Refactor how observation profiles are registered in order to generalise management of extra profiles

org.hl7.fhir.r5/src/main/java/org/hl7/fhir/r5/utils/validation/IMessagingServices.java

@@ -0,0 +1,11 @@
+package org.hl7.fhir.r5.utils.validation;
+
+import java.util.List;
+
+import org.hl7.fhir.utilities.validation.ValidationMessage;
+import org.hl7.fhir.utilities.validation.ValidationMessage.IssueType;
+
+public interface IMessagingServices {
+  ValidationMessage signpost(List<ValidationMessage> errors, String ruleDate, IssueType type, int line, int col, String path, String theMessage, Object... theMessageArguments);
+
+}

org.hl7.fhir.r5/src/main/java/org/hl7/fhir/r5/utils/validation/IResourceValidator.java

@@ -31,6 +31,7 @@ package org.hl7.fhir.r5.utils.validation;
 
 
 import org.hl7.fhir.exceptions.FHIRException;
+import org.hl7.fhir.r5.context.IWorkerContext;
 import org.hl7.fhir.r5.elementmodel.Manager.FhirFormat;
 import org.hl7.fhir.r5.model.Coding;
 import org.hl7.fhir.r5.model.StructureDefinition;
@@ -53,6 +54,8 @@ import java.util.List;
    *
    */
 public interface IResourceValidator {
+  
+  IWorkerContext getContext();
 
   /**
    * how much to check displays for coded elements 

org.hl7.fhir.r5/src/main/java/org/hl7/fhir/r5/utils/validation/IValidationPolicyAdvisor.java

@@ -10,7 +10,6 @@ import org.hl7.fhir.r5.model.ValueSet;
 import org.hl7.fhir.r5.utils.validation.constants.ContainedReferenceValidationPolicy;
 import org.hl7.fhir.r5.utils.validation.constants.ReferenceValidationPolicy;
 import org.hl7.fhir.utilities.validation.ValidationMessage;
-import org.hl7.fhir.validation.instance.BasePolicyAdvisorForMandatoryProfiles;
 import org.hl7.fhir.r5.utils.validation.constants.CodedContentValidationPolicy;
 import org.hl7.fhir.r5.utils.validation.IValidationPolicyAdvisor.ElementValidationAction;
 import org.hl7.fhir.r5.utils.validation.constants.BindingKind;
@@ -135,7 +134,7 @@ public interface IValidationPolicyAdvisor {
 
   /**
    * This is called after a resource has been validated against the base structure, 
-   * but before any profiles specified in .meta.profile or in the parameters are applied. 
+   * but before it's validated against any profiles specified in .meta.profile or in the parameters. 
    * This can be used to determine what additional profiles should be applied, for instance
    * those derived from the http://hl7.org/fhir/tools/StructureDefinition/profile-mapping extension
    *  
@@ -144,9 +143,9 @@ public interface IValidationPolicyAdvisor {
    * might be any version from R2-R6)
    * 
    * The base implementation applies the mandatory vital signs to observations that have LOINC or SNOMED CT
-   * codes that indicate that they are vital signs. Note that these profiles are not optional; all resources 
+   * codes that indicate that they are vital signs. Note that these profiles are not optional; all vital sign resources 
    * are required to conform to them. For this reason, if you're providing your own policy advisor, you should
-   * keep a reference to the default one, or call BasePolicyAdvisorForMandatoryProfiles. You can choose not to,
+   * keep a reference to the default one, or call BasePolicyAdvisorForFullValidation directly. You can choose not to,
    * but if you do, you are allowing for resources that deviate from the FHIR specification (in a way that the 
    * community considers clinically unsafe, since it means that software (probably) will miss vital signs for 
    * patients).
@@ -161,13 +160,14 @@ public interface IValidationPolicyAdvisor {
    * @param messages all the validation messages. Implementations can inspect this, but the real purpose is to populate the messages with information messages explaining why profiles were (or weren't) applied
    * @return
    */
-  List<StructureDefinition> getImpliedProfilesForInstance(IResourceValidator validator,
+  List<StructureDefinition> getImpliedProfilesForResource(IResourceValidator validator,
                                                         Object appContext,
                                                         String stackPath,
                                                         ElementDefinition definition,
                                                         StructureDefinition structure,
                                                         Element resource,
                                                         boolean valid,
+                                                        IMessagingServices msgServices,
                                                         List<ValidationMessage> messages);
   
 }

org.hl7.fhir.validation/src/main/java/org/hl7/fhir/validation/BaseValidator.java

@@ -67,6 +67,7 @@ import org.hl7.fhir.r5.terminologies.ValueSetUtilities;
 import org.hl7.fhir.r5.utils.ToolingExtensions;
 import org.hl7.fhir.r5.utils.XVerExtensionManager;
 import org.hl7.fhir.r5.utils.XVerExtensionManager.XVerExtensionStatus;
+import org.hl7.fhir.r5.utils.validation.IMessagingServices;
 import org.hl7.fhir.r5.utils.validation.IResourceValidator;
 import org.hl7.fhir.r5.utils.validation.IValidatorResourceFetcher;
 import org.hl7.fhir.r5.utils.validation.ValidationContextCarrier.IValidationContextResourceLoader;
@@ -87,7 +88,7 @@ import org.hl7.fhir.validation.cli.utils.ValidationLevel;
 import org.hl7.fhir.validation.instance.utils.IndexedElement;
 import org.hl7.fhir.validation.instance.utils.NodeStack;
 
-public class BaseValidator implements IValidationContextResourceLoader {
+public class BaseValidator implements IValidationContextResourceLoader, IMessagingServices {
 
   public static class BooleanHolder {
     private boolean value = true;
@@ -411,7 +412,7 @@ public class BaseValidator implements IValidationContextResourceLoader {
     return thePass;
   }
 
-  protected ValidationMessage signpost(List<ValidationMessage> errors, String ruleDate, IssueType type, int line, int col, String path, String theMessage, Object... theMessageArguments) {
+  public ValidationMessage signpost(List<ValidationMessage> errors, String ruleDate, IssueType type, int line, int col, String path, String theMessage, Object... theMessageArguments) {
     String message = context.formatMessage(theMessage, theMessageArguments);
     return addValidationMessage(errors, ruleDate, type, line, col, path, message, IssueSeverity.INFORMATION, theMessage).setSignpost(true);
   }

org.hl7.fhir.validation/src/main/java/org/hl7/fhir/validation/ValidationEngine.java

@@ -67,6 +67,7 @@ import org.hl7.fhir.r5.utils.EOperationOutcome;
 import org.hl7.fhir.r5.utils.ToolingExtensions;
 import org.hl7.fhir.r5.utils.structuremap.StructureMapUtilities;
 import org.hl7.fhir.r5.utils.validation.BundleValidationRule;
+import org.hl7.fhir.r5.utils.validation.IMessagingServices;
 import org.hl7.fhir.r5.utils.validation.IResourceValidator;
 import org.hl7.fhir.r5.utils.validation.IValidationPolicyAdvisor;
 import org.hl7.fhir.r5.utils.validation.IValidatorResourceFetcher;
@@ -104,6 +105,7 @@ import org.hl7.fhir.validation.cli.utils.ProfileLoader;
 import org.hl7.fhir.validation.cli.utils.QuestionnaireMode;
 import org.hl7.fhir.validation.cli.utils.SchemaValidator;
 import org.hl7.fhir.validation.cli.utils.ValidationLevel;
+import org.hl7.fhir.validation.instance.BasePolicyAdvisorForFullValidation;
 import org.hl7.fhir.validation.instance.InstanceValidator;
 import org.hl7.fhir.validation.instance.utils.ValidationContext;
 import org.hl7.fhir.utilities.ByteProvider;
@@ -1253,4 +1255,12 @@ public class ValidationEngine implements IValidatorResourceFetcher, IValidationP
     return res;
   }
 
+  @Override
+  public List<StructureDefinition> getImpliedProfilesForResource(IResourceValidator validator, Object appContext,
+      String stackPath, ElementDefinition definition, StructureDefinition structure, Element resource, boolean valid,
+      IMessagingServices msgServices, List<ValidationMessage> messages) {
+    return new BasePolicyAdvisorForFullValidation().getImpliedProfilesForResource(validator, appContext, stackPath, 
+          definition, structure, resource, valid, msgServices, messages);
+  }
+
 }

org.hl7.fhir.validation/src/main/java/org/hl7/fhir/validation/cli/services/StandAloneValidatorFetcher.java

@@ -42,11 +42,12 @@ import org.hl7.fhir.utilities.json.parser.JsonParser;
 import org.hl7.fhir.utilities.npm.FilesystemPackageCacheManager;
 import org.hl7.fhir.utilities.npm.NpmPackage;
 import org.hl7.fhir.validation.cli.utils.Common;
+import org.hl7.fhir.validation.instance.BasePolicyAdvisorForFullValidation;
 
 import javax.annotation.Nonnull;
 
 
-public class StandAloneValidatorFetcher implements IValidatorResourceFetcher, IValidationPolicyAdvisor, IWorkerContextManager.ICanonicalResourceLocator {
+public class StandAloneValidatorFetcher extends BasePolicyAdvisorForFullValidation implements IValidatorResourceFetcher, IValidationPolicyAdvisor, IWorkerContextManager.ICanonicalResourceLocator {
 
   List<String> mappingsUris = new ArrayList<>();
   private FilesystemPackageCacheManager pcm;
@@ -75,31 +76,6 @@ public class StandAloneValidatorFetcher implements IValidatorResourceFetcher, IV
                                                       String url) {
     return ReferenceValidationPolicy.CHECK_TYPE_IF_EXISTS;
   }
-
-  @Override
-  public ContainedReferenceValidationPolicy policyForContained(IResourceValidator validator,
-      Object appContext,
-      StructureDefinition structure,
-      ElementDefinition element,
-      String containerType,
-      String containerId,
-      Element.SpecialElement containingResourceType,
-      String path,
-      String url) {
-    return ContainedReferenceValidationPolicy.CHECK_VALID;
-  }
-
-  @Override
-  public EnumSet<ResourceValidationAction> policyForResource(IResourceValidator validator, Object appContext,
-      StructureDefinition type, String path) {
-    return EnumSet.allOf(ResourceValidationAction.class);
-  }
-
-  @Override
-  public EnumSet<ElementValidationAction> policyForElement(IResourceValidator validator, Object appContext,
-      StructureDefinition structure, ElementDefinition element, String path) {
-    return EnumSet.allOf(ElementValidationAction.class);
-  }
   
   @Override
   public boolean resolveURL(IResourceValidator validator, Object appContext, String path, String url, String type, boolean canonical) throws IOException, FHIRException {
@@ -316,19 +292,6 @@ public class StandAloneValidatorFetcher implements IValidatorResourceFetcher, IV
     }
   }
 
-  @Override
-  public EnumSet<CodedContentValidationAction> policyForCodedContent(IResourceValidator validator,
-      Object appContext,
-      String stackPath,
-      ElementDefinition definition,
-      StructureDefinition structure,
-      BindingKind kind,
-      AdditionalBindingPurpose purpose,
-      ValueSet valueSet,
-      List<String> systems) {
-    return EnumSet.allOf(CodedContentValidationAction.class);
-  }
-
   @Override
   public Set<String> fetchCanonicalResourceVersions(IResourceValidator validator, Object appContext, String url) {
     return new HashSet<>();

org.hl7.fhir.validation/src/main/java/org/hl7/fhir/validation/instance/BasePolicyAdvisorForFullValidation.java

@@ -1,65 +1,166 @@
 package org.hl7.fhir.validation.instance;
 
+import java.util.ArrayList;
 import java.util.EnumSet;
 import java.util.List;
 
+import org.hl7.fhir.r5.context.IWorkerContext;
 import org.hl7.fhir.r5.elementmodel.Element;
 import org.hl7.fhir.r5.elementmodel.Element.SpecialElement;
 import org.hl7.fhir.r5.model.ElementDefinition;
 import org.hl7.fhir.r5.model.StructureDefinition;
 import org.hl7.fhir.r5.model.ValueSet;
+import org.hl7.fhir.r5.utils.validation.IMessagingServices;
 import org.hl7.fhir.r5.utils.validation.IResourceValidator;
 import org.hl7.fhir.r5.utils.validation.IValidationPolicyAdvisor;
+import org.hl7.fhir.r5.utils.validation.IValidationPolicyAdvisor.AdditionalBindingPurpose;
+import org.hl7.fhir.r5.utils.validation.IValidationPolicyAdvisor.CodedContentValidationAction;
+import org.hl7.fhir.r5.utils.validation.IValidationPolicyAdvisor.ElementValidationAction;
+import org.hl7.fhir.r5.utils.validation.IValidationPolicyAdvisor.ResourceValidationAction;
 import org.hl7.fhir.r5.utils.validation.constants.BindingKind;
 import org.hl7.fhir.r5.utils.validation.constants.ContainedReferenceValidationPolicy;
 import org.hl7.fhir.r5.utils.validation.constants.ReferenceValidationPolicy;
+import org.hl7.fhir.utilities.Utilities;
+import org.hl7.fhir.utilities.VersionUtilities;
+import org.hl7.fhir.utilities.i18n.I18nConstants;
 import org.hl7.fhir.utilities.validation.ValidationMessage;
+import org.hl7.fhir.utilities.validation.ValidationMessage.IssueType;
 
 public class BasePolicyAdvisorForFullValidation implements IValidationPolicyAdvisor {
 
   @Override
-  public ReferenceValidationPolicy policyForReference(IResourceValidator validator, Object appContext, String path,
+  public ReferenceValidationPolicy policyForReference(IResourceValidator validator, Object appContext, String path, String url) {
-      String url) {
+    return ReferenceValidationPolicy.CHECK_TYPE_IF_EXISTS;
-    // TODO Auto-generated method stub
-    return null;
   }
 
   @Override
   public ContainedReferenceValidationPolicy policyForContained(IResourceValidator validator, Object appContext,
       StructureDefinition structure, ElementDefinition element, String containerType, String containerId,
       SpecialElement containingResourceType, String path, String url) {
-    // TODO Auto-generated method stub
-    return null;
-  }
 
+    return ContainedReferenceValidationPolicy.CHECK_VALID;
+  }
+  
   @Override
   public EnumSet<ResourceValidationAction> policyForResource(IResourceValidator validator, Object appContext,
       StructureDefinition type, String path) {
-    // TODO Auto-generated method stub
+    return EnumSet.allOf(ResourceValidationAction.class);
-    return null;
   }
 
   @Override
   public EnumSet<ElementValidationAction> policyForElement(IResourceValidator validator, Object appContext,
       StructureDefinition structure, ElementDefinition element, String path) {
-    // TODO Auto-generated method stub
+    return EnumSet.allOf(ElementValidationAction.class);
-    return null;
   }
 
   @Override
-  public EnumSet<CodedContentValidationAction> policyForCodedContent(IResourceValidator validator, Object appContext,
+  public EnumSet<CodedContentValidationAction> policyForCodedContent(IResourceValidator validator,
-      String stackPath, ElementDefinition definition, StructureDefinition structure, BindingKind kind,
+      Object appContext,
-      AdditionalBindingPurpose purpose, ValueSet valueSet, List<String> systems) {
+      String stackPath,
-    // TODO Auto-generated method stub
+      ElementDefinition definition,
-    return null;
+      StructureDefinition structure,
+      BindingKind kind,
+      AdditionalBindingPurpose purpose,
+      ValueSet valueSet,
+      List<String> systems) {
+    return EnumSet.allOf(CodedContentValidationAction.class);
   }
 
   @Override
-  public List<StructureDefinition> getImpliedProfilesForInstance(IResourceValidator validator, Object appContext,
+  public List<StructureDefinition> getImpliedProfilesForResource(IResourceValidator validator, Object appContext,
       String stackPath, ElementDefinition definition, StructureDefinition structure, Element resource, boolean valid,
-      List<ValidationMessage> messages) {
+      IMessagingServices msgServices, List<ValidationMessage> messages) {
-    // TODO Auto-generated method stub
+    List<StructureDefinition> profiles = new ArrayList<StructureDefinition>();
-    return null;
+    if ("Observation".equals(resource.fhirType()) && VersionUtilities.isR4Plus(validator.getContext().getVersion())) {
+      getImpliedProfilesForObservation(profiles, msgServices, messages, validator.getContext(), stackPath, resource);
+    }
+    return profiles;
+  }
+    
+
+  private void getImpliedProfilesForObservation(List<StructureDefinition> profiles, IMessagingServices msgServices, List<ValidationMessage> messages, IWorkerContext context, String stackPath, Element resource) {
+    Element code = resource.getNamedChild("code", false);
+    List<String> codes = new ArrayList<>();
+    if (hasLoincCode(code, codes, "85353-1")) {
+      addProfile(profiles, msgServices, messages, context, stackPath, resource, "http://hl7.org/fhir/StructureDefinition/vitalspanel", "Vital Signs Panel", "LOINC", codes);
+    } else if (hasLoincCode(code, codes, "9279-1", "76170-0", "76172-6", "76171-8", "19840-8", "33438-3", "76270-8", "11291-2")) {
+      addProfile(profiles, msgServices, messages, context, stackPath, resource, "http://hl7.org/fhir/StructureDefinition/resprate", "Respiratory Rate", "LOINC", codes);
+    } else if (hasLoincCode(code, codes, "60978-4", "73795-7", "73799-9", "76476-1", "76477-9", "8867-4", "8889-8", "8890-6", "8891-4", "8892-2", "8893-0", "40443-4", "55425-3", "68999-2", "11328-2", "69000-8", "69000-8", "60978-4", "60978-4", "8890-6", "8886-4", "68999-2", "68999-2")) {
+      addProfile(profiles, msgServices, messages, context, stackPath, resource, "http://hl7.org/fhir/StructureDefinition/heartrate", "Heart rate", "LOINC", codes);
+    } else if (hasLoincCode(code, codes, "2708-6", "19224-5", "20564-1", "2709-4", "2710-2", "2713-6", "51733-4", "59408-5", "59417-6", "89276-0", "97549-0")) {
+      addProfile(profiles, msgServices, messages, context, stackPath, resource, "http://hl7.org/fhir/StructureDefinition/oxygensat", "Oxygen saturation", "LOINC", codes);
+    } else if (hasLoincCode(code, codes, "8310-5", "60834-9", "60835-6", "60836-4", "60838-0", "60955-2", "61009-7", "75539-7", "75987-8", "76010-8", "76011-6", "76278-1", "8309-7", "8310-5", "8328-7", "8329-5", "8330-3", "8331-1", "8332-9", "8333-7", "8334-5", "91371-5", "98657-0", "98663-8")) {
+      addProfile(profiles, msgServices, messages, context, stackPath, resource, "http://hl7.org/fhir/StructureDefinition/bodytemp", "Body temperature", "LOINC", codes);
+    } else if (hasLoincCode(code, codes, "8302-2", "3137-7", "3138-5", "8302-2", "8306-3", "8308-9")) {
+      addProfile(profiles, msgServices, messages, context, stackPath, resource, "http://hl7.org/fhir/StructureDefinition/bodyheight", "Body height", "LOINC", codes);
+    } else if (hasLoincCode(code, codes, "9843-4", "8287-5", "9843-4")) {
+      addProfile(profiles, msgServices, messages, context, stackPath, resource, "http://hl7.org/fhir/StructureDefinition/headcircum", "Head circumference", "LOINC", codes);
+    } else if (hasLoincCode(code, codes, "29463-7", "29463-7", "3141-9", "3142-7", "75292-3", "79348-9", "8350-1", "8351-9")) {
+      addProfile(profiles, msgServices, messages, context, stackPath, resource, "http://hl7.org/fhir/StructureDefinition/bodyweight", "Body weight", "LOINC", codes);
+    } else if (hasLoincCode(code, codes, "39156-5", "39156-5", "59574-4", "89270-3")) {
+      addProfile(profiles, msgServices, messages, context, stackPath, resource, "http://hl7.org/fhir/StructureDefinition/bmi", "Body mass index", "LOINC", codes);
+    } else if (hasLoincCode(code, codes, "85354-9", "35094-2", "8459-0", "85354-9", "76534-7", "55284-4", "8480-6")) {
+      addProfile(profiles, msgServices, messages, context, stackPath, resource, "http://hl7.org/fhir/StructureDefinition/bp", "Blood pressure systolic and diastolic", "LOINC", codes);
+    
+    } else if (hasSctCode(code, codes, "46680005")) {
+      addProfile(profiles, msgServices, messages, context, stackPath, resource, "http://hl7.org/fhir/StructureDefinition/vitalspanel", "Vital Signs Panel", "SNOMED CT", codes);
+    } else if (hasSctCode(code, codes, "86290005", "271625008", "271306003")) {
+      addProfile(profiles, msgServices, messages, context, stackPath, resource, "http://hl7.org/fhir/StructureDefinition/bp", "Blood pressure systolic and diastolic", "SNOMED CT", codes);
+    } else if (hasSctCode(code, codes, "271306003", "249043002", "444981005", "399017001", "251670001", "429525003", "429614003")) {
+      addProfile(profiles, msgServices, messages, context, stackPath, resource, "http://hl7.org/fhir/StructureDefinition/heartrate", "Heart rate", "SNOMED CT", codes);
+    } else if (hasSctCode(code, codes, "103228002", "103228002", "442349007", "442476006", "442440005", "431314004", "442734002", "713194001")) {
+      addProfile(profiles, msgServices, messages, context, stackPath, resource, "http://hl7.org/fhir/StructureDefinition/oxygensat", "Oxygen saturation", "SNOMED CT", codes);
+    } else if (hasSctCode(code, codes, "386725007", "276885007", "300076005", "1222808002", "364246006", "307047009", "708499008", "708499008", "431598003", "698831002", "698832009", "415882003", "415974002", "415929009", "415945006")) {
+      addProfile(profiles, msgServices, messages, context, stackPath, resource, "http://hl7.org/fhir/StructureDefinition/bodytemp", "Body temperature", "SNOMED CT", codes);
+    } else if (hasSctCode(code, codes, "1153637007", "1162419008", "50373000", "1162418000", "1230278008", "1162392001", "1162417005")) {
+      addProfile(profiles, msgServices, messages, context, stackPath, resource, "http://hl7.org/fhir/StructureDefinition/bodyheight", "Body height", "SNOMED CT", codes);
+    } else if (hasSctCode(code, codes, "363812007", "169876006", "1269262007", "363811000")) {
+      addProfile(profiles, msgServices, messages, context, stackPath, resource, "http://hl7.org/fhir/StructureDefinition/headcircum", "Head circumference", "SNOMED CT", codes);
+    } else if (hasSctCode(code, codes, "363811000", "60621009", "735395000", "425024002", "424927000", "784399000", "1162416001", "1162415002")) {
+      addProfile(profiles, msgServices, messages, context, stackPath, resource, "http://hl7.org/fhir/StructureDefinition/bodyweight", "Body weight", "SNOMED CT", codes);
+    } else if (hasSctCode(code, codes, "60621009")) {
+      addProfile(profiles, msgServices, messages, context, stackPath, resource, "http://hl7.org/fhir/StructureDefinition/bmi", "Body mass index", "SNOMED CT", codes);
+    } else if (hasSctCode(code, codes, "75367002", "251076008", "163033001", "163035008", "386534000", "386536003", "271649006", "271649006", "271650006", "407556006", "407554009", "716579001", "399304008")) {
+      addProfile(profiles, msgServices, messages, context, stackPath, resource, "http://hl7.org/fhir/StructureDefinition/bp", "Blood pressure systolic and diastolic", "SNOMED CT", codes);
+    }  
+    
   }
 
+  private void addProfile(List<StructureDefinition> profiles, IMessagingServices msgServices, List<ValidationMessage> messages, IWorkerContext context, String stackPath, Element resource, String url, String name, String systemName, List<String> codes) {
+    resource.addMessage(msgServices.signpost(messages, null, IssueType.INFORMATIONAL, resource.line(), resource.col(), stackPath, I18nConstants.VALIDATION_VAL_PROFILE_SIGNPOST_OBS, url, name, systemName, codes.get(0)));
+    StructureDefinition sd = context.fetchResource(StructureDefinition.class, url);
+    if (sd != null) {
+      profiles.add(sd);
+    } else {
+      // complain?
+    }
+  }
+
+  protected boolean hasLoincCode(Element code, List<String> codes, String... values) {
+    if (code != null) {
+      List<Element> codings = code.getChildren("coding");
+      for (Element coding : codings) {
+        if ("http://loinc.org".equals(coding.getNamedChildValue("system", false)) && Utilities.existsInList(coding.getNamedChildValue("code", false), values)) {
+          codes.add(coding.getNamedChildValue("code", false));
+          return true;
+        }
+      }
+    }
+    return false;
+  }
+
+  protected boolean hasSctCode(Element code, List<String> codes, String... values) {
+    if (code != null) {
+      List<Element> codings = code.getChildren("coding");
+      for (Element coding : codings) {
+        if ("http://snomed.info/sct".equals(coding.getNamedChildValue("system", false)) && Utilities.existsInList(coding.getNamedChildValue("code", false), values)) {
+          codes.add(coding.getNamedChildValue("code", false));
+          return true;
+        }
+      }
+    }
+    return false;
+  }
+
+  
 }

org.hl7.fhir.validation/src/main/java/org/hl7/fhir/validation/instance/InstanceValidator.java

@@ -173,6 +173,7 @@ import org.hl7.fhir.r5.utils.XVerExtensionManager;
 import org.hl7.fhir.r5.utils.XVerExtensionManager.XVerExtensionStatus;
 import org.hl7.fhir.r5.utils.sql.Validator;
 import org.hl7.fhir.r5.utils.validation.BundleValidationRule;
+import org.hl7.fhir.r5.utils.validation.IMessagingServices;
 import org.hl7.fhir.r5.utils.validation.IResourceValidator;
 import org.hl7.fhir.r5.utils.validation.IValidationPolicyAdvisor;
 import org.hl7.fhir.r5.utils.validation.IValidationProfileUsageTracker;
@@ -595,7 +596,7 @@ public class InstanceValidator extends BaseValidator implements IResourceValidat
   private boolean noBindingMsgSuppressed;
   private Map<String, Element> fetchCache = new HashMap<>();
   private HashMap<Element, ResourceValidationTracker> resourceTracker = new HashMap<>();
-  private IValidationPolicyAdvisor policyAdvisor;
+  private IValidationPolicyAdvisor policyAdvisor = new BasePolicyAdvisorForFullValidation();
   long time = 0;
   long start = 0;
   long lastlog = 0;
@@ -691,6 +692,9 @@ public class InstanceValidator extends BaseValidator implements IResourceValidat
 
   @Override
   public IResourceValidator setPolicyAdvisor(IValidationPolicyAdvisor advisor) {
+    if (advisor == null) {
+      throw new Error("Cannot set advisor to null");
+    }
     this.policyAdvisor = advisor;
     return this;
   }
@@ -3111,7 +3115,7 @@ public class InstanceValidator extends BaseValidator implements IResourceValidat
       }
       if (!found) {
         if (type.equals("canonical")) {
-          ReferenceValidationPolicy rp = policyAdvisor == null ? ReferenceValidationPolicy.CHECK_VALID : policyAdvisor.policyForReference(this, valContext, path, url);
+          ReferenceValidationPolicy rp = policyAdvisor.policyForReference(this, valContext, path, url);
           if (rp == ReferenceValidationPolicy.CHECK_EXISTS || rp == ReferenceValidationPolicy.CHECK_EXISTS_AND_TYPE) {
             ok = rule(errors, NO_RULE_DATE, IssueType.INVALID, e.line(), e.col(), path, false, I18nConstants.TYPE_SPECIFIC_CHECKS_DT_CANONICAL_RESOLVE, url) && ok;
           } else {
@@ -3128,7 +3132,7 @@ public class InstanceValidator extends BaseValidator implements IResourceValidat
         }
       } else {
         if (type.equals("canonical")) {
-          ReferenceValidationPolicy rp = policyAdvisor == null ? ReferenceValidationPolicy.CHECK_VALID : policyAdvisor.policyForReference(this, valContext, path, url);
+          ReferenceValidationPolicy rp = policyAdvisor.policyForReference(this, valContext, path, url);
           if (rp == ReferenceValidationPolicy.CHECK_EXISTS_AND_TYPE || rp == ReferenceValidationPolicy.CHECK_TYPE_IF_EXISTS || rp == ReferenceValidationPolicy.CHECK_VALID) {
             try {
               Resource r = null;
@@ -3581,8 +3585,7 @@ public class InstanceValidator extends BaseValidator implements IResourceValidat
           ok = false;
         }
       } else {
-        EnumSet<CodedContentValidationAction> validationPolicy = getPolicyAdvisor() == null ?
+        EnumSet<CodedContentValidationAction> validationPolicy = policyAdvisor.policyForCodedContent(this, valContext, stack.getLiteralPath(), elementContext, profile, BindingKind.PRIMARY, null, vs, new ArrayList<>());
-            EnumSet.allOf(CodedContentValidationAction.class) : getPolicyAdvisor().policyForCodedContent(this, valContext, stack.getLiteralPath(), elementContext, profile, BindingKind.PRIMARY, null, vs, new ArrayList<>());
 
         if (!validationPolicy.isEmpty()) {
           long t = System.nanoTime();
@@ -3918,11 +3921,7 @@ public class InstanceValidator extends BaseValidator implements IResourceValidat
     if (refType.equals("contained") || refType.equals("bundled")) {
       pol = ReferenceValidationPolicy.CHECK_VALID;
     } else {
-      if (policyAdvisor == null) {
+      pol = policyAdvisor.policyForReference(this, valContext.getAppContext(), path, ref);
-        pol = ReferenceValidationPolicy.IGNORE;
-      } else {
-        pol = policyAdvisor.policyForReference(this, valContext.getAppContext(), path, ref);
-      }
     }
 
     if (conditional) {
@@ -5705,15 +5704,22 @@ public class InstanceValidator extends BaseValidator implements IResourceValidat
       ok = false;
     }
     if (checkSpecials) {      
-      ok = checkSpecials(valContext, errors, element, stack, checkSpecials, pct, mode, fromContained) && ok;
+      ok = checkSpecials(valContext, errors, element, stack, checkSpecials, pct, mode, fromContained, ok) && ok;
       ok = validateResourceRules(errors, element, stack) && ok;
     }
     return ok;
   }
 
-  public boolean checkSpecials(ValidationContext valContext, List<ValidationMessage> errors, Element element, NodeStack stack, boolean checkSpecials, PercentageTracker pct, ValidationMode mode, boolean contained) {
+  public boolean checkSpecials(ValidationContext valContext, List<ValidationMessage> errors, Element element, NodeStack stack, boolean checkSpecials, PercentageTracker pct, ValidationMode mode, boolean contained, boolean isOk) {
     boolean ok = true;
     
+    // first, does the policy advisor have profiles it wants us to check? 
+    List<StructureDefinition> profiles = policyAdvisor.getImpliedProfilesForResource(this, valContext.getAppContext(), stack.getLiteralPath(), 
+        element.getProperty().getDefinition(), element.getProperty().getStructure(), element, isOk, this, errors);
+    for (StructureDefinition sd : profiles) {
+      ok = startInner(valContext, errors, element, element, sd, stack, false, pct, mode, false) && ok;
+    }
+
     long t = System.nanoTime();
     try {
       if (VersionUtilities.getCanonicalResourceNames(context.getVersion()).contains(element.getType())) {
@@ -5966,8 +5972,7 @@ public class InstanceValidator extends BaseValidator implements IResourceValidat
     } else {
       SpecialElement special = element.getSpecial();
 
-      ContainedReferenceValidationPolicy containedValidationPolicy = getPolicyAdvisor() == null ?
+      ContainedReferenceValidationPolicy containedValidationPolicy = policyAdvisor.policyForContained(this,
-          ContainedReferenceValidationPolicy.CHECK_VALID : getPolicyAdvisor().policyForContained(this,
               valContext, parentProfile, child, context.fhirType(), context.getId(), special, path, parentProfile.getUrl());
 
       if (containedValidationPolicy.ignore()) {
@@ -6021,7 +6026,7 @@ public class InstanceValidator extends BaseValidator implements IResourceValidat
             }
           }
           
-          checkSpecials(valContext, errors, element, stack, ok, pct, mode, true);
+          checkSpecials(valContext, errors, element, stack, ok, pct, mode, true, ok);
 
           if (typeForResource.getProfile().size() == 1) {
             long t = System.nanoTime();
@@ -6427,8 +6432,7 @@ public class InstanceValidator extends BaseValidator implements IResourceValidat
     if (debug) {
       System.out.println("  check " + localStack.getLiteralPath()+" against "+ei.getDefinition().getId()+" in profile "+profile.getVersionedUrl()+time());
     }
-    EnumSet<ElementValidationAction> actionSet = policyAdvisor == null ? EnumSet.allOf(ElementValidationAction.class) : 
+    EnumSet<ElementValidationAction> actionSet = policyAdvisor.policyForElement(this, valContext.getAppContext(), profile, ei.getDefinition(), localStack.getLiteralPath());
-      policyAdvisor.policyForElement(this, valContext.getAppContext(), profile, ei.getDefinition(), localStack.getLiteralPath());
     
     String localStackLiteralPath = localStack.getLiteralPath();
     String eiPath = ei.getPath();

org.hl7.fhir.validation/src/main/java/org/hl7/fhir/validation/instance/type/BundleValidator.java

@@ -181,7 +181,7 @@ public class BundleValidator extends BaseValidator {
           }
         }
         // also, while we're here, check the specials, since this doesn't happen anywhere else 
-        ((InstanceValidator) parent).checkSpecials(hostContext, errors, res, rstack, true, pct, mode, true);
+        ((InstanceValidator) parent).checkSpecials(hostContext, errors, res, rstack, true, pct, mode, true, ok);
       }
       
       // todo: check specials

org.hl7.fhir.validation/src/main/java/org/hl7/fhir/validation/instance/type/ObservationValidator.java

@@ -38,92 +38,8 @@ public class ObservationValidator extends BaseValidator {
           element.getNamedChild("effectiveTiming", false) != null || element.getNamedChild("effectiveInstant", false) != null, 
           I18nConstants.ALL_OBSERVATIONS_SHOULD_HAVE_AN_EFFECTIVEDATETIME_OR_AN_EFFECTIVEPERIOD, element.getProperty().typeSummary()) && ok;   
     
-    // hook in the vital signs 
+    // Looking for the vital signs code? It's moved to BasePolicyAdvisorForFullValidation.getImpliedProfilesForObservation
-    if (VersionUtilities.isR4Plus(context.getVersion())) {
-      Element code = element.getNamedChild("code", false);
-      List<String> codes = new ArrayList<>();
-      if (hasLoincCode(code, codes, "85353-1")) {
-        ok = checkObservationAgainstProfile(valContext, errors, element, stack, "http://hl7.org/fhir/StructureDefinition/vitalspanel", "Vital Signs Panel", "LOINC", codes, pct, mode) && ok;
-      } else if (hasLoincCode(code, codes, "9279-1", "76170-0", "76172-6", "76171-8", "19840-8", "33438-3", "76270-8", "11291-2")) {
-        ok = checkObservationAgainstProfile(valContext,errors, element, stack, "http://hl7.org/fhir/StructureDefinition/resprate", "Respiratory Rate", "LOINC", codes, pct, mode) && ok;
-      } else if (hasLoincCode(code, codes, "60978-4", "73795-7", "73799-9", "76476-1", "76477-9", "8867-4", "8889-8", "8890-6", "8891-4", "8892-2", "8893-0", "40443-4", "55425-3", "68999-2", "11328-2", "69000-8", "69000-8", "60978-4", "60978-4", "8890-6", "8886-4", "68999-2", "68999-2")) {
-        ok = checkObservationAgainstProfile(valContext,errors, element, stack, "http://hl7.org/fhir/StructureDefinition/heartrate", "Heart rate", "LOINC", codes, pct, mode) && ok;
-      } else if (hasLoincCode(code, codes, "2708-6", "19224-5", "20564-1", "2709-4", "2710-2", "2713-6", "51733-4", "59408-5", "59417-6", "89276-0", "97549-0")) {
-        ok = checkObservationAgainstProfile(valContext,errors, element, stack, "http://hl7.org/fhir/StructureDefinition/oxygensat", "Oxygen saturation", "LOINC", codes, pct, mode) && ok;
-      } else if (hasLoincCode(code, codes, "8310-5", "60834-9", "60835-6", "60836-4", "60838-0", "60955-2", "61009-7", "75539-7", "75987-8", "76010-8", "76011-6", "76278-1", "8309-7", "8310-5", "8328-7", "8329-5", "8330-3", "8331-1", "8332-9", "8333-7", "8334-5", "91371-5", "98657-0", "98663-8")) {
-        ok = checkObservationAgainstProfile(valContext,errors, element, stack, "http://hl7.org/fhir/StructureDefinition/bodytemp", "Body temperature", "LOINC", codes, pct, mode) && ok;
-      } else if (hasLoincCode(code, codes, "8302-2", "3137-7", "3138-5", "8302-2", "8306-3", "8308-9")) {
-        ok = checkObservationAgainstProfile(valContext,errors, element, stack, "http://hl7.org/fhir/StructureDefinition/bodyheight", "Body height", "LOINC", codes, pct, mode) && ok;
-      } else if (hasLoincCode(code, codes, "9843-4", "8287-5", "9843-4")) {
-        ok = checkObservationAgainstProfile(valContext,errors, element, stack, "http://hl7.org/fhir/StructureDefinition/headcircum", "Head circumference", "LOINC", codes, pct, mode) && ok;
-      } else if (hasLoincCode(code, codes, "29463-7", "29463-7", "3141-9", "3142-7", "75292-3", "79348-9", "8350-1", "8351-9")) {
-        ok = checkObservationAgainstProfile(valContext,errors, element, stack, "http://hl7.org/fhir/StructureDefinition/bodyweight", "Body weight", "LOINC", codes, pct, mode) && ok;
-      } else if (hasLoincCode(code, codes, "39156-5", "39156-5", "59574-4", "89270-3")) {
-        ok = checkObservationAgainstProfile(valContext,errors, element, stack, "http://hl7.org/fhir/StructureDefinition/bmi", "Body mass index", "LOINC", codes, pct, mode) && ok;
-      } else if (hasLoincCode(code, codes, "85354-9", "35094-2", "8459-0", "85354-9", "76534-7", "55284-4", "8480-6")) {
-        ok = checkObservationAgainstProfile(valContext,errors, element, stack, "http://hl7.org/fhir/StructureDefinition/bp", "Blood pressure systolic and diastolic", "LOINC", codes, pct, mode) && ok;
-      
-      } else if (hasSctCode(code, codes, "46680005")) {
-        ok = checkObservationAgainstProfile(valContext, errors, element, stack, "http://hl7.org/fhir/StructureDefinition/vitalspanel", "Vital Signs Panel", "SNOMED CT", codes, pct, mode) && ok;
-      } else if (hasSctCode(code, codes, "86290005", "271625008", "271306003")) {
-        ok = checkObservationAgainstProfile(valContext,errors, element, stack, "Blood pressure systolic and diastolic", "Respiratory Rate", "SNOMED CT", codes, pct, mode) && ok;
-      } else if (hasSctCode(code, codes, "271306003", "249043002", "444981005", "399017001", "251670001", "429525003", "429614003")) {
-        ok = checkObservationAgainstProfile(valContext,errors, element, stack, "http://hl7.org/fhir/StructureDefinition/heartrate", "Heart rate", "SNOMED CT", codes, pct, mode) && ok;
-      } else if (hasSctCode(code, codes, "103228002", "103228002", "442349007", "442476006", "442440005", "431314004", "442734002", "713194001")) {
-        ok = checkObservationAgainstProfile(valContext,errors, element, stack, "http://hl7.org/fhir/StructureDefinition/oxygensat", "Oxygen saturation", "SNOMED CT", codes, pct, mode) && ok;
-      } else if (hasSctCode(code, codes, "386725007", "276885007", "300076005", "1222808002", "364246006", "307047009", "708499008", "708499008", "431598003", "698831002", "698832009", "415882003", "415974002", "415929009", "415945006")) {
-        ok = checkObservationAgainstProfile(valContext,errors, element, stack, "http://hl7.org/fhir/StructureDefinition/bodytemp", "Body temperature", "SNOMED CT", codes, pct, mode) && ok;
-      } else if (hasSctCode(code, codes, "1153637007", "1162419008", "50373000", "1162418000", "1230278008", "1162392001", "1162417005")) {
-        ok = checkObservationAgainstProfile(valContext,errors, element, stack, "http://hl7.org/fhir/StructureDefinition/bodyheight", "Body height", "SNOMED CT", codes, pct, mode) && ok;
-      } else if (hasSctCode(code, codes, "363812007", "169876006", "1269262007", "363811000")) {
-        ok = checkObservationAgainstProfile(valContext,errors, element, stack, "http://hl7.org/fhir/StructureDefinition/headcircum", "Head circumference", "SNOMED CT", codes, pct, mode) && ok;
-      } else if (hasSctCode(code, codes, "363811000", "60621009", "735395000", "425024002", "424927000", "784399000", "1162416001", "1162415002")) {
-        ok = checkObservationAgainstProfile(valContext,errors, element, stack, "http://hl7.org/fhir/StructureDefinition/bodyweight", "Body weight", "SNOMED CT", codes, pct, mode) && ok;
-      } else if (hasSctCode(code, codes, "60621009")) {
-        ok = checkObservationAgainstProfile(valContext,errors, element, stack, "http://hl7.org/fhir/StructureDefinition/bmi", "Body mass index", "SNOMED CT", codes, pct, mode) && ok;
-      } else if (hasSctCode(code, codes, "75367002", "251076008", "163033001", "163035008", "386534000", "386536003", "271649006", "271649006", "271650006", "407556006", "407554009", "716579001", "399304008")) {
-        ok = checkObservationAgainstProfile(valContext,errors, element, stack, "http://hl7.org/fhir/StructureDefinition/bp", "Blood pressure systolic and diastolic", "SNOMED CT", codes, pct, mode) && ok;
-      }  
-    }
     return ok;
   }
 
-  private boolean checkObservationAgainstProfile(ValidationContext valContext, List<ValidationMessage> errors, Element element, NodeStack stack, String url, String name, String sys, List<String> loinc, PercentageTracker pct, ValidationMode mode) {
-    element.addMessage(signpost(errors, NO_RULE_DATE, IssueType.INFORMATIONAL, element.line(), element.col(), stack.getLiteralPath(), I18nConstants.VALIDATION_VAL_PROFILE_SIGNPOST_OBS, url, name, sys, loinc.get(0)));
-    StructureDefinition sd = context.fetchResource(StructureDefinition.class, url);
-    if (sd == null) {
-      return false;
-    } else {
-      return ((InstanceValidator) parent).startInner(valContext, errors, element, element, sd, stack, false, pct, mode, false);
-    }
-  }
-
-  private boolean hasLoincCode(Element code, List<String> codes, String... values) {
-    if (code != null) {
-      List<Element> codings = code.getChildren("coding");
-      for (Element coding : codings) {
-        if ("http://loinc.org".equals(coding.getNamedChildValue("system", false)) && Utilities.existsInList(coding.getNamedChildValue("code", false), values)) {
-          codes.add(coding.getNamedChildValue("code", false));
-          return true;
-        }
-      }
-    }
-    return false;
-  }
-
-  private boolean hasSctCode(Element code, List<String> codes, String... values) {
-    if (code != null) {
-      List<Element> codings = code.getChildren("coding");
-      for (Element coding : codings) {
-        if ("http://snomed.info/sct".equals(coding.getNamedChildValue("system", false)) && Utilities.existsInList(coding.getNamedChildValue("code", false), values)) {
-          codes.add(coding.getNamedChildValue("code", false));
-          return true;
-        }
-      }
-    }
-    return false;
-  }
-
-  
-
 }

org.hl7.fhir.validation/src/test/java/org/hl7/fhir/validation/tests/ValidationTests.java

@@ -59,6 +59,7 @@ import org.hl7.fhir.r5.test.utils.TestingUtilities;
 import org.hl7.fhir.r5.utils.OperationOutcomeUtilities;
 import org.hl7.fhir.r5.utils.ToolingExtensions;
 import org.hl7.fhir.r5.utils.validation.BundleValidationRule;
+import org.hl7.fhir.r5.utils.validation.IMessagingServices;
 import org.hl7.fhir.r5.utils.validation.IResourceValidator;
 import org.hl7.fhir.r5.utils.validation.IValidationPolicyAdvisor;
 import org.hl7.fhir.r5.utils.validation.IValidatorResourceFetcher;
@@ -90,6 +91,7 @@ import org.hl7.fhir.validation.ValidationEngine;
 import org.hl7.fhir.validation.ValidatorUtils;
 import org.hl7.fhir.validation.cli.model.HtmlInMarkdownCheck;
 import org.hl7.fhir.validation.cli.services.StandAloneValidatorFetcher;
+import org.hl7.fhir.validation.instance.BasePolicyAdvisorForFullValidation;
 import org.hl7.fhir.validation.instance.InstanceValidator;
 import org.hl7.fhir.validation.tests.utilities.TestUtilities;
 import org.junit.AfterClass;
@@ -469,7 +471,7 @@ public class ValidationTests implements IEvaluationContext, IValidatorResourceFe
   }
 
   private ValidationEngine buildVersionEngine(String ver, String txLog) throws Exception {
-    String server = FhirSettings.getTxFhirLocal();
+    String server = FhirSettings.getTxFhirDevelopment();
     switch (ver) {
     case "1.0": return TestUtilities.getValidationEngine("hl7.fhir.r2.core#1.0.2", server, txLog, FhirPublication.DSTU2, true, "1.0.2");
     case "1.4": return TestUtilities.getValidationEngine("hl7.fhir.r2b.core#1.4.0", server, txLog, FhirPublication.DSTU2016May, true, "1.4.0"); 
@@ -887,4 +889,12 @@ public class ValidationTests implements IEvaluationContext, IValidatorResourceFe
   public Set<String> fetchCanonicalResourceVersions(IResourceValidator validator, Object appContext, String url) {
     return new HashSet<>();
   }
+
+  @Override
+  public List<StructureDefinition> getImpliedProfilesForResource(IResourceValidator validator, Object appContext,
+      String stackPath, ElementDefinition definition, StructureDefinition structure, Element resource, boolean valid,
+      IMessagingServices msgServices, List<ValidationMessage> messages) {
+    return new BasePolicyAdvisorForFullValidation().getImpliedProfilesForResource(validator, appContext, stackPath, 
+        definition, structure, resource, valid, msgServices, messages);
+  }
 }

pom.xml

@@ -21,7 +21,7 @@
         <commons_compress_version>1.26.0</commons_compress_version>
         <guava_version>32.0.1-jre</guava_version>
         <hapi_fhir_version>6.4.1</hapi_fhir_version>
-        <validator_test_case_version>1.5.10</validator_test_case_version>
+        <validator_test_case_version>1.5.11-SNAPSHOT</validator_test_case_version>
         <jackson_version>2.17.0</jackson_version>
         <junit_jupiter_version>5.9.2</junit_jupiter_version>
         <junit_platform_launcher_version>1.8.2</junit_platform_launcher_version>