Scope and usage

KLGatewayChildrenTobaccoObservation is used to document small childrens exposue to tobacco, and teenagers tocacco use.

Observation.code.coding, holds the valid value for the types of observations allowed. It is bound to a fixed SNOMED CT code ‘Tobacco use and exposure’.

Observation.value[x] is a coded value Observation.valueCodeableConcept, which should be drawn from the required ValueSet. The valid values are:

• ‘Exposed to tobacco smoke at home’ (is registered when a child is exposed to tobaco. Exposure to tobacco smoke is defined by the national childrens database indicator as explained here)
• ‘Tobacco user’ (is registered when a child reports tobacco use in the school take-off examination/udskolingsundersøgelse)
• ‘No current problems or disability’ (is registered when the child does not have problems with tobacco exposure or use)

The time of the observation is documented in Observation.effective[x].

Observation.subject holds the reference to the child, who is obsesrved. Observation.encounter holds the reference to the encounter in which the observation is performed.

Notice that the status-attribute is mandatory. For normal use, just set to “final”, if data is missing or another problem has occured, follow the FHIR guidance to populate the field correctly. To indicate missing data, Observation.dataAbsentReason can be used as well. E.g when citizens are asked, but decline to answer, the dataAbsentReason should be populated with ‘asked-declined’.

Conversions between Danish information model and FHIR-profile

Nedenstående tabel oversætter mellem de attributter der er defineret i den fælleskommunale informationsmodel (FKI), definerer kort den enkelte attribut på dansk og specificerer hvilke af FHIR-profilens atributter der skal bruges til specifikation af indholdet.

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

This structure is derived from Observation

Name	Flags	Card.	Type	Description & Constraints
Observation	C	0..*	Observation	Measurements and simple assertions obs-2: If the value is not given, then explain why using dataAbsentReason
identifier		0..0
basedOn		0..0
partOf		0..0
status		1..1	code	[DK] tobaksobservationStatus
code		1..1	CodeableConcept	[DK] tobaksobservationsKode Binding: TobaccoobservablesChildren (required)
subject		1..1	Reference(KLGatewayChildrenCitizen) {b}	[DK] tobaksobservationSubjekt
focus		0..0
encounter		0..1	Reference(KLGatewayChildrenEncounter) {b}	[DK] tobaksobservationKontakt
effective[x]		1..1	dateTime	[DK] tobaksobservationTid
issued		0..0
performer		0..0
value[x]		0..1	CodeableConcept	[DK] tobaksobservationsResultat Binding: TobaccoResultsChildren (required)
dataAbsentReason		0..1	CodeableConcept	[DK] tobaksobservationMangler
interpretation		0..0
note		0..0
bodySite		0..0
method		0..0
specimen		0..0
device		0..0
hasMember		0..0
derivedFrom		0..0
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet
Observation.code	required	TobaccoObservablesChildren
Observation.value[x]	required	TobaccoResultsChildren

Constraints

Id	Grade	Path(s)	Details	Requirements
obs-2	error	Observation	If the value is not given, then explain why using dataAbsentReason : value.empty() implies dataAbsentReason.exists()

Name	Flags	Card.	Type	Description & Constraints
Observation	C	0..*	Observation	Measurements and simple assertions obs-2: If the value is not given, then explain why using dataAbsentReason
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	[DK] tobaksobservationStatus Binding: ObservationStatus (required): Codes providing the status of an observation.
code	Σ	1..1	CodeableConcept	[DK] tobaksobservationsKode Binding: TobaccoobservablesChildren (required)
subject	Σ	1..1	Reference(KLGatewayChildrenCitizen) {b}	[DK] tobaksobservationSubjekt
encounter	Σ	0..1	Reference(KLGatewayChildrenEncounter) {b}	[DK] tobaksobservationKontakt
effective[x]	Σ	1..1	dateTime	[DK] tobaksobservationTid
value[x]	ΣC	0..1	CodeableConcept	[DK] tobaksobservationsResultat Binding: TobaccoResultsChildren (required)
dataAbsentReason	C	0..1	CodeableConcept	[DK] tobaksobservationMangler Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet
Observation.status	required	ObservationStatus
Observation.code	required	TobaccoObservablesChildren
Observation.value[x]	required	TobaccoResultsChildren
Observation.dataAbsentReason	extensible	DataAbsentReason

Constraints

Id	Grade	Path(s)	Details	Requirements
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-2	error	Observation	If the value is not given, then explain why using dataAbsentReason : value.empty() implies dataAbsentReason.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()

Name	Flags	Card.	Type	Description & Constraints
Observation	C	0..*	Observation	Measurements and simple assertions obs-2: If the value is not given, then explain why using dataAbsentReason
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
status	?!Σ	1..1	code	[DK] tobaksobservationStatus Binding: ObservationStatus (required): Codes providing the status of an observation.
category		0..*	CodeableConcept	Classification of type of observation Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
code	Σ	1..1	CodeableConcept	[DK] tobaksobservationsKode Binding: TobaccoobservablesChildren (required)
subject	Σ	1..1	Reference(KLGatewayChildrenCitizen) {b}	[DK] tobaksobservationSubjekt
encounter	Σ	0..1	Reference(KLGatewayChildrenEncounter) {b}	[DK] tobaksobservationKontakt
effective[x]	Σ	1..1	dateTime	[DK] tobaksobservationTid
value[x]	ΣC	0..1	CodeableConcept	[DK] tobaksobservationsResultat Binding: TobaccoResultsChildren (required)
dataAbsentReason	C	0..1	CodeableConcept	[DK] tobaksobservationMangler Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
referenceRange	C	0..*	BackboneElement	Provides guide for interpretation
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
low	C	0..1	SimpleQuantity	Low Range, if relevant
high	C	0..1	SimpleQuantity	High Range, if relevant
type		0..1	CodeableConcept	Reference range qualifier Binding: ObservationReferenceRangeMeaningCodes (preferred): Code for the meaning of a reference range.
appliesTo		0..*	CodeableConcept	Reference range population Binding: ObservationReferenceRangeAppliesToCodes (example): Codes identifying the population the reference range applies to.
age		0..1	Range	Applicable age range, if relevant
text		0..1	string	Text based reference range in an observation
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) Binding: LOINCCodes (example): Codes identifying names of simple observations.
value[x]	Σ	0..1		Actual component result
valueQuantity			Quantity
valueCodeableConcept			CodeableConcept
valueString			string
valueBoolean			boolean
valueInteger			integer
valueRange			Range
valueRatio			Ratio
valueSampledData			SampledData
valueTime			time
valueDateTime			dateTime
valuePeriod			Period
dataAbsentReason	C	0..1	CodeableConcept	Why the component result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation		0..*	CodeableConcept	High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
referenceRange		0..*	See referenceRange (Observation)	Provides guide for interpretation of component result
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet
Observation.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding
Observation.status	required	ObservationStatus
Observation.category	preferred	ObservationCategoryCodes
Observation.code	required	TobaccoObservablesChildren
Observation.value[x]	required	TobaccoResultsChildren
Observation.dataAbsentReason	extensible	DataAbsentReason
Observation.referenceRange.type	preferred	ObservationReferenceRangeMeaningCodes
Observation.referenceRange.appliesTo	example	ObservationReferenceRangeAppliesToCodes
Observation.component.code	example	LOINCCodes (a valid code from LOINC)
Observation.component.dataAbsentReason	extensible	DataAbsentReason
Observation.component.interpretation	extensible	ObservationInterpretationCodes

Constraints

Id	Grade	Path(s)	Details	Requirements
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-2	error	Observation	If the value is not given, then explain why using dataAbsentReason : value.empty() implies dataAbsentReason.exists()
obs-3	error	Observation.referenceRange	Must have at least a low or a high or text : low.exists() or high.exists() or text.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

Name	Flags	Card.	Type	Description & Constraints
Observation	C	0..*	Observation	Measurements and simple assertions obs-2: If the value is not given, then explain why using dataAbsentReason
identifier		0..0
basedOn		0..0
partOf		0..0
status		1..1	code	[DK] tobaksobservationStatus
code		1..1	CodeableConcept	[DK] tobaksobservationsKode Binding: TobaccoobservablesChildren (required)
subject		1..1	Reference(KLGatewayChildrenCitizen) {b}	[DK] tobaksobservationSubjekt
focus		0..0
encounter		0..1	Reference(KLGatewayChildrenEncounter) {b}	[DK] tobaksobservationKontakt
effective[x]		1..1	dateTime	[DK] tobaksobservationTid
issued		0..0
performer		0..0
value[x]		0..1	CodeableConcept	[DK] tobaksobservationsResultat Binding: TobaccoResultsChildren (required)
dataAbsentReason		0..1	CodeableConcept	[DK] tobaksobservationMangler
interpretation		0..0
note		0..0
bodySite		0..0
method		0..0
specimen		0..0
device		0..0
hasMember		0..0
derivedFrom		0..0
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet
Observation.code	required	TobaccoObservablesChildren
Observation.value[x]	required	TobaccoResultsChildren

Constraints

Id	Grade	Path(s)	Details	Requirements
obs-2	error	Observation	If the value is not given, then explain why using dataAbsentReason : value.empty() implies dataAbsentReason.exists()

Key Elements View

Name	Flags	Card.	Type	Description & Constraints
Observation	C	0..*	Observation	Measurements and simple assertions obs-2: If the value is not given, then explain why using dataAbsentReason
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	[DK] tobaksobservationStatus Binding: ObservationStatus (required): Codes providing the status of an observation.
code	Σ	1..1	CodeableConcept	[DK] tobaksobservationsKode Binding: TobaccoobservablesChildren (required)
subject	Σ	1..1	Reference(KLGatewayChildrenCitizen) {b}	[DK] tobaksobservationSubjekt
encounter	Σ	0..1	Reference(KLGatewayChildrenEncounter) {b}	[DK] tobaksobservationKontakt
effective[x]	Σ	1..1	dateTime	[DK] tobaksobservationTid
value[x]	ΣC	0..1	CodeableConcept	[DK] tobaksobservationsResultat Binding: TobaccoResultsChildren (required)
dataAbsentReason	C	0..1	CodeableConcept	[DK] tobaksobservationMangler Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet
Observation.status	required	ObservationStatus
Observation.code	required	TobaccoObservablesChildren
Observation.value[x]	required	TobaccoResultsChildren
Observation.dataAbsentReason	extensible	DataAbsentReason

Constraints

Id	Grade	Path(s)	Details	Requirements
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-2	error	Observation	If the value is not given, then explain why using dataAbsentReason : value.empty() implies dataAbsentReason.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()

Snapshot View

Name	Flags	Card.	Type	Description & Constraints
Observation	C	0..*	Observation	Measurements and simple assertions obs-2: If the value is not given, then explain why using dataAbsentReason
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
status	?!Σ	1..1	code	[DK] tobaksobservationStatus Binding: ObservationStatus (required): Codes providing the status of an observation.
category		0..*	CodeableConcept	Classification of type of observation Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
code	Σ	1..1	CodeableConcept	[DK] tobaksobservationsKode Binding: TobaccoobservablesChildren (required)
subject	Σ	1..1	Reference(KLGatewayChildrenCitizen) {b}	[DK] tobaksobservationSubjekt
encounter	Σ	0..1	Reference(KLGatewayChildrenEncounter) {b}	[DK] tobaksobservationKontakt
effective[x]	Σ	1..1	dateTime	[DK] tobaksobservationTid
value[x]	ΣC	0..1	CodeableConcept	[DK] tobaksobservationsResultat Binding: TobaccoResultsChildren (required)
dataAbsentReason	C	0..1	CodeableConcept	[DK] tobaksobservationMangler Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
referenceRange	C	0..*	BackboneElement	Provides guide for interpretation
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
low	C	0..1	SimpleQuantity	Low Range, if relevant
high	C	0..1	SimpleQuantity	High Range, if relevant
type		0..1	CodeableConcept	Reference range qualifier Binding: ObservationReferenceRangeMeaningCodes (preferred): Code for the meaning of a reference range.
appliesTo		0..*	CodeableConcept	Reference range population Binding: ObservationReferenceRangeAppliesToCodes (example): Codes identifying the population the reference range applies to.
age		0..1	Range	Applicable age range, if relevant
text		0..1	string	Text based reference range in an observation
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) Binding: LOINCCodes (example): Codes identifying names of simple observations.
value[x]	Σ	0..1		Actual component result
valueQuantity			Quantity
valueCodeableConcept			CodeableConcept
valueString			string
valueBoolean			boolean
valueInteger			integer
valueRange			Range
valueRatio			Ratio
valueSampledData			SampledData
valueTime			time
valueDateTime			dateTime
valuePeriod			Period
dataAbsentReason	C	0..1	CodeableConcept	Why the component result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation		0..*	CodeableConcept	High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
referenceRange		0..*	See referenceRange (Observation)	Provides guide for interpretation of component result
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet
Observation.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding
Observation.status	required	ObservationStatus
Observation.category	preferred	ObservationCategoryCodes
Observation.code	required	TobaccoObservablesChildren
Observation.value[x]	required	TobaccoResultsChildren
Observation.dataAbsentReason	extensible	DataAbsentReason
Observation.referenceRange.type	preferred	ObservationReferenceRangeMeaningCodes
Observation.referenceRange.appliesTo	example	ObservationReferenceRangeAppliesToCodes
Observation.component.code	example	LOINCCodes (a valid code from LOINC)
Observation.component.dataAbsentReason	extensible	DataAbsentReason
Observation.component.interpretation	extensible	ObservationInterpretationCodes

Constraints

Id	Grade	Path(s)	Details	Requirements
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-2	error	Observation	If the value is not given, then explain why using dataAbsentReason : value.empty() implies dataAbsentReason.exists()
obs-3	error	Observation.referenceRange	Must have at least a low or a high or text : low.exists() or high.exists() or text.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

Summary

Mandatory: 2 elements
Prohibited: 14 elements

Structures

This structure refers to these other structures:

• KLGatewayChildrenCitizen (http://fhir.kl.dk/children/StructureDefinition/klgateway-children-citizen)
• KLGatewayChildrenEncounter (http://fhir.kl.dk/children/StructureDefinition/klgateway-children-encounter)