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Resource Profile: CareFollowUpObservation

Official URL: http://fhir.kl.dk/gateway/StructureDefinition/klgateway-care-follow-up-observation Version: 1.1.0
Active as of 2023-06-21 Computable Name: KLGatewayCareFollowUpObservation

Structured result or outcome of a follow up.

Scope and usage

FollowUpObservation is used for documenting the result of a follow-up procedure, as documented by FSIII. Follow-ups are documented using this profile, whether they are documented by suppliers during an intervention, or documented by autorities, at planned follow-ups.

The profile has the Follow-up result in Observation.valueCodeableConcept.coding

The ObservationCode is mandatory, and fixed to a specific SNOMED CT code that signifies that this is an evaluation of a care plan (evaluering af indsats i bred forstand).

The status is in this implementation guide should either be final or entered-in-error.

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.

FKI-attribut Definition FHIR
opfølgningskode Klasse, der udtrykker at der evalueres på den indsats der er igangsat. Observation.code.coding
opfølgningsresultatStruktureret Struktureret resultat af en opfølgningen Observation.valueCodeableConcept.coding
opfølgningssubjekt Den borger, der er genstand for opfølgningen Observation.subject
opfølgningstid Det tidspunkt, hvor opfølgningen er foretaget Observation.effectiveDateTime
opfølgningsstatus Kode der udtrykker, hvor i sin proces, opfølgningen er Observation.status

Usage:

Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work.

This structure is derived from Observation

NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation C0..*ObservationMeasurements and simple assertions
gateway-care-follow-up-1: A follow-up observation resource shall have status final or entered-in-error
... identifier 0..0
... basedOn 0..0
... partOf 0..0
... category 0..0
... code
.... coding 1..1CodingCode defined by a terminology system
Required Pattern: At least the following
..... system1..1uriIdentity of the terminology system
Fixed Value: http://snomed.info/sct
..... code1..1codeSymbol in syntax defined by the system
Fixed Value: 712744002
... subject 0..1Reference(CareCitizen) {b}[DK] opfølgningsubjekt
... focus 1..*Reference(CareCondition | CarePlannedIntervention)What the observation is about, when it is not about the subject of record
... encounter 0..0
... effective[x] 1..1dateTime[DK] opfølgningstid
... issued 0..0
... performer 0..0
... value[x] 1..1CodeableConceptActual result
Binding: KLOpfølgningKoderFSIII (required)
... dataAbsentReason 0..0
... interpretation 0..0
... note 0..0
... bodySite 0..0
... method 0..0
... specimen 0..0
... device 0..0
... referenceRange 0..0
... hasMember 0..0
... derivedFrom 0..0
... component 0..0

doco Documentation for this format

Terminology Bindings (Differential)

PathConformanceValueSet
Observation.value[x]requiredKLFollowUpCodesFSIII

Constraints

IdGradePath(s)DetailsRequirements
gateway-care-follow-up-1errorObservationA follow-up observation resource shall have status final or entered-in-error
: status = 'final' or status = 'entered-in-error'
NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation C0..*ObservationMeasurements and simple assertions
gateway-care-follow-up-1: A follow-up observation resource shall have status final or entered-in-error
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... status ?!Σ1..1code[DK] opfølgningsstatus
Binding: ObservationStatus (required): Codes providing the status of an observation.

.... coding Σ1..1CodingCode defined by a terminology system

Required Pattern: At least the following
..... system1..1uriIdentity of the terminology system
Fixed Value: http://snomed.info/sct
..... code1..1codeSymbol in syntax defined by the system
Fixed Value: 712744002
... subject Σ0..1Reference(CareCitizen) {b}[DK] opfølgningsubjekt
... focus Σ1..*Reference(CareCondition | CarePlannedIntervention)What the observation is about, when it is not about the subject of record
... effective[x] Σ1..1dateTime[DK] opfølgningstid
... value[x] ΣC1..1CodeableConceptActual result
Binding: KLOpfølgningKoderFSIII (required)

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet
Observation.statusrequiredObservationStatus
Observation.codeexampleLOINCCodes (a valid code from LOINC)
Observation.value[x]requiredKLFollowUpCodesFSIII
Observation.component.codeexampleLOINCCodes (a valid code from LOINC)

Constraints

IdGradePath(s)DetailsRequirements
dom-2errorObservationIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorObservationIf 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-4errorObservationIf 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-5errorObservationIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practiceObservationA resource should have narrative for robust management
: text.`div`.exists()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()
gateway-care-follow-up-1errorObservationA follow-up observation resource shall have status final or entered-in-error
: status = 'final' or status = 'entered-in-error'
obs-6errorObservationdataAbsentReason SHALL only be present if Observation.value[x] is not present
: dataAbsentReason.empty() or value.empty()
obs-7errorObservationIf 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()
NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation C0..*ObservationMeasurements and simple assertions
gateway-care-follow-up-1: A follow-up observation resource shall have status final or entered-in-error
... id Σ0..1idLogical id of this artifact
... meta Σ0..1MetaMetadata about the resource
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... text 0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... extension 0..*ExtensionAdditional content defined by implementations
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... status ?!Σ1..1code[DK] opfølgningsstatus
Binding: ObservationStatus (required): Codes providing the status of an observation.

... code Σ1..1CodeableConceptType of observation (code / type)
Binding: LOINCCodes (example): Codes identifying names of simple observations.

.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
.... coding Σ1..1CodingCode defined by a terminology system

Required Pattern: At least the following
..... id0..1stringUnique id for inter-element referencing
..... extension0..*ExtensionAdditional content defined by implementations
..... system1..1uriIdentity of the terminology system
Fixed Value: http://snomed.info/sct
..... version0..1stringVersion of the system - if relevant
..... code1..1codeSymbol in syntax defined by the system
Fixed Value: 712744002
..... display0..1stringRepresentation defined by the system
..... userSelected0..1booleanIf this coding was chosen directly by the user
.... text Σ0..1stringPlain text representation of the concept
... subject Σ0..1Reference(CareCitizen) {b}[DK] opfølgningsubjekt
... focus Σ1..*Reference(CareCondition | CarePlannedIntervention)What the observation is about, when it is not about the subject of record
... effective[x] Σ1..1dateTime[DK] opfølgningstid
... value[x] ΣC1..1CodeableConceptActual result
Binding: KLOpfølgningKoderFSIII (required)

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet
Observation.languagepreferredCommonLanguages
Additional Bindings Purpose
AllLanguages Max Binding
Observation.statusrequiredObservationStatus
Observation.codeexampleLOINCCodes (a valid code from LOINC)
Observation.value[x]requiredKLFollowUpCodesFSIII
Observation.referenceRange.typepreferredObservationReferenceRangeMeaningCodes
Observation.referenceRange.appliesToexampleObservationReferenceRangeAppliesToCodes
Observation.component.codeexampleLOINCCodes (a valid code from LOINC)
Observation.component.dataAbsentReasonextensibleDataAbsentReason
Observation.component.interpretationextensibleObservationInterpretationCodes

Constraints

IdGradePath(s)DetailsRequirements
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()

Differential View

This structure is derived from Observation

NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation C0..*ObservationMeasurements and simple assertions
gateway-care-follow-up-1: A follow-up observation resource shall have status final or entered-in-error
... identifier 0..0
... basedOn 0..0
... partOf 0..0
... category 0..0
... code
.... coding 1..1CodingCode defined by a terminology system
Required Pattern: At least the following
..... system1..1uriIdentity of the terminology system
Fixed Value: http://snomed.info/sct
..... code1..1codeSymbol in syntax defined by the system
Fixed Value: 712744002
... subject 0..1Reference(CareCitizen) {b}[DK] opfølgningsubjekt
... focus 1..*Reference(CareCondition | CarePlannedIntervention)What the observation is about, when it is not about the subject of record
... encounter 0..0
... effective[x] 1..1dateTime[DK] opfølgningstid
... issued 0..0
... performer 0..0
... value[x] 1..1CodeableConceptActual result
Binding: KLOpfølgningKoderFSIII (required)
... dataAbsentReason 0..0
... interpretation 0..0
... note 0..0
... bodySite 0..0
... method 0..0
... specimen 0..0
... device 0..0
... referenceRange 0..0
... hasMember 0..0
... derivedFrom 0..0
... component 0..0

doco Documentation for this format

Terminology Bindings (Differential)

PathConformanceValueSet
Observation.value[x]requiredKLFollowUpCodesFSIII

Constraints

IdGradePath(s)DetailsRequirements
gateway-care-follow-up-1errorObservationA follow-up observation resource shall have status final or entered-in-error
: status = 'final' or status = 'entered-in-error'

Key Elements View

NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation C0..*ObservationMeasurements and simple assertions
gateway-care-follow-up-1: A follow-up observation resource shall have status final or entered-in-error
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... status ?!Σ1..1code[DK] opfølgningsstatus
Binding: ObservationStatus (required): Codes providing the status of an observation.

.... coding Σ1..1CodingCode defined by a terminology system

Required Pattern: At least the following
..... system1..1uriIdentity of the terminology system
Fixed Value: http://snomed.info/sct
..... code1..1codeSymbol in syntax defined by the system
Fixed Value: 712744002
... subject Σ0..1Reference(CareCitizen) {b}[DK] opfølgningsubjekt
... focus Σ1..*Reference(CareCondition | CarePlannedIntervention)What the observation is about, when it is not about the subject of record
... effective[x] Σ1..1dateTime[DK] opfølgningstid
... value[x] ΣC1..1CodeableConceptActual result
Binding: KLOpfølgningKoderFSIII (required)

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet
Observation.statusrequiredObservationStatus
Observation.codeexampleLOINCCodes (a valid code from LOINC)
Observation.value[x]requiredKLFollowUpCodesFSIII
Observation.component.codeexampleLOINCCodes (a valid code from LOINC)

Constraints

IdGradePath(s)DetailsRequirements
dom-2errorObservationIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorObservationIf 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-4errorObservationIf 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-5errorObservationIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practiceObservationA resource should have narrative for robust management
: text.`div`.exists()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()
gateway-care-follow-up-1errorObservationA follow-up observation resource shall have status final or entered-in-error
: status = 'final' or status = 'entered-in-error'
obs-6errorObservationdataAbsentReason SHALL only be present if Observation.value[x] is not present
: dataAbsentReason.empty() or value.empty()
obs-7errorObservationIf 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

NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation C0..*ObservationMeasurements and simple assertions
gateway-care-follow-up-1: A follow-up observation resource shall have status final or entered-in-error
... id Σ0..1idLogical id of this artifact
... meta Σ0..1MetaMetadata about the resource
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... text 0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... extension 0..*ExtensionAdditional content defined by implementations
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... status ?!Σ1..1code[DK] opfølgningsstatus
Binding: ObservationStatus (required): Codes providing the status of an observation.

... code Σ1..1CodeableConceptType of observation (code / type)
Binding: LOINCCodes (example): Codes identifying names of simple observations.

.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
.... coding Σ1..1CodingCode defined by a terminology system

Required Pattern: At least the following
..... id0..1stringUnique id for inter-element referencing
..... extension0..*ExtensionAdditional content defined by implementations
..... system1..1uriIdentity of the terminology system
Fixed Value: http://snomed.info/sct
..... version0..1stringVersion of the system - if relevant
..... code1..1codeSymbol in syntax defined by the system
Fixed Value: 712744002
..... display0..1stringRepresentation defined by the system
..... userSelected0..1booleanIf this coding was chosen directly by the user
.... text Σ0..1stringPlain text representation of the concept
... subject Σ0..1Reference(CareCitizen) {b}[DK] opfølgningsubjekt
... focus Σ1..*Reference(CareCondition | CarePlannedIntervention)What the observation is about, when it is not about the subject of record
... effective[x] Σ1..1dateTime[DK] opfølgningstid
... value[x] ΣC1..1CodeableConceptActual result
Binding: KLOpfølgningKoderFSIII (required)

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet
Observation.languagepreferredCommonLanguages
Additional Bindings Purpose
AllLanguages Max Binding
Observation.statusrequiredObservationStatus
Observation.codeexampleLOINCCodes (a valid code from LOINC)
Observation.value[x]requiredKLFollowUpCodesFSIII
Observation.referenceRange.typepreferredObservationReferenceRangeMeaningCodes
Observation.referenceRange.appliesToexampleObservationReferenceRangeAppliesToCodes
Observation.component.codeexampleLOINCCodes (a valid code from LOINC)
Observation.component.dataAbsentReasonextensibleDataAbsentReason
Observation.component.interpretationextensibleObservationInterpretationCodes

Constraints

IdGradePath(s)DetailsRequirements
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()

 

Other representations of profile: CSV, Excel, Schematron