> ## Documentation Index
> Fetch the complete documentation index at: https://help.elationhealth.com/llms.txt
> Use this file to discover all available pages before exploring further.

# Observation Social History

## Overview

Social History is represented using Observation FHIR Resource. Observations are a central element in healthcare, used to support diagnosis, monitor progress, determine baselines and patterns and even capture demographic characteristics, as well as capture results of tests performed on products and substances. Most observations are simple name/value pair assertions with some metadata, but some observations group other observations together logically, or even are multi-component observations.

**Each Observation has next elements:**

* a status
* a category code of “social-history”
* a code
* a patient

**Each Observation supports next elements:**

* a category code of ‘sdoh’
* a time indicating when observation was made
* who answered the questions
* a value

**Profile specific implementation guidance:**

* See the [SDOH](http://hl7.org/fhir/us/core/sdoh.html) guidance page for how this profile can used to represent SDOH assessments.1
* Observations that are formally derived from an assessment tool or survey should use the [US Core Observation Survey Profile](http://hl7.org/fhir/us/core/StructureDefinition-us-core-observation-survey.html). However, simple assertion may be derived from a screening tool assessments and can reference them using Observation.derivedFrom.
* The codes can be from LOINC or SNOMED CT.
* Often the pattern for these types of observations that the Observation.code indicates a statement about findings and the Observation.value is present and “qualifies” the finding typically confirming or refuting it. For example:

code: Transport too expensive (SNOMED CT: 160695008)\
value: true

This resource conforms to [USCDI V2 profile](https://www.healthit.gov/isa/uscdi-data-class/assessment-and-plan-treatment#uscdi-v2) for Observation - refer to [US Core Observation Social History Profile](http://hl7.org/fhir/us/core/StructureDefinition-us-core-observation-social-history.html). Observation response will be provided in JSON (refers to Capability Statement) format as per [FHIR](https://hl7.org/fhir) standard R4 version.

| USCore Data Element                         | FHIR Resource Field       |
| ------------------------------------------- | ------------------------- |
| status                                      | Observation.status        |
| a category code of “social-history”         | Observation.category      |
| a code                                      | Observation.code          |
| a patient                                   | Observation.subject       |
| a category code of ‘sdoh’                   | Observation.category      |
| a time indicating when observation was made | Observation.effective\[x] |
| who answered the questions                  | Observation.performer     |
| a value                                     | Observation.value\[x]     |

### Must support elements, mandatory and optional search parameters

*Observation**must support** these elements:*

* `status`
* `Slices for category`
  * ` category:us-core/social-history`
  * ` category:sdoh`
* `code`
* `subject`
* `effectiveDateTime`
* `performer`
* `value[x]`
  * `valueQuantity`
  * `valueString`
  * `valueBoolean`
  * `valueCodeableConcept`

*The following search parameters and search parameter combinations SHALL be supported:*

The syntax used to describe the interactions is described [here](/articles/fhir/us-core-guidance).

**SHALL** support searching for all Observations for a patient and category search parameters:\
`GET [base url]/Observation?patient={Type/}[id]&category=http://terminology.hl7.org/CodeSystem/observation-category|social-history`

**SHALL** support searching for all Observations for a patient and code search parameters:

* including optional support for OR search on code (e.g.code=\{system|}|\{code},\{system|}|\{code},...)\
  `GET [base url]/Observation?patient={Type/}[id]&code={system|}|{code}{,{system|}|{code},...}}`

**SHALL** support searching for all Observations for a patient and category and date search parameters:

* including support for these date comparators: gt,lt,ge,le
* including optional support for AND search on date (e.g.date=\{date}\&date=\{date}&...)\
  `GET [base url]/Observation?patient={Type/}[id]&category=http://terminology.hl7.org/CodeSystem/observation-category|social-history&date={gt|lt|ge|le}{date}{&date={gt|lt|ge|le}{date}&...}`

*The following search parameter combinations**SHOULD**  be supported (**optional**):*

**SHOULD** support searching using the combination of the patient and category and status search parameters:

* including support for OR search on status (e.g.status=\{system|}|\{code},\{system|}|\{code},...)\
  `GET [base url]/Observation?patient={Type/}[id]&category=http://terminology.hl7.org/CodeSystem/observation-category|social-history&status={system|}|{code}{,{system|}|{code},...}`

**SHOULD** support searching using the combination of the patient and code and date search parameters

* including optional support for OR search on code (e.g.code=\{system|}|\{code},\{system|}|\{code},...)
* including support for these date comparators: gt,lt,ge,le
* including optional support for AND search on date (e.g.date=\{date}\&date=\{date}}&...)\
  `GET [base url]/Observation?patient={Type/}[id]&code={system|}|{code}{,{system|}|{code},...}&date={gt|lt|ge|le}{date}{&date={gt|lt|ge|le}{date}&...}`

The response to any search operation is always a list of resources in a Bundle or an Operation Outcome.

## Observation By Patient Id

Search for Observation by patient.

**METHOD** *GET*

```
[base url]/Observation?patient={Type/}[id]
```

**PARAMS**\
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)
\[id] - Id for the Patient

**HEADERS**

The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.

| Header        | Type       | Required/Optional | Value            |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required          | `Bearer <token>` |

**RESPONSES**

| Code | Description                        | Comment                                                                                                                                         |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200  | OK                                 | The request was processed successfully                                                                                                          |
| 400  | Bad request                        | Invalid request parameters or FHIR operation outcome resource returned                                                                          |
| 401  | Unauthorized                       | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404  | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested                                       |
| 500  | Internal Server Error              | The server has encountered a situation it doesn't know how to handle                                                                            |

**EXAMPLE:**

```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Observation?patient=Patient/c5137fa5-3216-b12a-cbbc-a0c6bef361g7' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'
```

## Observation By Id

Get Observation by ID.

**METHOD** *GET*

```
[base url]/Observation/{id}
```

or

```
[base url]/Observation?_id={id}
```

**PARAMS**

\[base url] - [FHIR base url](/articles/fhir/service-base-urls)
\{id} - Id for Observation resource

**HEADERS**

The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.

| Header        | Type       | Required/Optional | Value            |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required          | `Bearer <token>` |

**RESPONSES**

| Code | Description                        | Comment                                                                                                                                         |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200  | OK                                 | The request was processed successfully                                                                                                          |
| 400  | Bad request                        | Invalid request parameters or FHIR operation outcome resource returned                                                                          |
| 401  | Unauthorized                       | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404  | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested                                       |
| 500  | Internal Server Error              | The server has encountered a situation it doesn't know how to handle                                                                            |

**EXAMPLE:**

```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Observation/c5137fa5-3216-b12a-cbbc-a0c6bef361g7' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'
```

## Observation by patient and category search parameters

Get Observations  using the combination of the patient and category search parameters:

**METHOD** *GET*

```
GET [base url]/Observation?patient={Type/}[id]&category=http://terminology.hl7.org/CodeSystem/observation-category|social-history
```

**PARAMS**\
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)
\{Type} - Type for the Reference. *Example:* `Patient`\
\[id] - patient id\
**HEADERS**

The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.

| Header        | Type       | Required/Optional | Value            |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required          | `Bearer <token>` |

**RESPONSES**

| Code | Description                        | Comment                                                                                                                                         |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200  | OK                                 | The request was processed successfully                                                                                                          |
| 400  | Bad request                        | Invalid request parameters or FHIR operation outcome resource returned                                                                          |
| 401  | Unauthorized                       | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404  | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested                                       |
| 500  | Internal Server Error              | The server has encountered a situation it doesn't know how to handle                                                                            |

**EXAMPLE:**

```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Observation?patient=Patient/fe1cd986-1ac7-4c26-b8b3-d632a48408fd&category=http://terminology.hl7.org/CodeSystem/observation-category|social-history\
--header 'Authorization: Bearer 1239b275-909e-4754-8f73-1e411fd6769e'
```

## Observation by patient and category and date search parameters

Get Observations  using the combination of the patient and category and date search parameters:

**METHOD** *GET*

```
GET [base url]/Observation?patient={Type/}[id]&category=http://terminology.hl7.org/CodeSystem/observation-category|social-history&date={gt|lt|ge|le}{date}{&date={gt|lt|ge|le}{date}&...}
```

**PARAMS**\
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)
\{Type} - Type for the Reference. *Example:* `Patient`\
\[id] - patient id\
\{date} - observation effective date

**HEADERS**

The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.

| Header        | Type       | Required/Optional | Value            |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required          | `Bearer <token>` |

**RESPONSES**

| Code | Description                        | Comment                                                                                                                                         |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200  | OK                                 | The request was processed successfully                                                                                                          |
| 400  | Bad request                        | Invalid request parameters or FHIR operation outcome resource returned                                                                          |
| 401  | Unauthorized                       | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404  | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested                                       |
| 500  | Internal Server Error              | The server has encountered a situation it doesn't know how to handle                                                                            |

**EXAMPLE:**

```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Observation?patient=Patient/fe1cd986-1ac7-4c26-b8b3-d632a48408fd&category=http://terminology.hl7.org/CodeSystem/observation-category|social-history&date=ge2018-03-14T00:00:00Z\
--header 'Authorization: Bearer 1239b275-909e-4754-8f73-1e411fd6769e'
```

## Observation by patient and code search parameters

Get Observations  using the combination of the patient and code search parameters:

**METHOD** *GET*

```
GET [base url]/Observation?patient={Type/}[id]&code={system|}|{code}{,{system|}|{code},...}
```

**PARAMS**

\[base url] - [FHIR base url](/articles/fhir/service-base-urls)
\{Type} - Type for the Reference. *Example:* `Patient`\
\[id] - patient id\
\{system|} - system used to identify observation code\
\{code} - observation code

**HEADERS**

The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.

| Header        | Type       | Required/Optional | Value            |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required          | `Bearer <token>` |

**RESPONSES**

| Code | Description                        | Comment                                                                                                                                         |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200  | OK                                 | The request was processed successfully                                                                                                          |
| 400  | Bad request                        | Invalid request parameters or FHIR operation outcome resource returned                                                                          |
| 401  | Unauthorized                       | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404  | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested                                       |
| 500  | Internal Server Error              | The server has encountered a situation it doesn't know how to handle                                                                            |

**EXAMPLE:**

```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Observation?patient=Patient/fe1cd986-1ac7-4c26-b8b3-d632a48408fd&code=http://loinc.org|76690-7 \
--header 'Authorization: Bearer 1239b275-909e-4754-8f73-1e411fd6769e'
```

## Observation by patient and code and date search parameters

Get Observations  using the combination of the patient and code and date search parameters:

**METHOD** *GET*

```
GET [base url]/Observation?patient={Type/}[id]&code={system|}|{code}{,{system|}|{code},...}&date={gt|lt|ge|le}{date}{&date={gt|lt|ge|le}{date}&...}
```

**PARAMS**\
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)
\{Type} - Type for the Reference. *Example:* `Patient`\
\[id] - patient id\
\{system|} - terminology system used to identify observation code\
\{code} - observation code\
\{date} - observation effective date

**HEADERS**

The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.

| Header        | Type       | Required/Optional | Value            |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required          | `Bearer <token>` |

**RESPONSES**

| Code | Description                        | Comment                                                                                                                                         |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200  | OK                                 | The request was processed successfully                                                                                                          |
| 400  | Bad request                        | Invalid request parameters or FHIR operation outcome resource returned                                                                          |
| 401  | Unauthorized                       | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404  | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested                                       |
| 500  | Internal Server Error              | The server has encountered a situation it doesn't know how to handle                                                                            |

**EXAMPLE:**

```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Observation?patient=Patient/fe1cd986-1ac7-4c26-b8b3-d632a48408fd&code=http://loinc.org|76690-7&date=ge2018-03-14T00:00:00Z\
--header 'Authorization: Bearer 1239b275-909e-4754-8f73-1e411fd6769e'
```

## Observation by patient and category and status search parameters

Get Observations  using the combination of the patient and category and status search parameters:

**METHOD** *GET*

```
GET [base url]/Observation?patient={Type/}[id]&category=http://terminology.hl7.org/CodeSystem/observation-category|social-history&status={status_system}|{status}{,{status_system}|{status},...}
```

**PARAMS**\
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)
\{Type} - Type for the Reference. *Example:* `Patient`\
\[id] - patient id\
\{status\_system} - terminology system used to identify observation status\
\{status} - observation status

**HEADERS**

The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.

| Header        | Type       | Required/Optional | Value            |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required          | `Bearer <token>` |

**RESPONSES**

| Code | Description                        | Comment                                                                                                                                         |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200  | OK                                 | The request was processed successfully                                                                                                          |
| 400  | Bad request                        | Invalid request parameters or FHIR operation outcome resource returned                                                                          |
| 401  | Unauthorized                       | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404  | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested                                       |
| 500  | Internal Server Error              | The server has encountered a situation it doesn't know how to handle                                                                            |

**EXAMPLE:**

```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Observation?patient=Patient/fe1cd986-1ac7-4c26-b8b3-d632a48408fd&category=http://terminology.hl7.org/CodeSystem/observation-category|social-history&status=final\
--header 'Authorization: Bearer 1239b275-909e-4754-8f73-1e411fd6769e'

 
```