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

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<Observation xmlns="http://hl7.org/fhir">
  <id value="ObsWithAvailableAt"/>
  <meta>
    <profile
             value="https://annotatemd.com/fhir/ig/StructureDefinition/dermatology-image-annotation"/>
  </meta>
  <text>
    <status value="generated"/>
    <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>
  </text>
  <status value="final"/>
  <category>
    <coding>
      <system
              value="http://terminology.hl7.org/CodeSystem/observation-category"/>
      <code value="imaging"/>
    </coding>
  </category>
  <category>
    <coding>
      <system
              value="https://annotatemd.com/fhir/ig/CodeSystem/annotation-type"/>
      <code value="dermatology-annotation"/>
    </coding>
  </category>
  <code>
    <coding>
      <system
              value="https://annotatemd.com/fhir/ig/CodeSystem/annotation-type"/>
      <code value="lesion-classification"/>
      <display value="Lesion Classification"/>
    </coding>
  </code>
  <subject>🔗 
    <reference value="Patient/example-patient"/>
  </subject>
  <effectiveDateTime value="2026-04-30T15:00:00Z">
    <extension
               url="https://annotatemd.com/fhir/ig/StructureDefinition/label-available-at">
      <valueDateTime value="2026-04-30T15:15:00Z"/>
    </extension>
  </effectiveDateTime>
  <performer>🔗 
    <reference value="Practitioner/example-dermatologist"/>
  </performer>
  <method>
    <coding>
      <system
              value="https://annotatemd.com/fhir/ig/CodeSystem/annotation-method"/>
      <code value="expert-annotation"/>
      <display value="Expert Manual Annotation"/>
    </coding>
  </method>
  <derivedFrom>🔗 
    <reference value="DocumentReference/example-clinical-photo"/>
  </derivedFrom>
  <component>
    <code>
      <coding>
        <system value="http://snomed.info/sct"/>
        <code value="106076001"/>
        <display value="Skin finding"/>
      </coding>
    </code>
    <valueCodeableConcept>
      <coding>
        <system value="http://snomed.info/sct"/>
        <code value="398943008"/>
        <display value="Congenital melanocytic nevus of skin"/>
      </coding>
    </valueCodeableConcept>
  </component>
</Observation>