Prepare 0.4.0: DGDA Drug and LOINC Integration

input/fsh/profile/BDObservation.fsh

@@ -2,51 +2,83 @@ Profile:     BDObservationProfile
 Id:          bd-observation
 Parent:      Observation
 Title:       "Bangladesh Observation Profile"
-Description: "Bangladesh Observation Profile"
-* ^url = "https://fhir.dghs.gov.bd/core/StructureDefinition/bd-observation"
-* ^version = "1.0.0"
-* ^status = #active
+Description: """
+Base observation profile for Bangladesh. This is an abstract-style base profile
+from which all BD-Core observation profiles are derived. It is not intended to
+be used directly in clinical resources — use a derived profile instead.
 
-* identifier 1..* MS
+Derived profiles (v0.4.0):
+  - bd-lab-panel-observation  : Laboratory panel/order (hasMember pattern)
+  - bd-lab-result-observation : Laboratory leaf result (child of hasMember)
+
+Planned derived profiles (v0.5.0+):
+  - bd-vital-signs-observation
+  - bd-exam-observation
+"""
+
+* ^url = "https://fhir.dghs.gov.bd/core/StructureDefinition/bd-observation"
+* ^version = "2.0.0"
+* ^status = #draft
+
+// ── Identifier ────────────────────────────────────────────────────────────
+// 0..* at base — not all observation types carry identifiers.
+// Child profiles (e.g. lab results) constrain to 1..*.
+* identifier 0..* MS
 * identifier.value 1..1
 
+// ── Status ────────────────────────────────────────────────────────────────
 * status 1..1
 
-* partOf 0..*
-
+// ── Category ──────────────────────────────────────────────────────────────
+// Preferred binding at base — child profiles fix to specific category codes
+// (e.g. laboratory, vital-signs). Required binding here would block child
+// profiles from narrowing to a fixed category slice.
 * category 1..* MS
-* category from http://hl7.org/fhir/ValueSet/observation-category (required)
-* category ^definition = "Type of category"
-* category ^comment = "E.g. vital, physical examination"
+* category from http://hl7.org/fhir/ValueSet/observation-category (preferred)
+* category ^definition = "Type of observation category"
+* category ^comment = "E.g. laboratory, vital-signs, exam. Child profiles fix this to a specific value."
 
+// ── Code ──────────────────────────────────────────────────────────────────
+// Extensible binding at base — child profiles bind to narrower ValueSets
+// (e.g. BD LOINC lab panels, BD LOINC lab results). Required binding here
+// would prevent child profiles from using a subset binding.
 * code 1..1 MS
-* code from http://hl7.org/fhir/ValueSet/observation-codes (required)
-* code ^definition = "Type of test/measurement"
-* code ^comment = "E.g., Hb, RBS, CBC"
+* code from http://hl7.org/fhir/ValueSet/observation-codes (extensible)
+* code ^definition = "Type of observation / test / measurement"
+* code ^comment = "E.g. Hb, RBS, CBC. Child profiles bind to specific ValueSets."
 
-// Subject: Reference to Patient Profile (Required)
+// ── Subject ───────────────────────────────────────────────────────────────
 * subject 1..1 MS
+* subject only Reference(Patient)
 * subject.reference 1..1 MS
 * subject.display 1..1 MS
 * subject.identifier 0..1
-* subject ^definition = "Reference to Patient Profile"
+* subject ^definition = "Reference to the Patient this observation is about"
 * subject ^comment = "EX: http://mci.mcishr.dghs.gov.bd/api/v1/patients/98002412586"
 
-
+// ── Encounter ─────────────────────────────────────────────────────────────
 * encounter 1..1 MS
 * encounter.reference 1..1 MS
-* encounter ^definition = "Reference to Patient Profile"
-* encounter ^comment = "EX: uuid:34c38499-58ab-41e0-8e94-c3931491ad0e - bundle encounter uuid from local"
+* encounter ^definition = "Reference to the Encounter during which this observation was made"
+* encounter ^comment = "EX: uuid:34c38499-58ab-41e0-8e94-c3931491ad0e"
 
+// ── Performer ─────────────────────────────────────────────────────────────
 * performer 1..*
 * performer.reference 1..1
 
-// Value[x]: Result value (Optional, but constrained)
+// ── Part Of ───────────────────────────────────────────────────────────────
+* partOf 0..*
+
+// ── Value[x] ──────────────────────────────────────────────────────────────
+// 0..1 at base — child profiles constrain presence and type.
+// Panel observations set value[x] to 0..0.
+// Result observations set value[x] to 1..1.
 * value[x] 0..1
 * value[x] ^definition = "Result value (Quantity, string, code, boolean, etc.)"
 * valueQuantity 0..1
 * valueQuantity ^comment = "If numeric, must include UCUM unit"
 * valueQuantity.system 0..1
+* valueQuantity.system = "http://unitsofmeasure.org"
 * valueQuantity.code 0..1
 * valueString 0..1
 * valueCodeableConcept 0..1
@@ -59,26 +91,43 @@ Description: "Bangladesh Observation Profile"
 * valueDateTime 0..1
 * valuePeriod 0..1
 
+// ── Interpretation ────────────────────────────────────────────────────────
+// Extensible at base — required was too strict for general observation use.
 * interpretation 0..*
-* interpretation from http://hl7.org/fhir/ValueSet/observation-interpretation (required)
-* interpretation ^definition = "Type of test/measurement"
-* interpretation ^comment = "E.g.: High, low, normal, etc"
+* interpretation from http://hl7.org/fhir/ValueSet/observation-interpretation (extensible)
+* interpretation ^definition = "Assessment of the observation result"
+* interpretation ^comment = "E.g. High, Low, Normal"
 
+// ── Method ────────────────────────────────────────────────────────────────
+// Extensible at base — required was too strict for general observation use.
 * method 0..1
-* method from http://hl7.org/fhir/ValueSet/observation-methods (required)
+* method from http://hl7.org/fhir/ValueSet/observation-methods (extensible)
 * method ^definition = "Type of observation method"
-* method ^comment = "E.g.: Technique, Total measurement"
+* method ^comment = "E.g. Technique, Total measurement"
 
-// Issued: Date/time result was issued (Optional)
+// ── Issued ────────────────────────────────────────────────────────────────
 * issued 0..1
-* issued ^definition = "Date/time result was issued"
+* issued ^definition = "Date/time the result was issued"
 
-// Reference Range: Normal reference range (Optional)
+// ── Reference Range ───────────────────────────────────────────────────────
 * referenceRange 0..*
-* referenceRange ^definition = "Normal reference range"
-* referenceRange ^comment = "Optional"
+* referenceRange ^definition = "Normal reference range for the observation"
 
-// Specimen: Specimen used for the observation (Optional)
-* specimen 0..1
-* specimen ^definition = "Specimen used for the observation"
-* specimen ^comment = "Optional"
+// ── Specimen ──────────────────────────────────────────────────────────────
+// MustSupport at base — relevant for lab, pathology, and future imaging.
+* specimen 0..1 MS
+* specimen ^definition = "Specimen used for this observation"
+
+// ── hasMember ─────────────────────────────────────────────────────────────
+// Defined at base to support the panel/component pattern.
+// bd-lab-panel-observation constrains this to 1..* typed references.
+// bd-lab-result-observation constrains this to 0..0.
+* hasMember 0..* MS
+* hasMember ^definition = "References to component result Observations that belong to this panel"
+* hasMember ^comment = "Used in panel-type Observations. Leaf result Observations must not use hasMember."
+
+// ── derivedFrom ───────────────────────────────────────────────────────────
+// Defined at base to support child results referencing their parent panel.
+* derivedFrom 0..* MS
+* derivedFrom ^definition = "References to the panel Observation from which this result is derived"
+* derivedFrom ^comment = "Used in leaf result Observations to reference their parent panel."