US Core v6.1.0 - 10.32.07: All must support elements are provided in the Observation resources returned (Screening Assessment)

[neharastogi]

Inferno is skipping this test with the message - Could not find valueQuantity, valueCodeableConcept, valueString in the 1 provided Observation resource(s)
This is the Observation that is returned in the first search -

{
  "resourceType": "Bundle",
  "type": "searchset",
  "total": 1,
  "entry": [
    {
      "fullUrl": "https://fhir.staging.flatiron.io/fhir/Observation/201.PD--0668TDV3YQ91W9XR8X5R.24",
      "resource": {
        "resourceType": "Observation",
        "id": "201.PD--0668TDV3YQ91W9XR8X5R.24",
        "meta": {
          "profile": [
            "http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-screening-assessment"
          ]
        },
        "status": "final",
        "category": [
          {
            "coding": [
              {
                "system": "http://terminology.hl7.org/CodeSystem/observation-category",
                "code": "survey",
                "display": "Survey"
              }
            ],
            "text": "Survey"
          },
          {
            "coding": [
              {
                "system": "http://hl7.org/fhir/us/core/CodeSystem/us-core-category",
                "code": "sdoh"
              }
            ]
          }
        ],
        "code": {
          "coding": [
            {
              "code": "96777-8",
              "display": "Accountable health communities (AHC) health-related social needs screening (HRSN) tool"
            }
          ],
          "text": "AHC Health-Related Social Needs Screening Tool"
        },
        "subject": {
          "reference": "Patient/PD--0668TDV3YQ91W9XR8X5R.GH--0648TB2T5CQNQGR2WQQP",
          "type": "Patient"
        },
        "effectiveDateTime": "2024-07-16T21:37:38+00:00",
        "performer": [
          {
            "reference": "Practitioner/UH-B9BLPMQD214KFAE4X35KLT.GH--0648TB2T5CQNQGR2WQQP",
            "type": "Practitioner"
          }
        ],
        "hasMember": [
          {
            "reference": "Observation/755.PD--0668TDV3YQ91W9XR8X5R.25",
            "type": "Observation"
          },
          {
            "reference": "Observation/756.PD--0668TDV3YQ91W9XR8X5R.25",
            "type": "Observation"
          },
          {
            "reference": "Observation/757.PD--0668TDV3YQ91W9XR8X5R.25",
            "type": "Observation"
          },
          {
            "reference": "Observation/758.PD--0668TDV3YQ91W9XR8X5R.25",
            "type": "Observation"
          },
          {
            "reference": "Observation/759.PD--0668TDV3YQ91W9XR8X5R.25",
            "type": "Observation"
          },
          {
            "reference": "Observation/760.PD--0668TDV3YQ91W9XR8X5R.25",
            "type": "Observation"
          },
          {
            "reference": "Observation/761.PD--0668TDV3YQ91W9XR8X5R.25",
            "type": "Observation"
          },
          {
            "reference": "Observation/762.PD--0668TDV3YQ91W9XR8X5R.25",
            "type": "Observation"
          },
          {
            "reference": "Observation/763.PD--0668TDV3YQ91W9XR8X5R.25",
            "type": "Observation"
          },
          {
            "reference": "Observation/764.PD--0668TDV3YQ91W9XR8X5R.25",
            "type": "Observation"
          },
          {
            "reference": "Observation/765.PD--0668TDV3YQ91W9XR8X5R.25",
            "type": "Observation"
          },
          {
            "reference": "Observation/766.PD--0668TDV3YQ91W9XR8X5R.25",
            "type": "Observation"
          }
        ],
        "derivedFrom": [
          {
            "reference": "QuestionnaireResponse/201.PD--0668TDV3YQ91W9XR8X5R",
            "type": "QuestionnaireResponse"
          }
        ]
      },
      "search": {
        "mode": "match"
      }
    }
  ]
}

And according to the guidance, Observation.value[x] would not be needed if Observation.hasMember is present ( which is present here )
Also attaching the screenshots from the guidance.

and -

and -

Can you please let us know what we are missing here?

[yunwwang]

Hello @neharastogi :

Thank you for reaching out to the Inferno team.

There are two different sets of requirements for each profile:

• Validation Requirements: These relate to the validation of each resource.
• Must Support Requirements: These relate to the server's capability to support specific elements.

What you mentioned - "Observation.value[x] would not be needed if Observation.hasMember is present" - is correct for validations. Each Screening and Assessment Observation resource SHALL have either hasMember or value[x] to pass the validation test. This is addressed in Inferno Test 10.32.06.

Test 10.32.07, on the other hand, verifies the server’s capability to populate Observation.value[x]. To meet this requirement, the server must return at least one resource where the Must Support element is populated with a reasonable value.

For more details about Inferno’s Must Support testing logic, you can refer to this FAQ.

[neharastogi]

Thanks a lot @yunwwang .
Also to confirm that we need to surface Observation.value[x] in the search results by 10.32.01 ?

[yunwwang]

Yes these need to be returned, at least, in the first search test. Also keep in mind that the value[x] has three must supported date types: Quantity, CodeableConcept, and string. So the server need to returned at least three Observation resources for these three different data types.