GAO Ballot Package

This page is part of the FHIR Specification (v1.1.0: STU 3 Ballot 1). The current version which supercedes this version is 5.0.0. For a full list of available versions, see the Directory of published versions . Page versions: R5 R4B R4 R3 R2

This is a frozen snapshot of the FHIR specification created for the purpose of balloting the GAO implementation Guide. It includes draft changes that may be part of the future DSTU 2.1 release but further change is expected. Readers should focus solely on the GAO implementation content, and FHIR DSTU 2 for other purposes.

Observation-example-bloodpressure-cancel.xml

Raw XML (canonical form)

Blood Pressure Measurement cancelled (id = "blood-pressure-cancel")

<Observation xmlns="http://hl7.org/fhir">
  <id value="blood-pressure-cancel"/>
  <meta>
    <lastUpdated value="2014-01-30T22:35:23+11:00"/>
  </meta>
  <!--     EH  Narrative created by build
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml">Sept 17, 2012: Systolic Blood pressure 107/60
   mmHg (low)</div>
  </text>
   -->
  <text><status value="generated"/><div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative with Details</b></p><p><b>id</b>: blood-pressure-cancel</p><p><b>meta</b>: </p><p><b>identifier</b>: urn:uuid:187e0c12-8dd2-67e2-99b2-bf273c878281</p><p><b>status</b>: cancelled</p><p><b>code</b>: Blood pressure systolic &amp; diastolic <span>(Details : {LOINC code '55284-4' = 'Blood pressure systolic and diastolic', given as 'Blood
           pressure systolic &amp; diastolic'})</span></p><p><b>subject</b>: <a>Patient/example</a></p><p><b>effective</b>: 17/09/2012</p><p><b>performer</b>: <a>Practitioner/example</a></p><p><b>interpretation</b>: Below low normal <span>(Details : {http://hl7.org/fhir/v2/0078 code 'L' = 'Low', given as 'low'})</span></p><p><b>comments</b>: In this example, the blood pressure measurements are not available due to cancellation
         of the order.  Data absent reason is present for each component</p><p><b>bodySite</b>: Right arm <span>(Details : {SNOMED CT code '368209003' = '368209003', given as 'Right arm'})</span></p><blockquote><p><b>component</b></p><p><b>code</b>: Systolic blood pressure <span>(Details : {LOINC code '8480-6' = 'Systolic blood pressure', given as 'Systolic blood
             pressure'}; {SNOMED CT code '271649006' = '271649006', given as 'Systolic blood pressure'};
             {http://acme.org/devices/clinical-codes code 'bp-s' = '??', given as 'Systolic Blood pressure'})</span></p><p><b>dataAbsentReason</b>: Not Asked <span>(Details : {http://hl7.org/fhir/data-absent-reason code 'not-asked' = 'Not Asked', given
             as 'Not Asked'})</span></p></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: Diastolic blood pressure <span>(Details : {LOINC code '8462-4' = 'Diastolic blood pressure', given as 'Diastolic blood
             pressure'})</span></p><p><b>dataAbsentReason</b>: Not Asked <span>(Details : {http://hl7.org/fhir/data-absent-reason code 'not-asked' = 'Not Asked', given
             as 'Not Asked'})</span></p></blockquote></div></text><identifier>
    <system value="urn:ietf:rfc:3986"/>
    <value value="urn:uuid:187e0c12-8dd2-67e2-99b2-bf273c878281"/>
  </identifier>
  <status value="cancelled"/>
  <code>
    <coding>
      <system value="http://loinc.org"/>
      <code value="55284-4"/>
      <display value="Blood pressure systolic &amp; diastolic"/>
    </coding>
  </code>
  <subject>
    <reference value="Patient/example"/>
  </subject>
  <effectiveDateTime value="2012-09-17"/>
  <performer>
    <reference value="Practitioner/example"/>
  </performer>
  <!--    an interpretation offered to the combination observation
        generally, it would only be appropriate to offer an interpretation
        of an observation that has no value if it has "COMP" (component)
        observations    -->
  <interpretation>
    <coding>
      <system value="http://hl7.org/fhir/v2/0078"/>
      <code value="L"/>
      <display value="low"/>
    </coding>
    <text value="Below low normal"/>
  </interpretation>
  <comments value="In this example, the blood pressure measurements are not available due to cancellation
   of the order.  Data absent reason is present for each component"/>
  <!--    for an observation with components, these cannot disagree with the flags on the components
      -->
  <bodySite>
    <coding>
      <system value="http://snomed.info/sct"/>
      <code value="368209003"/>
      <display value="Right arm"/>
    </coding>
  </bodySite>
  <component>
    <!--   
           Observations are often coded in multiple code systems.
           - LOINC provides a very specific code (though not usefully more specific in
     this particular case)
           - snomed provides a clinically relevant code that is usually less granular
     than LOINC
           - the source system provides its own code, which may be less or more granular
     than LOINC
   this instance shows the concept. The other codes only have a LOINC code    -->
       
    <code>
      <!--    LOINC - always recommended to have a LOINC code    -->
      <coding>
        <system value="http://loinc.org"/>
        <code value="8480-6"/>
        <display value="Systolic blood pressure"/>
      </coding>
      <!--    SNOMED CT Codes - becoming more common    -->
      <coding>
        <system value="http://snomed.info/sct"/>
        <code value="271649006"/>
        <display value="Systolic blood pressure"/>
      </coding>
      <!--    Also, a local code specific to the source system    -->
      <coding>
        <system value="http://acme.org/devices/clinical-codes"/>
        <code value="bp-s"/>
        <display value="Systolic Blood pressure"/>
      </coding>
      <!--    that shows the concept. The next two names only have a LOINC code    -->
    </code>
    <!--    no value due to some error 
    <valueQuantity>
      <value value="107"/>
      <unit value="mm[Hg]"/>
    </valueQuantity>
   -->
    <dataAbsentReason>
      <coding>
        <system value="http://hl7.org/fhir/data-absent-reason"/>
        <code value="not-asked"/>
        <display value="Not Asked"/>
      </coding>
    </dataAbsentReason>
  </component>
  <component>
    <code>
      <coding>
        <system value="http://loinc.org"/>
        <code value="8462-4"/>
        <display value="Diastolic blood pressure"/>
      </coding>
    </code>
    <!--    no value due to some error 
    <valueQuantity>
      <value value="60"/>
      <unit value="mm[Hg]"/>
    </valueQuantity>
   -->
    <dataAbsentReason>
      <coding>
        <system value="http://hl7.org/fhir/data-absent-reason"/>
        <code value="not-asked"/>
        <display value="Not Asked"/>
      </coding>
    </dataAbsentReason>
  </component>
</Observation>

Usage note: every effort has been made to ensure that the examples are correct and useful, but they are not a normative part of the specification.