Segment OBX [Component] to Observation Map

This ConceptMap represents a mapping from the HL7 V2 Segment OBX to the FHIR Observation Resource.
View in v2-to-FHIR IG
#V2 FieldNameV2 TypeCard.FHIR AttributeFHIR TypeEquiv.
1OBX-3Observation IdentifierCWE1..1
code
component[each].code
CodeableConceptCodeableConcept
equivalentequivalent
2OBX-4Observation Sub-IDST1..1
$this

IF: Map to Observation.partOf or Observation.hasMember or Observation.DerivedFrom according to the implementation guidance for the v2 message at hand, otherwise map to the extension-sub-id to enable the final destination to determine how to structure the observations.

OBX-4 Sub Identifier would determine how to use Observation.partOf or Observation.hasMember or Observation.DerivedFrom, but is highly dependent on the local implementation of OBX-4 or an implementation guide (e.g., LRI, Clinical Genomics). That is not known at the standard level, so we cannot provide specific mapping guidance here. However, if the mapper does not have access to the syntax used and its meaning, we need to be able to pass on OBX-4 Sub Identifier to the final destination that should know how to then structure it using FHIR attributes.

-
equivalent
3OBX-5Observation Valuevaries-1..*
component[each].valueQuantity
component[each].valueString

IF: Any markup in ST, FT or TX data may not present properly given that valueString is a string data type

component[each].valueCodeableConcept
component[each].valueCodeableConcept
component[each].valueCodeableConcept
component[each].valueCodeableConcept
component[each].valueCodeableConcept
component[each].valuePeriod
component[each].valueDateTime
component[each].valueRange
component[each].valueString

= OBX-5.1+"-"+OBX-5.2

component[each].valueTime
component[each].valueString

= OBX-5.1+" "+OBX-5.2+" "+OBX-5.3+" "+OBX-5.4" "OBX-6"

component[each].valueRatio[1]
component[each].valueRange[1]
component[each].valueString

= OBX-5.1+" "+OBX-5.2+" "+OBX-5.3+" "+OBX-5.4" "OBX-6"

component[each].valueQuantity[1]
component[each].valueString

= OBX-5.1+" "+OBX-5.2+" "+OBX-5.3+" "+OBX-5.4" "OBX-6"

IF: If line 19 through 23 all fail while OBX-2 = SN

component[each].extension[1].url

= "https://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.valueAttachment"

IF: If none of the other observations in OBX-5 are not derived from the documentation included

Some implementers may include in OBX-5 the documentation that the other OBX-5 components are derived from. In that situations

component[each].extension[1].valueAttachment

IF: If none of the other observations in OBX-5 are not derived from the documentation included

We are for now addressing Base64 that cover .pdf, pictures and other binaries. If somebody does this, we will address those.

derivedFrom(DocumentReference)

IF: And if other observation in OBX-5 are derived from the documentation included

component[each].extension[1].url

= "https://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.valueAttachment"

IF: If none of the other observations in OBX-5 are not derived from the documentation referenced

component[each].extension[1].valueAttachment

IF: If none of the other observations in OBX-5 are not derived from the documentation referenced

To be resolved when we resolve DocumentReference and valueAttachment

derivedFrom(DocumentReference)

IF: And if other observation in OBX-5 are derived from the documentation being referenced

quantitystringCodeableConceptCodeableConceptCodeableConceptCodeableConceptCodeableConceptPerioddateTimeRangestringtimestringRatioRangestringQuantitystringuriAttachmentReferenceuriAttachmentReference
equivalentequivalentequivalentequivalentequivalentequivalentequivalentequivalentequivalentequivalentequivalentequivalentequivalentequivalentequivalentequivalentequivalentequivalentequivalentequivalentequivalentequivalentequivalentequivalent
4OBX-6UnitsCWE1..1
component[each].valueQuantity
component[each].valueQuantity[1]

Note that OBX-5 and OBX-6 resolve to different components for the same Quantity data type.

component[each].valueRange[1].low
component[each].valueRange[1].high
component[each].valueRatio[1].numerator
component[each].valueRatio[1].denominator
QuantityQuantitySimpleQuantitySimpleQuantityQuantityQuantity
equivalentequivalentequivalentequivalentequivalentequivalent
5OBX-7References RangeST1..1
component[each].referenceRange.text

If OBX-7 is sufficiently parseable, then the low, high, type, appliesTo, and/or age may be used.

-
equivalent
6OBX-8Interpretation CodesCWE-1..*
interpretation
CodeableConcept
equivalent
7OBX-10Nature of Abnormal TestID-1..*
extension[2].uri

= "http://hl7.org/fhir/StructureDefinition/observation-nature-of-abnormal-test"

extension[2].valueCodeableConcept
uriCodeableConcept
equivalentequivalent
8OBX-11Observation Result StatusID1..1
status
status.extension[1].url

= "http://hl7.org/fhir/StructureDefinition/alternate-codes"

status.extension[1].valueCodeableConcept.coding.code

= "X"

status.extension[1].valueCodeableConcept.coding.system

= "http://terminology.hl7.org/CodeSystem/v2-0085"

dataAbsentReason.coding[2].code

= "not-asked"

dataAbsentReason.coding[2].system

= "http://terminology.hl7.org/CodeSystem/data-absent-reason"

codeuriCodeableConceptstring--
equivalentequivalentequivalentequivalentequivalentequivalent
9OBX-14Date/Time of the ObservationDTM1..1
effectiveDateTime
dateTime
equivalent
10OBX-16Responsible ObserverXCN-1..*
performer[1](PractitionerRole.practitioner(Practitioner))
performer[1](PractitionerRole.code.coding.code)

= "responsibleObserver"

performer[1](PractitionerRole.code.coding.system)

= "http://terminology.hl7.org/CodeSystem/practitioner-role"

Reference(PractitionerRole)stringuri
equivalentequivalentequivalent
11OBX-17Observation MethodCWE-1..*
method

The cardinality of Observation.method is 0..1 while the source allows for multiple methods. As we are not aware of anybody populating multiples in HL7 v2, we did not provide further mapping guidance. If you need to support multiples, please submit a gForge to OO for the HL7 v2 to FHIR mapping Implementation Guide.

CodeableConcept
equivalent
12OBX-18Equipment Instance IdentifierEI-1..*
device(Device.identifier)
Identifier
equivalent
13OBX-19Date/Time of the AnalysisDTM1..1
extension[1].url

"http://hl7.org/fhir/StructureDefinition/observation-analysis-date-time"

extension[1].valueDateTime
uridateTime
equivalentequivalent
14OBX-20Observation SiteCWE-1..*
bodySite

The cardinality of Observation.bodySite is 0..1 while the source allows for multiple body sites. As we are not aware of anybody populating multiples in HL7 v2, we did not provide further mapping guidance. If you need to support multiples, please submit a gForge to OO for the HL7 v2 to FHIR mapping Implementation Guide.

CodeableConcept
equivalent
15OBX-21Observation Instance IdentifierEI1..1
identifier
identifier.type.coding.code

= "FILL"

Identifiercode
equivalentequivalent
16OBX-23Performing Organization NameXON1..1
performer[2](Organization)
performer[2](PractitionerRole.organization(Organization))
Reference(Organization)Reference(Organization)
equivalentequivalent
17OBX-24Performing Organization AddressXAD1..1
performer[2](Organization.address)
performer[2](PractitionerRole.organization(Organization.address))
AddressAddress
equivalentequivalent
18OBX-25Performing Organization Medical DirectorXCN1..1
performer[2](PractitionerRole)
performer[2](PractitionerRole.code.coding.value)

= "MDIR"

performer[2](PractitionerRole.code.coding.system)

= "http://terminology.hl7.org/CodeSystem/v2-0912"

Reference(PractitionerRole)stringuri
equivalentequivalentequivalent
19OBX-29Observation TypeID1..1
category[1].coding.code
category[1].coding.system
codeuri
equivalentequivalent
20OBX-30Observation Sub-TypeID1..1
extension[2].url

= "http://hl7.org/fhir/StructureDefinition/observation-structure-type"

extension[2].valueCodeableConcept.coding.code
extension[2].valueCodeableConcept.coding.system

= "http://hl7.org/fhir/StructureDefinition/observation-structure-type"

uricodeuri
equivalentequivalentequivalent
21OBX-33Observation Related Specimen IdentifierEIP-1..*
extension[1].uri

= "http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.specimen"

Note that in v2 messages the observations that a calculated observation is derived from on and involve multiple specimens are typically not included with the message. To enable relating the calculated observation to the correct specimens it relates to, the v2 message should include the originating observations that in turn use OBX-33 to link to the correct specimens. Without that, and if there are multiple specimens in OBX-33, there is no standard method to correctly associate the observation with the correct specimens. The implementer will have to devise an appropriate method for that in their context.

extension[1].valueReference(Group.member.entity(Specimen.identifier[1])
extension[2].uri

= "http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.specimen"

extension[2].valueReference(Group.member.entity(Specimen.identifier[2]))
specimen(Specimen.identifier[1])
specimen(Specimen.identifier[2])
Reference---IdentifierIdentifier
equivalentequivalentequivalentequivalentequivalentequivalent

Equivalence Legend

equivalentExact match
wider/narrowerBroader/more specific meaning
relatedtoRelated but not exact
unmatchedNo equivalent in target