# Observation Results: laboratory - HL7 Europe Laboratory Report v2.0.0

* [**Table of Contents**](toc.md)
* [**Artifacts Summary**](artifacts.md)
* **Observation Results: laboratory**

## Resource Profile: Observation Results: laboratory 

| | | |
| :--- | :--- | :--- |
| *Official URL*:http://hl7.eu/fhir/laboratory/StructureDefinition/Observation-resultslab-eu-lab | *Version*:2.0.0 | |
| * Standards status: *[Trial-use](http://hl7.org/fhir/R4/versions.html#std-process) | [Maturity Level](http://hl7.org/fhir/versions.html#maturity): 2 | *Computable Name*:ObservationResultsLaboratoryEu |
| **Copyright/Legal**: Copyright HL7 Europe. Licensed under creative commons public domain (CC0 1.0). | | |

 
This profile constrains the Observation resource to represent results produced by laboratory tests or panels/studies for the HL7 Europe project. This observation may represent the result of a simple laboratory test such as hematocrit or it may group the set of results produced by a multi-test study or panel such as a complete blood count, a dynamic function test, a urine specimen study. In the latter case, the observation carries the overall conclusion of the study and or a global interpretation by the producer of the study, in the comment element; and references the atomic results of the study as "has-member" child observations. 

 
This profile constrains the Observation resource to represent a laboratory in vitro diagnostic test or panel/study. In case of a panel/study, the results of the panel appear as sub-observations. In this case this top-level Observation acts as a grouper of all the observations belonging to the panel or study. The top-level observation may carry a conclusion in the value element and or a global interpretation by the producer of the study, in the comment element. 

### Medical and Laboratory Test Results

#### Medical Test Results

Medical test results represent the outcomes of procedures performed to determine values of properties of the human body or of subjects related to the body (e.g., environment, substances, animals, devices etc.).

This broad category includes laboratory test results typically based on in vitro diagnostic devices that follow In Vitro Diagnostic Medical Devices Regulation (IVDR) (EU) 2017/746 and results based on measurements and diagnostic functions by medical devices according to the Medical Device Regulation (MDR) 2017/745. Additionally, the medical test results may include results from direct observation or emerging technologies for minimally invasive tests, such as biosensor monitoring or other non-invasive tests for direct measurement of the properties of saliva, sweat, or tears, as well as techniques for transcutaneous measurement of properties, regardless of whether the measurement is performed in a healthcare provider setting, such as in dedicated outpatient clinics, or at the point of care, or in patient’s home environment.

Medical test results include, but are not limited to:

* laboratory tests typically based on in vitro diagnostic devices regulated under the IVDR (EU) 2017/746;
* results from measurements performed by medical devices regulated under the MDR (EU) 2017/745, such as physiological or functional in vivo measurements;
* measurement results obtained by the imaging observation methods
* examination results from observation of the patient, body parts of the patient and/or their functions
* results generated by emerging technologies, including minimally invasive or non-invasive techniques such as biosensors and direct measurements from saliva, sweat, or tears, as well as transcutaneous measurement techniques.

#### Laboratory Test Results

Laboratory test results are a subset of medical test results and represent electronic health data produced by studies performed primarily using in vitro diagnostic methods under controlled conditions.

Laboratory test results constitute a major subset of medical test results and represent the primary focus of the specifications defined in this IG. Laboratory test results in electronic form represent results from studies performed through in vitro diagnostics such as clinical biochemistry, haematology, transfusion medicine, microbiology, immunology and related disciplines. Laboratory test results are often provided together with additional information supporting the interpretation of the results.

Laboratory test results are typically produced using in vitro diagnostic devices compliant with IVDR (EU) 2017/746. The results may originate from dedicated laboratories, point of care testing performed in healthcare settings such as doctor’s office or hospital wards, or from supervised testing performed in a non-clinical environment, including patient homes.

Laboratory test results are typically characterized by:

* controlled environmental conditions (e.g. temperature, humidity, lighting);
* standardized and validated standard operating procedures (SOPs);
* use of calibrated and maintained instruments;
* application of internal quality control (IQC) and participation in external quality assessment (EQA) / proficiency testing schemes;
* performance by trained and qualified personnel operating within defined professional roles and responsibilities.

Laboratory results are typically generated in:

* accredited clinical laboratories,
* hospital laboratory departments,
* or certified POCT environments operating under laboratory governance frameworks.

These conditions provide a high level of analytical reliability and support the use of laboratory test results for diagnostic decision-making, clinical monitoring, and secondary use such as research and population health analysis.

#### Guidance for Use

It is not easy to draw a clear line between general medical test results and laboratory test results as they are rather similar, with only minor differences in content, as shown in the logical models. Nevertheless, FHIR IG developers and implementers of the EHR systems would have to decide which type of observation to use. We propose to take into consideration the following rules:

* Use Laboratory test results when results originate from in vitro diagnostic procedures performed under laboratory governance and quality assurance frameworks.
* Use Medical test results as the broader category for results obtained across different environments and technologies.
* When representing medical including laboratory test results, ensure that the measurement context is available to support appropriate clinical interpretation.

#### Implementation note: Laboratory panels

Laboratory panels (or batteries) are predefined groups of tests that can be ordered from a laboratory using a single code from a chosen coding system. Upon receiving such an order, the laboratory expands it into its individual component tests and reports results for each test separately.

If it is necessary to preserve the relationship between the panel and its component tests, the panel should be represented as a grouping Observation. In this approach, the panel code is used as the code of the grouping Observation, and each component test is represented as a separate Observation. These individual Observations are then linked to the grouping Observation via the `hasMember` reference.

#### Implementation note: Reflex tests

Reflex tests are additional laboratory tests performed automatically based on predefined criteria, such as the result of an initial test. They are not usually ordered directly as part of the original request, but are triggered by the laboratory workflow when specific conditions are met.

When it is necessary to preserve the relationship between the initial test and the reflex test, this relationship should be represented using the triggeredBy element. The original test result is represented as one Observation, and each reflex test result is represented as a separate Observation. The reflex test Observation should reference the Observation that triggered it using triggeredBy.observation, and the appropriate trigger type should be recorded in triggeredBy.type.

This allows the result report to clearly indicate that the reflex test was performed as a consequence of another observation, while keeping each test result as a distinct Observation.

> This profile offers two options to indicate the Certified Reference Material used for the calibration (in general when the UCUM International Units are used for the results [IU]). 
* The first to be used when the Certified Reference Material is represented by a coded concept
* The second when the Certified Reference Material is identified with an Identifier.
 Adopters are invited to give their feedback about 
1. The most proper way to refer the Certified Reference Material, that is by using an Identifier or a CodeableConcept
1. If a CodeableReference should be used
1. If this information should be an extension of the Observation resource, or of other elements (e.g. DeviceMetric.calibration)
 

**Usages:**

* Refer to this Profile: [DiagnosticReport: Laboratory Report](StructureDefinition-DiagnosticReport-eu-lab.md) and [Observation Results: laboratory](StructureDefinition-Observation-resultslab-eu-lab.md)
* Examples for this Profile: [Observation/4335db48-7090-45b3-a2c2-45b45f94a67c](Observation-4335db48-7090-45b3-a2c2-45b45f94a67c.md), [Observation/d29b286d-b99c-410f-af4e-9455ea49d0af](Observation-d29b286d-b99c-410f-af4e-9455ea49d0af.md), [Observation/obs-aerobic-culture](Observation-obs-aerobic-culture.md), [Observation/obs-anaerobic-culture](Observation-obs-anaerobic-culture.md)... Show 11 more, [Observation/obs-gram-stain](Observation-obs-gram-stain.md), [Observation/obs-gs-org1-quant](Observation-obs-gs-org1-quant.md), [Observation/obs-gs-org1](Observation-obs-gs-org1.md), [Observation/obs-org-id1-growth](Observation-obs-org-id1-growth.md), [Observation/obs-org-id1-susc-1](Observation-obs-org-id1-susc-1.md), [Observation/obs-org-id1-susc-2](Observation-obs-org-id1-susc-2.md), [Observation/obs-org-id1-susc-3](Observation-obs-org-id1-susc-3.md), [Observation/obs-org-id1-susc-4](Observation-obs-org-id1-susc-4.md), [Observation/obs-org-id1-susc-panel](Observation-obs-org-id1-susc-panel.md), [Observation/obs-org-id1](Observation-obs-org-id1.md) and [Observation/obs-wbc](Observation-obs-wbc.md)

You can also check for [usages in the FHIR IG Statistics](https://packages2.fhir.org/xig/hl7.fhir.eu.laboratory|current/StructureDefinition/Observation-resultslab-eu-lab)

### Formal Views of Profile Content

 [Description of Profiles, Differentials, Snapshots and how the different presentations work](http://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#structure-definitions). 

 

Other representations of profile: [CSV](StructureDefinition-Observation-resultslab-eu-lab.csv), [Excel](StructureDefinition-Observation-resultslab-eu-lab.xlsx), [Schematron](StructureDefinition-Observation-resultslab-eu-lab.sch) 

### Notes:

#### Notes on valueString vs valueCodeableConcept.text

If the result is purely free text without categorical meaning, **`Observation.valueString`** SHALL be used.

If the result is conceptually categorical (i.e. it represents a classification, interpretation, or selectable answer option), **`Observation.valueCodeableConcept`** SHALL be used.

If no formal coding system is available, the human-readable result SHALL be conveyed in **`Observation.valueCodeableConcept.text`** instead of using `valueString`.

This distinction ensures that categorical results remain semantically identifiable as coded data, even if only a textual representation is available.



## Resource Content

```json
{
  "resourceType" : "StructureDefinition",
  "id" : "Observation-resultslab-eu-lab",
  "extension" : [{
    "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm",
    "valueInteger" : 2
  },
  {
    "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
    "valueCode" : "trial-use"
  }],
  "url" : "http://hl7.eu/fhir/laboratory/StructureDefinition/Observation-resultslab-eu-lab",
  "version" : "2.0.0",
  "name" : "ObservationResultsLaboratoryEu",
  "title" : "Observation Results: laboratory",
  "status" : "active",
  "experimental" : false,
  "date" : "2026-05-05T16:28:07+02:00",
  "publisher" : "HL7 Europe",
  "contact" : [{
    "name" : "HL7 Europe",
    "telecom" : [{
      "system" : "url",
      "value" : "http://hl7.eu"
    }]
  }],
  "description" : "This profile constrains the Observation resource to represent results produced by laboratory tests or panels/studies for the  HL7 Europe project.\nThis observation may represent the result of a simple laboratory test such as hematocrit or it may group the set of results produced by a multi-test study or panel such as a complete blood count, a dynamic function test, a urine specimen study. In the latter case, the observation carries the overall conclusion of the study and or a global interpretation by the producer of the study, in the comment element; and references the atomic results of the study as \"has-member\" child observations.",
  "jurisdiction" : [{
    "coding" : [{
      "system" : "http://unstats.un.org/unsd/methods/m49/m49.htm",
      "code" : "150",
      "display" : "Europe"
    }]
  }],
  "purpose" : "This profile constrains the Observation resource to represent a laboratory in vitro diagnostic test or panel/study. In case of a panel/study, the results of the panel appear as sub-observations. In this case this top-level Observation acts as a grouper of all the observations belonging to the panel or study.  The top-level observation may carry a conclusion in the value element and or a global interpretation by the producer of the study, in the comment element.",
  "copyright" : "Copyright HL7 Europe. Licensed under creative commons public domain (CC0 1.0).",
  "fhirVersion" : "4.0.1",
  "mapping" : [{
    "identity" : "workflow",
    "uri" : "http://hl7.org/fhir/workflow",
    "name" : "Workflow Pattern"
  },
  {
    "identity" : "sct-concept",
    "uri" : "http://snomed.info/conceptdomain",
    "name" : "SNOMED CT Concept Domain Binding"
  },
  {
    "identity" : "v2",
    "uri" : "http://hl7.org/v2",
    "name" : "HL7 v2 Mapping"
  },
  {
    "identity" : "rim",
    "uri" : "http://hl7.org/v3",
    "name" : "RIM Mapping"
  },
  {
    "identity" : "w5",
    "uri" : "http://hl7.org/fhir/fivews",
    "name" : "FiveWs Pattern Mapping"
  },
  {
    "identity" : "sct-attr",
    "uri" : "http://snomed.org/attributebinding",
    "name" : "SNOMED CT Attribute Binding"
  }],
  "kind" : "resource",
  "abstract" : false,
  "type" : "Observation",
  "baseDefinition" : "http://hl7.eu/fhir/base/StructureDefinition/medicalTestResult-eu-core",
  "derivation" : "constraint",
  "differential" : {
    "element" : [{
      "id" : "Observation",
      "path" : "Observation",
      "short" : "Laboratory result for a simple test or for a panel/study",
      "definition" : "This observation may represent the result of a simple laboratory test such as hematocrit or it may group the set of results produced by a multi-test study or panel such as a complete blood count, a dynamic function test, a urine specimen study. In the latter case, the observation carries the overall conclusion of the study and references the atomic results of the study as \"has-member\" child observations",
      "comment" : "Represents either a lab simple observation or the group of observations produced by a laboratory study.",
      "constraint" : [{
        "key" : "eu-lab-1",
        "severity" : "error",
        "human" : "If observation status is other then \"registered\" or \"cancelled\", at least one of these Observation elements shall be provided:  \"value\", \"dataAbsentReason\", \"hasMember\" or \"component\"",
        "expression" : "(status in ('registered'|'cancelled')) or value.exists() or extension.where(url='http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.value').exists() or hasMember.exists() or component.exists() or dataAbsentReason.exists()",
        "source" : "http://hl7.eu/fhir/laboratory/StructureDefinition/Observation-resultslab-eu-lab"
      },
      {
        "key" : "eu-lab-2",
        "severity" : "error",
        "human" : "If observation has components and observation status is other then \"registered\" or \"cancelled\", at least one of these Observation.component elements shall be provided:  \"value\" or \"dataAbsentReason\"",
        "expression" : "component.exists() implies (status in ('registered'|'cancelled')) or component.value.exists() or component.extension.where(url='http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.component.value').exists() or component.dataAbsentReason.exists()",
        "source" : "http://hl7.eu/fhir/laboratory/StructureDefinition/Observation-resultslab-eu-lab"
      }]
    },
    {
      "id" : "Observation.extension:supportingInfo",
      "path" : "Observation.extension",
      "sliceName" : "supportingInfo",
      "min" : 0,
      "max" : "*",
      "type" : [{
        "code" : "Extension",
        "profile" : ["http://hl7.org/fhir/StructureDefinition/workflow-supportingInfo|5.2.0"]
      }]
    },
    {
      "id" : "Observation.extension:labTestKit",
      "path" : "Observation.extension",
      "sliceName" : "labTestKit",
      "short" : "Laboratory Test Kit",
      "definition" : "The laboratory test kit used for this test.",
      "min" : 0,
      "max" : "*",
      "type" : [{
        "code" : "Extension",
        "profile" : ["http://hl7.eu/fhir/laboratory/StructureDefinition/observation-deviceLabTestKit"]
      }]
    },
    {
      "id" : "Observation.extension:certifiedRefMaterialCodeable",
      "path" : "Observation.extension",
      "sliceName" : "certifiedRefMaterialCodeable",
      "min" : 0,
      "max" : "*",
      "type" : [{
        "code" : "Extension",
        "profile" : ["http://hl7.eu/fhir/laboratory/StructureDefinition/observation-certifiedRefMaterialCodeable"]
      }]
    },
    {
      "id" : "Observation.extension:certifiedRefMaterialIdentifer",
      "path" : "Observation.extension",
      "sliceName" : "certifiedRefMaterialIdentifer",
      "min" : 0,
      "max" : "*",
      "type" : [{
        "code" : "Extension",
        "profile" : ["http://hl7.eu/fhir/laboratory/StructureDefinition/observation-certifiedRefMaterialIdentifer"]
      }]
    },
    {
      "id" : "Observation.extension:accredited",
      "path" : "Observation.extension",
      "sliceName" : "accredited",
      "short" : "Accredited test",
      "definition" : "Indicates that this laboratory test was/is accredited.",
      "min" : 0,
      "max" : "1",
      "type" : [{
        "code" : "Extension",
        "profile" : ["http://hl7.eu/fhir/StructureDefinition/laboratory-accredited"]
      }]
    },
    {
      "id" : "Observation.status",
      "path" : "Observation.status",
      "short" : "Status of this observation (e.g. preliminary, final,...)"
    },
    {
      "id" : "Observation.category",
      "path" : "Observation.category",
      "slicing" : {
        "discriminator" : [{
          "type" : "pattern",
          "path" : "$this"
        }],
        "ordered" : false,
        "rules" : "open"
      },
      "comment" : "\"laboratory\" includes laboratory medicine and pathology"
    },
    {
      "id" : "Observation.category:laboratory",
      "path" : "Observation.category",
      "sliceName" : "laboratory",
      "min" : 1,
      "max" : "1",
      "patternCodeableConcept" : {
        "coding" : [{
          "system" : "http://terminology.hl7.org/CodeSystem/observation-category",
          "code" : "laboratory"
        }]
      }
    },
    {
      "id" : "Observation.category:studyType",
      "path" : "Observation.category",
      "sliceName" : "studyType",
      "short" : "The way of grouping of the test results into clinically meaningful domains (e.g. hematology study, microbiology study, etc.)",
      "min" : 0,
      "max" : "*",
      "binding" : {
        "strength" : "required",
        "valueSet" : "http://hl7.eu/fhir/laboratory/ValueSet/lab-studyType-eu-lab"
      }
    },
    {
      "id" : "Observation.category:specialty",
      "path" : "Observation.category",
      "sliceName" : "specialty",
      "short" : "The clinical domain of the laboratory performing the observation (e.g. microbiology, toxicology, chemistry)",
      "min" : 0,
      "max" : "*",
      "binding" : {
        "strength" : "required",
        "valueSet" : "http://hl7.eu/fhir/laboratory/ValueSet/lab-specialty-eu-lab"
      }
    },
    {
      "id" : "Observation.code",
      "path" : "Observation.code",
      "definition" : "Describes what was observed. Sometimes this is called the observation \"name\".  In this profile this code represents either a simple laboratory test or a laboratory study with multiple child observations",
      "comment" : "In the context of this Observation-laboratory profile, when the observation plays the role of a grouper of member sub-observations, the code represent the group (for instance a panel code). In case no code is available, at least a text shall be provided.",
      "binding" : {
        "strength" : "preferred",
        "valueSet" : "http://hl7.eu/fhir/laboratory/ValueSet/lab-obsCode-eu-lab"
      }
    },
    {
      "id" : "Observation.focus",
      "path" : "Observation.focus",
      "type" : [{
        "code" : "Reference",
        "targetProfile" : ["http://hl7.eu/fhir/base/StructureDefinition/patient-eu-core",
        "http://hl7.eu/fhir/laboratory/StructureDefinition/animal-specimen-eu-lab",
        "http://hl7.org/fhir/StructureDefinition/Group",
        "http://hl7.org/fhir/StructureDefinition/Device",
        "http://hl7.eu/fhir/base/StructureDefinition/location-eu-core"]
      }]
    },
    {
      "id" : "Observation.issued",
      "path" : "Observation.issued",
      "short" : "Date/Time this result was made available"
    },
    {
      "id" : "Observation.performer",
      "path" : "Observation.performer",
      "min" : 1
    },
    {
      "id" : "Observation.value[x]",
      "path" : "Observation.value[x]",
      "slicing" : {
        "discriminator" : [{
          "type" : "type",
          "path" : "$this"
        }],
        "ordered" : false,
        "rules" : "closed"
      }
    },
    {
      "id" : "Observation.value[x]:valueQuantity",
      "path" : "Observation.value[x]",
      "sliceName" : "valueQuantity",
      "type" : [{
        "code" : "Quantity",
        "profile" : ["http://hl7.eu/fhir/laboratory/StructureDefinition/Quantity-eu-lab"]
      }]
    },
    {
      "id" : "Observation.value[x]:valueString",
      "path" : "Observation.value[x]",
      "sliceName" : "valueString",
      "min" : 0,
      "max" : "1",
      "type" : [{
        "code" : "string"
      }]
    },
    {
      "id" : "Observation.value[x]:valueRange",
      "path" : "Observation.value[x]",
      "sliceName" : "valueRange",
      "min" : 0,
      "max" : "1",
      "type" : [{
        "code" : "Range",
        "profile" : ["http://hl7.eu/fhir/laboratory/StructureDefinition/Range-eu-lab"]
      }]
    },
    {
      "id" : "Observation.value[x]:valueRatio",
      "path" : "Observation.value[x]",
      "sliceName" : "valueRatio",
      "min" : 0,
      "max" : "1",
      "type" : [{
        "code" : "Ratio",
        "profile" : ["http://hl7.eu/fhir/laboratory/StructureDefinition/Ratio-eu-lab"]
      }]
    },
    {
      "id" : "Observation.value[x]:valueTime",
      "path" : "Observation.value[x]",
      "sliceName" : "valueTime",
      "min" : 0,
      "max" : "1",
      "type" : [{
        "code" : "time"
      }]
    },
    {
      "id" : "Observation.value[x]:valueDateTime",
      "path" : "Observation.value[x]",
      "sliceName" : "valueDateTime",
      "min" : 0,
      "max" : "1",
      "type" : [{
        "code" : "dateTime"
      }]
    },
    {
      "id" : "Observation.value[x]:valuePeriod",
      "path" : "Observation.value[x]",
      "sliceName" : "valuePeriod",
      "min" : 0,
      "max" : "1",
      "type" : [{
        "code" : "Period"
      }]
    },
    {
      "id" : "Observation.value[x]:valueCodeableConcept",
      "path" : "Observation.value[x]",
      "sliceName" : "valueCodeableConcept",
      "min" : 0,
      "max" : "1",
      "type" : [{
        "code" : "CodeableConcept"
      }],
      "binding" : {
        "extension" : [{
          "extension" : [{
            "url" : "key",
            "valueId" : "lab-blood-group"
          },
          {
            "url" : "purpose",
            "valueCode" : "candidate"
          },
          {
            "url" : "valueSet",
            "valueCanonical" : "http://hl7.org/fhir/uv/ips/ValueSet/results-blood-group-snomed-ct-ips-free-set"
          },
          {
            "url" : "documentation",
            "valueMarkdown" : "Additional conformance binding to a blood group findings value set for laboratory result values from the SNOMED CT IPS free set for use globally (in SNOMED member and non-member jurisdictions)."
          }],
          "url" : "http://hl7.org/fhir/tools/StructureDefinition/additional-binding"
        },
        {
          "extension" : [{
            "url" : "key",
            "valueId" : "lab-presence-absence"
          },
          {
            "url" : "purpose",
            "valueCode" : "preferred"
          },
          {
            "url" : "valueSet",
            "valueCanonical" : "http://hl7.eu/fhir/laboratory/ValueSet/lab-presenceAbsence-eu-lab"
          },
          {
            "url" : "documentation",
            "valueMarkdown" : "Additional conformance binding to a presence and absence findings (qualifier values) value set for laboratory result values, aligned with the eHDSI PresenceAbsence value set adopted by the eEHMSEG."
          }],
          "url" : "http://hl7.org/fhir/tools/StructureDefinition/additional-binding"
        },
        {
          "extension" : [{
            "url" : "key",
            "valueId" : "lab-microorganism"
          },
          {
            "url" : "purpose",
            "valueCode" : "candidate"
          },
          {
            "url" : "valueSet",
            "valueCanonical" : "http://hl7.org/fhir/uv/ips/ValueSet/results-microorganism-snomed-ct-ips-free-set"
          },
          {
            "url" : "documentation",
            "valueMarkdown" : "Additional conformance binding to a microorganisms value set for laboratory result values from the SNOMED CT IPS free set for use globally (in SNOMED member and non-member jurisdictions)."
          }],
          "url" : "http://hl7.org/fhir/tools/StructureDefinition/additional-binding"
        }],
        "strength" : "preferred",
        "valueSet" : "http://hl7.org/fhir/uv/ips/ValueSet/results-coded-values-laboratory-pathology-uv-ips"
      }
    },
    {
      "id" : "Observation.dataAbsentReason",
      "path" : "Observation.dataAbsentReason",
      "short" : "Provides a reason why the expected value is missing."
    },
    {
      "id" : "Observation.method",
      "path" : "Observation.method",
      "definition" : "Laboratory technigue that has been used",
      "comment" : "Laboratory technique (method of measurement) are integral parts of the test specification of some laboratory test coding systems (e.g. NPU), in LOINC hovewer measurement principle is not always present in the test definition. In some cases however knowledge of the used measurment techique is important for proper interpretation of the test result.\r\nThat's why it is important to explicitly include informaiton about measurement method is such cases.",
      "binding" : {
        "strength" : "preferred",
        "valueSet" : "http://hl7.eu/fhir/laboratory/ValueSet/lab-technique-eu-lab"
      }
    },
    {
      "id" : "Observation.specimen",
      "path" : "Observation.specimen",
      "comment" : "When the specimen is applicable and known it shall be documented",
      "type" : [{
        "code" : "Reference",
        "targetProfile" : ["http://hl7.eu/fhir/laboratory/StructureDefinition/Specimen-eu-lab"]
      }]
    },
    {
      "id" : "Observation.device",
      "path" : "Observation.device",
      "short" : "Measuring instrument"
    },
    {
      "id" : "Observation.hasMember",
      "path" : "Observation.hasMember",
      "definition" : "A reference to another Observation profiled by Observation-results-laboratory-uv-ips. The target observation (for instance an individual test member of a panel) is considered as a sub-observation of the current one, which plays the role of a grouper.",
      "comment" : "This element is used in the context of international patient summary when there is a need to group a collection of observations, because they belong to the same panel, or because they share a common interpretation comment, or a common media attachment (illustrative image or graph). In these cases, the current observation is the grouper, and its set of sub-observations are related observations using the type \"has-member\".  For a discussion on the ways Observations can be assembled in groups together see [Observation Grouping](http://hl7.org/fhir/observation.html#obsgrouping).",
      "type" : [{
        "code" : "Reference",
        "targetProfile" : ["http://hl7.eu/fhir/laboratory/StructureDefinition/Observation-resultslab-eu-lab"]
      }]
    },
    {
      "id" : "Observation.component",
      "path" : "Observation.component",
      "short" : "Laboratory result"
    },
    {
      "id" : "Observation.component.code",
      "path" : "Observation.component.code",
      "binding" : {
        "strength" : "preferred",
        "valueSet" : "http://hl7.eu/fhir/laboratory/ValueSet/lab-obsCode-eu-lab"
      }
    },
    {
      "id" : "Observation.component.value[x]",
      "path" : "Observation.component.value[x]",
      "slicing" : {
        "discriminator" : [{
          "type" : "type",
          "path" : "$this"
        }],
        "ordered" : false,
        "rules" : "closed"
      }
    },
    {
      "id" : "Observation.component.value[x]:valueQuantity",
      "path" : "Observation.component.value[x]",
      "sliceName" : "valueQuantity",
      "type" : [{
        "code" : "Quantity",
        "profile" : ["http://hl7.eu/fhir/laboratory/StructureDefinition/Quantity-eu-lab"]
      }]
    },
    {
      "id" : "Observation.component.value[x]:valueString",
      "path" : "Observation.component.value[x]",
      "sliceName" : "valueString",
      "min" : 0,
      "max" : "1",
      "type" : [{
        "code" : "string"
      }]
    },
    {
      "id" : "Observation.component.value[x]:valueRange",
      "path" : "Observation.component.value[x]",
      "sliceName" : "valueRange",
      "min" : 0,
      "max" : "1",
      "type" : [{
        "code" : "Range",
        "profile" : ["http://hl7.eu/fhir/laboratory/StructureDefinition/Range-eu-lab"]
      }]
    },
    {
      "id" : "Observation.component.value[x]:valueRatio",
      "path" : "Observation.component.value[x]",
      "sliceName" : "valueRatio",
      "min" : 0,
      "max" : "1",
      "type" : [{
        "code" : "Ratio",
        "profile" : ["http://hl7.eu/fhir/laboratory/StructureDefinition/Ratio-eu-lab"]
      }]
    },
    {
      "id" : "Observation.component.value[x]:valueTime",
      "path" : "Observation.component.value[x]",
      "sliceName" : "valueTime",
      "min" : 0,
      "max" : "1",
      "type" : [{
        "code" : "time"
      }]
    },
    {
      "id" : "Observation.component.value[x]:valueDateTime",
      "path" : "Observation.component.value[x]",
      "sliceName" : "valueDateTime",
      "min" : 0,
      "max" : "1",
      "type" : [{
        "code" : "dateTime"
      }]
    },
    {
      "id" : "Observation.component.value[x]:valuePeriod",
      "path" : "Observation.component.value[x]",
      "sliceName" : "valuePeriod",
      "min" : 0,
      "max" : "1",
      "type" : [{
        "code" : "Period"
      }]
    },
    {
      "id" : "Observation.component.value[x]:valueCodeableConcept",
      "path" : "Observation.component.value[x]",
      "sliceName" : "valueCodeableConcept",
      "min" : 0,
      "max" : "1",
      "type" : [{
        "code" : "CodeableConcept"
      }],
      "binding" : {
        "extension" : [{
          "extension" : [{
            "url" : "key",
            "valueId" : "lab-blood-group"
          },
          {
            "url" : "purpose",
            "valueCode" : "candidate"
          },
          {
            "url" : "valueSet",
            "valueCanonical" : "http://hl7.org/fhir/uv/ips/ValueSet/results-blood-group-snomed-ct-ips-free-set"
          },
          {
            "url" : "documentation",
            "valueMarkdown" : "Additional conformance binding to a blood group findings value set for laboratory result values from the SNOMED CT IPS free set for use globally (in SNOMED member and non-member jurisdictions)."
          }],
          "url" : "http://hl7.org/fhir/tools/StructureDefinition/additional-binding"
        },
        {
          "extension" : [{
            "url" : "key",
            "valueId" : "lab-presence-absence"
          },
          {
            "url" : "purpose",
            "valueCode" : "preferred"
          },
          {
            "url" : "valueSet",
            "valueCanonical" : "http://hl7.eu/fhir/laboratory/ValueSet/lab-presenceAbsence-eu-lab"
          },
          {
            "url" : "documentation",
            "valueMarkdown" : "Additional conformance binding to a presence and absence findings (qualifier values) value set for laboratory result values, aligned with the eHDSI PresenceAbsence value set adopted by the eEHMSEG."
          }],
          "url" : "http://hl7.org/fhir/tools/StructureDefinition/additional-binding"
        },
        {
          "extension" : [{
            "url" : "key",
            "valueId" : "lab-microorganism"
          },
          {
            "url" : "purpose",
            "valueCode" : "candidate"
          },
          {
            "url" : "valueSet",
            "valueCanonical" : "http://hl7.org/fhir/uv/ips/ValueSet/results-microorganism-snomed-ct-ips-free-set"
          },
          {
            "url" : "documentation",
            "valueMarkdown" : "Additional conformance binding to a microorganisms value set for laboratory result values from the SNOMED CT IPS free set for use globally (in SNOMED member and non-member jurisdictions)."
          }],
          "url" : "http://hl7.org/fhir/tools/StructureDefinition/additional-binding"
        }],
        "strength" : "preferred",
        "valueSet" : "http://hl7.org/fhir/uv/ips/ValueSet/results-coded-values-laboratory-pathology-uv-ips"
      }
    }]
  }
}

```
