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Resource
https://www.hl7.org/fhir/observation.html
Profile examples
Relevant Confluence pages
Resource – concept model mapping
Yellow rows denote SNOMED CT attributes where there is no specific FHIR counterpart.
Resource element (CodeableConcept) | FHIR ValueSet | SNOMED CT attribute | SNOMED CT range | Comments |
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Observation.category | ObservationCategoryCodes n=9, preferred: social-history vital-signs imaging laboratory procedure survey exam therapy activity |
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| Is there a use case for providing SNOMED mappings as an alternative to the preferred set of 9? Unlikely that will be able to draft a 'tidy' mapping to the exact same set of 9 categories, such that if Observation.code, .method, .bodySite and .type are all known then .category can be computed. 2019-04-16: recommend not to use this, but would be allowed |
Observation.code |
https://www.hl7.org/fhir/valueset-observation-codes.html#expansion |
| <<363787002|Observable entity| OR << 386053000|Evaluation procedure| | AP: What happens to the findings like 'pulmonary oedema' from the findings hierarchy? Is that only a Condition, or can it also be an Observation? Many clinical condition labels are synonyms for the primary clinical symptom or observation that they cause. And many genuine symptoms are certainly observations (that a phenomenon exists), not pathologies DK: Findings are not the "question" component of the question-answer model - they're a conflation of both question AND answer AP: But where the conflated answer is typically always "is present" UNRESOLVED....revisit |
Observation.Value.valueCodeableConcept |
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| <<362981000|Qualifier value| MINUS <valueset for Observation.Interpretation> ?
| LB: why not also members from <<441742003 Evaluation finding JC: Because they decompose (in theory) into an Observable+Qualifier pair |
Observation.dataAbsentReason | DataAbsentReason (Extensible) HL7 Code | Definition | SNOMED CT |
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unknown | The value is expected to exist but is not known. |
| asked-unknown | The source was asked but does not know the value. |
| temp-unknown | There is reason to expect (from the workflow) that the value may become known. |
| not-asked | The workflow didn't lead to this value being known. |
| asked-declined | The source was asked but declined to answer. |
| masked | The information is not available due to security, privacy or related reasons. |
| not-applicable | There is no proper value for this element (e.g. last menstrual period for a male). |
| unsupported | The source system wasn't capable of supporting this element. |
| as-text | The content of the data is represented in the resource narrative. |
| error | Some system or workflow process error means that the information is not available. |
| not-a-number | The numeric value is undefined or unrepresentable due to a floating point processing error. |
| negative-infinity | The numeric value is excessively low and unrepresentable due to a floating point processing error. |
| positive-infinity | The numeric value is excessively high and unrepresentable due to a floating point processing error. |
| not-performed | The value is not available because the observation procedure (test, etc.) was not performed. |
| not-permitted | The value is not permitted in this context (e.g. due to profiles, or the base data types). |
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| 2019-04-16: seems to be out of scope of SNOMED CT |
Observation.interpretation | Observation Interpretation Codes (Extensible) HL7 Code | HL7 Code Display | SNOMED CT |
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_GeneticObservationInterpretation |
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| CAR | Carrier | 29679002|Carrier of disorder| | _ObservationInterpretationChange |
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| B | Better | 385425000|Improved| | D | Significant change down | 442474009|Decreased relative to previous| | U | Significant change up | 442387004|Increased relative to previous| | W | Worse | 231877006|Worse| | _ObservationInterpretationExceptions |
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| < | Off scale low |
| > | Off scale high |
| IE | Insufficient evidence |
| _ObservationInterpretationNormality |
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| A | Abnormal | 263654008|Abnormal| | AA | Critical abnormal |
| HH | Critical high |
| LL | Critical low |
| H | High | 371879000 | Abnormally high (qualifier value) | | HU | Significantly high |
| L | Low | 371880002 | Abnormally low (qualifier value) | | LU | Significantly low |
| N | Normal | 17621005|Normal| | _ObservationInterpretationSusceptibility |
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| I | Intermediate | 264841006|Intermediately susceptible| | NCL | No CLSI defined breakpoint |
| NS | Non-susceptible |
| R | Resistant | 30714006|Resistant| | SYN-R | Synergy - resistant |
| S | Susceptible | 131196009|Susceptible| | SDD | Susceptible-dose dependent |
| SYN-S | Synergy - susceptible |
| EX | outside threshold | 394844007|Outside reference range| | HX | above high threshold | 281302008|Above reference range| | LX | below low threshold | 281300000|Below reference range| | ObservationInterpretationDetection |
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| IND | Indeterminate | 82334004|Indeterminate| | E | Equivocal | 42425007|Equivocal| | NEG | Negative | 260385009|Negative| | ND | Not detected | 260415000|Not detected| | POS | Positive | 10828004|Positive| | DET | Detected | 260373001|Detected| | ObservationInterpretationExpectation |
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| EXP | Expected |
| UNE | Unexpected |
| ReactivityObservationInterpretation |
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| NR | Non-reactive | 131194007|Non-Reactive| | RR | Reactive | 11214006|Reactive| | WR | Weakly reactive | 117006002|Weakly-reactive| |
| HL7 valueset (n=48) is extensible, so could add new expressivity as SNOMED codes if there were any gaps in existing list ... but that existing list is already relatively matured and 'metalled' by use, so that seem an unlikely requirement. Many of the existing members of the HL7 valuelist have obvious SNOMED equivalents, so there is scope for a mapping rather than a completely separate SNOMED-only valuelist. Mapping exercise may also reveal some holes in existing SNOMED expressivity. 2019-04-16: gaps could be filled with new SNOMED CT content, e.g. _ObservationInterpretationNormality |
Observation.bodySite | SNOMED CT Body Structures (Example) |
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Observation.method | Observation Methods (Example) |
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Observation.referenceRange.type | Observation Reference Range Meaning Codes (Preferred) |
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Observation.referenceRange.appliesTo | Observation Reference Range Applies To Codes (Example) |
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Observation.component.code | LOINC Codes (Example) |
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Observation.component.value[x].valueCodeableConcept |
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Observation.component.dataAbsentReason | DataAbsentReason (Extensible) |
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Observation.component.interpretation | Observation Interpretation Codes (Extensible) |
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