Observation-example-bloodpressure-dar.xml

Blood Pressure Measurement with an absent Diastolic measurement (id = "blood-pressure-dar")

<Observation xmlns="http://hl7.org/fhir">
  <id value="blood-pressure-dar"/> 
  <meta> 
    <profile value="http://hl7.org/fhir/StructureDefinition/vitalsigns"/> 
  </meta> 
  <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-dar</p> <p> <b> meta</b> : </p> <p> <b> identifier</b> : urn:uuid:187e0c12-8dd2-67e2-99b2-bf273c878281</p> <p> <b> status</b> : final</p> <p> <b> category</b> : Vital Signs <span> (Details : {http://hl7.org/fhir/observation-category code 'vital-signs' = 'Vital Signs',
           given as 'Vital Signs'})</span> </p> <p> <b> code</b> : Blood pressure systolic &amp; diastolic <span> (Details : {LOINC code '85354-9' = 'Blood pressure panel with all children optional',
           given as 'Blood pressure panel with all children optional'})</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> bodySite</b> : Right arm <span> (Details : {SNOMED CT code '368209003' = 'Right upper arm', 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' = 'Systolic blood pressure', given as 'Systolic
             blood pressure'}; {http://acme.org/devices/clinical-codes code 'bp-s' = 'bp-s', given
             as 'Systolic Blood pressure'})</span> </p> <p> <b> value</b> : 107 mmHg<span>  (Details: UCUM code mm[Hg] = 'mmHg')</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 Performed <span> (Details : {http://hl7.org/fhir/data-absent-reason code 'not-performed' = 'Not Performed',
             given as 'Not Performed'})</span> </p> </blockquote> </div> </text> <identifier> 
    <system value="urn:ietf:rfc:3986"/> 
    <value value="urn:uuid:187e0c12-8dd2-67e2-99b2-bf273c878281"/> 
  </identifier> 
  <status value="final"/> 
  <category> 
    <coding> 
      <system value="http://hl7.org/fhir/observation-category"/> 
      <code value="vital-signs"/> 
      <display value="Vital Signs"/> 
    </coding> 
  </category> 
  <code> <!--    replaced by 85354-9
        <coding>
          <system value="http://loinc.org"/>
          <code value="85354-9"/>
          <display value="Blood pressure systolic &amp; diastolic"/>
        </coding>
       --><coding> 
      <system value="http://loinc.org"/> 
      <code value="85354-9"/> 
      <display value="Blood pressure panel with all children optional"/> 
    </coding> 
    <text value="Blood pressure systolic &amp; diastolic"/> 
  </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> <!--   The BodySite can be captured in a LOINC code but am showing it here to demonstrate populating
   the element    --><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 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 is shown here to demonstrate  the concept of translations within the codeableConcept
     datatype. The diastolic code below only has a LOINC code
              --><code> <!--      LOINC -code      --><coding> 
        <system value="http://loinc.org"/> 
        <code value="8480-6"/> 
        <display value="Systolic blood pressure"/> 
      </coding> <!--      SNOMED CT Codes      --><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> 
    <valueQuantity> 
      <value value="107"/> 
      <unit value="mmHg"/> 
      <system value="http://unitsofmeasure.org"/> 
      <code value="mm[Hg]"/> 
    </valueQuantity> <!--       Should have a refrange as well     --></component> <component> 
    <code> 
      <coding> 
        <system value="http://loinc.org"/> 
        <code value="8462-4"/> 
        <display value="Diastolic blood pressure"/> 
      </coding> 
    </code> <!--      Here the Diastolic measurement is missing and we give a reason using the DataAbsentReason
     element      --><dataAbsentReason> 
      <coding> 
        <system value="http://hl7.org/fhir/data-absent-reason"/> 
        <code value="not-performed"/> 
        <display value="Not Performed"/> 
      </coding> 
    </dataAbsentReason> <!--       Should have a refrange as well     --></component> </Observation>