關於病人、裝置或其他主體的測量與簡單陳述。

用於簡單觀察，例如裝置測量、實驗室原子結果、生命徵象、身高、體重、吸菸狀態、備註等。其他資源則用於提供觀察的上下文，例如實驗室報告等。

指向建構本 resource 時所遵循規則的參照，處理內容時必須理解這些規則。通常是參照定義特殊規則的實作指南（Implementation Guide），以及其他 profiles 等。

宣告這套規則限制了內容只能被有限的交易夥伴所理解，這從本質上限制了資料的長期有用性。然而，現有的健康生態體系高度分裂，尚未準備好以普遍可計算的方式定義、收集和交換資料。只要有可能，實作者和/或規範編寫者應避免使用此欄位。

May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

此欄位表示照護偏好觀察結果的狀態。

此元素被標記為修飾性（modifier），因為 status 可能包含標示資源目前無效的代碼。

Codes providing the status of an observation.

Need to track the status of individual results. Some results are finalized before the whole report is finalized.

用於分類所進行觀察的一般類型的代碼。

除了必要的 category 值集外，此元素也允許根據擁有者自訂的分類方案進行多元分類，且可同時使用多個分類。分類的細緻程度由值集中的 category 概念所決定。

Codes for high level observation categories.

Used for filtering what observations are retrieved and displayed.

用於分類照護偏好觀察的類型代碼。

In addition to the required category valueset, this element allows various categorization schemes based on the owner’s definition of the category and effectively multiple categories can be used at once. The level of granularity is defined by the category concepts in the value set.

Codes for high level observation categories.

Used for filtering what observations are retrieved and displayed.

參照由術語系統定義的代碼。

Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

Allows for alternative encodings within a code system, and translations to other code systems.

定義代碼符號意義的代碼系統之識別。

The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

Need to be unambiguous about the source of the definition of the symbol.

由系統定義的語法符號，代表照護偏好的類型。

Need to refer to a particular code in the system.

描述所觀察到的照護偏好內容。此處使用 LOINC 代碼表示病人的照護偏好。

所有的 code-value 配對需要被考慮，才能正確理解照護偏好觀察的意義。

Codes identifying names of simple observations.

Knowing what kind of observation is being made is essential to understanding the observation.

參照由術語系統定義的代碼。

代碼可以在列舉清單（enumerations）或代碼清單（code lists）中非常隨意地定義，直至有非常正式的定義，例如：SNOMED CT—更多資訊見HL7 v3核心原則（Core Principles ）。編碼的排序是未定義的因而 必須沒有（SHALL NOT） 被用來推斷意義。一般來說，最多只有一個編碼值（coding values）會被標記為UserSelected = true。

允許代碼系統中的替代編碼，以及翻譯到其他編碼系統。

定義代碼符號意義的代碼系統之識別。

URI可以是一個OID（urn:oid:...）或一個UUID（urn:uuid:...）；OID和UUID 必須（SHALL） 參照HL7 OID註冊中心；否則，URI應該來自HL7的FHIR定義的特殊URI列表，或者它應該參照一些明確建立的系统定義。

需要明確說明符號定義的來源

由系統定義的語法符號，代表照護偏好的類型。

需要參照系統中的一個特定代碼

遵循系統的規則以呈現代碼含義的表示法

需要能為不了解此系統的讀者呈現可讀的代碼含義

輸入資料的使用者所見／所選／所說的人類可讀文字表述，和（或）其代表使用者的預期含義。

很多時候，此文字表述與其中一個代碼的顯示名稱相同。

專門術語中的代碼並不總是能捕捉人類使用的細微差別的正確意義，或者根本就沒有合適的代碼；這些情況下，文字表述被用來捕捉來源的全部意義。

此照護偏好觀察所關於且將觀察記錄存入其病歷的病人。

照護偏好觀察通常關聯到特定病人，用於記錄其治療和照護方式的偏好。

Observations have no value if you don't know who or what they're about.

此照護偏好觀察所發生的醫療事件（例如病人與醫療提供者的會談）。

這通常是記錄照護偏好時的就診（encounter），可能是諮詢、收案或評估的場合。

For some observations it may be important to know the link between an observation and a particular encounter.

照護偏好被紀錄或被視為有效的時間或時間區間。

照護偏好的記錄時間非常重要，因為病人的偏好可能隨時間而變化。

Knowing when an observation was deemed true is important to its relevance as well as determining trends.

負責記錄或確認照護偏好觀察為「真實」的人員。

通常是醫護人員、社工或病人本人記錄照護偏好。

May give a degree of confidence in the observation and also indicates where follow-up questions should be directed.

照護偏好觀察的實際內容，可能是文字描述或代碼化的偏好記錄。

照護偏好可以多種形式表達，包括自由文字陳述或使用預定義的偏好選項代碼。

An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

進行此觀察時所使用的標本。

照護偏好觀察通常不涉及標本，但此欄位保留以維持與 Observation 資源的一致性。

關於病人、裝置或其他主體的測量與簡單陳述。

用於簡單觀察，例如裝置測量、實驗室原子結果、生命徵象、身高、體重、吸菸狀態、備註等。其他資源則用於提供觀察的上下文，例如實驗室報告等。

指向建構本 resource 時所遵循規則的參照，處理內容時必須理解這些規則。通常是參照定義特殊規則的實作指南（Implementation Guide），以及其他 profiles 等。

宣告這套規則限制了內容只能被有限的交易夥伴所理解，這從本質上限制了資料的長期有用性。然而，現有的健康生態體系高度分裂，尚未準備好以普遍可計算的方式定義、收集和交換資料。只要有可能，實作者和/或規範編寫者應避免使用此欄位。

此欄位表示照護偏好觀察結果的狀態。

此元素被標記為修飾性（modifier），因為 status 可能包含標示資源目前無效的代碼。

用於分類所進行觀察的一般類型的代碼。

除了必要的 category 值集外，此元素也允許根據擁有者自訂的分類方案進行多元分類，且可同時使用多個分類。分類的細緻程度由值集中的 category 概念所決定。

用於分類照護偏好觀察的類型代碼。

參照由術語系統定義的代碼。

定義代碼符號意義的代碼系統之識別。

由系統定義的語法符號，代表照護偏好的類型。

描述所觀察到的照護偏好內容。此處使用 LOINC 代碼表示病人的照護偏好。

所有的 code-value 配對需要被考慮，才能正確理解照護偏好觀察的意義。

參照由術語系統定義的代碼。

定義代碼符號意義的代碼系統之識別。

由系統定義的語法符號，代表照護偏好的類型。

此照護偏好觀察所關於且將觀察記錄存入其病歷的病人。

照護偏好觀察通常關聯到特定病人，用於記錄其治療和照護方式的偏好。

此照護偏好觀察所發生的醫療事件（例如病人與醫療提供者的會談）。

這通常是記錄照護偏好時的就診（encounter），可能是諮詢、收案或評估的場合。

照護偏好被紀錄或被視為有效的時間或時間區間。

照護偏好的記錄時間非常重要，因為病人的偏好可能隨時間而變化。

負責記錄或確認照護偏好觀察為「真實」的人員。

通常是醫護人員、社工或病人本人記錄照護偏好。

照護偏好觀察的實際內容，可能是文字描述或代碼化的偏好記錄。

照護偏好可以多種形式表達，包括自由文字陳述或使用預定義的偏好選項代碼。

進行此觀察時所使用的標本。

照護偏好觀察通常不涉及標本，但此欄位保留以維持與 Observation 資源的一致性。

關於病人、裝置或其他主體的測量與簡單陳述。

用於簡單觀察，例如裝置測量、實驗室原子結果、生命徵象、身高、體重、吸菸狀態、備註等。其他資源則用於提供觀察的上下文，例如實驗室報告等。

The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.

指向建構本 resource 時所遵循規則的參照，處理內容時必須理解這些規則。通常是參照定義特殊規則的實作指南（Implementation Guide），以及其他 profiles 等。

宣告這套規則限制了內容只能被有限的交易夥伴所理解，這從本質上限制了資料的長期有用性。然而，現有的健康生態體系高度分裂，尚未準備好以普遍可計算的方式定義、收集和交換資料。只要有可能，實作者和/或規範編寫者應避免使用此欄位。

The base language in which the resource is written.

Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).

A human language.

A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.

Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.

These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.

This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.

May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

A unique identifier assigned to this observation.

Allows observations to be distinguished and referenced.

A plan, proposal or order that is fulfilled in whole or in part by this event. For example, a MedicationRequest may require a patient to have laboratory test performed before it is dispensed.

Allows tracing of authorization for the event and tracking whether proposals/recommendations were acted upon.

A larger event of which this particular Observation is a component or step. For example, an observation as part of a procedure.

To link an Observation to an Encounter use encounter. See the Notes below for guidance on referencing another Observation.

此欄位表示照護偏好觀察結果的狀態。

此元素被標記為修飾性（modifier），因為 status 可能包含標示資源目前無效的代碼。

Codes providing the status of an observation.

Need to track the status of individual results. Some results are finalized before the whole report is finalized.

用於分類所進行觀察的一般類型的代碼。

除了必要的 category 值集外，此元素也允許根據擁有者自訂的分類方案進行多元分類，且可同時使用多個分類。分類的細緻程度由值集中的 category 概念所決定。

Codes for high level observation categories.

Used for filtering what observations are retrieved and displayed.

用於分類照護偏好觀察的類型代碼。

In addition to the required category valueset, this element allows various categorization schemes based on the owner’s definition of the category and effectively multiple categories can be used at once. The level of granularity is defined by the category concepts in the value set.

Codes for high level observation categories.

Used for filtering what observations are retrieved and displayed.

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

參照由術語系統定義的代碼。

Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

Allows for alternative encodings within a code system, and translations to other code systems.

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

定義代碼符號意義的代碼系統之識別。

The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

Need to be unambiguous about the source of the definition of the symbol.

The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

由系統定義的語法符號，代表照護偏好的類型。

Need to refer to a particular code in the system.

A representation of the meaning of the code in the system, following the rules of the system.

Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).

Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

Very often the text is the same as a displayName of one of the codings.

The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

描述所觀察到的照護偏好內容。此處使用 LOINC 代碼表示病人的照護偏好。

所有的 code-value 配對需要被考慮，才能正確理解照護偏好觀察的意義。

Codes identifying names of simple observations.

Knowing what kind of observation is being made is essential to understanding the observation.

resource中資料項目的唯一ID（用於內部參照）。這可以是任何不含空格的字串。

擴充的資料項目

參照由術語系統定義的代碼。

代碼可以在列舉清單（enumerations）或代碼清單（code lists）中非常隨意地定義，直至有非常正式的定義，例如：SNOMED CT—更多資訊見HL7 v3核心原則（Core Principles ）。編碼的排序是未定義的因而 必須沒有（SHALL NOT） 被用來推斷意義。一般來說，最多只有一個編碼值（coding values）會被標記為UserSelected = true。

允許代碼系統中的替代編碼，以及翻譯到其他編碼系統。

resource中資料項目的唯一ID（用於內部參照），這可以是任何不含空格的字串。

可用於表示不屬於此資料項目基本定義的附加資訊。為了擴充的使用安全和可管理，對擴充的定義和使用有一套嚴格的管理。儘管任何實作者都可以定義一個擴充，但作為擴充定義的一部分，有一套要求 必須（SHALL） 滿足。

無論使用或定義擴充的機構或管轄區，任何應用程式、專案或標準使用擴充都不背負任何污名（stigma）。使用擴充是允許FHIR規範為每個人保留一個核心的簡易性。

定義代碼符號意義的代碼系統之識別。

URI可以是一個OID（urn:oid:...）或一個UUID（urn:uuid:...）；OID和UUID 必須（SHALL） 參照HL7 OID註冊中心；否則，URI應該來自HL7的FHIR定義的特殊URI列表，或者它應該參照一些明確建立的系统定義。

需要明確說明符號定義的來源

選擇此代碼時使用的代碼系統版本；請注意，一個維護良好的代碼系統不需要版本報告，因為代碼的意義在不同系統版本中是一致的；然而，不能始終保證這點，當不能保證意義一致時， 必須（SHALL） 將版本資訊也一併作交換。

如果專門術語沒有明確定義應該使用什麼字串來識別代碼系統的版本，建議使用版本正式發布的日期（用FHIR日期格式表示）作為版本日期。

由系統定義的語法符號，代表照護偏好的類型。

需要參照系統中的一個特定代碼

遵循系統的規則以呈現代碼含義的表示法

需要能為不了解此系統的讀者呈現可讀的代碼含義

表明此編碼是由使用者直接選擇，例如：從可用項目（代碼或顯示名稱）的清單中選擇。

在一系列備選方案中，直接選擇的代碼是新翻譯最合適的起點；關於「直接選擇」的確切意義，存在模糊不清之處，可能需要貿易夥伴的同意，以更完整澄清此資料項目的使用及其後果。

已被確定為一個臨床安全準則—此確切的系統／代碼對(code pair)是被明確選擇的，而不是由系統根據一些規則或是程式語言處理判斷。

輸入資料的使用者所見／所選／所說的人類可讀文字表述，和（或）其代表使用者的預期含義。

很多時候，此文字表述與其中一個代碼的顯示名稱相同。

專門術語中的代碼並不總是能捕捉人類使用的細微差別的正確意義，或者根本就沒有合適的代碼；這些情況下，文字表述被用來捕捉來源的全部意義。

此照護偏好觀察所關於且將觀察記錄存入其病歷的病人。

照護偏好觀察通常關聯到特定病人，用於記錄其治療和照護方式的偏好。

Observations have no value if you don't know who or what they're about.

The actual focus of an observation when it is not the patient of record representing something or someone associated with the patient such as a spouse, parent, fetus, or donor. For example, fetus observations in a mother's record. The focus of an observation could also be an existing condition, an intervention, the subject's diet, another observation of the subject, or a body structure such as tumor or implanted device. An example use case would be using the Observation resource to capture whether the mother is trained to change her child's tracheostomy tube. In this example, the child is the patient of record and the mother is the focus.

Typically, an observation is made about the subject - a patient, or group of patients, location, or device - and the distinction between the subject and what is directly measured for an observation is specified in the observation code itself ( e.g., "Blood Glucose") and does not need to be represented separately using this element. Use specimen if a reference to a specimen is required. If a code is required instead of a resource use either bodysite for bodysites or the standard extension focusCode.

此照護偏好觀察所發生的醫療事件（例如病人與醫療提供者的會談）。

這通常是記錄照護偏好時的就診（encounter），可能是諮詢、收案或評估的場合。

For some observations it may be important to know the link between an observation and a particular encounter.

照護偏好被紀錄或被視為有效的時間或時間區間。

照護偏好的記錄時間非常重要，因為病人的偏好可能隨時間而變化。

Knowing when an observation was deemed true is important to its relevance as well as determining trends.

The date and time this version of the observation was made available to providers, typically after the results have been reviewed and verified.

For Observations that don’t require review and verification, it may be the same as the lastUpdated time of the resource itself. For Observations that do require review and verification for certain updates, it might not be the same as the lastUpdated time of the resource itself due to a non-clinically significant update that doesn’t require the new version to be reviewed and verified again.

負責記錄或確認照護偏好觀察為「真實」的人員。

通常是醫護人員、社工或病人本人記錄照護偏好。

May give a degree of confidence in the observation and also indicates where follow-up questions should be directed.

照護偏好觀察的實際內容，可能是文字描述或代碼化的偏好記錄。

照護偏好可以多種形式表達，包括自由文字陳述或使用預定義的偏好選項代碼。

An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

Provides a reason why the expected value in the element Observation.value[x] is missing.

Null or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "specimen unsatisfactory".

The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Note that an observation may only be reported if there are values to report. For example differential cell counts values may be reported only when > 0. Because of these options, use-case agreements are required to interpret general observations for null or exceptional values.

Codes specifying why the result (Observation.value[x]) is missing.

For many results it is necessary to handle exceptional values in measurements.

A categorical assessment of an observation value. For example, high, low, normal.

Historically used for laboratory results (known as 'abnormal flag' ), its use extends to other use cases where coded interpretations are relevant. Often reported as one or more simple compact codes this element is often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result.

Codes identifying interpretations of observations.

For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.

Comments about the observation or the results.

May include general statements about the observation, or statements about significant, unexpected or unreliable results values, or information about its source when relevant to its interpretation.

Need to be able to provide free text additional information.

Indicates the site on the subject's body where the observation was made (i.e. the target site).

Only used if not implicit in code found in Observation.code. In many systems, this may be represented as a related observation instead of an inline component.

If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use the standard extension bodySite.

Codes describing anatomical locations. May include laterality.

Indicates the mechanism used to perform the observation.

Only used if not implicit in code for Observation.code.

Methods for simple observations.

In some cases, method can impact results and is thus used for determining whether results can be compared or determining significance of results.

進行此觀察時所使用的標本。

照護偏好觀察通常不涉及標本，但此欄位保留以維持與 Observation 資源的一致性。

The device used to generate the observation data.

Note that this is not meant to represent a device involved in the transmission of the result, e.g., a gateway. Such devices may be documented using the Provenance resource where relevant.

Guidance on how to interpret the value by comparison to a normal or recommended range. Multiple reference ranges are interpreted as an "OR". In other words, to represent two distinct target populations, two referenceRange elements would be used.

Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this might not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.

Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

The value of the low bound of the reference range. The low bound of the reference range endpoint is inclusive of the value (e.g. reference range is >=5 - <=9). If the low bound is omitted, it is assumed to be meaningless (e.g. reference range is <=2.3).

The value of the high bound of the reference range. The high bound of the reference range endpoint is inclusive of the value (e.g. reference range is >=5 - <=9). If the high bound is omitted, it is assumed to be meaningless (e.g. reference range is >= 2.3).

Codes to indicate the what part of the targeted reference population it applies to. For example, the normal or therapeutic range.

This SHOULD be populated if there is more than one range. If this element is not present then the normal range is assumed.

Code for the meaning of a reference range.

Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc., - for proper interpretation.

Codes to indicate the target population this reference range applies to. For example, a reference range may be based on the normal population or a particular sex or race. Multiple appliesTo are interpreted as an "AND" of the target populations. For example, to represent a target population of African American females, both a code of female and a code for African American would be used.

This SHOULD be populated if there is more than one range. If this element is not present then the normal population is assumed.

Codes identifying the population the reference range applies to.

Need to be able to identify the target population for proper interpretation.

The age at which this reference range is applicable. This is a neonatal age (e.g. number of weeks at term) if the meaning says so.

Some analytes vary greatly over age.

Text based reference range in an observation which may be used when a quantitative range is not appropriate for an observation. An example would be a reference value of "Negative" or a list or table of "normals".

This observation is a group observation (e.g. a battery, a panel of tests, a set of vital sign measurements) that includes the target as a member of the group.

When using this element, an observation will typically have either a value or a set of related resources, although both may be present in some cases. For a discussion on the ways Observations can assembled in groups together, see Notes below. Note that a system may calculate results from QuestionnaireResponse into a final score and represent the score as an Observation.

The target resource that represents a measurement from which this observation value is derived. For example, a calculated anion gap or a fetal measurement based on an ultrasound image.

All the reference choices that are listed in this element can represent clinical observations and other measurements that may be the source for a derived value. The most common reference will be another Observation. For a discussion on the ways Observations can assembled in groups together, see Notes below.

Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.

For a discussion on the ways Observations can be assembled in groups together see Notes below.

Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Describes what was observed. Sometimes this is called the observation "code".

All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

Codes identifying names of simple observations.

Knowing what kind of observation is being made is essential to understanding the observation.

The information determined as a result of making the observation, if the information has a simple value.

Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

Provides a reason why the expected value in the element Observation.component.value[x] is missing.

"Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done".

The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

Codes specifying why the result (Observation.value[x]) is missing.

For many results it is necessary to handle exceptional values in measurements.

A categorical assessment of an observation value. For example, high, low, normal.

Historically used for laboratory results (known as 'abnormal flag' ), its use extends to other use cases where coded interpretations are relevant. Often reported as one or more simple compact codes this element is often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result.

Codes identifying interpretations of observations.

For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.

Guidance on how to interpret the value by comparison to a normal or recommended range.

Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this might not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.

Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.