HL7中国FHIR Connectathon测试实施指南
2024.5.5 - release

本指南适用于HL7中国的FHIR Connectathon测试。

Resource Profile: 生命体征结构定义

Defining URL:http://hl7.org.cn/fhir/StructureDefinition/vital-sign
Version:2024.5.5
Name:VitalSign
Title:生命体征结构定义
Status:Active as of 2024-05-05 21:11:47+0800
Definition:

生命体征资源本地化定义。

Publisher:HL7中国. HL7中国,
Source Resource:XML / JSON / Turtle

本定义的正式URL为: 

http://hl7.org.cn/fhir/StructureDefinition/vital-sign

定义内容的视图

关于定义、差异、快照以及如何解读这些表示法。

这种结构源自 Observation

Summary

Mandatory: 2 elements

Slices

This structure defines the following Slices:

  • The element Observation.code.coding is sliced based on the value of value:system
  • The element Observation.component.code.coding is sliced based on the value of value:system

这种结构源自 Observation

NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation 0..*ObservationMeasurements and simple assertions
... status 1..1code生命体征的状态，默认值可以设为final
... code 1..1CodeableConcept生命体征的编码, 最少应提供一种编码
.... Slices for coding 0..*CodingCode defined by a terminology system
Slice: Unordered, Open by value:system
..... coding:Local 0..1Coding编码限定为卫生行业标准定义的数据元标准
Binding: 卫生标准数据元代码表 (required)
..... coding:International 0..1Coding编码限定为LOINC
Binding: http://loinc.org (required)
... subject 1..1Reference(Patient | Group | Device | Location | Organization | Procedure | Practitioner | Medication | Substance | BiologicallyDerivedProduct | NutritionProduct)指向患者的引用
... component 0..*BackboneElement用于表达生命体征的子组成，例如：血压就会分为收缩压和舒张压。
.... code 1..1CodeableConcept生命体征的编码, 最少应提供一种编码
..... Slices for coding 0..*CodingCode defined by a terminology system
Slice: Unordered, Open by value:system
...... coding:Local 0..1Coding编码限定为卫生行业标准定义的数据元标准
Binding: 卫生标准数据元代码表 (required)
...... coding:International 0..1Coding编码限定为LOINC
Binding: http://loinc.org (required)

doco Documentation for this format
NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation C0..*ObservationMeasurements and simple assertions
obs-6: dataAbsentReason SHALL only be present if Observation.value[x] is not present
obs-7: If Observation.component.code is the same as Observation.code, then Observation.value SHALL NOT be present (the Observation.component.value[x] holds the value).
obs-8: bodyStructure SHALL only be present if Observation.bodySite is not present
... 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
... language 0..1codeLanguage of the resource content
Binding: AllLanguages (required): IETF language tag for a human language

Additional BindingsPurpose
CommonLanguagesStarter Set
... text 0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... extension 0..*ExtensionAdditional content defined by implementations
... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored
... identifier Σ0..*IdentifierBusiness Identifier for observation
... instantiates[x] Σ0..1canonical(ObservationDefinition), Reference(ObservationDefinition)Instantiates FHIR ObservationDefinition
... basedOn Σ0..*Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest)Fulfills plan, proposal or order
... triggeredBy 0..*BackboneElementTriggering observation(s)
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... observation Σ1..1Reference(Observation)Triggering observation
.... type Σ1..1codereflex | repeat | re-run
Binding: TriggeredBytype (required): The type of TriggeredBy Observation.

.... reason 0..1stringReason that the observation was triggered
... partOf Σ0..*Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy | GenomicStudy)Part of referenced event
... status ?!Σ1..1code生命体征的状态，默认值可以设为final
Binding: ObservationStatus (required): Codes providing the status of an observation.

... category 0..*CodeableConceptClassification of type of observation
Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.


... code ΣC1..1CodeableConcept生命体征的编码, 最少应提供一种编码
Binding: LOINCCodes (example): Codes identifying names of simple observations.

.... id 0..1idUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
.... Slices for coding Σ0..*CodingCode defined by a terminology system
Slice: Unordered, Open by value:system
..... coding:Local Σ0..1Coding编码限定为卫生行业标准定义的数据元标准
Binding: 卫生标准数据元代码表 (required)
..... coding:International Σ0..1Coding编码限定为LOINC
Binding: http://loinc.org (required)
.... text Σ0..1stringPlain text representation of the concept
... subject Σ1..1Reference(Patient | Group | Device | Location | Organization | Procedure | Practitioner | Medication | Substance | BiologicallyDerivedProduct | NutritionProduct)指向患者的引用
... focus Σ0..*Reference(Resource)What the observation is about, when it is not about the subject of record
... encounter Σ1..1Reference(Encounter)指向诊疗或健康活动资源
... effective[x] Σ0..1Clinically relevant time/time-period for observation
.... effectiveDateTimedateTime
.... effectivePeriodPeriod
.... effectiveTimingTiming
.... effectiveInstantinstant
... issued Σ0..1instantDate/Time this version was made available
... performer Σ0..*Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson)Who is responsible for the observation
... value[x] ΣC0..1Actual result
.... valueQuantityQuantity
.... valueCodeableConceptCodeableConcept
.... valueStringstring
.... valueBooleanboolean
.... valueIntegerinteger
.... valueRangeRange
.... valueRatioRatio
.... valueSampledDataSampledData
.... valueTimetime
.... valueDateTimedateTime
.... valuePeriodPeriod
.... valueAttachmentAttachment
.... valueReferenceReference(MolecularSequence)
... dataAbsentReason C0..1CodeableConceptWhy the result is missing
Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.

... interpretation 0..*CodeableConceptHigh, low, normal, etc
Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.


... note 0..*AnnotationComments about the observation
... bodySite C0..1CodeableConceptObserved body part
Binding: SNOMEDCTBodyStructures (example): SNOMED CT Body site concepts

... bodyStructure C0..1Reference(BodyStructure)Observed body structure
... method 0..1CodeableConceptHow it was done
Binding: ObservationMethods (example): Methods for simple observations.

... specimen C0..1Reference(Specimen | Group)Specimen used for this observation
obs-9: If Observation.specimen is a reference to Group, the group can only have specimens
... device 0..1Reference(Device | DeviceMetric)A reference to the device that generates the measurements or the device settings for the device
... referenceRange C0..*BackboneElementProvides guide for interpretation
obs-3: Must have at least a low or a high or text
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... low C0..1SimpleQuantityLow Range, if relevant
.... high C0..1SimpleQuantityHigh Range, if relevant
.... normalValue 0..1CodeableConceptNormal value, if relevant
Binding: ObservationReferenceRangeNormalValueCodes (extensible): Codes identifying the normal value of the observation.

.... type 0..1CodeableConceptReference range qualifier
Binding: ObservationReferenceRangeMeaningCodes (preferred): Code for the meaning of a reference range.

.... appliesTo 0..*CodeableConceptReference range population
Binding: ObservationReferenceRangeAppliesToCodes (example): Codes identifying the population the reference range applies to.


.... age 0..1RangeApplicable age range, if relevant
.... text C0..1markdownText based reference range in an observation
... hasMember Σ0..*Reference(Observation | QuestionnaireResponse | MolecularSequence)Related resource that belongs to the Observation group
... derivedFrom Σ0..*Reference(DocumentReference | ImagingStudy | ImagingSelection | QuestionnaireResponse | Observation | MolecularSequence | GenomicStudy)Related resource from which the observation is made
... component ΣC0..*BackboneElement用于表达生命体征的子组成，例如：血压就会分为收缩压和舒张压。
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... code ΣC1..1CodeableConcept生命体征的编码, 最少应提供一种编码
Binding: LOINCCodes (example): Codes identifying names of simple observations.

..... id 0..1idUnique id for inter-element referencing
..... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
..... Slices for coding Σ0..*CodingCode defined by a terminology system
Slice: Unordered, Open by value:system
...... coding:Local Σ0..1Coding编码限定为卫生行业标准定义的数据元标准
Binding: 卫生标准数据元代码表 (required)
...... coding:International Σ0..1Coding编码限定为LOINC
Binding: http://loinc.org (required)
..... text Σ0..1stringPlain text representation of the concept
.... value[x] Σ0..1Actual component result
..... valueQuantityQuantity
..... valueCodeableConceptCodeableConcept
..... valueStringstring
..... valueBooleanboolean
..... valueIntegerinteger
..... valueRangeRange
..... valueRatioRatio
..... valueSampledDataSampledData
..... valueTimetime
..... valueDateTimedateTime
..... valuePeriodPeriod
..... valueAttachmentAttachment
..... valueReferenceReference(MolecularSequence)
.... dataAbsentReason 0..1CodeableConceptWhy the component result is missing
Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.

.... interpretation 0..*CodeableConceptHigh, low, normal, etc
Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.


.... referenceRange 0..*See referenceRange (Observation)Provides guide for interpretation of component result

doco Documentation for this format

这种结构源自 Observation

Summary

Mandatory: 2 elements

Slices

This structure defines the following Slices:

  • The element Observation.code.coding is sliced based on the value of value:system
  • The element Observation.component.code.coding is sliced based on the value of value:system

差异视图

这种结构源自 Observation

NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation 0..*ObservationMeasurements and simple assertions
... status 1..1code生命体征的状态，默认值可以设为final
... code 1..1CodeableConcept生命体征的编码, 最少应提供一种编码
.... Slices for coding 0..*CodingCode defined by a terminology system
Slice: Unordered, Open by value:system
..... coding:Local 0..1Coding编码限定为卫生行业标准定义的数据元标准
Binding: 卫生标准数据元代码表 (required)
..... coding:International 0..1Coding编码限定为LOINC
Binding: http://loinc.org (required)
... subject 1..1Reference(Patient | Group | Device | Location | Organization | Procedure | Practitioner | Medication | Substance | BiologicallyDerivedProduct | NutritionProduct)指向患者的引用
... component 0..*BackboneElement用于表达生命体征的子组成，例如：血压就会分为收缩压和舒张压。
.... code 1..1CodeableConcept生命体征的编码, 最少应提供一种编码
..... Slices for coding 0..*CodingCode defined by a terminology system
Slice: Unordered, Open by value:system
...... coding:Local 0..1Coding编码限定为卫生行业标准定义的数据元标准
Binding: 卫生标准数据元代码表 (required)
...... coding:International 0..1Coding编码限定为LOINC
Binding: http://loinc.org (required)

doco Documentation for this format

快照视图

NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation C0..*ObservationMeasurements and simple assertions
obs-6: dataAbsentReason SHALL only be present if Observation.value[x] is not present
obs-7: If Observation.component.code is the same as Observation.code, then Observation.value SHALL NOT be present (the Observation.component.value[x] holds the value).
obs-8: bodyStructure SHALL only be present if Observation.bodySite is not present
... 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
... language 0..1codeLanguage of the resource content
Binding: AllLanguages (required): IETF language tag for a human language

Additional BindingsPurpose
CommonLanguagesStarter Set
... text 0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... extension 0..*ExtensionAdditional content defined by implementations
... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored
... identifier Σ0..*IdentifierBusiness Identifier for observation
... instantiates[x] Σ0..1canonical(ObservationDefinition), Reference(ObservationDefinition)Instantiates FHIR ObservationDefinition
... basedOn Σ0..*Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest)Fulfills plan, proposal or order
... triggeredBy 0..*BackboneElementTriggering observation(s)
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... observation Σ1..1Reference(Observation)Triggering observation
.... type Σ1..1codereflex | repeat | re-run
Binding: TriggeredBytype (required): The type of TriggeredBy Observation.

.... reason 0..1stringReason that the observation was triggered
... partOf Σ0..*Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy | GenomicStudy)Part of referenced event
... status ?!Σ1..1code生命体征的状态，默认值可以设为final
Binding: ObservationStatus (required): Codes providing the status of an observation.

... category 0..*CodeableConceptClassification of type of observation
Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.


... code ΣC1..1CodeableConcept生命体征的编码, 最少应提供一种编码
Binding: LOINCCodes (example): Codes identifying names of simple observations.

.... id 0..1idUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
.... Slices for coding Σ0..*CodingCode defined by a terminology system
Slice: Unordered, Open by value:system
..... coding:Local Σ0..1Coding编码限定为卫生行业标准定义的数据元标准
Binding: 卫生标准数据元代码表 (required)
..... coding:International Σ0..1Coding编码限定为LOINC
Binding: http://loinc.org (required)
.... text Σ0..1stringPlain text representation of the concept
... subject Σ1..1Reference(Patient | Group | Device | Location | Organization | Procedure | Practitioner | Medication | Substance | BiologicallyDerivedProduct | NutritionProduct)指向患者的引用
... focus Σ0..*Reference(Resource)What the observation is about, when it is not about the subject of record
... encounter Σ1..1Reference(Encounter)指向诊疗或健康活动资源
... effective[x] Σ0..1Clinically relevant time/time-period for observation
.... effectiveDateTimedateTime
.... effectivePeriodPeriod
.... effectiveTimingTiming
.... effectiveInstantinstant
... issued Σ0..1instantDate/Time this version was made available
... performer Σ0..*Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson)Who is responsible for the observation
... value[x] ΣC0..1Actual result
.... valueQuantityQuantity
.... valueCodeableConceptCodeableConcept
.... valueStringstring
.... valueBooleanboolean
.... valueIntegerinteger
.... valueRangeRange
.... valueRatioRatio
.... valueSampledDataSampledData
.... valueTimetime
.... valueDateTimedateTime
.... valuePeriodPeriod
.... valueAttachmentAttachment
.... valueReferenceReference(MolecularSequence)
... dataAbsentReason C0..1CodeableConceptWhy the result is missing
Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.

... interpretation 0..*CodeableConceptHigh, low, normal, etc
Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.


... note 0..*AnnotationComments about the observation
... bodySite C0..1CodeableConceptObserved body part
Binding: SNOMEDCTBodyStructures (example): SNOMED CT Body site concepts

... bodyStructure C0..1Reference(BodyStructure)Observed body structure
... method 0..1CodeableConceptHow it was done
Binding: ObservationMethods (example): Methods for simple observations.

... specimen C0..1Reference(Specimen | Group)Specimen used for this observation
obs-9: If Observation.specimen is a reference to Group, the group can only have specimens
... device 0..1Reference(Device | DeviceMetric)A reference to the device that generates the measurements or the device settings for the device
... referenceRange C0..*BackboneElementProvides guide for interpretation
obs-3: Must have at least a low or a high or text
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... low C0..1SimpleQuantityLow Range, if relevant
.... high C0..1SimpleQuantityHigh Range, if relevant
.... normalValue 0..1CodeableConceptNormal value, if relevant
Binding: ObservationReferenceRangeNormalValueCodes (extensible): Codes identifying the normal value of the observation.

.... type 0..1CodeableConceptReference range qualifier
Binding: ObservationReferenceRangeMeaningCodes (preferred): Code for the meaning of a reference range.

.... appliesTo 0..*CodeableConceptReference range population
Binding: ObservationReferenceRangeAppliesToCodes (example): Codes identifying the population the reference range applies to.


.... age 0..1RangeApplicable age range, if relevant
.... text C0..1markdownText based reference range in an observation
... hasMember Σ0..*Reference(Observation | QuestionnaireResponse | MolecularSequence)Related resource that belongs to the Observation group
... derivedFrom Σ0..*Reference(DocumentReference | ImagingStudy | ImagingSelection | QuestionnaireResponse | Observation | MolecularSequence | GenomicStudy)Related resource from which the observation is made
... component ΣC0..*BackboneElement用于表达生命体征的子组成，例如：血压就会分为收缩压和舒张压。
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... code ΣC1..1CodeableConcept生命体征的编码, 最少应提供一种编码
Binding: LOINCCodes (example): Codes identifying names of simple observations.

..... id 0..1idUnique id for inter-element referencing
..... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
..... Slices for coding Σ0..*CodingCode defined by a terminology system
Slice: Unordered, Open by value:system
...... coding:Local Σ0..1Coding编码限定为卫生行业标准定义的数据元标准
Binding: 卫生标准数据元代码表 (required)
...... coding:International Σ0..1Coding编码限定为LOINC
Binding: http://loinc.org (required)
..... text Σ0..1stringPlain text representation of the concept
.... value[x] Σ0..1Actual component result
..... valueQuantityQuantity
..... valueCodeableConceptCodeableConcept
..... valueStringstring
..... valueBooleanboolean
..... valueIntegerinteger
..... valueRangeRange
..... valueRatioRatio
..... valueSampledDataSampledData
..... valueTimetime
..... valueDateTimedateTime
..... valuePeriodPeriod
..... valueAttachmentAttachment
..... valueReferenceReference(MolecularSequence)
.... dataAbsentReason 0..1CodeableConceptWhy the component result is missing
Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.

.... interpretation 0..*CodeableConceptHigh, low, normal, etc
Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.


.... referenceRange 0..*See referenceRange (Observation)Provides guide for interpretation of component result

doco Documentation for this format

 

本定义的其它表示法: Schematron

Terminology Bindings

PathConformanceValueSetURI
Observation.languagerequiredAllLanguages
http://hl7.org/fhir/ValueSet/all-languages|5.0.0
from the FHIR Standard
Observation.triggeredBy.typerequiredTriggeredBytype
http://hl7.org/fhir/ValueSet/observation-triggeredbytype|5.0.0
from the FHIR Standard
Observation.statusrequiredObservationStatus
http://hl7.org/fhir/ValueSet/observation-status|5.0.0
from the FHIR Standard
Observation.categorypreferredObservationCategoryCodes
http://hl7.org/fhir/ValueSet/observation-category
from the FHIR Standard
Observation.codeexampleLOINCCodes (a valid code from LOINC)
http://hl7.org/fhir/ValueSet/observation-codes
from the FHIR Standard
Observation.code.coding:LocalrequiredWSDE (a valid code from WS363标准数据元代码表)
http://hl7.org.cn/fhir/ValueSet/ws-dataelement
from this IG
Observation.code.coding:Internationalrequiredhttp://loinc.org
http://loinc.org
Observation.dataAbsentReasonextensibleDataAbsentReason
http://hl7.org/fhir/ValueSet/data-absent-reason
from the FHIR Standard
Observation.interpretationextensibleObservationInterpretationCodes
http://hl7.org/fhir/ValueSet/observation-interpretation
from the FHIR Standard
Observation.bodySiteexampleSNOMEDCTBodyStructures
http://hl7.org/fhir/ValueSet/body-site
from the FHIR Standard
Observation.methodexampleObservationMethods
http://hl7.org/fhir/ValueSet/observation-methods
from the FHIR Standard
Observation.referenceRange.normalValueextensibleObservationReferenceRangeNormalValueCodes
http://hl7.org/fhir/ValueSet/observation-referencerange-normalvalue
from the FHIR Standard
Observation.referenceRange.typepreferredObservationReferenceRangeMeaningCodes
http://hl7.org/fhir/ValueSet/referencerange-meaning
from the FHIR Standard
Observation.referenceRange.appliesToexampleObservationReferenceRangeAppliesToCodes
http://hl7.org/fhir/ValueSet/referencerange-appliesto
from the FHIR Standard
Observation.component.codeexampleLOINCCodes (a valid code from LOINC)
http://hl7.org/fhir/ValueSet/observation-codes
from the FHIR Standard
Observation.component.code.coding:LocalrequiredWSDE (a valid code from WS363标准数据元代码表)
http://hl7.org.cn/fhir/ValueSet/ws-dataelement
from this IG
Observation.component.code.coding:Internationalrequiredhttp://loinc.org
http://loinc.org
Observation.component.dataAbsentReasonextensibleDataAbsentReason
http://hl7.org/fhir/ValueSet/data-absent-reason
from the FHIR Standard
Observation.component.interpretationextensibleObservationInterpretationCodes
http://hl7.org/fhir/ValueSet/observation-interpretation
from the FHIR Standard

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().ofType(canonical) | %resource.descendants().ofType(uri) | %resource.descendants().ofType(url))) or descendants().where(reference = '#').exists() or descendants().where(ofType(canonical) = '#').exists() or descendants().where(ofType(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()
obs-3errorObservation.referenceRangeMust have at least a low or a high or text
: low.exists() or high.exists() or text.exists()
obs-6errorObservationdataAbsentReason SHALL only be present if Observation.value[x] is not present
: dataAbsentReason.empty() or value.empty()
obs-7errorObservationIf Observation.component.code is the same as Observation.code, then Observation.value SHALL NOT be present (the Observation.component.value[x] holds the value).
: value.empty() or component.code.where(coding.intersect(%resource.code.coding).exists()).empty()
obs-8errorObservationbodyStructure SHALL only be present if Observation.bodySite is not present
: bodySite.exists() implies bodyStructure.empty()
obs-9errorObservation.specimenIf Observation.specimen is a reference to Group, the group can only have specimens
: (reference.resolve().exists() and reference.resolve() is Group) implies reference.resolve().member.entity.resolve().all($this is Specimen)