Dermatology Image Annotation FHIR Implementation Guide
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: Dermatology annotation with available-at extension - JSON Representation

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{
  "resourceType" : "Observation",
  "id" : "ObsWithAvailableAt",
  "meta" : {
    "profile" : [
      🔗 "https://annotatemd.com/fhir/ig/StructureDefinition/dermatology-image-annotation"
    ]
  },
  "text" : {
    "status" : "generated",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p class=\"res-header-id\"><b>Generated Narrative: Observation ObsWithAvailableAt</b></p><a name=\"ObsWithAvailableAt\"> </a><a name=\"hcObsWithAvailableAt\"> </a><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\"/><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-dermatology-image-annotation.html\">Dermatology Image Annotation</a></p></div><p><b>status</b>: Final</p><p><b>category</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/observation-category imaging}\">Imaging</span>, <span title=\"Codes:{https://annotatemd.com/fhir/ig/CodeSystem/annotation-type dermatology-annotation}\">Dermatology Annotation</span></p><p><b>code</b>: <span title=\"Codes:{https://annotatemd.com/fhir/ig/CodeSystem/annotation-type lesion-classification}\">Lesion Classification</span></p><p><b>subject</b>: <a href=\"Patient-example-patient.html\">Jane Smith  Female, DoB: 1975-06-15</a></p><p><b>effective</b>: 2026-04-30 15:00:00+0000</p><p><b>performer</b>: <a href=\"Practitioner-example-dermatologist.html\">Practitioner Robert Johnson </a></p><p><b>method</b>: <span title=\"Codes:{https://annotatemd.com/fhir/ig/CodeSystem/annotation-method expert-annotation}\">Expert Manual Annotation</span></p><p><b>derivedFrom</b>: <a href=\"DocumentReference-example-clinical-photo.html\">DocumentReference: status = current; type = Photographic image</a></p><h3>Components</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Code</b></td><td><b>Value[x]</b></td></tr><tr><td style=\"display: none\">*</td><td><span title=\"Codes:{http://snomed.info/sct 106076001}\">Skin finding</span></td><td><span title=\"Codes:{http://snomed.info/sct 398943008}\">Congenital melanocytic nevus of skin</span></td></tr></table></div>"
  },
  "status" : "final",
  "category" : [
    {
      "coding" : [
        {
          "system" : "http://terminology.hl7.org/CodeSystem/observation-category",
          "code" : "imaging"
        }
      ]
    },
    {
      "coding" : [
        {
          "system" : "https://annotatemd.com/fhir/ig/CodeSystem/annotation-type",
          "code" : "dermatology-annotation"
        }
      ]
    }
  ],
  "code" : {
    "coding" : [
      {
        "system" : "https://annotatemd.com/fhir/ig/CodeSystem/annotation-type",
        "code" : "lesion-classification",
        "display" : "Lesion Classification"
      }
    ]
  },
  "subject" : {
    🔗 "reference" : "Patient/example-patient"
  },
  "effectiveDateTime" : "2026-04-30T15:00:00Z",
  "_effectiveDateTime" : {
    "extension" : [
      {
        "url" : "https://annotatemd.com/fhir/ig/StructureDefinition/label-available-at",
        "valueDateTime" : "2026-04-30T15:15:00Z"
      }
    ]
  },
  "performer" : [
    {
      🔗 "reference" : "Practitioner/example-dermatologist"
    }
  ],
  "method" : {
    "coding" : [
      {
        "system" : "https://annotatemd.com/fhir/ig/CodeSystem/annotation-method",
        "code" : "expert-annotation",
        "display" : "Expert Manual Annotation"
      }
    ]
  },
  "derivedFrom" : [
    {
      🔗 "reference" : "DocumentReference/example-clinical-photo"
    }
  ],
  "component" : [
    {
      "code" : {
        "coding" : [
          {
            "system" : "http://snomed.info/sct",
            "code" : "106076001",
            "display" : "Skin finding"
          }
        ]
      },
      "valueCodeableConcept" : {
        "coding" : [
          {
            "system" : "http://snomed.info/sct",
            "code" : "398943008",
            "display" : "Congenital melanocytic nevus of skin"
          }
        ]
      }
    }
  ]
}