Dieses Profil stuft für eine Patientin oder einen Patienten eine Kategorie der WHO-Internationalen Klassifikation der Funktionsfähigkeit, Behinderung und Gesundheit (ICF) ein. Sowohl der JARDIN-MDS-Entwurf als auch das ERDRI-CDS verlangen, Funktionsfähigkeit und Behinderung auf diese Weise zu erfassen; kein MII-Modul deckte das bisher ab.

Observation.code trägt die ICF-Kategorie, Observation.component die WHO-Beurteilungsmerkmale.

Warum die Beurteilungsmerkmale Components sind und kein Wert

Ihre Zahl ist je ICF-Kapitel verschieden, ein einzelnes value[x] kann sie daher nicht tragen. value[x] ist folglich geschlossen (0..0), und je Kapitel regelt eine Invariante, welche Components auftreten dürfen:

Ohne diese Einschränkungen nähme das Profil anstandslos eine anatomische Lokalisation auf einer Körperfunktion entgegen — etwas, das die ICF nicht definiert.

Die Unterscheidung in Kapitel d ist das Herzstück der Klassifikation und bei seltenen Erkrankungen häufig der eigentliche Punkt: Leistungsfähigkeit (capacity) ist, was jemand unter Testbedingungen kann, Leistung (performance), was er in seiner eigenen Umgebung tatsächlich tut. Beide teilen sich ein BfArM-CodeSystem und werden deshalb am Component-Code auseinandergehalten, nicht am Wertesystem.

Hinweis zur Reihenfolge: Die ICF selbst nennt in Kapitel d zuerst die Leistung und dann die Leistungsfähigkeit. Die Slice-Reihenfolge dieses Profils ist alphabetisch und bedeutet nichts — maßgeblich ist der Component-Code, nicht die Position.

Terminologie

Aufgelöst gegen das BfArM-FHIR-Paket bfarm.terminologien.icf:

• Die Klassifikation erscheint unter dem HL7-Canonical http://hl7.org/fhir/sid/icf. Ein eigenes URI prägt das BfArM dafür nicht.
• Deutsch ist kein zweites CodeSystem. icf-translation ist ein content=supplement gegen dasselbe Canonical — ein CodeSystem, beide Sprachen. Hier muss sich nichts für eine Sprache entscheiden, und das ValueSet braucht keinen deutschen Zwilling.
• Die Beurteilungsmerkmale sind eigene CodeSystems, sieben an der Zahl, veröffentlicht unter https://terminologien.bfarm.de/fhir/CodeSystem/icf-q-*.
• Das Trennzeichen trägt Bedeutung, und das BfArM hat es in die Codes gelegt: Das Ausmaß der Schädigung läuft .0….4, .8, .9, Förderfaktoren laufen +0…+4. Barriere und Förderfaktor unterscheiden sich damit am Code selbst und nicht an einem Vorzeichen, das ein Parser rekonstruieren müsste.

Drei offene Punkte

Die Bindung löst im Build womöglich nicht auf. Der MII-Terminologieserver führt http://hl7.org/fhir/sid/icf derzeit nicht und meldet es als unbekanntes CodeSystem. mii-vs-seltene-icf hat in dieser Publikation deshalb keine Expansion, obwohl code.coding required dagegen gebunden ist. Die Lücke liegt beim Serverbetrieb und schließt sich, sobald das BfArM-Paket dort geladen ist; die ICF-Codes selbst bleiben gültig.

Die Edition ist nicht gepinnt. Das BfArM liefert Release 2005 mit 1495 Konzepten; tx.fhir.org führt unter demselben Canonical 2017a, eine Expansion dort ergab 1616. Gleiches URI, rund 120 Konzepte Unterschied. Eine required-Bindung darf nicht stillschweigend über beides hinweggehen.

Die Zuständigkeit ist offen — bewusst, nicht aus Versehen. Dieser Datenpunkt ist nicht spezifisch für seltene Erkrankungen: Funktionsfähigkeit und Behinderung werden bei Schlaganfall, in der Onkologie und in der Geriatrie genauso eingestuft, und die ICF ist eine WHO-Klassifikation für die gesamte Gesundheit, nicht für eine Indikation. Modelliert ist sie hier, weil der Bedarf hier entstand und konkret war — der JARDIN-MDS-Entwurf ist die Datenanforderung eines europäischen Referenznetzwerks mit Frist, und kein angebundenes MII-Modul deckte sie ab. Ein Modul für Symptome und den klinischen Phänotyp wäre der naheliegende Ort, sollte eines sie übernehmen; dieselbe Abwägung fiel beim Geschlecht bei Geburt anders aus (HDB-782), das ans Basismodul verwiesen wurde, weil es dort sowohl einen Standard als auch einen Platz dafür schon gab. Rückmeldungen dazu sind im Ballot willkommen.

Suchparameter sind modulweit im CapabilityStatement deklariert — dort maschinenlesbar und vollständig, statt je Profil von Hand wiederholt.

Beispielinstanzen sind auf der Profilseite im Abschnitt „Examples" verlinkt.

• Schlüsselelemente-Tabelle
• Differential-Tabelle
• Snapshot-Tabelle
• Statistiken/Referenzen
• Alle

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Observation	C	0..*	Observation	Measurements and simple assertions Constraints: obs-6, obs-7, mii-icf-1, mii-icf-2, mii-icf-3, mii-icf-4, mii-icf-5
id	SΣ	0..1	id	Logical id of this artifact
meta	SΣ	0..1	Meta	Metadata about the resource
profile	SΣ	0..*	canonical(StructureDefinition)	Profiles this resource claims to conform to
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
status	?!SΣ	1..1	code	registered | preliminary | final | amended + Binding: ObservationStatus (required): Codes providing the status of an observation.
Slices for category	S	1..*	CodeableConcept	Classification of type of observation Slice: Unordered, Open by pattern:$this Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
category:survey	S	1..1	CodeableConcept	Category: survey/assessment Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: survey
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
code	SΣ	1..1	CodeableConcept	ICF category being graded Binding: LOINCCodes (example): Codes identifying names of simple observations.
coding	SΣ	0..*	Coding	Code defined by a terminology system Binding: MII VS SE ICF Categories (required)
system	Σ	0..1	uri	Identity of the terminology system Required Pattern: http://hl7.org/fhir/sid/icf
subject	SΣ	1..1	Reference(Patient)	Who and/or what the observation is about
effective[x]	SΣ	1..1		When the assessment was made — ICF gradings are point-in-time and change over the course of a disease
effectiveDateTime			dateTime
effectivePeriod			Period
performer	SΣ	0..*	Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson)	Who is responsible for the observation
note	S	0..*	Annotation	Comments about the observation
Slices for component	SΣ	0..*	BackboneElement	Component results Slice: Unordered, Open by pattern:code
component:All Slices				Content/Rules for all slices
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
component:extentOfImpairment	SΣ	0..1	BackboneElement	Body functions (b): extent of impairment
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. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: https://www.medizininformatik-initiative.de/fhir/ext/modul-seltene/CodeSystem/mii-cs-seltene-icf-beurteilungsmerkmal
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: extent-of-impairment
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
value[x]	Σ	0..1	CodeableConcept	Actual component result Binding: https://terminologien.bfarm.de/fhir/ValueSet/icf-q-ausmass-der-schaedigung (required)
component:extentOfImpairmentBodyStructure	SΣ	0..1	BackboneElement	Body structures (s), first qualifier: extent of impairment
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. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: https://www.medizininformatik-initiative.de/fhir/ext/modul-seltene/CodeSystem/mii-cs-seltene-icf-beurteilungsmerkmal
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: extent-of-impairment-structure
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
value[x]	Σ	0..1	CodeableConcept	Actual component result Binding: https://terminologien.bfarm.de/fhir/ValueSet/icf-q-ausmass-der-schaedigung-s (required)
component:natureOfChange	SΣ	0..1	BackboneElement	Body structures (s), second qualifier: nature of the change
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. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: https://www.medizininformatik-initiative.de/fhir/ext/modul-seltene/CodeSystem/mii-cs-seltene-icf-beurteilungsmerkmal
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: nature-of-change
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
value[x]	Σ	0..1	CodeableConcept	Actual component result Binding: https://terminologien.bfarm.de/fhir/ValueSet/icf-q-art-oder-veraenderung-in-der-entsprechenden-koerperstruktur (required)
component:anatomicalLocation	SΣ	0..1	BackboneElement	Body structures (s), third qualifier: anatomical location
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. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: https://www.medizininformatik-initiative.de/fhir/ext/modul-seltene/CodeSystem/mii-cs-seltene-icf-beurteilungsmerkmal
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: anatomical-location
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
value[x]	Σ	0..1	CodeableConcept	Actual component result Binding: https://terminologien.bfarm.de/fhir/ValueSet/icf-q-anatomische-lokalisation (required)
component:capacity	SΣ	0..1	BackboneElement	Activities and participation (d): CAPACITY — what the person can do in a standardised environment
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. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: https://www.medizininformatik-initiative.de/fhir/ext/modul-seltene/CodeSystem/mii-cs-seltene-icf-beurteilungsmerkmal
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: capacity
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
value[x]	Σ	0..1	CodeableConcept	Actual component result Binding: https://terminologien.bfarm.de/fhir/ValueSet/icf-q-leistungsfaehigkeit-und-leistung (required)
component:performance	SΣ	0..1	BackboneElement	Activities and participation (d): PERFORMANCE — what the person actually does in their current environment
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. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: https://www.medizininformatik-initiative.de/fhir/ext/modul-seltene/CodeSystem/mii-cs-seltene-icf-beurteilungsmerkmal
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: performance
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
value[x]	Σ	0..1	CodeableConcept	Actual component result Binding: https://terminologien.bfarm.de/fhir/ValueSet/icf-q-leistungsfaehigkeit-und-leistung (required)
component:barrier	SΣ	0..1	BackboneElement	Environmental factors (e): extent to which the factor acts as a barrier
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. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: https://www.medizininformatik-initiative.de/fhir/ext/modul-seltene/CodeSystem/mii-cs-seltene-icf-beurteilungsmerkmal
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: barrier
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
value[x]	Σ	0..1	CodeableConcept	Actual component result Binding: https://terminologien.bfarm.de/fhir/ValueSet/icf-q-barrieren (required)
component:facilitator	SΣ	0..1	BackboneElement	Environmental factors (e): extent to which the factor acts as a facilitator
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. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: https://www.medizininformatik-initiative.de/fhir/ext/modul-seltene/CodeSystem/mii-cs-seltene-icf-beurteilungsmerkmal
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: facilitator
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
value[x]	Σ	0..1	CodeableConcept	Actual component result Binding: https://terminologien.bfarm.de/fhir/ValueSet/icf-q-foerderfaktoren (required)
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.category:survey	Base	preferred	Observation Category Codes	📍4.0.1	FHIR Std.
Observation.code	Base	example	LOINC Codes	📍4.0.1	FHIR Std.
Observation.code.coding	Base	required	MII VS SE ICF Categories	📦2027.0.0-ballot	This IG
Observation.component.​code	Base	example	LOINC Codes	📍4.0.1	FHIR Std.
Observation.component:extentOfImpairment.​code	Base	example	LOINC Codes	📍4.0.1	FHIR Std.
Observation.component:extentOfImpairment.​value[x]	Base	required	https://terminologien.bfarm.de/fhir/ValueSet/icf-q-ausmass-der-schaedigung	Not State	Unknown
Observation.component:extentOfImpairmentBodyStructure.​code	Base	example	LOINC Codes	📍4.0.1	FHIR Std.
Observation.component:extentOfImpairmentBodyStructure.​value[x]	Base	required	https://terminologien.bfarm.de/fhir/ValueSet/icf-q-ausmass-der-schaedigung-s	Not State	Unknown
Observation.component:natureOfChange.​code	Base	example	LOINC Codes	📍4.0.1	FHIR Std.
Observation.component:natureOfChange.​value[x]	Base	required	https://terminologien.bfarm.de/fhir/ValueSet/icf-q-art-oder-veraenderung-in-der-entsprechenden-koerperstruktur	Not State	Unknown
Observation.component:anatomicalLocation.​code	Base	example	LOINC Codes	📍4.0.1	FHIR Std.
Observation.component:anatomicalLocation.​value[x]	Base	required	https://terminologien.bfarm.de/fhir/ValueSet/icf-q-anatomische-lokalisation	Not State	Unknown
Observation.component:capacity.​code	Base	example	LOINC Codes	📍4.0.1	FHIR Std.
Observation.component:capacity.​value[x]	Base	required	https://terminologien.bfarm.de/fhir/ValueSet/icf-q-leistungsfaehigkeit-und-leistung	Not State	Unknown
Observation.component:performance.​code	Base	example	LOINC Codes	📍4.0.1	FHIR Std.
Observation.component:performance.​value[x]	Base	required	https://terminologien.bfarm.de/fhir/ValueSet/icf-q-leistungsfaehigkeit-und-leistung	Not State	Unknown
Observation.component:barrier.​code	Base	example	LOINC Codes	📍4.0.1	FHIR Std.
Observation.component:barrier.​value[x]	Base	required	https://terminologien.bfarm.de/fhir/ValueSet/icf-q-barrieren	Not State	Unknown
Observation.component:facilitator.​code	Base	example	LOINC Codes	📍4.0.1	FHIR Std.
Observation.component:facilitator.​value[x]	Base	required	https://terminologien.bfarm.de/fhir/ValueSet/icf-q-foerderfaktoren	Not State	Unknown

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()
mii-icf-1	error	Observation	Body functions (chapter b) take only the extent-of-impairment qualifier.	code.coding.where(system='http://hl7.org/fhir/sid/icf').code.first().startsWith('b') implies component.where(code.coding.code != 'extent-of-impairment').empty()
mii-icf-2	error	Observation	Body structures (chapter s) take only extent, nature of change and anatomical location.	code.coding.where(system='http://hl7.org/fhir/sid/icf').code.first().startsWith('s') implies component.where(code.coding.code != 'extent-of-impairment-structure' and code.coding.code != 'nature-of-change' and code.coding.code != 'anatomical-location').empty()
mii-icf-3	error	Observation	Activities and participation (chapter d) take only capacity and performance.	code.coding.where(system='http://hl7.org/fhir/sid/icf').code.first().startsWith('d') implies component.where(code.coding.code != 'capacity' and code.coding.code != 'performance').empty()
mii-icf-4	error	Observation	Environmental factors (chapter e) take only the barrier or facilitator qualifier.	code.coding.where(system='http://hl7.org/fhir/sid/icf').code.first().startsWith('e') implies component.where(code.coding.code != 'barrier' and code.coding.code != 'facilitator').empty()
mii-icf-5	error	Observation	An environmental factor is graded as a barrier or as a facilitator, not as both at once.	component.where(code.coding.code = 'barrier').empty() or component.where(code.coding.code = 'facilitator').empty()
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()

Diese Struktur ist abgeleitet von Observation

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Observation	C	0..*	Observation	Measurements and simple assertions Constraints: mii-icf-1, mii-icf-2, mii-icf-3, mii-icf-4, mii-icf-5
id	S	0..1	id	Logical id of this artifact
meta	S	0..1	Meta	Metadata about the resource
profile	S	0..*	canonical(StructureDefinition)	Profiles this resource claims to conform to
status	S	1..1	code	registered | preliminary | final | amended +
Slices for category	S	1..*	CodeableConcept	Classification of type of observation Slice: Unordered, Open by pattern:$this
category:survey	S	1..1	CodeableConcept	Category: survey/assessment Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category
code		1..1	code	Symbol in syntax defined by the system Fixed Value: survey
code	S	1..1	CodeableConcept	ICF category being graded
coding	S	0..*	Coding	Code defined by a terminology system Binding: MII VS SE ICF Categories (required)
system		0..1	uri	Identity of the terminology system Required Pattern: http://hl7.org/fhir/sid/icf
subject	S	1..1	Reference(Patient)	Who and/or what the observation is about
effective[x]	S	1..1		When the assessment was made — ICF gradings are point-in-time and change over the course of a disease
effectiveDateTime			dateTime
effectivePeriod			Period
performer	S	0..*	Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson)	Who is responsible for the observation
value[x]		0..0		Actual result
note	S	0..*	Annotation	Comments about the observation
Slices for component	S	0..*	BackboneElement	Component results Slice: Unordered, Open by pattern:code
component:All Slices				Content/Rules for all slices
value[x]		0..1	Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period	Actual component result
component:extentOfImpairment	S	0..1	BackboneElement	Body functions (b): extent of impairment
code		1..1	CodeableConcept	Type of component observation (code / type) Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
system		1..1	uri	Identity of the terminology system Fixed Value: https://www.medizininformatik-initiative.de/fhir/ext/modul-seltene/CodeSystem/mii-cs-seltene-icf-beurteilungsmerkmal
code		1..1	code	Symbol in syntax defined by the system Fixed Value: extent-of-impairment
value[x]		0..1	CodeableConcept	Actual component result Binding: https://terminologien.bfarm.de/fhir/ValueSet/icf-q-ausmass-der-schaedigung (required)
component:extentOfImpairmentBodyStructure	S	0..1	BackboneElement	Body structures (s), first qualifier: extent of impairment
code		1..1	CodeableConcept	Type of component observation (code / type) Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
system		1..1	uri	Identity of the terminology system Fixed Value: https://www.medizininformatik-initiative.de/fhir/ext/modul-seltene/CodeSystem/mii-cs-seltene-icf-beurteilungsmerkmal
code		1..1	code	Symbol in syntax defined by the system Fixed Value: extent-of-impairment-structure
value[x]		0..1	CodeableConcept	Actual component result Binding: https://terminologien.bfarm.de/fhir/ValueSet/icf-q-ausmass-der-schaedigung-s (required)
component:natureOfChange	S	0..1	BackboneElement	Body structures (s), second qualifier: nature of the change
code		1..1	CodeableConcept	Type of component observation (code / type) Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
system		1..1	uri	Identity of the terminology system Fixed Value: https://www.medizininformatik-initiative.de/fhir/ext/modul-seltene/CodeSystem/mii-cs-seltene-icf-beurteilungsmerkmal
code		1..1	code	Symbol in syntax defined by the system Fixed Value: nature-of-change
value[x]		0..1	CodeableConcept	Actual component result Binding: https://terminologien.bfarm.de/fhir/ValueSet/icf-q-art-oder-veraenderung-in-der-entsprechenden-koerperstruktur (required)
component:anatomicalLocation	S	0..1	BackboneElement	Body structures (s), third qualifier: anatomical location
code		1..1	CodeableConcept	Type of component observation (code / type) Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
system		1..1	uri	Identity of the terminology system Fixed Value: https://www.medizininformatik-initiative.de/fhir/ext/modul-seltene/CodeSystem/mii-cs-seltene-icf-beurteilungsmerkmal
code		1..1	code	Symbol in syntax defined by the system Fixed Value: anatomical-location
value[x]		0..1	CodeableConcept	Actual component result Binding: https://terminologien.bfarm.de/fhir/ValueSet/icf-q-anatomische-lokalisation (required)
component:capacity	S	0..1	BackboneElement	Activities and participation (d): CAPACITY — what the person can do in a standardised environment
code		1..1	CodeableConcept	Type of component observation (code / type) Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
system		1..1	uri	Identity of the terminology system Fixed Value: https://www.medizininformatik-initiative.de/fhir/ext/modul-seltene/CodeSystem/mii-cs-seltene-icf-beurteilungsmerkmal
code		1..1	code	Symbol in syntax defined by the system Fixed Value: capacity
value[x]		0..1	CodeableConcept	Actual component result Binding: https://terminologien.bfarm.de/fhir/ValueSet/icf-q-leistungsfaehigkeit-und-leistung (required)
component:performance	S	0..1	BackboneElement	Activities and participation (d): PERFORMANCE — what the person actually does in their current environment
code		1..1	CodeableConcept	Type of component observation (code / type) Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
system		1..1	uri	Identity of the terminology system Fixed Value: https://www.medizininformatik-initiative.de/fhir/ext/modul-seltene/CodeSystem/mii-cs-seltene-icf-beurteilungsmerkmal
code		1..1	code	Symbol in syntax defined by the system Fixed Value: performance
value[x]		0..1	CodeableConcept	Actual component result Binding: https://terminologien.bfarm.de/fhir/ValueSet/icf-q-leistungsfaehigkeit-und-leistung (required)
component:barrier	S	0..1	BackboneElement	Environmental factors (e): extent to which the factor acts as a barrier
code		1..1	CodeableConcept	Type of component observation (code / type) Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
system		1..1	uri	Identity of the terminology system Fixed Value: https://www.medizininformatik-initiative.de/fhir/ext/modul-seltene/CodeSystem/mii-cs-seltene-icf-beurteilungsmerkmal
code		1..1	code	Symbol in syntax defined by the system Fixed Value: barrier
value[x]		0..1	CodeableConcept	Actual component result Binding: https://terminologien.bfarm.de/fhir/ValueSet/icf-q-barrieren (required)
component:facilitator	S	0..1	BackboneElement	Environmental factors (e): extent to which the factor acts as a facilitator
code		1..1	CodeableConcept	Type of component observation (code / type) Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
system		1..1	uri	Identity of the terminology system Fixed Value: https://www.medizininformatik-initiative.de/fhir/ext/modul-seltene/CodeSystem/mii-cs-seltene-icf-beurteilungsmerkmal
code		1..1	code	Symbol in syntax defined by the system Fixed Value: facilitator
value[x]		0..1	CodeableConcept	Actual component result Binding: https://terminologien.bfarm.de/fhir/ValueSet/icf-q-foerderfaktoren (required)
Documentation for this format

Terminology Bindings (Differential)

Path	Status	Usage	ValueSet	Version	Source
Observation.code.coding	Base	required	MII VS SE ICF Categories	📦2027.0.0-ballot	This IG
Observation.component:extentOfImpairment.​value[x]	Base	required	https://terminologien.bfarm.de/fhir/ValueSet/icf-q-ausmass-der-schaedigung	Not State	Unknown
Observation.component:extentOfImpairmentBodyStructure.​value[x]	Base	required	https://terminologien.bfarm.de/fhir/ValueSet/icf-q-ausmass-der-schaedigung-s	Not State	Unknown
Observation.component:natureOfChange.​value[x]	Base	required	https://terminologien.bfarm.de/fhir/ValueSet/icf-q-art-oder-veraenderung-in-der-entsprechenden-koerperstruktur	Not State	Unknown
Observation.component:anatomicalLocation.​value[x]	Base	required	https://terminologien.bfarm.de/fhir/ValueSet/icf-q-anatomische-lokalisation	Not State	Unknown
Observation.component:capacity.​value[x]	Base	required	https://terminologien.bfarm.de/fhir/ValueSet/icf-q-leistungsfaehigkeit-und-leistung	Not State	Unknown
Observation.component:performance.​value[x]	Base	required	https://terminologien.bfarm.de/fhir/ValueSet/icf-q-leistungsfaehigkeit-und-leistung	Not State	Unknown
Observation.component:barrier.​value[x]	Base	required	https://terminologien.bfarm.de/fhir/ValueSet/icf-q-barrieren	Not State	Unknown
Observation.component:facilitator.​value[x]	Base	required	https://terminologien.bfarm.de/fhir/ValueSet/icf-q-foerderfaktoren	Not State	Unknown

Constraints

Id	Grade	Path(s)	Description	Expression
mii-icf-1	error	Observation	Body functions (chapter b) take only the extent-of-impairment qualifier.	code.coding.where(system='http://hl7.org/fhir/sid/icf').code.first().startsWith('b') implies component.where(code.coding.code != 'extent-of-impairment').empty()
mii-icf-2	error	Observation	Body structures (chapter s) take only extent, nature of change and anatomical location.	code.coding.where(system='http://hl7.org/fhir/sid/icf').code.first().startsWith('s') implies component.where(code.coding.code != 'extent-of-impairment-structure' and code.coding.code != 'nature-of-change' and code.coding.code != 'anatomical-location').empty()
mii-icf-3	error	Observation	Activities and participation (chapter d) take only capacity and performance.	code.coding.where(system='http://hl7.org/fhir/sid/icf').code.first().startsWith('d') implies component.where(code.coding.code != 'capacity' and code.coding.code != 'performance').empty()
mii-icf-4	error	Observation	Environmental factors (chapter e) take only the barrier or facilitator qualifier.	code.coding.where(system='http://hl7.org/fhir/sid/icf').code.first().startsWith('e') implies component.where(code.coding.code != 'barrier' and code.coding.code != 'facilitator').empty()
mii-icf-5	error	Observation	An environmental factor is graded as a barrier or as a facilitator, not as both at once.	component.where(code.coding.code = 'barrier').empty() or component.where(code.coding.code = 'facilitator').empty()

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Observation	C	0..*	Observation	Measurements and simple assertions Constraints: obs-6, obs-7, mii-icf-1, mii-icf-2, mii-icf-3, mii-icf-4, mii-icf-5
id	SΣ	0..1	id	Logical id of this artifact
meta	SΣ	0..1	Meta	Metadata about the resource
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
versionId	Σ	0..1	id	Version specific identifier
lastUpdated	Σ	0..1	instant	When the resource version last changed
source	Σ	0..1	uri	Identifies where the resource comes from
profile	SΣ	0..*	canonical(StructureDefinition)	Profiles this resource claims to conform to
security	Σ	0..*	Coding	Security Labels applied to this resource Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
tag	Σ	0..*	Coding	Tags applied to this resource Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".
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 Bindings Purpose 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
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	0..*	Identifier	Business Identifier for observation
basedOn	Σ	0..*	Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest)	Fulfills plan, proposal or order
partOf	Σ	0..*	Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy)	Part of referenced event
status	?!SΣ	1..1	code	registered | preliminary | final | amended + Binding: ObservationStatus (required): Codes providing the status of an observation.
Slices for category	S	1..*	CodeableConcept	Classification of type of observation Slice: Unordered, Open by pattern:$this Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
category:survey	S	1..1	CodeableConcept	Category: survey/assessment Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: survey
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
code	SΣ	1..1	CodeableConcept	ICF category being graded Binding: LOINCCodes (example): Codes identifying names of simple observations.
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
coding	SΣ	0..*	Coding	Code defined by a terminology system Binding: MII VS SE ICF Categories (required)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	Σ	0..1	uri	Identity of the terminology system Required Pattern: http://hl7.org/fhir/sid/icf
version	Σ	0..1	string	Version of the system - if relevant
code	Σ	0..1	code	Symbol in syntax defined by the system
display	Σ	0..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
text	Σ	0..1	string	Plain text representation of the concept
subject	SΣ	1..1	Reference(Patient)	Who and/or what the observation is about
focus	Σ	0..*	Reference(Resource)	What the observation is about, when it is not about the subject of record
encounter	Σ	0..1	Reference(Encounter)	Healthcare event during which this observation is made
effective[x]	SΣ	1..1		When the assessment was made — ICF gradings are point-in-time and change over the course of a disease
effectiveDateTime			dateTime
effectivePeriod			Period
issued	Σ	0..1	instant	Date/Time this version was made available
performer	SΣ	0..*	Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson)	Who is responsible for the observation
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	S	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(Specimen)	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
Slices for component	SΣ	0..*	BackboneElement	Component results Slice: Unordered, Open by pattern:code
component:All Slices				Content/Rules for all slices
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
component:extentOfImpairment	SΣ	0..1	BackboneElement	Body functions (b): extent of impairment
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. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: https://www.medizininformatik-initiative.de/fhir/ext/modul-seltene/CodeSystem/mii-cs-seltene-icf-beurteilungsmerkmal
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: extent-of-impairment
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
value[x]	Σ	0..1	CodeableConcept	Actual component result Binding: https://terminologien.bfarm.de/fhir/ValueSet/icf-q-ausmass-der-schaedigung (required)
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
component:extentOfImpairmentBodyStructure	SΣ	0..1	BackboneElement	Body structures (s), first qualifier: extent of impairment
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. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: https://www.medizininformatik-initiative.de/fhir/ext/modul-seltene/CodeSystem/mii-cs-seltene-icf-beurteilungsmerkmal
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: extent-of-impairment-structure
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
value[x]	Σ	0..1	CodeableConcept	Actual component result Binding: https://terminologien.bfarm.de/fhir/ValueSet/icf-q-ausmass-der-schaedigung-s (required)
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
component:natureOfChange	SΣ	0..1	BackboneElement	Body structures (s), second qualifier: nature of the change
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. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: https://www.medizininformatik-initiative.de/fhir/ext/modul-seltene/CodeSystem/mii-cs-seltene-icf-beurteilungsmerkmal
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: nature-of-change
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
value[x]	Σ	0..1	CodeableConcept	Actual component result Binding: https://terminologien.bfarm.de/fhir/ValueSet/icf-q-art-oder-veraenderung-in-der-entsprechenden-koerperstruktur (required)
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
component:anatomicalLocation	SΣ	0..1	BackboneElement	Body structures (s), third qualifier: anatomical location
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. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: https://www.medizininformatik-initiative.de/fhir/ext/modul-seltene/CodeSystem/mii-cs-seltene-icf-beurteilungsmerkmal
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: anatomical-location
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
value[x]	Σ	0..1	CodeableConcept	Actual component result Binding: https://terminologien.bfarm.de/fhir/ValueSet/icf-q-anatomische-lokalisation (required)
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
component:capacity	SΣ	0..1	BackboneElement	Activities and participation (d): CAPACITY — what the person can do in a standardised environment
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. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: https://www.medizininformatik-initiative.de/fhir/ext/modul-seltene/CodeSystem/mii-cs-seltene-icf-beurteilungsmerkmal
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: capacity
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
value[x]	Σ	0..1	CodeableConcept	Actual component result Binding: https://terminologien.bfarm.de/fhir/ValueSet/icf-q-leistungsfaehigkeit-und-leistung (required)
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
component:performance	SΣ	0..1	BackboneElement	Activities and participation (d): PERFORMANCE — what the person actually does in their current environment
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. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: https://www.medizininformatik-initiative.de/fhir/ext/modul-seltene/CodeSystem/mii-cs-seltene-icf-beurteilungsmerkmal
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: performance
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
value[x]	Σ	0..1	CodeableConcept	Actual component result Binding: https://terminologien.bfarm.de/fhir/ValueSet/icf-q-leistungsfaehigkeit-und-leistung (required)
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
component:barrier	SΣ	0..1	BackboneElement	Environmental factors (e): extent to which the factor acts as a barrier
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. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: https://www.medizininformatik-initiative.de/fhir/ext/modul-seltene/CodeSystem/mii-cs-seltene-icf-beurteilungsmerkmal
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: barrier
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
value[x]	Σ	0..1	CodeableConcept	Actual component result Binding: https://terminologien.bfarm.de/fhir/ValueSet/icf-q-barrieren (required)
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
component:facilitator	SΣ	0..1	BackboneElement	Environmental factors (e): extent to which the factor acts as a facilitator
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. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: https://www.medizininformatik-initiative.de/fhir/ext/modul-seltene/CodeSystem/mii-cs-seltene-icf-beurteilungsmerkmal
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: facilitator
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
value[x]	Σ	0..1	CodeableConcept	Actual component result Binding: https://terminologien.bfarm.de/fhir/ValueSet/icf-q-foerderfaktoren (required)
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
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
Observation.meta.security	Base	extensible	SecurityLabels	📍4.0.1	FHIR Std.
Observation.meta.tag	Base	example	Common Tags	📍4.0.1	FHIR Std.
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.category:survey	Base	preferred	Observation Category Codes	📍4.0.1	FHIR Std.
Observation.code	Base	example	LOINC Codes	📍4.0.1	FHIR Std.
Observation.code.coding	Base	required	MII VS SE ICF Categories	📦2027.0.0-ballot	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.
Observation.component:extentOfImpairment.​code	Base	example	LOINC Codes	📍4.0.1	FHIR Std.
Observation.component:extentOfImpairment.​value[x]	Base	required	https://terminologien.bfarm.de/fhir/ValueSet/icf-q-ausmass-der-schaedigung	Not State	Unknown
Observation.component:extentOfImpairment.​dataAbsentReason	Base	extensible	DataAbsentReason	📍4.0.1	FHIR Std.
Observation.component:extentOfImpairment.​interpretation	Base	extensible	Observation Interpretation Codes	📍4.0.1	FHIR Std.
Observation.component:extentOfImpairmentBodyStructure.​code	Base	example	LOINC Codes	📍4.0.1	FHIR Std.
Observation.component:extentOfImpairmentBodyStructure.​value[x]	Base	required	https://terminologien.bfarm.de/fhir/ValueSet/icf-q-ausmass-der-schaedigung-s	Not State	Unknown
Observation.component:extentOfImpairmentBodyStructure.​dataAbsentReason	Base	extensible	DataAbsentReason	📍4.0.1	FHIR Std.
Observation.component:extentOfImpairmentBodyStructure.​interpretation	Base	extensible	Observation Interpretation Codes	📍4.0.1	FHIR Std.
Observation.component:natureOfChange.​code	Base	example	LOINC Codes	📍4.0.1	FHIR Std.
Observation.component:natureOfChange.​value[x]	Base	required	https://terminologien.bfarm.de/fhir/ValueSet/icf-q-art-oder-veraenderung-in-der-entsprechenden-koerperstruktur	Not State	Unknown
Observation.component:natureOfChange.​dataAbsentReason	Base	extensible	DataAbsentReason	📍4.0.1	FHIR Std.
Observation.component:natureOfChange.​interpretation	Base	extensible	Observation Interpretation Codes	📍4.0.1	FHIR Std.
Observation.component:anatomicalLocation.​code	Base	example	LOINC Codes	📍4.0.1	FHIR Std.
Observation.component:anatomicalLocation.​value[x]	Base	required	https://terminologien.bfarm.de/fhir/ValueSet/icf-q-anatomische-lokalisation	Not State	Unknown
Observation.component:anatomicalLocation.​dataAbsentReason	Base	extensible	DataAbsentReason	📍4.0.1	FHIR Std.
Observation.component:anatomicalLocation.​interpretation	Base	extensible	Observation Interpretation Codes	📍4.0.1	FHIR Std.
Observation.component:capacity.​code	Base	example	LOINC Codes	📍4.0.1	FHIR Std.
Observation.component:capacity.​value[x]	Base	required	https://terminologien.bfarm.de/fhir/ValueSet/icf-q-leistungsfaehigkeit-und-leistung	Not State	Unknown
Observation.component:capacity.​dataAbsentReason	Base	extensible	DataAbsentReason	📍4.0.1	FHIR Std.
Observation.component:capacity.​interpretation	Base	extensible	Observation Interpretation Codes	📍4.0.1	FHIR Std.
Observation.component:performance.​code	Base	example	LOINC Codes	📍4.0.1	FHIR Std.
Observation.component:performance.​value[x]	Base	required	https://terminologien.bfarm.de/fhir/ValueSet/icf-q-leistungsfaehigkeit-und-leistung	Not State	Unknown
Observation.component:performance.​dataAbsentReason	Base	extensible	DataAbsentReason	📍4.0.1	FHIR Std.
Observation.component:performance.​interpretation	Base	extensible	Observation Interpretation Codes	📍4.0.1	FHIR Std.
Observation.component:barrier.​code	Base	example	LOINC Codes	📍4.0.1	FHIR Std.
Observation.component:barrier.​value[x]	Base	required	https://terminologien.bfarm.de/fhir/ValueSet/icf-q-barrieren	Not State	Unknown
Observation.component:barrier.​dataAbsentReason	Base	extensible	DataAbsentReason	📍4.0.1	FHIR Std.
Observation.component:barrier.​interpretation	Base	extensible	Observation Interpretation Codes	📍4.0.1	FHIR Std.
Observation.component:facilitator.​code	Base	example	LOINC Codes	📍4.0.1	FHIR Std.
Observation.component:facilitator.​value[x]	Base	required	https://terminologien.bfarm.de/fhir/ValueSet/icf-q-foerderfaktoren	Not State	Unknown
Observation.component:facilitator.​dataAbsentReason	Base	extensible	DataAbsentReason	📍4.0.1	FHIR Std.
Observation.component:facilitator.​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()
mii-icf-1	error	Observation	Body functions (chapter b) take only the extent-of-impairment qualifier.	code.coding.where(system='http://hl7.org/fhir/sid/icf').code.first().startsWith('b') implies component.where(code.coding.code != 'extent-of-impairment').empty()
mii-icf-2	error	Observation	Body structures (chapter s) take only extent, nature of change and anatomical location.	code.coding.where(system='http://hl7.org/fhir/sid/icf').code.first().startsWith('s') implies component.where(code.coding.code != 'extent-of-impairment-structure' and code.coding.code != 'nature-of-change' and code.coding.code != 'anatomical-location').empty()
mii-icf-3	error	Observation	Activities and participation (chapter d) take only capacity and performance.	code.coding.where(system='http://hl7.org/fhir/sid/icf').code.first().startsWith('d') implies component.where(code.coding.code != 'capacity' and code.coding.code != 'performance').empty()
mii-icf-4	error	Observation	Environmental factors (chapter e) take only the barrier or facilitator qualifier.	code.coding.where(system='http://hl7.org/fhir/sid/icf').code.first().startsWith('e') implies component.where(code.coding.code != 'barrier' and code.coding.code != 'facilitator').empty()
mii-icf-5	error	Observation	An environmental factor is graded as a barrier or as a facilitator, not as both at once.	component.where(code.coding.code = 'barrier').empty() or component.where(code.coding.code = 'facilitator').empty()
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()