Observation-example-bloodpressure.xml

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

Raw XML

<Bundle xmlns="http://hl7.org/fhir">
  <id value="blood-pressure"/>
  <meta>
    <lastUpdated value="2014-01-30T22:35:23+11:00"/>
  </meta>
  <type value="collection"/>
  <base value="http://hl7.org/fhir"/><!--    first entry: the single resource with combined
     narrative, and links to the 2 component resources    -->
  <entry>
    <resource>
      <Observation><!--    this id is purely arbitrary. It could have been a UUID, or something else    -->
        <id value="34252345234"/>
        <meta>
          <lastUpdated value="2014-01-30T22:35:23+11:00"/>
        </meta>
        <text>
          <status value="generated"/>
          <div xmlns="http://www.w3.org/1999/xhtml"><!-- Snipped for brevity --></div>
        </text>
        <code>
          <coding>
            <system value="http://loinc.org"/>
            <code value="55284-4"/>
            <display value="Blood pressure systolic &amp; diastolic"/>
          </coding>
        </code><!--    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 &quot;COMP&quot; (component)
        observations    -->
        <interpretation>
          <coding>
            <system value="http://hl7.org/fhir/v2/0078"/>
            <code value="L"/>
            <display value="Below low normal"/>
          </coding>
          <text value="low"/>
        </interpretation>
        <appliesDateTime value="2012-09-17"/><!--    for an observation with components, these cannot disagree with the flags on the components
            -->
        <status value="final"/>
        <reliability value="ok"/>
        <identifier>
          <system value="urn:ietf:rfc:3986"/>
          <value value="urn:uuid:187e0c12-8dd2-67e2-99b2-bf273c878281"/>
        </identifier>
        <subject>
          <reference value="Patient/example"/>
        </subject>
        <performer>
          <reference value="Practitioner/example"/>
        </performer>
        <related>
          <type value="has-component"/>
          <target>
            <reference value="http://acme.org/ehr/observations/34252345234-s"/>
          </target>
        </related>
        <related>
          <type value="has-component"/>
          <target>
            <reference value="http://acme.org/ehr/observations/34252345234-d"/>
          </target>
        </related>
      </Observation>
    </resource>
  </entry><!--    Observation for systolic blood pressure: name, value, and flags    -->
  <entry>
    <resource>
      <Observation><!--   
      Most systems won't store systolic and diastolic observations separately.
      They'd usually be two fields in a database or something like that. The
      FHIR interface treats these as separate observation for consistency
      purposes (makes query easy). But that doesn't mean that the systems
      have to really do that internally. This example implies a system that
      appends -d or -s to the id of the base observation for the individual
      components.

      This implies that you can operate on them separately, even though
      this would probably not be true. It would be up to the implementing
      system to decide how to manage this (e.g. readonly, so there's no
      update operations to worry about)
       -->
        <id value="34252345234-s"/>
        <meta>
          <lastUpdated value="2014-01-30T22:35:23+11:00"/>
        </meta>
        <text>
          <status value="generated"/>
          <div xmlns="http://www.w3.org/1999/xhtml"><!-- Snipped for brevity --></div>
        </text><!--   
           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
            -->
        <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>
        </code><!--    that shows the concept. The next two names only have a LOINC code    --><!--    no formal units in this example    -->
        <valueQuantity>
          <value value="107"/>
          <units value="mm[Hg]"/>
        </valueQuantity><!--    the mandatory quality flags:    -->
        <status value="final"/>
        <reliability value="ok"/>
        <subject>
          <reference value="Patient/example"/>
        </subject>
      </Observation>
    </resource>
  </entry><!--    diastolic blood pressure: name, value, and flags    -->
  <entry>
    <resource>
      <Observation>
        <id value="34252345234-d"/>
        <meta>
          <lastUpdated value="2014-01-30T22:35:23+11:00"/>
        </meta>
        <text>
          <status value="generated"/>
          <div xmlns="http://www.w3.org/1999/xhtml"><!-- Snipped for brevity --></div>
        </text>
        <code>
          <coding>
            <system value="http://loinc.org"/>
            <code value="8462-4"/>
            <display value="Diastolic blood pressure"/>
          </coding>
        </code><!--    no formal units in this example    -->
        <valueQuantity>
          <value value="60"/>
          <units value="mm[Hg]"/>
        </valueQuantity><!--    the mandatory quality flags:    -->
        <status value="final"/>
        <reliability value="ok"/>
        <subject>
          <reference value="Patient/example"/>
        </subject>
      </Observation>
    </resource>
  </entry>
</Bundle>