Eswatini HL7 FHIR Implementation Guide
1.0.0 - draft
Eswatini
Eswatini HL7 FHIR Implementation Guide - Local Development build (v1.0.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions
| Official URL: https://eswatinihie.com/fhir/StructureDefinition/SzClinicalObservation | Version: 1.0.0 | |||
| Active as of 2026-08-21 | Computable Name: SzClinicalObservation | |||
The Eswatini Clinical Observation Profile defines the constraints and usage of the HL7 FHIR Observation resource for representing clinical observations and measurements within the Eswatini National Digital Health Ecosystem. It provides a standardized approach for capturing, exchanging, and interpreting clinical findings generated during patient care, supporting clinical decision-making, continuity of care, reporting, and analytics. This profile ensures that clinical observation data is consistent, interoperable, and aligned with national clinical documentation practices.
This profile SHALL be used by systems that record or exchange clinical observation data, including:
Electronic Medical Record (EMR) systems Laboratory and diagnostic systems Facility-based and community health information systems Public health and surveillance platforms National health information exchange (HIE) services
The profile applies to a wide range of clinical observations, including but not limited to:
HIV testing (e.g., test modality, entrypoint, etc) Clinical measurements and assessments General clinical findings recorded during patient encounters
It is intended for routine clinical observations and complements more specialized profiles.
Usages:
You can also check for usages in the FHIR IG Statistics
Description of Profiles, Differentials, Snapshots and how the different presentations work.
| Name | Flags | Card. | Type | Description & Constraints Filter: ![]() ![]() |
|---|---|---|---|---|
![]() |
C | 0..* | Observation | Measurements and simple assertions Constraints: obs-6, obs-7 |
![]() ![]() |
Σ | 1..1 | id | Logical id of this artifact |
![]() ![]() |
?!Σ | 0..1 | uri | A set of rules under which this content was created |
![]() ![]() |
?! | 0..* | Extension | Extensions that cannot be ignored |
![]() ![]() |
?!Σ | 1..1 | code | registered | preliminary | final | amended + Binding: ObservationStatus (required): Codes providing the status of an observation. |
![]() ![]() |
SΣ | 1..1 | CodeableConcept | Observation code Binding: LOINCCodes (example): Codes identifying names of simple observations. |
![]() ![]() |
Σ | 1..1 | Reference(Eswatini Patient Profile) | Patient's information |
![]() ![]() |
Σ | 1..1 | Reference(Eswatini Encounter Profile) | Encounter information |
![]() ![]() |
Σ | 0..1 | Clinically relevant time/time-period for observation | |
![]() ![]() ![]() |
dateTime | |||
![]() ![]() ![]() |
Period | |||
![]() ![]() |
ΣC | 1..1 | string | Observation value |
Documentation for this format | ||||
| Path | Status | Usage | ValueSet | Version | Source |
| Observation.status | Base | required | ObservationStatus | 📍4.0.1 | FHIR Std. |
| Observation.code | Base | example | LOINC Codes | 📍4.0.1 | FHIR Std. |
| Id | Grade | Path(s) | Description | Expression |
| 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-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
| Name | Flags | Card. | Type | Description & Constraints Filter: ![]() ![]() |
|---|---|---|---|---|
![]() |
0..* | Observation | Measurements and simple assertions | |
![]() ![]() |
1..1 | id | Logical id of this artifact | |
![]() ![]() |
S | 1..1 | CodeableConcept | Observation code |
![]() ![]() |
1..1 | Reference(Eswatini Patient Profile) | Patient's information | |
![]() ![]() |
1..1 | Reference(Eswatini Encounter Profile) | Encounter information | |
![]() ![]() |
0..1 | Clinically relevant time/time-period for observation | ||
![]() ![]() ![]() |
dateTime | |||
![]() ![]() ![]() |
Period | |||
![]() ![]() |
1..1 | string | Observation value | |
Documentation for this format | ||||
| Name | Flags | Card. | Type | Description & Constraints Filter: ![]() ![]() | ||||
|---|---|---|---|---|---|---|---|---|
![]() |
C | 0..* | Observation | Measurements and simple assertions Constraints: obs-6, obs-7 | ||||
![]() ![]() |
Σ | 1..1 | id | Logical id of this artifact | ||||
![]() ![]() |
Σ | 0..1 | Meta | Metadata about the resource | ||||
![]() ![]() |
?!Σ | 0..1 | uri | A set of rules under which this content was created | ||||
![]() ![]() |
0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
| |||||
![]() ![]() |
0..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements | |||||
![]() ![]() |
0..* | Resource | Contained, inline Resources | |||||
![]() ![]() |
0..* | Extension | Additional content defined by implementations | |||||
![]() ![]() |
?! | 0..* | Extension | Extensions that cannot be ignored | ||||
![]() ![]() |
Σ | 0..* | Identifier | Business Identifier for observation | ||||
![]() ![]() |
Σ | 0..* | Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest) | Fulfills plan, proposal or order | ||||
![]() ![]() |
Σ | 0..* | Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy) | Part of referenced event | ||||
![]() ![]() |
?!Σ | 1..1 | code | registered | preliminary | final | amended + Binding: ObservationStatus (required): Codes providing the status of an observation. | ||||
![]() ![]() |
0..* | CodeableConcept | Classification of type of observation Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories. | |||||
![]() ![]() |
SΣ | 1..1 | CodeableConcept | Observation code Binding: LOINCCodes (example): Codes identifying names of simple observations. | ||||
![]() ![]() |
Σ | 1..1 | Reference(Eswatini Patient Profile) | Patient's information | ||||
![]() ![]() |
Σ | 0..* | Reference(Resource) | What the observation is about, when it is not about the subject of record | ||||
![]() ![]() |
Σ | 1..1 | Reference(Eswatini Encounter Profile) | Encounter information | ||||
![]() ![]() |
Σ | 0..1 | Clinically relevant time/time-period for observation | |||||
![]() ![]() ![]() |
dateTime | |||||||
![]() ![]() ![]() |
Period | |||||||
![]() ![]() |
Σ | 0..1 | instant | Date/Time this version was made available | ||||
![]() ![]() |
Σ | 0..* | Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson) | Who is responsible for the observation | ||||
![]() ![]() |
ΣC | 1..1 | string | Observation value | ||||
![]() ![]() |
C | 0..1 | CodeableConcept | Why the result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing. | ||||
![]() ![]() |
0..* | CodeableConcept | High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations. | |||||
![]() ![]() |
0..* | Annotation | Comments about the observation | |||||
![]() ![]() |
0..1 | CodeableConcept | Observed body part Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality. | |||||
![]() ![]() |
0..1 | CodeableConcept | How it was done Binding: ObservationMethods (example): Methods for simple observations. | |||||
![]() ![]() |
0..1 | Reference(Specimen) | Specimen used for this observation | |||||
![]() ![]() |
0..1 | Reference(Device | DeviceMetric) | (Measurement) Device | |||||
![]() ![]() |
C | 0..* | BackboneElement | Provides guide for interpretation Constraints: obs-3 | ||||
![]() ![]() ![]() |
0..1 | string | Unique id for inter-element referencing | |||||
![]() ![]() ![]() |
0..* | Extension | Additional content defined by implementations | |||||
![]() ![]() ![]() |
?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
![]() ![]() ![]() |
C | 0..1 | SimpleQuantity(4.0.1) | Low Range, if relevant | ||||
![]() ![]() ![]() |
C | 0..1 | SimpleQuantity(4.0.1) | High Range, if relevant | ||||
![]() ![]() ![]() |
0..1 | CodeableConcept | Reference range qualifier Binding: ObservationReferenceRangeMeaningCodes (preferred): Code for the meaning of a reference range. | |||||
![]() ![]() ![]() |
0..* | CodeableConcept | Reference range population Binding: ObservationReferenceRangeAppliesToCodes (example): Codes identifying the population the reference range applies to. | |||||
![]() ![]() ![]() |
0..1 | Range | Applicable age range, if relevant | |||||
![]() ![]() ![]() |
0..1 | string | Text based reference range in an observation | |||||
![]() ![]() |
Σ | 0..* | Reference(Observation | QuestionnaireResponse | MolecularSequence) | Related resource that belongs to the Observation group | ||||
![]() ![]() |
Σ | 0..* | Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | Observation | MolecularSequence) | Related measurements the observation is made from | ||||
![]() ![]() |
Σ | 0..* | BackboneElement | Component results | ||||
![]() ![]() ![]() |
0..1 | string | Unique id for inter-element referencing | |||||
![]() ![]() ![]() |
0..* | Extension | Additional content defined by implementations | |||||
![]() ![]() ![]() |
?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
![]() ![]() ![]() |
Σ | 1..1 | CodeableConcept | Type of component observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations. | ||||
![]() ![]() ![]() |
Σ | 0..1 | Actual component result | |||||
![]() ![]() ![]() ![]() |
Quantity | |||||||
![]() ![]() ![]() ![]() |
CodeableConcept | |||||||
![]() ![]() ![]() ![]() |
string | |||||||
![]() ![]() ![]() ![]() |
boolean | |||||||
![]() ![]() ![]() ![]() |
integer | |||||||
![]() ![]() ![]() ![]() |
Range | |||||||
![]() ![]() ![]() ![]() |
Ratio | |||||||
![]() ![]() ![]() ![]() |
SampledData | |||||||
![]() ![]() ![]() ![]() |
time | |||||||
![]() ![]() ![]() ![]() |
dateTime | |||||||
![]() ![]() ![]() ![]() |
Period | |||||||
![]() ![]() ![]() |
C | 0..1 | CodeableConcept | Why the component result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing. | ||||
![]() ![]() ![]() |
0..* | CodeableConcept | High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations. | |||||
![]() ![]() ![]() |
0..* | See referenceRange (Observation) | Provides guide for interpretation of component result | |||||
Documentation for this format | ||||||||
| Path | Status | Usage | ValueSet | Version | Source |
| Observation.language | Base | preferred | Common Languages | 📍4.0.1 | FHIR Std. |
| Observation.status | Base | required | ObservationStatus | 📍4.0.1 | FHIR Std. |
| Observation.category | Base | preferred | Observation Category Codes | 📍4.0.1 | FHIR Std. |
| Observation.code | Base | example | LOINC Codes | 📍4.0.1 | FHIR Std. |
| Observation.dataAbsentReason | Base | extensible | DataAbsentReason | 📍4.0.1 | FHIR Std. |
| Observation.interpretation | Base | extensible | Observation Interpretation Codes | 📍4.0.1 | FHIR Std. |
| Observation.bodySite | Base | example | SNOMED CT Body Structures | 📍4.0.1 | FHIR Std. |
| Observation.method | Base | example | Observation Methods | 📍4.0.1 | FHIR Std. |
| Observation.referenceRange.type | Base | preferred | Observation Reference Range Meaning Codes | 📍4.0.1 | FHIR Std. |
| Observation.referenceRange.appliesTo | Base | example | Observation Reference Range Applies To Codes | 📍4.0.1 | FHIR Std. |
| Observation.component.code | Base | example | LOINC Codes | 📍4.0.1 | FHIR Std. |
| Observation.component.dataAbsentReason | Base | extensible | DataAbsentReason | 📍4.0.1 | FHIR Std. |
| Observation.component.interpretation | Base | extensible | Observation Interpretation Codes | 📍4.0.1 | FHIR Std. |
| Id | Grade | Path(s) | Description | Expression |
| 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-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
Key Elements View
| Name | Flags | Card. | Type | Description & Constraints Filter: ![]() ![]() |
|---|---|---|---|---|
![]() |
C | 0..* | Observation | Measurements and simple assertions Constraints: obs-6, obs-7 |
![]() ![]() |
Σ | 1..1 | id | Logical id of this artifact |
![]() ![]() |
?!Σ | 0..1 | uri | A set of rules under which this content was created |
![]() ![]() |
?! | 0..* | Extension | Extensions that cannot be ignored |
![]() ![]() |
?!Σ | 1..1 | code | registered | preliminary | final | amended + Binding: ObservationStatus (required): Codes providing the status of an observation. |
![]() ![]() |
SΣ | 1..1 | CodeableConcept | Observation code Binding: LOINCCodes (example): Codes identifying names of simple observations. |
![]() ![]() |
Σ | 1..1 | Reference(Eswatini Patient Profile) | Patient's information |
![]() ![]() |
Σ | 1..1 | Reference(Eswatini Encounter Profile) | Encounter information |
![]() ![]() |
Σ | 0..1 | Clinically relevant time/time-period for observation | |
![]() ![]() ![]() |
dateTime | |||
![]() ![]() ![]() |
Period | |||
![]() ![]() |
ΣC | 1..1 | string | Observation value |
Documentation for this format | ||||
| Path | Status | Usage | ValueSet | Version | Source |
| Observation.status | Base | required | ObservationStatus | 📍4.0.1 | FHIR Std. |
| Observation.code | Base | example | LOINC Codes | 📍4.0.1 | FHIR Std. |
| Id | Grade | Path(s) | Description | Expression |
| 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-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 Filter: ![]() ![]() |
|---|---|---|---|---|
![]() |
0..* | Observation | Measurements and simple assertions | |
![]() ![]() |
1..1 | id | Logical id of this artifact | |
![]() ![]() |
S | 1..1 | CodeableConcept | Observation code |
![]() ![]() |
1..1 | Reference(Eswatini Patient Profile) | Patient's information | |
![]() ![]() |
1..1 | Reference(Eswatini Encounter Profile) | Encounter information | |
![]() ![]() |
0..1 | Clinically relevant time/time-period for observation | ||
![]() ![]() ![]() |
dateTime | |||
![]() ![]() ![]() |
Period | |||
![]() ![]() |
1..1 | string | Observation value | |
Documentation for this format | ||||
Snapshot View
| Name | Flags | Card. | Type | Description & Constraints Filter: ![]() ![]() | ||||
|---|---|---|---|---|---|---|---|---|
![]() |
C | 0..* | Observation | Measurements and simple assertions Constraints: obs-6, obs-7 | ||||
![]() ![]() |
Σ | 1..1 | id | Logical id of this artifact | ||||
![]() ![]() |
Σ | 0..1 | Meta | Metadata about the resource | ||||
![]() ![]() |
?!Σ | 0..1 | uri | A set of rules under which this content was created | ||||
![]() ![]() |
0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
| |||||
![]() ![]() |
0..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements | |||||
![]() ![]() |
0..* | Resource | Contained, inline Resources | |||||
![]() ![]() |
0..* | Extension | Additional content defined by implementations | |||||
![]() ![]() |
?! | 0..* | Extension | Extensions that cannot be ignored | ||||
![]() ![]() |
Σ | 0..* | Identifier | Business Identifier for observation | ||||
![]() ![]() |
Σ | 0..* | Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest) | Fulfills plan, proposal or order | ||||
![]() ![]() |
Σ | 0..* | Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy) | Part of referenced event | ||||
![]() ![]() |
?!Σ | 1..1 | code | registered | preliminary | final | amended + Binding: ObservationStatus (required): Codes providing the status of an observation. | ||||
![]() ![]() |
0..* | CodeableConcept | Classification of type of observation Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories. | |||||
![]() ![]() |
SΣ | 1..1 | CodeableConcept | Observation code Binding: LOINCCodes (example): Codes identifying names of simple observations. | ||||
![]() ![]() |
Σ | 1..1 | Reference(Eswatini Patient Profile) | Patient's information | ||||
![]() ![]() |
Σ | 0..* | Reference(Resource) | What the observation is about, when it is not about the subject of record | ||||
![]() ![]() |
Σ | 1..1 | Reference(Eswatini Encounter Profile) | Encounter information | ||||
![]() ![]() |
Σ | 0..1 | Clinically relevant time/time-period for observation | |||||
![]() ![]() ![]() |
dateTime | |||||||
![]() ![]() ![]() |
Period | |||||||
![]() ![]() |
Σ | 0..1 | instant | Date/Time this version was made available | ||||
![]() ![]() |
Σ | 0..* | Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson) | Who is responsible for the observation | ||||
![]() ![]() |
ΣC | 1..1 | string | Observation value | ||||
![]() ![]() |
C | 0..1 | CodeableConcept | Why the result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing. | ||||
![]() ![]() |
0..* | CodeableConcept | High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations. | |||||
![]() ![]() |
0..* | Annotation | Comments about the observation | |||||
![]() ![]() |
0..1 | CodeableConcept | Observed body part Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality. | |||||
![]() ![]() |
0..1 | CodeableConcept | How it was done Binding: ObservationMethods (example): Methods for simple observations. | |||||
![]() ![]() |
0..1 | Reference(Specimen) | Specimen used for this observation | |||||
![]() ![]() |
0..1 | Reference(Device | DeviceMetric) | (Measurement) Device | |||||
![]() ![]() |
C | 0..* | BackboneElement | Provides guide for interpretation Constraints: obs-3 | ||||
![]() ![]() ![]() |
0..1 | string | Unique id for inter-element referencing | |||||
![]() ![]() ![]() |
0..* | Extension | Additional content defined by implementations | |||||
![]() ![]() ![]() |
?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
![]() ![]() ![]() |
C | 0..1 | SimpleQuantity(4.0.1) | Low Range, if relevant | ||||
![]() ![]() ![]() |
C | 0..1 | SimpleQuantity(4.0.1) | High Range, if relevant | ||||
![]() ![]() ![]() |
0..1 | CodeableConcept | Reference range qualifier Binding: ObservationReferenceRangeMeaningCodes (preferred): Code for the meaning of a reference range. | |||||
![]() ![]() ![]() |
0..* | CodeableConcept | Reference range population Binding: ObservationReferenceRangeAppliesToCodes (example): Codes identifying the population the reference range applies to. | |||||
![]() ![]() ![]() |
0..1 | Range | Applicable age range, if relevant | |||||
![]() ![]() ![]() |
0..1 | string | Text based reference range in an observation | |||||
![]() ![]() |
Σ | 0..* | Reference(Observation | QuestionnaireResponse | MolecularSequence) | Related resource that belongs to the Observation group | ||||
![]() ![]() |
Σ | 0..* | Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | Observation | MolecularSequence) | Related measurements the observation is made from | ||||
![]() ![]() |
Σ | 0..* | BackboneElement | Component results | ||||
![]() ![]() ![]() |
0..1 | string | Unique id for inter-element referencing | |||||
![]() ![]() ![]() |
0..* | Extension | Additional content defined by implementations | |||||
![]() ![]() ![]() |
?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
![]() ![]() ![]() |
Σ | 1..1 | CodeableConcept | Type of component observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations. | ||||
![]() ![]() ![]() |
Σ | 0..1 | Actual component result | |||||
![]() ![]() ![]() ![]() |
Quantity | |||||||
![]() ![]() ![]() ![]() |
CodeableConcept | |||||||
![]() ![]() ![]() ![]() |
string | |||||||
![]() ![]() ![]() ![]() |
boolean | |||||||
![]() ![]() ![]() ![]() |
integer | |||||||
![]() ![]() ![]() ![]() |
Range | |||||||
![]() ![]() ![]() ![]() |
Ratio | |||||||
![]() ![]() ![]() ![]() |
SampledData | |||||||
![]() ![]() ![]() ![]() |
time | |||||||
![]() ![]() ![]() ![]() |
dateTime | |||||||
![]() ![]() ![]() ![]() |
Period | |||||||
![]() ![]() ![]() |
C | 0..1 | CodeableConcept | Why the component result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing. | ||||
![]() ![]() ![]() |
0..* | CodeableConcept | High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations. | |||||
![]() ![]() ![]() |
0..* | See referenceRange (Observation) | Provides guide for interpretation of component result | |||||
Documentation for this format | ||||||||
| Path | Status | Usage | ValueSet | Version | Source |
| Observation.language | Base | preferred | Common Languages | 📍4.0.1 | FHIR Std. |
| Observation.status | Base | required | ObservationStatus | 📍4.0.1 | FHIR Std. |
| Observation.category | Base | preferred | Observation Category Codes | 📍4.0.1 | FHIR Std. |
| Observation.code | Base | example | LOINC Codes | 📍4.0.1 | FHIR Std. |
| Observation.dataAbsentReason | Base | extensible | DataAbsentReason | 📍4.0.1 | FHIR Std. |
| Observation.interpretation | Base | extensible | Observation Interpretation Codes | 📍4.0.1 | FHIR Std. |
| Observation.bodySite | Base | example | SNOMED CT Body Structures | 📍4.0.1 | FHIR Std. |
| Observation.method | Base | example | Observation Methods | 📍4.0.1 | FHIR Std. |
| Observation.referenceRange.type | Base | preferred | Observation Reference Range Meaning Codes | 📍4.0.1 | FHIR Std. |
| Observation.referenceRange.appliesTo | Base | example | Observation Reference Range Applies To Codes | 📍4.0.1 | FHIR Std. |
| Observation.component.code | Base | example | LOINC Codes | 📍4.0.1 | FHIR Std. |
| Observation.component.dataAbsentReason | Base | extensible | DataAbsentReason | 📍4.0.1 | FHIR Std. |
| Observation.component.interpretation | Base | extensible | Observation Interpretation Codes | 📍4.0.1 | FHIR Std. |
| Id | Grade | Path(s) | Description | Expression |
| 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-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
Other representations of profile: CSV, Excel, Schematron
The profile constrains the base Observation resource to ensure capture of essential clinical information, including:
Observation status indicating the state of the clinical observation (e.g., preliminary, final) Observation code identifying what was measured or assessed Subject (Patient) who is the focus of the observation Effective date/time representing when the observation was made Observation value indicating findings of the clinical observation
These elements ensure observations are clinically meaningful, traceable, and suitable for both individual patient care and aggregated use.
This profile is designed to:
Conform to HL7 FHIR R4 Observation semantics Support interoperability within the Eswatini National HIE Enable linkage with related resources such as Patient, Encounter, Practitioner, and Organization Facilitate continuity of care across facilities and levels of service
Clinical observations recorded using this profile can be safely shared between systems while preserving their clinical meaning and context.
Systems claiming conformance to this profile SHALL:
Populate all required and Must Support elements as defined in the profile Ensure observation data is accurate, timely, and reflective of clinical workflows Use appropriate observation status values to represent the lifecycle of results
Optional elements from the base Observation resource may be used where relevant and appropriate, provided they do not conflict with the constraints defined in this profile.
The Eswatini Clinical Observation Profile supports extensibility through standard FHIR mechanisms. Additional clinical attributes or program-specific data elements may be introduced using FHIR extensions, subject to governance and approval, without compromising interoperability.
The Eswatini Clinical Observation Profile provides a standardized and interoperable representation of clinical observation data, supporting patient care, clinical documentation, and health system reporting. Adoption of this profile promotes consistent capture and exchange of clinical findings across healthcare settings, contributing to improved quality of care and stronger health information systems within the Kingdom of Eswatini.