Overview
Observation Survey is represented using Observation FHIR Resource. Observations are a central element in healthcare, used to support diagnosis, monitor progress, determine baselines and patterns and even capture demographic characteristics, as well as capture results of tests performed on products and substances. Most observations are simple name/value pair assertions with some metadata, but some observations group other observations together logically, or even are multi-component observations.
Each Observation has next elements:
- a status
- a category code of “survey”
- a LOINC code, if available, which tells you the survey question
- a patient
Each Observation supports next elements:
- a time indicating when survey was taken
- the answer or a reason why the data is absent
- if the result value is a numeric quantity and coded quantity units are used, UCUM is required.
- who answered the questions
- related questionnaire responses or observations that this observation is made from
- reference to observations that make up this observation
Profile specific implementation guidance:
- For responses to individual survey questions, the question is represented in Observation.code, and the answer in Observation.value.
- For responses to multi-select or “check all that apply” questions, each response is represented as individual US Core Survey Observations. For each response, the question is represented in Observation.code, and the answer in Observation.value.
- For multi-question surveys and assessments represented in Observation.code, the Observation.value element should be empty, and the individual survey questions represented as distinct US Core Survey Observations and referenced using Observation.hasMember.
- See the SDOH guidance page for how this profile along with other Observation Profiles or alternatively QuestionnaireResponse to is used represent SDOH assessments.
- Individual clinical assessments made by an individual about a patient’s social history which array_to_sentence_string not derived from an assessment tool or survey should use the US Core Observation Social History Profile instead.
- The Observation.category element provides an efficient way of restricting search on observations to “survey” observations.However, clients need to understand that data categorization is somewhat subjective. The categorization applied by the source may not align with the client’s expectations. Clients may find it more useful to use queries based on a specific code or set of codes or to perform additional client side filtering of query results.
- An Observation without a value, SHALL include a reason why the data is absent unless there are 1) component observations, or 2) reporting panel observations using Observation.hasMember.
- For further guidance see the Observation Grouping section in FHIR Specification.
- Systems that never provide an observation without a value are not required to support Observation.dataAbsentReason.
- An Observation.component without a value, SHALL include a reason why the data is absent.
Systems that never provide a component observation without a component value are not required to support Observation.component.dataAbsentReason.
This resource conforms to USCDI V2 profile for Observation - refer to US Core Observation Survey Profile. Observation response will be provided in JSON (refers to Capability Statement) format as per FHIR standard R4 version.
| USCore Data Element | FHIR Resource Field |
|---|---|
| status | Observation.status |
| a category code of “survey” | Observation.category |
| a LOINC code, if available, which tells you the survey question | Observation.code |
| a patient | Observation.subject |
| a time indicating when survey was taken | Observation.effective[x] |
| the answer or a reason why the data is absent | Observation.dataAbsentReason |
| who answered the questions | Observation.performer |
| related questionnaire responses or observations that this observation is made from | Observation.derivedFrom |
| reference to observations that make up this observation | Observation.value[x] |
Must support elements, mandatory and optional search parameters
Observation must support these elements:
statusSlices for categorycategory:survey
codesubjecteffectiveDateTimeperformervalue[x]valueQuantityvalueStringvalueCodeableConcept
dataAbsentReasonhasMemberderivedFrom
The following search parameters and search parameter combinations SHALL be supported:
The syntax used to describe the interactions is described here.
SHALL support searching for all Observations for a patient and category search parameters:
GET [base url]/Observation?patient={Type/}[id]&category=http://terminology.hl7.org/CodeSystem/observation-category|survey
SHALL support searching for all Observations for a patient and code search parameters:
- including optional support for OR search on code (e.g.code={system|}|{code},{system|}|{code},...)
GET [base url]/Observation?patient={Type/}[id]&code={system|}|{code}{,{system|}|{code},...}}
SHALL support searching for all Observations for a patient and category and date search parameters:
- including support for these date comparators: gt,lt,ge,le
- including optional support for AND search on date (e.g.date={date}&date={date}&...)
GET [base url]/Observation?patient={Type/}[id]&category=http://terminology.hl7.org/CodeSystem/observation-category|survey&date={gt|lt|ge|le}{date}{&date={gt|lt|ge|le}{date}&...}
The following search parameter combinations SHOULD be supported (optional):
SHOULD support searching using the combination of the patient and category and status search parameters:
- including support for OR search on status (e.g.status={system|}|{code},{system|}|{code},...)
GET [base url]/Observation?patient={Type/}[id]&category=http://terminology.hl7.org/CodeSystem/observation-category|survey&status={system|}|{code}{,{system|}|{code},...}
SHOULD support searching using the combination of the patient and code and date search parameters
- including optional support for OR search on code (e.g.code={system|}|{code},{system|}|{code},...)
- including support for these date comparators: gt,lt,ge,le
- including optional support for AND search on date (e.g.date={date}&date={date}}&...)
GET [base url]/Observation?patient={Type/}[id]&code={system|}|{code}{,{system|}|{code},...}&date={gt|lt|ge|le}{date}{&date={gt|lt|ge|le}{date}&...}
The response to any search operation is always a list of resources in a Bundle or an Operation Outcome.
Observation By Patient Id
Search for Observation by patient.
METHOD GET
[base url]/Observation?patient={Type/}[id]
PARAMS
[base url] - FHIR base url
[id] - Id for the Patient
HEADERS
The Authorization token SHALL be obtained during Authentication and Authorization process. Go to Authentication and Authorization for further details.
| Header | Type | Required/Optional | Value |
|---|---|---|---|
| Authorization | string | required | 'Bearer' |
RESPONSES
| Code | Description | Comment |
|---|---|---|
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | no Route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
EXAMPLE:
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Observation?patient=Patient/c5137fa5-3216-b12a-cbbc-a0c6bef361g7' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'
Observation By Id
Get Observation by ID.
METHOD GET
[base url]/Observation/{id}
or
[base url]/Observation?_id={id}
PARAMS
[base url] - FHIR base url
{id} - Id for Observation resource
HEADERS
The Authorization token SHALL be obtained during Authentication and Authorization process. Authentication and Authorization for further details.
| Header | Type | Required/Optional | Value |
|---|---|---|---|
| Authorization | string | required | 'Bearer' |
RESPONSES
| Code | Description | Comment |
|---|---|---|
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | no Route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
EXAMPLE:
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Observation/c5137fa5-3216-b12a-cbbc-a0c6bef361g7' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'
Observation by patient and category search parameters
Get Observations using the combination of the patient and category search parameters:
METHOD GET
GET [base url]/Observation?patient={Type/}[id]&category=http://terminology.hl7.org/CodeSystem/observation-category|survey
PARAMS
[base url] - FHIR base url
{Type} - Type for the Reference. Example: Patient
[id] - patient id
HEADERS
The Authorization token SHALL be obtained during Authentication and Authorization process. Authentication and Authorization for further details.
| Header | Type | Required/Optional | Value |
|---|---|---|---|
| Authorization | string | required | 'Bearer' |
RESPONSES
| Code | Description | Comment |
|---|---|---|
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | no Route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
EXAMPLE:
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Observation?patient=Patient/fe1cd986-1ac7-4c26-b8b3-d632a48408fd&category=http://terminology.hl7.org/CodeSystem/observation-category|survey\
--header 'Authorization: Bearer 1239b275-909e-4754-8f73-1e411fd6769e'
Observation by patient and category and date search parameters
Get Observations using the combination of the patient and category and date search parameters:
METHOD GET
GET [base url]/Observation?patient={Type/}[id]&category=http://terminology.hl7.org/CodeSystem/observation-category|survey&date={gt|lt|ge|le}{date}{&date={gt|lt|ge|le}{date}&...}
PARAMS
[base url] - FHIR base url
{Type} - Type for the Reference. Example: Patient
[id] - patient id
{date} - observation effective date
HEADERS
The Authorization token SHALL be obtained during Authentication and Authorization process. Authentication and Authorization for further details.
| Header | Type | Required/Optional | Value |
|---|---|---|---|
| Authorization | string | required | 'Bearer' |
RESPONSES
| Code | Description | Comment |
|---|---|---|
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | no Route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
EXAMPLE:
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Observation?patient=Patient/fe1cd986-1ac7-4c26-b8b3-d632a48408fd&category=http://terminology.hl7.org/CodeSystem/observation-category|survey&date=ge2018-03-14T00:00:00Z\
--header 'Authorization: Bearer 1239b275-909e-4754-8f73-1e411fd6769e'
Observation by patient and code search parameters
Get Observations using the combination of the patient and code search parameters:
METHOD GET
GET [base url]/Observation?patient={Type/}[id]&code={system|}|{code}{,{system|}|{code},...}
PARAMS
[base url] - FHIR base url
{Type} - Type for the Reference. Example: Patient
[id] - patient id
{system|} - system used to identify observation code
{code} - observation code
HEADERS
The Authorization token SHALL be obtained during Authentication and Authorization process. Authentication and Authorization for further details.
| Header | Type | Required/Optional | Value |
|---|---|---|---|
| Authorization | string | required | 'Bearer' |
RESPONSES
| Code | Description | Comment |
|---|---|---|
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | no Route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
EXAMPLE:
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Observation?patient=Patient/fe1cd986-1ac7-4c26-b8b3-d632a48408fd&code=http://loinc.org|76690-7 \
--header 'Authorization: Bearer 1239b275-909e-4754-8f73-1e411fd6769e'
Observation by patient and code and date search parameters
Get Observations using the combination of the patient and code and date search parameters:
METHOD GET
GET [base url]/Observation?patient={Type/}[id]&code={system|}|{code}{,{system|}|{code},...}&date={gt|lt|ge|le}{date}{&date={gt|lt|ge|le}{date}&...}
PARAMS
[base url] - FHIR base url
{Type} - Type for the Reference. Example: Patient
[id] - patient id
{system|} - terminology system used to identify observation code
{code} - observation code
{date} - observation effective date
HEADERS
The Authorization token SHALL be obtained during Authentication and Authorization process. Authentication and Authorization for further details.
| Header | Type | Required/Optional | Value |
|---|---|---|---|
| Authorization | string | required | 'Bearer' |
RESPONSES
| Code | Description | Comment |
|---|---|---|
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | no Route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
EXAMPLE:
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Observation?patient=Patient/fe1cd986-1ac7-4c26-b8b3-d632a48408fd&code=http://loinc.org|76690-7&date=ge2018-03-14T00:00:00Z\
--header 'Authorization: Bearer 1239b275-909e-4754-8f73-1e411fd6769e'
Observation by patient and category and status search parameters
Get Observations using the combination of the patient and category and status search parameters:
METHOD GET
GET [base url]/Observation?patient={Type/}[id]&category=category=http://terminology.hl7.org/CodeSystem/observation-category|survey&status={status_system}|{status}{,{status_system}|{status},...}
PARAMS
[base url] - FHIR base url
{Type} - Type for the Reference. Example: Patient
[id] - patient id
{status_system} - terminology system used to identify observation status
{status} - observation status
HEADERS
The Authorization token SHALL be obtained during Authentication and Authorization process. Authentication and Authorization for further details.
| Header | Type | Required/Optional | Value |
|---|---|---|---|
| Authorization | string | required | 'Bearer' |
RESPONSES
| Code | Description | Comment |
|---|---|---|
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | no Route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
EXAMPLE:
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Observation?patient=Patient/fe1cd986-1ac7-4c26-b8b3-d632a48408fd&category=http://terminology.hl7.org/CodeSystem/observation-category|survey&status=final\
--header 'Authorization: Bearer 1239b275-909e-4754-8f73-1e411fd6769e'