PACIO Cognitive Status Implementation Guide
0.1.0 - STU Ballot
PACIO Cognitive Status Implementation Guide
0.1.0 - STU Ballot
PACIO Cognitive Status Implementation Guide - Local Development build (v0.1.0). See the Directory of published versions
| Defining URL: | http://paciowg.github.io/cognitive-status-ig/StructureDefinition/pacio-nhcs |
| Version: | 0.1.0 |
| Name: | NarrativeHistoryOfCognitiveStatus |
| Title: | PACIO Narrative History of Cognitive Status |
| Status: | Active as of 2021-09-30T07:46:12-07:00 |
| Definition: | An exchange of summary observation regarding the most recent prior level of cognitive function immediately preceding the current admission, illness, or exacerbation for a patient. The use of this profile is encouraged in the absence of formal prior level of cognitive assessments. For formal assessments conducted with for example, an assessment instrument, use the Cognitive Status Collection and Cognitive Status profiles to capture assessment data. |
| Publisher: | HL7 Patient Care Work Group |
| Source Resource: | XML / JSON / Turtle |
The official URL for this profile is:
http://paciowg.github.io/cognitive-status-ig/StructureDefinition/pacio-nhcs
Description of Profiles, Differentials, Snapshots and how the different presentations work.
This structure is derived from Observation
Summary
Mandatory: 7 elements
Must-Support: 2 elements
Structures
This structure refers to these other structures:
Extensions
This structure refers to these extensions:
Slices
This structure defines the following Slices:
This structure is derived from Observation
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
  Observation | 0..* | Observation | Measurements and simple assertions | |
  Slices for extension | 0..* | Extension | Extension Slice: Unordered, Open by value:url | |
 event-location | S | 0..1 | Reference(US Core Location Profile) | An extension to indicate where the observation event occurred. URL: http://paciowg.github.io/cognitive-status-ig/StructureDefinition/event-location |
| assistance-required | S | 0..1 | CodeableConcept | An extension to indicate the level of assistance required for a patient during an assessment. URL: http://paciowg.github.io/cognitive-status-ig/StructureDefinition/assistance-required Binding: LOINC Answer List LL4309-2 (extensible) |
 basedOn | 0..* | Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest) | Currently not used in PriorLevelOfCognitiveFunction. | |
| partOf | 0..* | Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy) | Currently not used in PriorLevelOfCognitiveFunction. | |
| status | 1..1 | code | Should have the value 'final' when the observation is complete and there are no further actions needed. Otherwise, another value from the value set may appropriately be used. | |
  Slices for category | 1..* | CodeableConcept | Classification of type of observation Slice: Ordered, Open by pattern:coding | |
  category:functioning | 1..1 | CodeableConcept | Classification of type of observation Binding: PACIO Functioning Category Value Set (extensible) | |
  coding | 1..* | Coding | Code defined by a terminology system Required Pattern: At least the following | |
 system | 1..1 | uri | Identity of the terminology system Fixed Value: http://paciowg.github.io/cognitive-status-ig/CodeSystem/pacio-cat-cs | |
| code | 1..1 | code | Symbol in syntax defined by the system Fixed Value: functioning | |
 display | 1..1 | string | Representation defined by the system Fixed Value: Functioning | |
| code | 1..1 | CodeableConcept | Type of observation (code / type) Binding: LOINCCodes (required) Required Pattern: At least the following | |
 coding | 1..* | Coding | Code defined by a terminology system Fixed Value: (complex) | |
| system | 1..1 | uri | Identity of the terminology system Fixed Value: http://loinc.org | |
| code | 1..1 | code | Symbol in syntax defined by the system Fixed Value: 11332-4 | |
| display | 1..1 | string | Representation defined by the system Fixed Value: History of Cognitive Function Narrative | |
 subject | 1..1 | Reference(US Core Patient Profile) | Who and/or what the observation is about | |
| focus | 0..* | Reference(Resource) | Currently not used in PriorLevelOfCognitiveFunction. | |
| encounter | 0..1 | Reference(US Core Encounter Profile) | Healthcare event during which this observation is made | |
 effective[x] | 1..1 | Clinically relevant time/time-period for observation | ||
 effectiveDateTime | dateTime | |||
 effectivePeriod | Period | |||
| issued | 0..1 | instant | Currently not used in PriorLevelOfCognitiveFunction. | |
| performer | 1..* | Reference(US Core Practitioner Profile | US Core PractitionerRole Profile | US Core Organization Profile) | The person who performed the assessment. The preferred way to specify the performer is to use the PractitionerRole resource to provide both the practitioner and organization. | |
| value[x] | 1..1 | string | Unstructured summary of cognitive status observation for the patient. (Strongly encouraged until more structured method is established) | |
| interpretation | 0..* | CodeableConcept | Currently not used in PriorLevelOfCognitiveFunction. | |
| bodySite | 0..1 | CodeableConcept | Currently not used in PriorLevelOfCognitiveFunction. | |
| method | 0..1 | CodeableConcept | Currently not used in PriorLevelOfCognitiveFunction. | |
| specimen | 0..1 | Reference(Specimen) | Currently not used in PriorLevelOfCognitiveFunction. | |
| device | 0..1 | Reference(Device | DeviceMetric) | Currently not used in PriorLevelOfCognitiveFunction. | |
| referenceRange | 0..* | BackboneElement | Currently not used in PriorLevelOfCognitiveFunction. | |
| hasMember | 0..* | Reference(Observation | QuestionnaireResponse | MolecularSequence) | Currently not used in PriorLevelOfCognitiveFunction. | |
| derivedFrom | 0..* | Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | Observation | MolecularSequence) | Currently not used in PriorLevelOfCognitiveFunction. | |
| component | 0..* | BackboneElement | Currently not used in PriorLevelOfCognitiveFunction. | |
| Documentation for this format | ||||
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
| Observation | I | 0..* | Observation | Measurements and simple assertions |
| id | Σ | 0..1 | string | 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) Max Binding: AllLanguages: A human language. | |
| text | 0..1 | Narrative | Text summary of the resource, for human interpretation | |
| contained | 0..* | Resource | Contained, inline Resources | |
| Slices for extension | 0..* | Extension | Extension Slice: Unordered, Open by value:url | |
| event-location | S | 0..1 | Reference(US Core Location Profile) | An extension to indicate where the observation event occurred. URL: http://paciowg.github.io/cognitive-status-ig/StructureDefinition/event-location |
| assistance-required | S | 0..1 | CodeableConcept | An extension to indicate the level of assistance required for a patient during an assessment. URL: http://paciowg.github.io/cognitive-status-ig/StructureDefinition/assistance-required Binding: LOINC Answer List LL4309-2 (extensible) |
 modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored |
| identifier | Σ | 0..* | Identifier | Business Identifier for observation |
| basedOn | Σ | 0..* | Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest) | Currently not used in PriorLevelOfCognitiveFunction. |
| partOf | Σ | 0..* | Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy) | Currently not used in PriorLevelOfCognitiveFunction. |
| status | ?!Σ | 1..1 | code | Should have the value 'final' when the observation is complete and there are no further actions needed. Otherwise, another value from the value set may appropriately be used. Binding: ObservationStatus (required): Codes providing the status of an observation. |
| Slices for category | 1..* | CodeableConcept | Classification of type of observation Slice: Ordered, Open by pattern:coding Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories. | |
| category:functioning | 1..1 | CodeableConcept | Classification of type of observation Binding: PACIO Functioning Category Value Set (extensible) | |
 id | 0..1 | string | Unique id for inter-element referencing | |
| Slices for extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |
 coding | Σ | 1..* | Coding | Code defined by a terminology system Required Pattern: At least the following |
 id | 0..1 | string | Unique id for inter-element referencing | |
| extension | 0..* | Extension | Additional content defined by implementations | |
| system | 1..1 | uri | Identity of the terminology system Fixed Value: http://paciowg.github.io/cognitive-status-ig/CodeSystem/pacio-cat-cs | |
| version | 0..1 | string | Version of the system - if relevant | |
| code | 1..1 | code | Symbol in syntax defined by the system Fixed Value: functioning | |
| display | 1..1 | string | Representation defined by the system Fixed Value: Functioning | |
| userSelected | 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 | Type of observation (code / type) Binding: LOINCCodes (required) Required Pattern: At least the following |
| id | 0..1 | string | Unique id for inter-element referencing | |
| extension | 0..* | Extension | Additional content defined by implementations | |
| coding | 1..* | Coding | Code defined by a terminology system Fixed Value: (complex) | |
| id | 0..1 | string | Unique id for inter-element referencing | |
| extension | 0..* | Extension | Additional content defined by implementations | |
| system | 1..1 | uri | Identity of the terminology system Fixed Value: http://loinc.org | |
| version | 0..1 | string | Version of the system - if relevant | |
| code | 1..1 | code | Symbol in syntax defined by the system Fixed Value: 11332-4 | |
| display | 1..1 | string | Representation defined by the system Fixed Value: History of Cognitive Function Narrative | |
| userSelected | 0..1 | boolean | If this coding was chosen directly by the user | |
| text | 0..1 | string | Plain text representation of the concept | |
| subject | Σ | 1..1 | Reference(US Core Patient Profile) | Who and/or what the observation is about |
| focus | Σ | 0..* | Reference(Resource) | Currently not used in PriorLevelOfCognitiveFunction. |
| encounter | Σ | 0..1 | Reference(US Core Encounter Profile) | Healthcare event during which this observation is made |
| effective[x] | Σ | 1..1 | Clinically relevant time/time-period for observation | |
| effectiveDateTime | dateTime | |||
| effectivePeriod | Period | |||
| issued | Σ | 0..1 | instant | Currently not used in PriorLevelOfCognitiveFunction. |
| performer | Σ | 1..* | Reference(US Core Practitioner Profile | US Core PractitionerRole Profile | US Core Organization Profile) | The person who performed the assessment. The preferred way to specify the performer is to use the PractitionerRole resource to provide both the practitioner and organization. |
| value[x] | ΣI | 1..1 | string | Unstructured summary of cognitive status observation for the patient. (Strongly encouraged until more structured method is established) |
| dataAbsentReason | I | 0..1 | CodeableConcept | Why the result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing. |
| interpretation | 0..* | CodeableConcept | Currently not used in PriorLevelOfCognitiveFunction. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations. | |
| note | 0..* | Annotation | Comments about the observation | |
| bodySite | 0..1 | CodeableConcept | Currently not used in PriorLevelOfCognitiveFunction. Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality. | |
| method | 0..1 | CodeableConcept | Currently not used in PriorLevelOfCognitiveFunction. Binding: ObservationMethods (example): Methods for simple observations. | |
| specimen | 0..1 | Reference(Specimen) | Currently not used in PriorLevelOfCognitiveFunction. | |
| device | 0..1 | Reference(Device | DeviceMetric) | Currently not used in PriorLevelOfCognitiveFunction. | |
| referenceRange | I | 0..* | BackboneElement | Currently not used in PriorLevelOfCognitiveFunction. |
| 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 | I | 0..1 | SimpleQuantity | Low Range, if relevant |
| high | I | 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) | Currently not used in PriorLevelOfCognitiveFunction. |
| derivedFrom | Σ | 0..* | Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | Observation | MolecularSequence) | Currently not used in PriorLevelOfCognitiveFunction. |
| component | Σ | 0..* | BackboneElement | Currently not used in PriorLevelOfCognitiveFunction. |
| 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 | I | 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 | |
| Documentation for this format | ||||
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
| Observation | I | 0..* | Observation | Measurements and simple assertions |
| event-location | 0..1 | Reference(US Core Location Profile) | An extension to indicate where the observation event occurred. URL: http://paciowg.github.io/cognitive-status-ig/StructureDefinition/event-location | |
| assistance-required | 0..1 | CodeableConcept | An extension to indicate the level of assistance required for a patient during an assessment. URL: http://paciowg.github.io/cognitive-status-ig/StructureDefinition/assistance-required Binding: LOINC Answer List LL4309-2 (extensible) | |
| Documentation for this format | ||||
This structure is derived from Observation
Summary
Mandatory: 7 elements
Must-Support: 2 elements
Structures
This structure refers to these other structures:
Extensions
This structure refers to these extensions:
Slices
This structure defines the following Slices:
Differential View
This structure is derived from Observation
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
| Observation | 0..* | Observation | Measurements and simple assertions | |
| Slices for extension | 0..* | Extension | Extension Slice: Unordered, Open by value:url | |
| event-location | S | 0..1 | Reference(US Core Location Profile) | An extension to indicate where the observation event occurred. URL: http://paciowg.github.io/cognitive-status-ig/StructureDefinition/event-location |
| assistance-required | S | 0..1 | CodeableConcept | An extension to indicate the level of assistance required for a patient during an assessment. URL: http://paciowg.github.io/cognitive-status-ig/StructureDefinition/assistance-required Binding: LOINC Answer List LL4309-2 (extensible) |
| basedOn | 0..* | Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest) | Currently not used in PriorLevelOfCognitiveFunction. | |
| partOf | 0..* | Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy) | Currently not used in PriorLevelOfCognitiveFunction. | |
| status | 1..1 | code | Should have the value 'final' when the observation is complete and there are no further actions needed. Otherwise, another value from the value set may appropriately be used. | |
| Slices for category | 1..* | CodeableConcept | Classification of type of observation Slice: Ordered, Open by pattern:coding | |
| category:functioning | 1..1 | CodeableConcept | Classification of type of observation Binding: PACIO Functioning Category Value Set (extensible) | |
| coding | 1..* | Coding | Code defined by a terminology system Required Pattern: At least the following | |
| system | 1..1 | uri | Identity of the terminology system Fixed Value: http://paciowg.github.io/cognitive-status-ig/CodeSystem/pacio-cat-cs | |
| code | 1..1 | code | Symbol in syntax defined by the system Fixed Value: functioning | |
| display | 1..1 | string | Representation defined by the system Fixed Value: Functioning | |
| code | 1..1 | CodeableConcept | Type of observation (code / type) Binding: LOINCCodes (required) Required Pattern: At least the following | |
| coding | 1..* | Coding | Code defined by a terminology system Fixed Value: (complex) | |
| system | 1..1 | uri | Identity of the terminology system Fixed Value: http://loinc.org | |
| code | 1..1 | code | Symbol in syntax defined by the system Fixed Value: 11332-4 | |
| display | 1..1 | string | Representation defined by the system Fixed Value: History of Cognitive Function Narrative | |
| subject | 1..1 | Reference(US Core Patient Profile) | Who and/or what the observation is about | |
| focus | 0..* | Reference(Resource) | Currently not used in PriorLevelOfCognitiveFunction. | |
| encounter | 0..1 | Reference(US Core Encounter Profile) | Healthcare event during which this observation is made | |
| effective[x] | 1..1 | Clinically relevant time/time-period for observation | ||
| effectiveDateTime | dateTime | |||
| effectivePeriod | Period | |||
| issued | 0..1 | instant | Currently not used in PriorLevelOfCognitiveFunction. | |
| performer | 1..* | Reference(US Core Practitioner Profile | US Core PractitionerRole Profile | US Core Organization Profile) | The person who performed the assessment. The preferred way to specify the performer is to use the PractitionerRole resource to provide both the practitioner and organization. | |
| value[x] | 1..1 | string | Unstructured summary of cognitive status observation for the patient. (Strongly encouraged until more structured method is established) | |
| interpretation | 0..* | CodeableConcept | Currently not used in PriorLevelOfCognitiveFunction. | |
| bodySite | 0..1 | CodeableConcept | Currently not used in PriorLevelOfCognitiveFunction. | |
| method | 0..1 | CodeableConcept | Currently not used in PriorLevelOfCognitiveFunction. | |
| specimen | 0..1 | Reference(Specimen) | Currently not used in PriorLevelOfCognitiveFunction. | |
| device | 0..1 | Reference(Device | DeviceMetric) | Currently not used in PriorLevelOfCognitiveFunction. | |
| referenceRange | 0..* | BackboneElement | Currently not used in PriorLevelOfCognitiveFunction. | |
| hasMember | 0..* | Reference(Observation | QuestionnaireResponse | MolecularSequence) | Currently not used in PriorLevelOfCognitiveFunction. | |
| derivedFrom | 0..* | Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | Observation | MolecularSequence) | Currently not used in PriorLevelOfCognitiveFunction. | |
| component | 0..* | BackboneElement | Currently not used in PriorLevelOfCognitiveFunction. | |
| Documentation for this format | ||||
Snapshot View
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
| Observation | I | 0..* | Observation | Measurements and simple assertions |
| id | Σ | 0..1 | string | 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) Max Binding: AllLanguages: A human language. | |
| text | 0..1 | Narrative | Text summary of the resource, for human interpretation | |
| contained | 0..* | Resource | Contained, inline Resources | |
| Slices for extension | 0..* | Extension | Extension Slice: Unordered, Open by value:url | |
| event-location | S | 0..1 | Reference(US Core Location Profile) | An extension to indicate where the observation event occurred. URL: http://paciowg.github.io/cognitive-status-ig/StructureDefinition/event-location |
| assistance-required | S | 0..1 | CodeableConcept | An extension to indicate the level of assistance required for a patient during an assessment. URL: http://paciowg.github.io/cognitive-status-ig/StructureDefinition/assistance-required Binding: LOINC Answer List LL4309-2 (extensible) |
| modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored |
| identifier | Σ | 0..* | Identifier | Business Identifier for observation |
| basedOn | Σ | 0..* | Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest) | Currently not used in PriorLevelOfCognitiveFunction. |
| partOf | Σ | 0..* | Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy) | Currently not used in PriorLevelOfCognitiveFunction. |
| status | ?!Σ | 1..1 | code | Should have the value 'final' when the observation is complete and there are no further actions needed. Otherwise, another value from the value set may appropriately be used. Binding: ObservationStatus (required): Codes providing the status of an observation. |
| Slices for category | 1..* | CodeableConcept | Classification of type of observation Slice: Ordered, Open by pattern:coding Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories. | |
| category:functioning | 1..1 | CodeableConcept | Classification of type of observation Binding: PACIO Functioning Category Value Set (extensible) | |
| id | 0..1 | string | Unique id for inter-element referencing | |
| Slices for extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |
| coding | Σ | 1..* | Coding | Code defined by a terminology system Required Pattern: At least the following |
| id | 0..1 | string | Unique id for inter-element referencing | |
| extension | 0..* | Extension | Additional content defined by implementations | |
| system | 1..1 | uri | Identity of the terminology system Fixed Value: http://paciowg.github.io/cognitive-status-ig/CodeSystem/pacio-cat-cs | |
| version | 0..1 | string | Version of the system - if relevant | |
| code | 1..1 | code | Symbol in syntax defined by the system Fixed Value: functioning | |
| display | 1..1 | string | Representation defined by the system Fixed Value: Functioning | |
| userSelected | 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 | Type of observation (code / type) Binding: LOINCCodes (required) Required Pattern: At least the following |
| id | 0..1 | string | Unique id for inter-element referencing | |
| extension | 0..* | Extension | Additional content defined by implementations | |
| coding | 1..* | Coding | Code defined by a terminology system Fixed Value: (complex) | |
| id | 0..1 | string | Unique id for inter-element referencing | |
| extension | 0..* | Extension | Additional content defined by implementations | |
| system | 1..1 | uri | Identity of the terminology system Fixed Value: http://loinc.org | |
| version | 0..1 | string | Version of the system - if relevant | |
| code | 1..1 | code | Symbol in syntax defined by the system Fixed Value: 11332-4 | |
| display | 1..1 | string | Representation defined by the system Fixed Value: History of Cognitive Function Narrative | |
| userSelected | 0..1 | boolean | If this coding was chosen directly by the user | |
| text | 0..1 | string | Plain text representation of the concept | |
| subject | Σ | 1..1 | Reference(US Core Patient Profile) | Who and/or what the observation is about |
| focus | Σ | 0..* | Reference(Resource) | Currently not used in PriorLevelOfCognitiveFunction. |
| encounter | Σ | 0..1 | Reference(US Core Encounter Profile) | Healthcare event during which this observation is made |
| effective[x] | Σ | 1..1 | Clinically relevant time/time-period for observation | |
| effectiveDateTime | dateTime | |||
| effectivePeriod | Period | |||
| issued | Σ | 0..1 | instant | Currently not used in PriorLevelOfCognitiveFunction. |
| performer | Σ | 1..* | Reference(US Core Practitioner Profile | US Core PractitionerRole Profile | US Core Organization Profile) | The person who performed the assessment. The preferred way to specify the performer is to use the PractitionerRole resource to provide both the practitioner and organization. |
| value[x] | ΣI | 1..1 | string | Unstructured summary of cognitive status observation for the patient. (Strongly encouraged until more structured method is established) |
| dataAbsentReason | I | 0..1 | CodeableConcept | Why the result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing. |
| interpretation | 0..* | CodeableConcept | Currently not used in PriorLevelOfCognitiveFunction. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations. | |
| note | 0..* | Annotation | Comments about the observation | |
| bodySite | 0..1 | CodeableConcept | Currently not used in PriorLevelOfCognitiveFunction. Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality. | |
| method | 0..1 | CodeableConcept | Currently not used in PriorLevelOfCognitiveFunction. Binding: ObservationMethods (example): Methods for simple observations. | |
| specimen | 0..1 | Reference(Specimen) | Currently not used in PriorLevelOfCognitiveFunction. | |
| device | 0..1 | Reference(Device | DeviceMetric) | Currently not used in PriorLevelOfCognitiveFunction. | |
| referenceRange | I | 0..* | BackboneElement | Currently not used in PriorLevelOfCognitiveFunction. |
| 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 | I | 0..1 | SimpleQuantity | Low Range, if relevant |
| high | I | 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) | Currently not used in PriorLevelOfCognitiveFunction. |
| derivedFrom | Σ | 0..* | Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | Observation | MolecularSequence) | Currently not used in PriorLevelOfCognitiveFunction. |
| component | Σ | 0..* | BackboneElement | Currently not used in PriorLevelOfCognitiveFunction. |
| 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 | I | 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 | |
| Documentation for this format | ||||
Other representations of profile: CSV, Excel, Schematron
| Path | Conformance | ValueSet / Code |
| Observation.language | preferred | CommonLanguages Max Binding: AllLanguages |
| Observation.status | required | ObservationStatus |
| Observation.category | preferred | ObservationCategoryCodes |
| Observation.category:functioning | extensible | PACIOFunctioningCategoryVS |
| Observation.code | required | Pattern: LOINC code 11332-4("History of Cognitive Function Narrative") |
| Observation.dataAbsentReason | extensible | DataAbsentReason |
| Observation.interpretation | extensible | ObservationInterpretationCodes |
| Observation.bodySite | example | SNOMEDCTBodyStructures |
| Observation.method | example | ObservationMethods |
| Observation.referenceRange.type | preferred | ObservationReferenceRangeMeaningCodes |
| Observation.referenceRange.appliesTo | example | ObservationReferenceRangeAppliesToCodes |
| Observation.component.code | example | LOINCCodes |
| Observation.component.dataAbsentReason | extensible | DataAbsentReason |
| Observation.component.interpretation | extensible | ObservationInterpretationCodes |
IG © 2020+ HL7 Patient Care Work Group. Package hl7.fhir.us.pacio-cs#0.1.0 based on FHIR 4.0.1. Generated 2021-09-30
Links: Table of Contents |
QA Report
| Version History |
Search |
|
Propose a change