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

Resource Profile: Eswatini Lab Result Profile

Official URL: https://eswatinihie.com/fhir/StructureDefinition/SzLabResult Version: 1.0.0
Active as of 2026-08-21 Computable Name: SzLabResult

The Eswatini Laboratory Result Profile defines the constraints and usage of the HL7 FHIR Observation resource for representing laboratory test results within the Eswatini National Digital Health Ecosystem. It provides a standardized and interoperable method for capturing, exchanging, and interpreting results produced by laboratory investigations performed as part of patient care. This profile ensures that laboratory results are recorded in a consistent, structured, and nationally aligned manner, supporting clinical decision-making, continuity of care, and health system reporting.

Scope and Usage

This profile SHALL be used by systems that generate, manage, or exchange laboratory test results, including:

Laboratory Information Systems (LIS) Electronic Medical Record (EMR) systems Diagnostic and referral systems Facility-based and programmatic reporting platforms National health information exchange (HIE) services

The profile applies to results from a wide range of laboratory investigations, including:

Routine diagnostic tests Monitoring and follow-up tests Screening and preventive tests Programme-specific laboratory testing (e.g. HIV, TB, NCDs)

Each laboratory result represents the outcome of a performed laboratory test, whether quantitative, qualitative, or coded.

Usages:

You can also check for usages in the FHIR IG Statistics

Formal Views of Profile Content

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

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Observation C 0..* Observation Measurements and simple assertions
Constraints: obs-6, obs-7
... id Σ 1..1 id Logical id of this artifact
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
.... extension:authorizer 0..1 Reference(Eswatini Practitioner Profile) Lab results authorizer
URL: https://eswatinihie.com/fhir/StructureDefinition/SzAuthorizerExtension
.... extension:testingLaboratory 0..1 Reference(Eswatini Location Profile) Testing laboratory
URL: https://eswatinihie.com/fhir/StructureDefinition/SzTestingLabExtension
... basedOn Σ 0..* Reference(Eswatini Lab Request Profile) Reference to the lab request that resulted in this lab result
... status ?!Σ 1..1 code registered | preliminary | final | amended +
Binding: ObservationStatus (required): Codes providing the status of an observation.
... category 1..1 CodeableConcept Classification of type of observation
Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
... code SΣ 1..1 CodeableConcept Local test parameter code
Binding: Value Set: Eswatini Local Test Parameter Codes (required)
... subject Σ 1..1 Reference(Eswatini Patient Profile) Patient profile
... encounter Σ 1..1 Reference(Eswatini Encounter Profile) Encounter
... effective[x] Σ 0..1 dateTime Clinically relevant time/time-period for observation
... performer Σ 0..* Reference(Eswatini Practitioner Profile) Who is responsible for the observation
... value[x] SΣC 1..1 Actual result
.... valueQuantity Quantity
.... valueString string
.... valueInteger integer
... specimen 0..1 Reference(Eswatini Lab Test Specimen Profile) Specimen used for this observation

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
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 required Value Set: Eswatini Local Test Parameter Codes 📦1.0.0 This IG

Constraints

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

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Observation 0..* Observation Measurements and simple assertions
... id 1..1 id Logical id of this artifact
... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
.... extension:authorizer 0..1 Reference(Eswatini Practitioner Profile) Lab results authorizer
URL: https://eswatinihie.com/fhir/StructureDefinition/SzAuthorizerExtension
.... extension:testingLaboratory 0..1 Reference(Eswatini Location Profile) Testing laboratory
URL: https://eswatinihie.com/fhir/StructureDefinition/SzTestingLabExtension
... basedOn 0..* Reference(Eswatini Lab Request Profile) Reference to the lab request that resulted in this lab result
... code S 1..1 CodeableConcept Local test parameter code
Binding: Value Set: Eswatini Local Test Parameter Codes (required)
... subject 1..1 Reference(Eswatini Patient Profile) Patient profile
... encounter 1..1 Reference(Eswatini Encounter Profile) Encounter
... effective[x] 0..1 dateTime Clinically relevant time/time-period for observation
... performer 0..* Reference(Eswatini Practitioner Profile) Who is responsible for the observation
... value[x] S 1..1 Actual result
.... valueQuantity Quantity
.... valueString string
.... valueInteger integer
... specimen 0..1 Reference(Eswatini Lab Test Specimen Profile) Specimen used for this observation

doco Documentation for this format

Terminology Bindings (Differential)

Path Status Usage ValueSet Version Source
Observation.code Base required Value Set: Eswatini Local Test Parameter Codes 📦1.0.0 This IG
NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Observation C 0..* Observation Measurements and simple assertions
Constraints: obs-6, obs-7
... id Σ 1..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 BindingsPurpose
AllLanguages Max Binding
... text 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
... contained 0..* Resource Contained, inline Resources
... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
.... extension:authorizer 0..1 Reference(Eswatini Practitioner Profile) Lab results authorizer
URL: https://eswatinihie.com/fhir/StructureDefinition/SzAuthorizerExtension
.... extension:testingLaboratory 0..1 Reference(Eswatini Location Profile) Testing laboratory
URL: https://eswatinihie.com/fhir/StructureDefinition/SzTestingLabExtension
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... identifier Σ 0..* Identifier Business Identifier for observation
... basedOn Σ 0..* Reference(Eswatini Lab Request Profile) Reference to the lab request that resulted in this lab result
... partOf Σ 0..* Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy) Part of referenced event
... status ?!Σ 1..1 code registered | preliminary | final | amended +
Binding: ObservationStatus (required): Codes providing the status of an observation.
... category 1..1 CodeableConcept Classification of type of observation
Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
... code SΣ 1..1 CodeableConcept Local test parameter code
Binding: Value Set: Eswatini Local Test Parameter Codes (required)
... subject Σ 1..1 Reference(Eswatini Patient Profile) Patient profile
... focus Σ 0..* Reference(Resource) What the observation is about, when it is not about the subject of record
... encounter Σ 1..1 Reference(Eswatini Encounter Profile) Encounter
... effective[x] Σ 0..1 dateTime Clinically relevant time/time-period for observation
... issued Σ 0..1 instant Date/Time this version was made available
... performer Σ 0..* Reference(Eswatini Practitioner Profile) Who is responsible for the observation
... value[x] SΣC 1..1 Actual result
.... valueQuantity Quantity
.... valueString string
.... valueInteger integer
... dataAbsentReason C 0..1 CodeableConcept Why the 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.
... note 0..* Annotation Comments about the observation
... bodySite 0..1 CodeableConcept Observed body part
Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
... method 0..1 CodeableConcept How it was done
Binding: ObservationMethods (example): Methods for simple observations.
... specimen 0..1 Reference(Eswatini Lab Test Specimen Profile) Specimen used for this observation
... device 0..1 Reference(Device | DeviceMetric) (Measurement) Device
... referenceRange C 0..* BackboneElement Provides guide for interpretation
Constraints: obs-3
.... 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(4.0.1) Low Range, if relevant
.... high C 0..1 SimpleQuantity(4.0.1) 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
... hasMember Σ 0..* Reference(Observation | QuestionnaireResponse | MolecularSequence) Related resource that belongs to the Observation group
... derivedFrom Σ 0..* Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | Observation | MolecularSequence) Related measurements the observation is made from
... 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

doco Documentation for this format

Terminology Bindings

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 required Value Set: Eswatini Local Test Parameter Codes 📦1.0.0 This IG
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.

Constraints

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()

Key Elements View

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Observation C 0..* Observation Measurements and simple assertions
Constraints: obs-6, obs-7
... id Σ 1..1 id Logical id of this artifact
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
.... extension:authorizer 0..1 Reference(Eswatini Practitioner Profile) Lab results authorizer
URL: https://eswatinihie.com/fhir/StructureDefinition/SzAuthorizerExtension
.... extension:testingLaboratory 0..1 Reference(Eswatini Location Profile) Testing laboratory
URL: https://eswatinihie.com/fhir/StructureDefinition/SzTestingLabExtension
... basedOn Σ 0..* Reference(Eswatini Lab Request Profile) Reference to the lab request that resulted in this lab result
... status ?!Σ 1..1 code registered | preliminary | final | amended +
Binding: ObservationStatus (required): Codes providing the status of an observation.
... category 1..1 CodeableConcept Classification of type of observation
Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
... code SΣ 1..1 CodeableConcept Local test parameter code
Binding: Value Set: Eswatini Local Test Parameter Codes (required)
... subject Σ 1..1 Reference(Eswatini Patient Profile) Patient profile
... encounter Σ 1..1 Reference(Eswatini Encounter Profile) Encounter
... effective[x] Σ 0..1 dateTime Clinically relevant time/time-period for observation
... performer Σ 0..* Reference(Eswatini Practitioner Profile) Who is responsible for the observation
... value[x] SΣC 1..1 Actual result
.... valueQuantity Quantity
.... valueString string
.... valueInteger integer
... specimen 0..1 Reference(Eswatini Lab Test Specimen Profile) Specimen used for this observation

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
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 required Value Set: Eswatini Local Test Parameter Codes 📦1.0.0 This IG

Constraints

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

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Observation 0..* Observation Measurements and simple assertions
... id 1..1 id Logical id of this artifact
... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
.... extension:authorizer 0..1 Reference(Eswatini Practitioner Profile) Lab results authorizer
URL: https://eswatinihie.com/fhir/StructureDefinition/SzAuthorizerExtension
.... extension:testingLaboratory 0..1 Reference(Eswatini Location Profile) Testing laboratory
URL: https://eswatinihie.com/fhir/StructureDefinition/SzTestingLabExtension
... basedOn 0..* Reference(Eswatini Lab Request Profile) Reference to the lab request that resulted in this lab result
... code S 1..1 CodeableConcept Local test parameter code
Binding: Value Set: Eswatini Local Test Parameter Codes (required)
... subject 1..1 Reference(Eswatini Patient Profile) Patient profile
... encounter 1..1 Reference(Eswatini Encounter Profile) Encounter
... effective[x] 0..1 dateTime Clinically relevant time/time-period for observation
... performer 0..* Reference(Eswatini Practitioner Profile) Who is responsible for the observation
... value[x] S 1..1 Actual result
.... valueQuantity Quantity
.... valueString string
.... valueInteger integer
... specimen 0..1 Reference(Eswatini Lab Test Specimen Profile) Specimen used for this observation

doco Documentation for this format

Terminology Bindings (Differential)

Path Status Usage ValueSet Version Source
Observation.code Base required Value Set: Eswatini Local Test Parameter Codes 📦1.0.0 This IG

Snapshot View

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Observation C 0..* Observation Measurements and simple assertions
Constraints: obs-6, obs-7
... id Σ 1..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 BindingsPurpose
AllLanguages Max Binding
... text 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
... contained 0..* Resource Contained, inline Resources
... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
.... extension:authorizer 0..1 Reference(Eswatini Practitioner Profile) Lab results authorizer
URL: https://eswatinihie.com/fhir/StructureDefinition/SzAuthorizerExtension
.... extension:testingLaboratory 0..1 Reference(Eswatini Location Profile) Testing laboratory
URL: https://eswatinihie.com/fhir/StructureDefinition/SzTestingLabExtension
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... identifier Σ 0..* Identifier Business Identifier for observation
... basedOn Σ 0..* Reference(Eswatini Lab Request Profile) Reference to the lab request that resulted in this lab result
... partOf Σ 0..* Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy) Part of referenced event
... status ?!Σ 1..1 code registered | preliminary | final | amended +
Binding: ObservationStatus (required): Codes providing the status of an observation.
... category 1..1 CodeableConcept Classification of type of observation
Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
... code SΣ 1..1 CodeableConcept Local test parameter code
Binding: Value Set: Eswatini Local Test Parameter Codes (required)
... subject Σ 1..1 Reference(Eswatini Patient Profile) Patient profile
... focus Σ 0..* Reference(Resource) What the observation is about, when it is not about the subject of record
... encounter Σ 1..1 Reference(Eswatini Encounter Profile) Encounter
... effective[x] Σ 0..1 dateTime Clinically relevant time/time-period for observation
... issued Σ 0..1 instant Date/Time this version was made available
... performer Σ 0..* Reference(Eswatini Practitioner Profile) Who is responsible for the observation
... value[x] SΣC 1..1 Actual result
.... valueQuantity Quantity
.... valueString string
.... valueInteger integer
... dataAbsentReason C 0..1 CodeableConcept Why the 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.
... note 0..* Annotation Comments about the observation
... bodySite 0..1 CodeableConcept Observed body part
Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
... method 0..1 CodeableConcept How it was done
Binding: ObservationMethods (example): Methods for simple observations.
... specimen 0..1 Reference(Eswatini Lab Test Specimen Profile) Specimen used for this observation
... device 0..1 Reference(Device | DeviceMetric) (Measurement) Device
... referenceRange C 0..* BackboneElement Provides guide for interpretation
Constraints: obs-3
.... 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(4.0.1) Low Range, if relevant
.... high C 0..1 SimpleQuantity(4.0.1) 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
... hasMember Σ 0..* Reference(Observation | QuestionnaireResponse | MolecularSequence) Related resource that belongs to the Observation group
... derivedFrom Σ 0..* Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | Observation | MolecularSequence) Related measurements the observation is made from
... 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

doco Documentation for this format

Terminology Bindings

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 required Value Set: Eswatini Local Test Parameter Codes 📦1.0.0 This IG
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.

Constraints

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()

 

Other representations of profile: CSV, Excel, Schematron

Notes:

Core Data Requirements

The profile constrains the base Observation resource to ensure capture of essential laboratory result information, including:

Observation status indicating the state of the result (e.g. preliminary, final, amended) Test code identifying the laboratory investigation performed Subject (Patient) for whom the test was performed Effective date/time indicating when the specimen was collected or the test was performed Result value, including numeric, coded, or textual representations as appropriate

These elements ensure that results are clinically meaningful, comparable, and suitable for use in both patient care and reporting.

Interoperability and National Alignment

This profile is designed to:

Conform to HL7 FHIR R4 Observation semantics Support interoperability within the Eswatini National HIE Enable seamless exchange of laboratory results between laboratories and clinical systems Support national diagnostic reporting, monitoring, and evaluation

By standardizing laboratory result data, the profile enables accurate interpretation and reliable reuse across systems and care settings.

Data Quality and Conformance

Systems claiming conformance to this profile SHALL:

Populate all required and Must Support elements defined by the profile Maintain correct observation status values reflecting the result lifecycle Ensure laboratory results are accurate, validated, and traceable to the performing laboratory

Optional elements from the base Observation resource may be used where relevant, provided they do not conflict with the constraints defined in this profile.

Extensibility

The Eswatini Laboratory Result Profile supports extensibility through standard FHIR mechanisms. Additional laboratory-specific attributes—such as reference ranges, interpretation flags, or programme-related indicators—may be added using FHIR extensions, subject to national governance and approval.

Summary

The Eswatini Laboratory Result Profile provides a standardized and interoperable representation of laboratory test results, supporting clinical decision-making, diagnostic workflows, and national health reporting. Adoption of this profile improves result consistency, strengthens interoperability between laboratories and care providers, and enhances the overall quality of diagnostic services across the Kingdom of Eswatini.