STU3 Candidate

This page is part of the FHIR Specification (v1.8.0: STU 3 Draft). 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

10.1.17.2 StructureDefinition: VitalSigns

(No assigned work group) Maturity Level: 0Context: Any

The official URL for this profile is: 

http://hl7.org/fhir/StructureDefinition/vitalsigns

FHIR Vital Signs Profile

This profile was published on Fri, Mar 25, 2016 00:00+1100 as a draft by Health Level Seven International (Orders and Observations Workgroup).

10.1.17.2.1 Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots, and how the XML and JSON presentations work.

This structure is derived from Observation.

Summary

10.1.17.3 Complete Summary of the Mandatory Requirements

  1. One status in Observation.statuswhich has a required binding to:

  2. One category in Observation.category which must have:

    • a fixed Observation.category.coding.system="http://hl7.org/fhir/observation-category"
    • a fixed Observation.category.coding.code= "vital-signs"

  3. A code in Observation.code

    • a fixed Observation.code.coding.system= "http://loinc.org"
    • a LOINC code in Observation.code.coding.code which has an extensible binding to:

  4. One patient in Observation.subject

  5. A date and time in effectiveDateTime or effectivePeriod

  6. Either one Observation.valueQuantity or, if there is no value, one code in Observation.DataAbsentReason

    • Each Observation.valueQuantity must have:
      • One numeric value in Observation.valueQuantity.value
      • a fixed Observation.valueQuantity.system="http://unitsofmeasure"
      • a UCUM unit code in Observation.valueQuantity.code which has an required binding to:
    • Observation.DataAbsentReason is bound to Observation Value Absent Reason value set.

  7. When using a panel code to group component observations (Note: See the comments regarding blood pressure in the table above), one or more Observation.component.code each of which must have:

    • a fixed Observation.component.code.coding.system ="<http://loinc.org>"

  8. Either one Observation.component.valueQuantity or, if there is no value, one code in Observation.component.DataAbsentReason

    • Each Observation.component.valueQuantity must have:
      • One numeric value in Observation.component.valueQuantity.value
      • a fixed Observation.component.valueQuantity.system= "<http://unitsofmeasure.org>"
      • a UCUM unit code in Observation.component.valueQuantity.code which has an required binding to:
    • Observation.component.DataAbsentReason is bound to Observation Value Absent Reason value set.

  9. When using a panel code to group observations, one or more reference to Vitals Signs Observations in Observation.related.target

    • a fixed Observation.related.type= "has-member"

Mandatory: 5 elements (+11 nested mandatory elements)
Must-Support: 22 elements
Fixed Value: 3 elements

Structures

This structure refers to these other structures:

This structure is derived from Observation.

NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation I0..*FHIR Vital Signs Profile
vs-2: If there is no component or related element then either a value[x] or a data absent reason must be present
... status S1..1codeBinding: ObservationStatus (required)
... category S1..1CodeableConceptRequired Pattern: {"coding":[{"system":"http://hl7.org/fhir/observation-category","code":"vital-signs"}]}
... code S1..1CodeableConceptCoded Responses from C-CDA Vital Sign Results
Binding: Vital Signs (extensible)
... subject S1..1Reference(Patient)
... effective[x] SI1..1dateTime, PeriodOften just a dateTime for Vital Signs
vs-1: Datetime must be at least to day.
... valueQuantity SI0..1QuantityVital Sign Value recorded with UCUM
Binding: Vital Signs Units (required)
.... value S1..1decimal
.... unit S1..1string
.... system S1..1uriFixed Value: http://unitsofmeasure.org
.... code S1..1codeCoded responses from the common UCUM units for vital signs value set.
... dataAbsentReason SI0..1CodeableConceptBinding: Observation Value Absent Reason (extensible)
... related S0..*BackboneElementUsed when reporting systolic and diastolic blood pressure.
.... type S1..1codeFixed Value: has-member
.... target S1..1Reference(VitalSigns)
... component SI0..*BackboneElementUsed when reporting systolic and diastolic blood pressure.
vs-3: If there is no a value a data absent reason must be present
.... code S1..1CodeableConceptBinding: Vital Signs (extensible)
.... valueQuantity SI0..1QuantityVital Sign Value recorded with UCUM
Binding: Vital Signs Units (required)
..... value S1..1decimal
..... unit S1..1string
..... system S1..1uriFixed Value: http://unitsofmeasure.org
..... code S1..1codeCoded responses from the common UCUM units for vital signs value set.
.... dataAbsentReason SI0..1CodeableConceptBinding: Observation Value Absent Reason (extensible)

doco Documentation for this format
NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation I0..*FHIR Vital Signs Profile
vs-2: If there is no component or related element then either a value[x] or a data absent reason must be present
... id ∑0..1idLogical id of this artifact
... meta ∑0..1MetaMetadata about the resource
... implicitRules ?!∑0..1uriA set of rules under which this content was created
... language 0..1codeLanguage of the resource content
Binding: Common Languages (extensible)
... text I0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... extension 0..*ExtensionAdditional Content defined by implementations
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... identifier 0..*IdentifierUnique Id for this particular observation
... status ?!S∑1..1coderegistered | preliminary | final | amended +
Binding: ObservationStatus (required)
... category S1..1CodeableConceptClassification of type of observation
Binding: Observation Category Codes (example)
Required Pattern: {"coding":[{"system":"http://hl7.org/fhir/observation-category","code":"vital-signs"}]}
... code S∑1..1CodeableConceptCoded Responses from C-CDA Vital Sign Results
Binding: Vital Signs (extensible)
... subject S∑1..1Reference(Patient)Who and/or what this is about
... encounter 0..1Reference(Encounter)Healthcare event during which this observation is made
... effective[x] S∑I1..1dateTime, PeriodOften just a dateTime for Vital Signs
vs-1: Datetime must be at least to day.
... issued ∑0..1instantDate/Time this was made available
... performer ∑0..*Reference(Practitioner), Reference(Organization), Reference(Patient), Reference(RelatedPerson)Who is responsible for the observation
... valueQuantity S∑I0..1QuantityVital Sign Value recorded with UCUM
Binding: Vital Signs Units (required)
.... id 0..1stringxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
.... value S∑1..1decimalNumerical value (with implicit precision)
.... comparator ?!∑0..1code< | <= | >= | > - how to understand the value
Binding: QuantityComparator (required)
.... unit S∑1..1stringUnit representation
.... system S∑I1..1uriSystem that defines coded unit form
Fixed Value: http://unitsofmeasure.org
.... code S∑1..1codeCoded responses from the common UCUM units for vital signs value set.
... dataAbsentReason SI0..1CodeableConceptWhy the result is missing
Binding: Observation Value Absent Reason (extensible)
... interpretation 0..1CodeableConceptHigh, low, normal, etc.
Binding: Observation Interpretation Codes (extensible)
... comment 0..1stringComments about result
... bodySite 0..1CodeableConceptObserved body part
Binding: SNOMED CT Body Structures (example)
... method 0..1CodeableConceptHow it was done
Binding: Observation Methods (example)
... specimen 0..1Reference(Specimen)Specimen used for this observation
... device 0..1Reference(Device), Reference(DeviceMetric)(Measurement) Device
... referenceRange I0..*BackboneElementProvides guide for interpretation
obs-3: Must have at least a low or a high or text
.... id 0..1stringxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
.... modifierExtension ?!∑0..*ExtensionExtensions that cannot be ignored
.... low I0..1SimpleQuantityLow Range, if relevant
.... high I0..1SimpleQuantityHigh Range, if relevant
.... meaning 0..*CodeableConceptReference range qualifier
Binding: Observation Reference Range Meaning Codes (example)
.... age 0..1RangeApplicable age range, if relevant
.... text 0..1stringText based reference range in an observation
... related S∑I0..*BackboneElementUsed when reporting systolic and diastolic blood pressure.
.... id 0..1stringxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
.... modifierExtension ?!∑0..*ExtensionExtensions that cannot be ignored
.... type S1..1codehas-member | derived-from | sequel-to | replaces | qualified-by | interfered-by
Binding: ObservationRelationshipType (required)
Fixed Value: has-member
.... target S1..1Reference(VitalSigns)Resource that is related to this one
... component S∑I0..*BackboneElementUsed when reporting systolic and diastolic blood pressure.
vs-3: If there is no a value a data absent reason must be present
.... id 0..1stringxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
.... modifierExtension ?!∑0..*ExtensionExtensions that cannot be ignored
.... code S∑1..1CodeableConceptType of component observation (code / type)
Binding: Vital Signs (extensible)
.... valueQuantity S∑0..1QuantityVital Sign Value recorded with UCUM
Binding: Vital Signs Units (required)
..... id 0..1stringxml:id (or equivalent in JSON)
..... extension 0..*ExtensionAdditional Content defined by implementations
..... value S∑1..1decimalNumerical value (with implicit precision)
..... comparator ?!∑0..1code< | <= | >= | > - how to understand the value
Binding: QuantityComparator (required)
..... unit S∑1..1stringUnit representation
..... system S∑I1..1uriSystem that defines coded unit form
Fixed Value: http://unitsofmeasure.org
..... code S∑1..1codeCoded responses from the common UCUM units for vital signs value set.
.... dataAbsentReason SI0..1CodeableConceptWhy the component result is missing
Binding: Observation Value Absent Reason (extensible)
.... interpretation 0..1CodeableConceptHigh, low, normal, etc.
Binding: Observation Interpretation Codes (extensible)
.... referenceRange 0..*Unknown reference to #Observation:vitalsigns.referenceRange
Provides guide for interpretation of component result

doco Documentation for this format

todo

This structure is derived from Observation.

Summary

10.1.17.4 Complete Summary of the Mandatory Requirements

  1. One status in Observation.statuswhich has a required binding to:

  2. One category in Observation.category which must have:

    • a fixed Observation.category.coding.system="http://hl7.org/fhir/observation-category"
    • a fixed Observation.category.coding.code= "vital-signs"

  3. A code in Observation.code

    • a fixed Observation.code.coding.system= "http://loinc.org"
    • a LOINC code in Observation.code.coding.code which has an extensible binding to:

  4. One patient in Observation.subject

  5. A date and time in effectiveDateTime or effectivePeriod

  6. Either one Observation.valueQuantity or, if there is no value, one code in Observation.DataAbsentReason

    • Each Observation.valueQuantity must have:
      • One numeric value in Observation.valueQuantity.value
      • a fixed Observation.valueQuantity.system="http://unitsofmeasure"
      • a UCUM unit code in Observation.valueQuantity.code which has an required binding to:
    • Observation.DataAbsentReason is bound to Observation Value Absent Reason value set.

  7. When using a panel code to group component observations (Note: See the comments regarding blood pressure in the table above), one or more Observation.component.code each of which must have:

    • a fixed Observation.component.code.coding.system ="<http://loinc.org>"

  8. Either one Observation.component.valueQuantity or, if there is no value, one code in Observation.component.DataAbsentReason

    • Each Observation.component.valueQuantity must have:
      • One numeric value in Observation.component.valueQuantity.value
      • a fixed Observation.component.valueQuantity.system= "<http://unitsofmeasure.org>"
      • a UCUM unit code in Observation.component.valueQuantity.code which has an required binding to:
    • Observation.component.DataAbsentReason is bound to Observation Value Absent Reason value set.

  9. When using a panel code to group observations, one or more reference to Vitals Signs Observations in Observation.related.target

    • a fixed Observation.related.type= "has-member"

Mandatory: 5 elements (+11 nested mandatory elements)
Must-Support: 22 elements
Fixed Value: 3 elements

Structures

This structure refers to these other structures:

Differential View

This structure is derived from Observation.

NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation I0..*FHIR Vital Signs Profile
vs-2: If there is no component or related element then either a value[x] or a data absent reason must be present
... status S1..1codeBinding: ObservationStatus (required)
... category S1..1CodeableConceptRequired Pattern: {"coding":[{"system":"http://hl7.org/fhir/observation-category","code":"vital-signs"}]}
... code S1..1CodeableConceptCoded Responses from C-CDA Vital Sign Results
Binding: Vital Signs (extensible)
... subject S1..1Reference(Patient)
... effective[x] SI1..1dateTime, PeriodOften just a dateTime for Vital Signs
vs-1: Datetime must be at least to day.
... valueQuantity SI0..1QuantityVital Sign Value recorded with UCUM
Binding: Vital Signs Units (required)
.... value S1..1decimal
.... unit S1..1string
.... system S1..1uriFixed Value: http://unitsofmeasure.org
.... code S1..1codeCoded responses from the common UCUM units for vital signs value set.
... dataAbsentReason SI0..1CodeableConceptBinding: Observation Value Absent Reason (extensible)
... related S0..*BackboneElementUsed when reporting systolic and diastolic blood pressure.
.... type S1..1codeFixed Value: has-member
.... target S1..1Reference(VitalSigns)
... component SI0..*BackboneElementUsed when reporting systolic and diastolic blood pressure.
vs-3: If there is no a value a data absent reason must be present
.... code S1..1CodeableConceptBinding: Vital Signs (extensible)
.... valueQuantity SI0..1QuantityVital Sign Value recorded with UCUM
Binding: Vital Signs Units (required)
..... value S1..1decimal
..... unit S1..1string
..... system S1..1uriFixed Value: http://unitsofmeasure.org
..... code S1..1codeCoded responses from the common UCUM units for vital signs value set.
.... dataAbsentReason SI0..1CodeableConceptBinding: Observation Value Absent Reason (extensible)

doco Documentation for this format

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation I0..*FHIR Vital Signs Profile
vs-2: If there is no component or related element then either a value[x] or a data absent reason must be present
... id ∑0..1idLogical id of this artifact
... meta ∑0..1MetaMetadata about the resource
... implicitRules ?!∑0..1uriA set of rules under which this content was created
... language 0..1codeLanguage of the resource content
Binding: Common Languages (extensible)
... text I0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... extension 0..*ExtensionAdditional Content defined by implementations
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... identifier 0..*IdentifierUnique Id for this particular observation
... status ?!S∑1..1coderegistered | preliminary | final | amended +
Binding: ObservationStatus (required)
... category S1..1CodeableConceptClassification of type of observation
Binding: Observation Category Codes (example)
Required Pattern: {"coding":[{"system":"http://hl7.org/fhir/observation-category","code":"vital-signs"}]}
... code S∑1..1CodeableConceptCoded Responses from C-CDA Vital Sign Results
Binding: Vital Signs (extensible)
... subject S∑1..1Reference(Patient)Who and/or what this is about
... encounter 0..1Reference(Encounter)Healthcare event during which this observation is made
... effective[x] S∑I1..1dateTime, PeriodOften just a dateTime for Vital Signs
vs-1: Datetime must be at least to day.
... issued ∑0..1instantDate/Time this was made available
... performer ∑0..*Reference(Practitioner), Reference(Organization), Reference(Patient), Reference(RelatedPerson)Who is responsible for the observation
... valueQuantity S∑I0..1QuantityVital Sign Value recorded with UCUM
Binding: Vital Signs Units (required)
.... id 0..1stringxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
.... value S∑1..1decimalNumerical value (with implicit precision)
.... comparator ?!∑0..1code< | <= | >= | > - how to understand the value
Binding: QuantityComparator (required)
.... unit S∑1..1stringUnit representation
.... system S∑I1..1uriSystem that defines coded unit form
Fixed Value: http://unitsofmeasure.org
.... code S∑1..1codeCoded responses from the common UCUM units for vital signs value set.
... dataAbsentReason SI0..1CodeableConceptWhy the result is missing
Binding: Observation Value Absent Reason (extensible)
... interpretation 0..1CodeableConceptHigh, low, normal, etc.
Binding: Observation Interpretation Codes (extensible)
... comment 0..1stringComments about result
... bodySite 0..1CodeableConceptObserved body part
Binding: SNOMED CT Body Structures (example)
... method 0..1CodeableConceptHow it was done
Binding: Observation Methods (example)
... specimen 0..1Reference(Specimen)Specimen used for this observation
... device 0..1Reference(Device), Reference(DeviceMetric)(Measurement) Device
... referenceRange I0..*BackboneElementProvides guide for interpretation
obs-3: Must have at least a low or a high or text
.... id 0..1stringxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
.... modifierExtension ?!∑0..*ExtensionExtensions that cannot be ignored
.... low I0..1SimpleQuantityLow Range, if relevant
.... high I0..1SimpleQuantityHigh Range, if relevant
.... meaning 0..*CodeableConceptReference range qualifier
Binding: Observation Reference Range Meaning Codes (example)
.... age 0..1RangeApplicable age range, if relevant
.... text 0..1stringText based reference range in an observation
... related S∑I0..*BackboneElementUsed when reporting systolic and diastolic blood pressure.
.... id 0..1stringxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
.... modifierExtension ?!∑0..*ExtensionExtensions that cannot be ignored
.... type S1..1codehas-member | derived-from | sequel-to | replaces | qualified-by | interfered-by
Binding: ObservationRelationshipType (required)
Fixed Value: has-member
.... target S1..1Reference(VitalSigns)Resource that is related to this one
... component S∑I0..*BackboneElementUsed when reporting systolic and diastolic blood pressure.
vs-3: If there is no a value a data absent reason must be present
.... id 0..1stringxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
.... modifierExtension ?!∑0..*ExtensionExtensions that cannot be ignored
.... code S∑1..1CodeableConceptType of component observation (code / type)
Binding: Vital Signs (extensible)
.... valueQuantity S∑0..1QuantityVital Sign Value recorded with UCUM
Binding: Vital Signs Units (required)
..... id 0..1stringxml:id (or equivalent in JSON)
..... extension 0..*ExtensionAdditional Content defined by implementations
..... value S∑1..1decimalNumerical value (with implicit precision)
..... comparator ?!∑0..1code< | <= | >= | > - how to understand the value
Binding: QuantityComparator (required)
..... unit S∑1..1stringUnit representation
..... system S∑I1..1uriSystem that defines coded unit form
Fixed Value: http://unitsofmeasure.org
..... code S∑1..1codeCoded responses from the common UCUM units for vital signs value set.
.... dataAbsentReason SI0..1CodeableConceptWhy the component result is missing
Binding: Observation Value Absent Reason (extensible)
.... interpretation 0..1CodeableConceptHigh, low, normal, etc.
Binding: Observation Interpretation Codes (extensible)
.... referenceRange 0..*Unknown reference to #Observation:vitalsigns.referenceRange
Provides guide for interpretation of component result

doco Documentation for this format

XML Template

JSON Template

todo

 

Other representations of profile: Schematron

10.1.17.4.1 Terminology Bindings

PathNameConformanceValueSet
Observation.languageCommon LanguagesextensibleCommon Languages
Observation.statusObservationStatusrequiredObservationStatus
Observation.categoryObservation Category CodesexampleObservation Category Codes
Observation.codeVital SignsextensibleVital Signs
Observation.valueQuantityVital Signs UnitsrequiredVital Signs Units
Observation.valueQuantity.comparatorQuantityComparatorrequiredQuantityComparator
Observation.dataAbsentReasonObservation Value Absent ReasonextensibleObservation Value Absent Reason
Observation.interpretationObservation Interpretation CodesextensibleObservation Interpretation Codes
Observation.bodySiteSNOMED CT Body StructuresexampleSNOMED CT Body Structures
Observation.methodObservation MethodsexampleObservation Methods
Observation.referenceRange.meaningObservation Reference Range Meaning CodesexampleObservation Reference Range Meaning Codes
Observation.related.typeObservationRelationshipTyperequiredObservationRelationshipType
Observation.component.codeVital SignsextensibleVital Signs
Observation.component.valueQuantityVital Signs UnitsrequiredVital Signs Units
Observation.component.valueQuantity.comparatorQuantityComparatorrequiredQuantityComparator
Observation.component.dataAbsentReasonObservation Value Absent ReasonextensibleObservation Value Absent Reason
Observation.component.interpretationObservation Interpretation CodesextensibleObservation Interpretation Codes

10.1.17.4.2 Constraints

IdPathDetailsRequirements
vs-2ObservationIf there is no component or related element then either a value[x] or a data absent reason must be present
XPath: exists(f:component) or exists(f:related) or exists(f:*[starts-with(local-name(.), 'value)]) or exists(f:dataAbsentReason)
vs-1Observation.effective[x]Datetime must be at least to day.
XPath: f:matches(effectiveDateTime,/\d{4}-[01]\d-[0-3]\dT[0-2]\d:[0-5]\d([+-][0-2]\d:[0-5]\d|Z)/)
obs-3Observation.referenceRangeMust have at least a low or a high or text
XPath: (exists(f:low) or exists(f:high)or exists(f:text))
vs-3Observation.componentIf there is no a value a data absent reason must be present
XPath: exists(f:*[starts-with(local-name(.), 'value)]) or exists(f:dataAbsentReason)
.