Summary

10.1.28.2.2 Complete Summary of the Mandatory Requirements

1. One code in Observation.code which must have
   • a fixed Observation.code.coding.system='http ://loinc.org'
   • a fixed Observation.code.coding.code= 85354-9'
   • Other additional Codings are allowed in Observation.code- e.g. more specific LOINC Codes, SNOMED CT concepts, system specific codes. All codes SHALL have an system value
2. One Observation.component.code which must have
   • a fixed Observation.component.code.coding.system='http://loinc.org'
   • fixed Observation.component.code.coding.code= '8480-6'
   • Other additional Codings are allowed in Observation.code- e.g. more specific LOINC Codes, SNOMED CT concepts, system specific codes. All codes SHALL have an system value
3. One Observation.component.code which must have
   • a fixed Observation.component.code.coding.system='http://loinc.org'
   • fixed Observation.component.code.coding.code= '8462-4'
   • Other additional Codings are allowed in Observation.code- e.g. more specific LOINC Codes, SNOMED CT concepts, system specific codes. All codes SHALL have an system value
4. 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.org"
     • a UCUM unit code in Observation.valueQuantity.code = 'mm[Hg]'

Mandatory: 11 elements (+8 nested mandatory elements)
Must-Support: 8 elements
Fixed Value: 10 elements
Prohibited: 1 element

Slices

This structure defines the following Slices:

• The element Observation.code.coding is sliced based on the values of value:code, value:system
• The element Observation.component is sliced based on the values of value:code.coding.code, value:code.coding.system
• The element Observation.component.code.coding is sliced based on the values of value:code, value:system

<!-- observation-bp -->

<Observation xmlns="http://hl7.org/fhir"
>
  <!-- from Element: extension -->
 <id value="[id]"/><!-- 0..1 Logical id of this artifact -->
 <meta><!-- 0..1 Meta Metadata about the resource --></meta>
 <implicitRules value="[uri]"/><!-- 0..1 A set of rules under which this content was created -->
 <language value="[code]"/><!-- 0..1 Language of the resource content   -->
 <text><!-- 0..1 Narrative 
     Text summary of the resource, for human interpretation --></text>
 <contained><!-- 0..* Resource Contained, inline Resources --></contained>
 <modifierExtension><!-- 0..* Extension  Extensions that cannot be ignored  --></modifierExtension>
 <identifier><!-- 0..* Identifier 
     Business Identifier for observation --></identifier>
 <basedOn><!-- 0..* Reference(CarePlan) Fulfills plan, proposal or order --></basedOn>
 <partOf><!-- 0..* Reference(MedicationAdministration) Part of referenced event --></partOf>
 <status value="[code]"/><!-- 1..1 registered | preliminary | final | amended +   -->
 <-- category sliced by value:coding.code, value:coding.system  in the specified orderOpen-->
 <category> 1..1 CodeableConcept  <!-- 1..1 Classification of  type of observation -->
  <coding> 1..* Coding  <!-- 1..* Code defined by a terminology system -->
   <system value="[uri]"/><!-- 1..1 Identity of the terminology system -->
   <version value="[string]"/><!-- 0..1 Version of the system - if relevant -->
   <code value="[code]"/><!-- 1..1 Symbol in syntax defined by the system -->
   <display value="[string]"/><!-- 0..1 Representation defined by the system -->
   <userSelected value="[boolean]"/><!-- 0..1 If this coding was chosen directly by the user -->
  </coding>
  <text value="[string]"/><!-- 0..1 Plain text representation of the concept -->
 </category>
 <code> 1..1 CodeableConcept  <!-- 1..1 Blood Pressure -->
  <-- coding sliced by value:code, value:system  in the specified orderOpen-->
  <coding> 1..1 Coding  <!-- 1..1 Code defined by a terminology system -->
   <system value="[uri]"/><!-- 1..1 Identity of the terminology system -->
   <version value="[string]"/><!-- 0..1 Version of the system - if relevant -->
   <code value="[code]"/><!-- 1..1 Symbol in syntax defined by the system -->
   <display value="[string]"/><!-- 0..1 Representation defined by the system -->
   <userSelected value="[boolean]"/><!-- 0..1 If this coding was chosen directly by the user -->
  </coding>
  <text value="[string]"/><!-- 0..1 Plain text representation of the concept -->
 </code>
 <subject><!-- 1..1 Reference(Patient) 
     Who and/or what the observation is about --></subject>
 <focus><!-- 0..* Reference(Resource) 
     What the observation is about, when it is not about the subject of record --></focus>
 <encounter><!-- 0..1 Reference(Encounter) 
     Healthcare event during which this observation is made --></encounter>
 <effective[x]><!--  1..1 dateTime|Period 
     Often just a dateTime for Vital Signs --></effective[x]>
 <issued value="[instant]"/><!-- 0..1 Date/Time this version was made available -->
 <performer><!-- 0..* Reference(Practitioner) 
     Who is responsible for the observation --></performer>
 <value[x]><!-- 0..0 Quantity|CodeableConcept|string|boolean|integer|
   Range|Ratio|SampledData|time|dateTime|Period 
     Vital Signs value are recorded using the Quantity data type. For supporting observations such as Cuff size could use other datatypes such as CodeableConcept. --></value[x]>
 <dataAbsentReason><!-- 0..1 CodeableConcept Why the result is missing   --></dataAbsentReason>
 <interpretation><!-- 0..* CodeableConcept High, low, normal, etc.   --></interpretation>
 <comment value="[string]"/><!-- 0..1 Comments about the test result value -->
 <bodySite><!-- 0..1 CodeableConcept Observed body part   --></bodySite>
 <method><!-- 0..1 CodeableConcept How it was done   --></method>
 <specimen><!-- 0..1 Reference(Specimen) Specimen used for this observation --></specimen>
 <device><!-- 0..1 Reference(Device) (Measurement) Device --></device>
 <referenceRange>  0..* BackboneElement  <!--  0..* Provides guide for interpretation -->
  <modifierExtension><!-- 0..* Extension  Extensions that cannot be ignored if unrecognized  --></modifierExtension>
  <low><!-- 0..1 Quantity 
      Low Range, if relevant --></low>
  <high><!-- 0..1 Quantity 
      High Range, if relevant --></high>
  <type><!-- 0..1 CodeableConcept Reference range qualifier   --></type>
  <appliesTo><!-- 0..* CodeableConcept Reference range population   --></appliesTo>
  <age><!-- 0..1 Range 
      Applicable age range, if relevant --></age>
  <text value="[string]"/><!-- 0..1 Text based reference range in an observation -->
 </referenceRange>
 <hasMember><!-- 0..* Reference(QuestionnaireResponse) 
     Used when reporting vital signs panel components --></hasMember>
 <derivedFrom><!-- 0..* Reference(DocumentReference) 
     Related measurements the observation is made from --></derivedFrom>
 <-- component sliced by value:code.coding.code, value:code.coding.system  in the specified orderOpen-->
 <component>  1..1 BackboneElement  <!--  1..1 Used when reporting systolic and diastolic blood pressure. -->
  <modifierExtension><!-- 0..* Extension  Extensions that cannot be ignored if unrecognized  --></modifierExtension>
  <code> 1..1 CodeableConcept  <!-- 1..1 Type of component observation (code / type) -->
   <-- coding sliced by value:code, value:system  in the specified orderOpen-->
   <coding> 1..1 Coding  <!-- 1..1 Systolic Blood Pressure -->
    <system value="[uri]"/><!-- 1..1 Identity of the terminology system -->
    <version value="[string]"/><!-- 0..1 Version of the system - if relevant -->
    <code value="[code]"/><!-- 1..1 Symbol in syntax defined by the system -->
    <display value="[string]"/><!-- 0..1 Representation defined by the system -->
    <userSelected value="[boolean]"/><!-- 0..1 If this coding was chosen directly by the user -->
   </coding>
   <text value="[string]"/><!-- 0..1 Plain text representation of the concept -->
  </code>
  <valueQuantity> 0..1 Quantity  <!-- 0..1 Vital Sign Value recorded with UCUM -->
   <value value="[decimal]"/><!-- 1..1 Numerical value (with implicit precision) -->
   <comparator value="[code]"/><!-- 0..1 < | <= | >= | > - how to understand the value   -->
   <unit value="[string]"/><!-- 1..1 Unit representation -->
   <system value="[uri]"/><!-- 1..1 System that defines coded unit form -->
   <code value="[code]"/><!-- 1..1 
       Coded responses from the common UCUM units for vital signs value set. -->
  </valueQuantity>
  <dataAbsentReason><!-- 0..1 CodeableConcept Why the component result is missing   --></dataAbsentReason>
  <interpretation><!-- 0..* CodeableConcept High, low, normal, etc.   --></interpretation>
  <referenceRange><!-- See #Observation.referenceRange  Provides guide for interpretation of component result --></referenceRange>
 </component>
 <component>  1..1 BackboneElement  <!--  1..1 Used when reporting systolic and diastolic blood pressure. -->
  <modifierExtension><!-- 0..* Extension  Extensions that cannot be ignored if unrecognized  --></modifierExtension>
  <code> 1..1 CodeableConcept  <!-- 1..1 Type of component observation (code / type) -->
   <-- coding sliced by value:code, value:system  in the specified orderOpen-->
   <coding> 1..1 Coding  <!-- 1..1 Diastolic Blood Pressure -->
    <system value="[uri]"/><!-- 1..1 Identity of the terminology system -->
    <version value="[string]"/><!-- 0..1 Version of the system - if relevant -->
    <code value="[code]"/><!-- 1..1 Symbol in syntax defined by the system -->
    <display value="[string]"/><!-- 0..1 Representation defined by the system -->
    <userSelected value="[boolean]"/><!-- 0..1 If this coding was chosen directly by the user -->
   </coding>
   <text value="[string]"/><!-- 0..1 Plain text representation of the concept -->
  </code>
  <valueQuantity> 0..1 Quantity  <!-- 0..1 Vital Sign Value recorded with UCUM -->
   <value value="[decimal]"/><!-- 1..1 Numerical value (with implicit precision) -->
   <comparator value="[code]"/><!-- 0..1 < | <= | >= | > - how to understand the value   -->
   <unit value="[string]"/><!-- 1..1 Unit representation -->
   <system value="[uri]"/><!-- 1..1 System that defines coded unit form -->
   <code value="[code]"/><!-- 1..1 
       Coded responses from the common UCUM units for vital signs value set. -->
  </valueQuantity>
  <dataAbsentReason><!-- 0..1 CodeableConcept Why the component result is missing   --></dataAbsentReason>
  <interpretation><!-- 0..* CodeableConcept High, low, normal, etc.   --></interpretation>
  <referenceRange><!-- See #Observation.referenceRange  Provides guide for interpretation of component result --></referenceRange>
 </component>
</Observation>

{ // observation-bp
  // from Element: extension
    "meta" : { Meta }, //Metadata about the resource
    "implicitRules" : "<uri>", //A set of rules under which this content was created
    "language" : "<code>", //Language of the resource content
    "text" : { Narrative }, //Text summary of the resource, for human interpretation
    "contained" : [{ Resource }], //Contained, inline Resources
    "modifierExtension" : [{ Extension }], //Extensions that cannot be ignored
    "identifier" : [{ Identifier }], //Business Identifier for observation
    "basedOn" : [{ Reference(CarePlan) }], //Fulfills plan, proposal or order
    "partOf" : [{ Reference(MedicationAdministration) }], //Part of referenced event
    "status" : "<code>", // R! registered | preliminary | final | amended +
    "category" : [ //  sliced by value:coding.code, value:coding.system  in the specified order, Open 
      { // Classification of  type of observation // R! 
        // from Element: extension
        "extension" : [ //  sliced by value:url  in the specified order, Open ]
        "coding" : [{ Coding }], // R! Code defined by a terminology system
        "text" : "<string>" //Plain text representation of the concept
      }
    ],
    "code" : { CodeableConcept }, // R! Blood Pressure
    "subject" : { Reference(Patient) }, // R! Who and/or what the observation is about
    "focus" : [{ Reference(Resource) }], //What the observation is about, when it is not about the subject of record
    "encounter" : { Reference(Encounter) }, //Healthcare event during which this observation is made
// value[x]: Often just a dateTime for Vital Signs. One of these 2:
    "effectiveDateTime" : "<dateTime>", // C? R! Often just a dateTime for Vital Signs
    "effectivePeriod" : { Period }, // C? R! Often just a dateTime for Vital Signs
    "issued" : "<instant>", //Date/Time this version was made available
    "performer" : [{ Reference(Practitioner) }], //Who is responsible for the observation
// value[x]: Vital Signs value are recorded using the Quantity data type. For supporting observations such as Cuff size could use other datatypes such as CodeableConcept.. One of these 11:
    "dataAbsentReason" : { CodeableConcept }, //Why the result is missing
    "interpretation" : [{ CodeableConcept }], //High, low, normal, etc.
    "comment" : "<string>" //Comments about the test result value
    "bodySite" : { CodeableConcept }, //Observed body part
    "method" : { CodeableConcept }, //How it was done
    "specimen" : { Reference(Specimen) }, //Specimen used for this observation
    "device" : { Reference(Device) }, //(Measurement) Device
    "referenceRange" : [{ BackboneElement }], // C?Provides guide for interpretation
    "hasMember" : [{ Reference(QuestionnaireResponse) }], //Used when reporting vital signs panel components
    "derivedFrom" : [{ Reference(DocumentReference) }], //Related measurements the observation is made from
    "component" : [ //  sliced by value:code.coding.code, value:code.coding.system  in the specified order, Open 
      { // Used when reporting systolic and diastolic blood pressure. // C? R! 
        // from Element: extension
        "modifierExtension" : [{ Extension }], //Extensions that cannot be ignored if unrecognized
        "code" : { CodeableConcept }, // R! Type of component observation (code / type)
        "valueQuantity" : { Quantity }, //Vital Sign Value recorded with UCUM
        "dataAbsentReason" : { CodeableConcept }, //Why the component result is missing
        "interpretation" : [{ CodeableConcept }], //High, low, normal, etc.
// value[x]: Provides guide for interpretation of component result. One of these 0:
      },
      { // Used when reporting systolic and diastolic blood pressure. // C? R! 
        // from Element: extension
        "modifierExtension" : [{ Extension }], //Extensions that cannot be ignored if unrecognized
        "code" : { CodeableConcept }, // R! Type of component observation (code / type)
        "valueQuantity" : { Quantity }, //Vital Sign Value recorded with UCUM
        "dataAbsentReason" : { CodeableConcept }, //Why the component result is missing
        "interpretation" : [{ CodeableConcept }], //High, low, normal, etc.
// value[x]: Provides guide for interpretation of component result. One of these 0:
      }
    ],
  }

Summary

10.1.28.2.3 Complete Summary of the Mandatory Requirements

1. One code in Observation.code which must have
   • a fixed Observation.code.coding.system='http ://loinc.org'
   • a fixed Observation.code.coding.code= 85354-9'
   • Other additional Codings are allowed in Observation.code- e.g. more specific LOINC Codes, SNOMED CT concepts, system specific codes. All codes SHALL have an system value
2. One Observation.component.code which must have
   • a fixed Observation.component.code.coding.system='http://loinc.org'
   • fixed Observation.component.code.coding.code= '8480-6'
   • Other additional Codings are allowed in Observation.code- e.g. more specific LOINC Codes, SNOMED CT concepts, system specific codes. All codes SHALL have an system value
3. One Observation.component.code which must have
   • a fixed Observation.component.code.coding.system='http://loinc.org'
   • fixed Observation.component.code.coding.code= '8462-4'
   • Other additional Codings are allowed in Observation.code- e.g. more specific LOINC Codes, SNOMED CT concepts, system specific codes. All codes SHALL have an system value
4. 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.org"
     • a UCUM unit code in Observation.valueQuantity.code = 'mm[Hg]'

Mandatory: 11 elements (+8 nested mandatory elements)
Must-Support: 8 elements
Fixed Value: 10 elements
Prohibited: 1 element

Slices

This structure defines the following Slices:

• The element Observation.code.coding is sliced based on the values of value:code, value:system
• The element Observation.component is sliced based on the values of value:code.coding.code, value:code.coding.system
• The element Observation.component.code.coding is sliced based on the values of value:code, value:system

<!-- observation-bp -->

<Observation xmlns="http://hl7.org/fhir"
>
  <!-- from Element: extension -->
 <id value="[id]"/><!-- 0..1 Logical id of this artifact -->
 <meta><!-- 0..1 Meta Metadata about the resource --></meta>
 <implicitRules value="[uri]"/><!-- 0..1 A set of rules under which this content was created -->
 <language value="[code]"/><!-- 0..1 Language of the resource content   -->
 <text><!-- 0..1 Narrative 
     Text summary of the resource, for human interpretation --></text>
 <contained><!-- 0..* Resource Contained, inline Resources --></contained>
 <modifierExtension><!-- 0..* Extension  Extensions that cannot be ignored  --></modifierExtension>
 <identifier><!-- 0..* Identifier 
     Business Identifier for observation --></identifier>
 <basedOn><!-- 0..* Reference(CarePlan) Fulfills plan, proposal or order --></basedOn>
 <partOf><!-- 0..* Reference(MedicationAdministration) Part of referenced event --></partOf>
 <status value="[code]"/><!-- 1..1 registered | preliminary | final | amended +   -->
 <-- category sliced by value:coding.code, value:coding.system  in the specified orderOpen-->
 <category> 1..1 CodeableConcept  <!-- 1..1 Classification of  type of observation -->
  <coding> 1..* Coding  <!-- 1..* Code defined by a terminology system -->
   <system value="[uri]"/><!-- 1..1 Identity of the terminology system -->
   <version value="[string]"/><!-- 0..1 Version of the system - if relevant -->
   <code value="[code]"/><!-- 1..1 Symbol in syntax defined by the system -->
   <display value="[string]"/><!-- 0..1 Representation defined by the system -->
   <userSelected value="[boolean]"/><!-- 0..1 If this coding was chosen directly by the user -->
  </coding>
  <text value="[string]"/><!-- 0..1 Plain text representation of the concept -->
 </category>
 <code> 1..1 CodeableConcept  <!-- 1..1 Blood Pressure -->
  <-- coding sliced by value:code, value:system  in the specified orderOpen-->
  <coding> 1..1 Coding  <!-- 1..1 Code defined by a terminology system -->
   <system value="[uri]"/><!-- 1..1 Identity of the terminology system -->
   <version value="[string]"/><!-- 0..1 Version of the system - if relevant -->
   <code value="[code]"/><!-- 1..1 Symbol in syntax defined by the system -->
   <display value="[string]"/><!-- 0..1 Representation defined by the system -->
   <userSelected value="[boolean]"/><!-- 0..1 If this coding was chosen directly by the user -->
  </coding>
  <text value="[string]"/><!-- 0..1 Plain text representation of the concept -->
 </code>
 <subject><!-- 1..1 Reference(Patient) 
     Who and/or what the observation is about --></subject>
 <focus><!-- 0..* Reference(Resource) 
     What the observation is about, when it is not about the subject of record --></focus>
 <encounter><!-- 0..1 Reference(Encounter) 
     Healthcare event during which this observation is made --></encounter>
 <effective[x]><!--  1..1 dateTime|Period 
     Often just a dateTime for Vital Signs --></effective[x]>
 <issued value="[instant]"/><!-- 0..1 Date/Time this version was made available -->
 <performer><!-- 0..* Reference(Practitioner) 
     Who is responsible for the observation --></performer>
 <value[x]><!-- 0..0 Quantity|CodeableConcept|string|boolean|integer|
   Range|Ratio|SampledData|time|dateTime|Period 
     Vital Signs value are recorded using the Quantity data type. For supporting observations such as Cuff size could use other datatypes such as CodeableConcept. --></value[x]>
 <dataAbsentReason><!-- 0..1 CodeableConcept Why the result is missing   --></dataAbsentReason>
 <interpretation><!-- 0..* CodeableConcept High, low, normal, etc.   --></interpretation>
 <comment value="[string]"/><!-- 0..1 Comments about the test result value -->
 <bodySite><!-- 0..1 CodeableConcept Observed body part   --></bodySite>
 <method><!-- 0..1 CodeableConcept How it was done   --></method>
 <specimen><!-- 0..1 Reference(Specimen) Specimen used for this observation --></specimen>
 <device><!-- 0..1 Reference(Device) (Measurement) Device --></device>
 <referenceRange>  0..* BackboneElement  <!--  0..* Provides guide for interpretation -->
  <modifierExtension><!-- 0..* Extension  Extensions that cannot be ignored if unrecognized  --></modifierExtension>
  <low><!-- 0..1 Quantity 
      Low Range, if relevant --></low>
  <high><!-- 0..1 Quantity 
      High Range, if relevant --></high>
  <type><!-- 0..1 CodeableConcept Reference range qualifier   --></type>
  <appliesTo><!-- 0..* CodeableConcept Reference range population   --></appliesTo>
  <age><!-- 0..1 Range 
      Applicable age range, if relevant --></age>
  <text value="[string]"/><!-- 0..1 Text based reference range in an observation -->
 </referenceRange>
 <hasMember><!-- 0..* Reference(QuestionnaireResponse) 
     Used when reporting vital signs panel components --></hasMember>
 <derivedFrom><!-- 0..* Reference(DocumentReference) 
     Related measurements the observation is made from --></derivedFrom>
 <-- component sliced by value:code.coding.code, value:code.coding.system  in the specified orderOpen-->
 <component>  1..1 BackboneElement  <!--  1..1 Used when reporting systolic and diastolic blood pressure. -->
  <modifierExtension><!-- 0..* Extension  Extensions that cannot be ignored if unrecognized  --></modifierExtension>
  <code> 1..1 CodeableConcept  <!-- 1..1 Type of component observation (code / type) -->
   <-- coding sliced by value:code, value:system  in the specified orderOpen-->
   <coding> 1..1 Coding  <!-- 1..1 Systolic Blood Pressure -->
    <system value="[uri]"/><!-- 1..1 Identity of the terminology system -->
    <version value="[string]"/><!-- 0..1 Version of the system - if relevant -->
    <code value="[code]"/><!-- 1..1 Symbol in syntax defined by the system -->
    <display value="[string]"/><!-- 0..1 Representation defined by the system -->
    <userSelected value="[boolean]"/><!-- 0..1 If this coding was chosen directly by the user -->
   </coding>
   <text value="[string]"/><!-- 0..1 Plain text representation of the concept -->
  </code>
  <valueQuantity> 0..1 Quantity  <!-- 0..1 Vital Sign Value recorded with UCUM -->
   <value value="[decimal]"/><!-- 1..1 Numerical value (with implicit precision) -->
   <comparator value="[code]"/><!-- 0..1 < | <= | >= | > - how to understand the value   -->
   <unit value="[string]"/><!-- 1..1 Unit representation -->
   <system value="[uri]"/><!-- 1..1 System that defines coded unit form -->
   <code value="[code]"/><!-- 1..1 
       Coded responses from the common UCUM units for vital signs value set. -->
  </valueQuantity>
  <dataAbsentReason><!-- 0..1 CodeableConcept Why the component result is missing   --></dataAbsentReason>
  <interpretation><!-- 0..* CodeableConcept High, low, normal, etc.   --></interpretation>
  <referenceRange><!-- See #Observation.referenceRange  Provides guide for interpretation of component result --></referenceRange>
 </component>
 <component>  1..1 BackboneElement  <!--  1..1 Used when reporting systolic and diastolic blood pressure. -->
  <modifierExtension><!-- 0..* Extension  Extensions that cannot be ignored if unrecognized  --></modifierExtension>
  <code> 1..1 CodeableConcept  <!-- 1..1 Type of component observation (code / type) -->
   <-- coding sliced by value:code, value:system  in the specified orderOpen-->
   <coding> 1..1 Coding  <!-- 1..1 Diastolic Blood Pressure -->
    <system value="[uri]"/><!-- 1..1 Identity of the terminology system -->
    <version value="[string]"/><!-- 0..1 Version of the system - if relevant -->
    <code value="[code]"/><!-- 1..1 Symbol in syntax defined by the system -->
    <display value="[string]"/><!-- 0..1 Representation defined by the system -->
    <userSelected value="[boolean]"/><!-- 0..1 If this coding was chosen directly by the user -->
   </coding>
   <text value="[string]"/><!-- 0..1 Plain text representation of the concept -->
  </code>
  <valueQuantity> 0..1 Quantity  <!-- 0..1 Vital Sign Value recorded with UCUM -->
   <value value="[decimal]"/><!-- 1..1 Numerical value (with implicit precision) -->
   <comparator value="[code]"/><!-- 0..1 < | <= | >= | > - how to understand the value   -->
   <unit value="[string]"/><!-- 1..1 Unit representation -->
   <system value="[uri]"/><!-- 1..1 System that defines coded unit form -->
   <code value="[code]"/><!-- 1..1 
       Coded responses from the common UCUM units for vital signs value set. -->
  </valueQuantity>
  <dataAbsentReason><!-- 0..1 CodeableConcept Why the component result is missing   --></dataAbsentReason>
  <interpretation><!-- 0..* CodeableConcept High, low, normal, etc.   --></interpretation>
  <referenceRange><!-- See #Observation.referenceRange  Provides guide for interpretation of component result --></referenceRange>
 </component>
</Observation>

{ // observation-bp
  // from Element: extension
    "meta" : { Meta }, //Metadata about the resource
    "implicitRules" : "<uri>", //A set of rules under which this content was created
    "language" : "<code>", //Language of the resource content
    "text" : { Narrative }, //Text summary of the resource, for human interpretation
    "contained" : [{ Resource }], //Contained, inline Resources
    "modifierExtension" : [{ Extension }], //Extensions that cannot be ignored
    "identifier" : [{ Identifier }], //Business Identifier for observation
    "basedOn" : [{ Reference(CarePlan) }], //Fulfills plan, proposal or order
    "partOf" : [{ Reference(MedicationAdministration) }], //Part of referenced event
    "status" : "<code>", // R! registered | preliminary | final | amended +
    "category" : [ //  sliced by value:coding.code, value:coding.system  in the specified order, Open 
      { // Classification of  type of observation // R! 
        // from Element: extension
        "extension" : [ //  sliced by value:url  in the specified order, Open ]
        "coding" : [{ Coding }], // R! Code defined by a terminology system
        "text" : "<string>" //Plain text representation of the concept
      }
    ],
    "code" : { CodeableConcept }, // R! Blood Pressure
    "subject" : { Reference(Patient) }, // R! Who and/or what the observation is about
    "focus" : [{ Reference(Resource) }], //What the observation is about, when it is not about the subject of record
    "encounter" : { Reference(Encounter) }, //Healthcare event during which this observation is made
// value[x]: Often just a dateTime for Vital Signs. One of these 2:
    "effectiveDateTime" : "<dateTime>", // C? R! Often just a dateTime for Vital Signs
    "effectivePeriod" : { Period }, // C? R! Often just a dateTime for Vital Signs
    "issued" : "<instant>", //Date/Time this version was made available
    "performer" : [{ Reference(Practitioner) }], //Who is responsible for the observation
// value[x]: Vital Signs value are recorded using the Quantity data type. For supporting observations such as Cuff size could use other datatypes such as CodeableConcept.. One of these 11:
    "dataAbsentReason" : { CodeableConcept }, //Why the result is missing
    "interpretation" : [{ CodeableConcept }], //High, low, normal, etc.
    "comment" : "<string>" //Comments about the test result value
    "bodySite" : { CodeableConcept }, //Observed body part
    "method" : { CodeableConcept }, //How it was done
    "specimen" : { Reference(Specimen) }, //Specimen used for this observation
    "device" : { Reference(Device) }, //(Measurement) Device
    "referenceRange" : [{ BackboneElement }], // C?Provides guide for interpretation
    "hasMember" : [{ Reference(QuestionnaireResponse) }], //Used when reporting vital signs panel components
    "derivedFrom" : [{ Reference(DocumentReference) }], //Related measurements the observation is made from
    "component" : [ //  sliced by value:code.coding.code, value:code.coding.system  in the specified order, Open 
      { // Used when reporting systolic and diastolic blood pressure. // C? R! 
        // from Element: extension
        "modifierExtension" : [{ Extension }], //Extensions that cannot be ignored if unrecognized
        "code" : { CodeableConcept }, // R! Type of component observation (code / type)
        "valueQuantity" : { Quantity }, //Vital Sign Value recorded with UCUM
        "dataAbsentReason" : { CodeableConcept }, //Why the component result is missing
        "interpretation" : [{ CodeableConcept }], //High, low, normal, etc.
// value[x]: Provides guide for interpretation of component result. One of these 0:
      },
      { // Used when reporting systolic and diastolic blood pressure. // C? R! 
        // from Element: extension
        "modifierExtension" : [{ Extension }], //Extensions that cannot be ignored if unrecognized
        "code" : { CodeableConcept }, // R! Type of component observation (code / type)
        "valueQuantity" : { Quantity }, //Vital Sign Value recorded with UCUM
        "dataAbsentReason" : { CodeableConcept }, //Why the component result is missing
        "interpretation" : [{ CodeableConcept }], //High, low, normal, etc.
// value[x]: Provides guide for interpretation of component result. One of these 0:
      }
    ],
  }