0..1	Reference(Contato Assistencial)	Healthcare event during which this observation is made
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Fatia: Não ordenado, Aberto por value:url
reference	ΣC	0..1	string	Literal reference, Relative, internal or absolute URL
effective[x]	Σ	0..1		Clinically relevant time/time-period for observation
effectiveDateTime			dateTime
effectivePeriod			Period
effectiveTiming			Timing
effectiveInstant			instant
note		0..*	Annotation	Comments about the observation
bodySite		0..1	CodeableConcept	Observed body part Vínculo: https://terminologia.saude.gov.br/fhir/ValueSet/BRLocalAfericao (preferred)
method		0..1	CodeableConcept	How it was done Vínculo: https://terminologia.saude.gov.br/fhir/ValueSet/BRPosicaoIndividuo (preferred)
specimen		0..1	Reference(Specimen)	Specimen used for this observation
device		0..1	Reference(Device | DeviceMetric)	(Measurement) Device
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) Vínculo: 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 Vínculo: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
referenceRange		0..*	Ver referenceRange (Observation)	Provides guide for interpretation of component result
Documentação para este formato

Terminologia Ligações

Caminho	Conformidade	Conjunto de valores	URI
Observation.language	preferred	CommonLanguages http://hl7.org/fhir/ValueSet/languages From a norma FHIR Vínculos adicionais Objetivo AllLanguages Vínculo máximo
Observation.status	required	ObservationStatus http://hl7.org/fhir/ValueSet/observation-status|4.0.1 From a norma FHIR
Observation.category	preferred	ObservationCategoryCodes http://hl7.org/fhir/ValueSet/observation-category From a norma FHIR
Observation.code	preferred	LOINCCodes(a valid code from LOINC) http://hl7.org/fhir/ValueSet/observation-codes From a norma FHIR
Observation.bodySite	preferred	https://terminologia.saude.gov.br/fhir/ValueSet/BRLocalAfericao https://terminologia.saude.gov.br/fhir/ValueSet/BRLocalAfericao
Observation.method	preferred	https://terminologia.saude.gov.br/fhir/ValueSet/BRPosicaoIndividuo https://terminologia.saude.gov.br/fhir/ValueSet/BRPosicaoIndividuo
Observation.referenceRange.type	preferred	ObservationReferenceRangeMeaningCodes http://hl7.org/fhir/ValueSet/referencerange-meaning From a norma FHIR
Observation.referenceRange.appliesTo	example	ObservationReferenceRangeAppliesToCodes http://hl7.org/fhir/ValueSet/referencerange-appliesto From a norma FHIR
Observation.component.code	example	LOINCCodes(a valid code from LOINC) http://hl7.org/fhir/ValueSet/observation-codes From a norma FHIR
Observation.component.dataAbsentReason	extensible	DataAbsentReason http://hl7.org/fhir/ValueSet/data-absent-reason From a norma FHIR

Restrições

Id	Grau	Caminho(s)	Detalhes	Requisitos
dom-2	error	Observation	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Observation	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Observation	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Observation	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Observation	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
obs-6	error	Observation	dataAbsentReason SHALL only be present if Observation.value[x] is not present : dataAbsentReason.empty() or value.empty()
obs-7	error	Observation	If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present : value.empty() or component.code.where(coding.intersect(%resource.code.coding).exists()).empty()

This structure is derived from Observation

Resumo

Obrigatório: 1 elemento
Proibido: 19 elementos

Estruturas

Esta estrutura refere-se a estas outras estruturas:

• Paciente (https://fhir.ipes.tech/fhir/StructureDefinition/PatientBRIPES)
• Contato Assistencial (https://fhir.ipes.tech/fhir/StructureDefinition/EncounterBRIPES)