Release 5 Ballot

This page is part of the FHIR Specification (v5.0.0-ballot: R5 Ballot - see ballot notes). 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

10.1.19.44 StructureDefinition: observation-bp

Orders and Observations icon Work Group Maturity Level: 0Trial Use Use Context: Any

The canonical URL for this profile is: 

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

FHIR Blood Pressure Profile

This profile was published on Sat, Aug 11, 2018 00:00+1000 as a draft by Health Level Seven International (Orders and Observations Workgroup).

10.1.19.44.1 Formal Views of Profile Content

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

This structure is derived from observation-vitalsigns.

Summary

10.1.19.44.2 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

This indicates the differences between this profile and the base observation-vitalsigns structure.

NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation 0..*observation-vitalsignsFHIR Blood Pressure Profile
... code 1..1CodeableConceptBlood Pressure
.... Slices for coding 0..*CodingCode defined by a terminology system
Slice: Unordered, Open by value:code, value:system
..... coding:BPCode 1..1CodingCode defined by a terminology system
...... system 1..1uriIdentity of the terminology system
Fixed Value: http://loinc.org
...... code 1..1codeSymbol in syntax defined by the system
Fixed Value: 85354-9
... valueQuantity 0..0
... Slices for component 2..*BackboneElementUsed when reporting systolic and diastolic blood pressure.
Slice: Unordered, Open by value:code.coding.code, value:code.coding.system
.... component:SystolicBP 1..1BackboneElementUsed when reporting systolic and diastolic blood pressure.
..... code 1..1CodeableConceptType of component observation (code / type)
...... Slices for coding 0..*CodingSystolic Blood Pressure
Slice: Unordered, Open by value:code, value:system
....... coding:SBPCode 1..1CodingSystolic Blood Pressure
........ system 1..1uriIdentity of the terminology system
Fixed Value: http://loinc.org
........ code 1..1codeSymbol in syntax defined by the system
Fixed Value: 8480-6
..... valueQuantity 0..1QuantityVital Sign Value recorded with UCUM
...... value S1..1decimalNumerical value (with implicit precision)
...... unit S1..1stringUnit representation
...... system S1..1uriSystem that defines coded unit form
Fixed Value: http://unitsofmeasure.org
...... code S1..1codeCoded responses from the common UCUM units for vital signs value set.
Fixed Value: mm[Hg]
.... component:DiastolicBP 1..1BackboneElementUsed when reporting systolic and diastolic blood pressure.
..... code 1..1CodeableConceptType of component observation (code / type)
...... Slices for coding 0..*CodingDiastolic Blood Pressure
Slice: Unordered, Open by value:code, value:system
....... coding:DBPCode 1..1CodingDiastolic Blood Pressure
........ system 1..1uriIdentity of the terminology system
Fixed Value: http://loinc.org
........ code 1..1codeSymbol in syntax defined by the system
Fixed Value: 8462-4
..... valueQuantity 0..1QuantityVital Sign Value recorded with UCUM
...... value S1..1decimalNumerical value (with implicit precision)
...... unit S1..1stringUnit representation
...... system S1..1uriSystem that defines coded unit form
Fixed Value: http://unitsofmeasure.org
...... code S1..1codeCoded responses from the common UCUM units for vital signs value set.
Fixed Value: mm[Hg]

doco Documentation for this format

This provides the consolidated view (aka snapshot) of the profile after applying the changes in this profile to the base observation-vitalsigns structure.

NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation C icon0..*observation-vitalsignsFHIR Blood Pressure Profile
... id Σ0..1idLogical id of this artifact
... meta Σ0..1MetaMetadata about the resource
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... language 0..1codeLanguage of the resource content
Binding: Common Languages (preferred): IETF language tag

Additional BindingsPurpose
All LanguagesMax Binding
... text 0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... extension 0..*ExtensionAdditional content defined by implementations
... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored
... identifier Σ0..*IdentifierBusiness Identifier for observation
... instantiates[x] Σ0..1canonical(ObservationDefinition), Reference(ObservationDefinition)Instantiates FHIR ObservationDefinition
... basedOn Σ0..*Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest)Fulfills plan, proposal or order
... triggeredBy 0..*BackboneElementTriggering observation(s)
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... observation Σ1..1Reference(Observation)Triggering observation
.... type Σ1..1codereflex | repeat | re-run
Binding: triggeredBytype (required): The type of TriggeredBy Observation.

.... reason 0..1stringReason that the observation was triggered
... partOf Σ0..*Reference(MedicationAdministration | MedicationDispense | MedicationUsage | Procedure | Immunization | ImagingStudy | GenomicStudy)Part of referenced event
... status ?!SΣ1..1coderegistered | preliminary | final | amended +
Binding: ObservationStatus (required)
... Slices for category S1..*CodeableConceptClassification of type of observation
Slice: Unordered, Open by value:coding.code, value:coding.system
Binding: Observation Category Codes (preferred): Codes for high level observation categories.


.... category:VSCat S1..1CodeableConceptClassification of type of observation
Binding: Observation Category Codes (preferred): Codes for high level observation categories.


..... id 0..1idUnique id for inter-element referencing
..... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
..... coding SΣ1..*CodingCode defined by a terminology system
...... id 0..1idUnique id for inter-element referencing
...... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
...... system SΣ1..1uriIdentity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category
...... version Σ0..1stringVersion of the system - if relevant
...... code SΣ1..1codeSymbol in syntax defined by the system
Fixed Value: vital-signs
...... display Σ0..1stringRepresentation defined by the system
...... userSelected Σ0..1booleanIf this coding was chosen directly by the user
..... text Σ0..1stringPlain text representation of the concept
... code SΣ1..1CodeableConceptBlood Pressure
Binding: Vital Signs (extensible): This identifies the vital sign result type. Original source C-CDA R1.1 , HITSP Vital Sign Result Type.

.... id 0..1idUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
.... Slices for coding Σ0..*CodingCode defined by a terminology system
Slice: Unordered, Open by value:code, value:system
..... coding:BPCode Σ1..1CodingCode defined by a terminology system
...... id 0..1idUnique id for inter-element referencing
...... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
...... system Σ1..1uriIdentity of the terminology system
Fixed Value: http://loinc.org
...... version Σ0..1stringVersion of the system - if relevant
...... code Σ1..1codeSymbol in syntax defined by the system
Fixed Value: 85354-9
...... display Σ0..1stringRepresentation defined by the system
...... userSelected Σ0..1booleanIf this coding was chosen directly by the user
.... text Σ0..1stringPlain text representation of the concept
... subject SΣ1..1Reference(Patient)Who and/or what the observation is about
... focus Σ0..*Reference(Resource)What the observation is about, when it is not about the subject of record
... encounter Σ0..1Reference(Encounter)Healthcare event during which this observation is made
... effective[x] SΣC icon1..1Often just a dateTime for Vital Signs
.... effectiveDateTimedateTime
.... effectivePeriodPeriod
... issued Σ0..1instantDate/Time this version was made available
... performer Σ0..*Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson)Who is responsible for the observation
... Slices for value[x] SΣC icon0..1QuantityVital Signs value are recorded using the Quantity data type. For supporting observations such as Cuff size could use other datatypes such as CodeableConcept.
Slice: Unordered, Closed by type:$this
... dataAbsentReason SC icon0..1CodeableConceptWhy the result is missing
Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.

... interpretation 0..*CodeableConceptHigh, low, normal, etc.
Binding: Observation Interpretation Codes (extensible): Codes identifying interpretations of observations.


... note 0..*AnnotationComments about the observation
... bodySite 0..1CodeableConceptObserved body part
Binding: SNOMED CT Body Structures (example): SNOMED CT Body site concepts

... bodyStructure C icon0..1Reference(BodyStructure)Observed body structure
... method 0..1CodeableConceptHow it was done
Binding: Observation Methods (example): Methods for simple observations.

... specimen C icon0..1Reference(Specimen | Group)Specimen used for this observation
... device 0..1Reference(Device | DeviceMetric)(Measurement) Device
... referenceRange C icon0..*BackboneElementProvides guide for interpretation
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... low C icon0..1SimpleQuantityLow Range, if relevant
.... high C icon0..1SimpleQuantityHigh Range, if relevant
.... normalValue C icon0..1CodeableConceptNormal value, if relevant
Binding: Observation Reference Range Normal Value Codes (extensible): Codes identifying the normal value of the observation.

.... type 0..1CodeableConceptReference range qualifier
Binding: Observation Reference Range Meaning Codes (preferred): Code for the meaning of a reference range.

.... appliesTo 0..*CodeableConceptReference range population
Binding: Observation Reference Range Applies To Codes (example): Codes identifying the population the reference range applies to.


.... age 0..1RangeApplicable age range, if relevant
.... text 0..1stringText based reference range in an observation
... hasMember Σ0..*Reference(QuestionnaireResponse | MolecularSequence | Vital Signs Profile)Used when reporting vital signs panel components
... derivedFrom Σ0..*Reference(DocumentReference | ImagingStudy | QuestionnaireResponse | MolecularSequence | Vital Signs Profile)Related resource from which the observation is made
... Slices for component SΣC icon2..*BackboneElementUsed when reporting systolic and diastolic blood pressure.
Slice: Unordered, Open by value:code.coding.code, value:code.coding.system
.... component:All Slices Content/Rules for all slices
..... id 0..1stringUnique id for inter-element referencing
..... extension 0..*ExtensionAdditional content defined by implementations
..... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
..... code SΣ1..1CodeableConceptType of component observation (code / type)
Binding: Vital Signs (extensible): This identifies the vital sign result type. Original source C-CDA R1.1 , HITSP Vital Sign Result Type.

..... value[x] SΣC icon0..1Vital Sign Value recorded with UCUM
Binding: Vital Signs Units (required): Commonly encountered UCUM units for recording Vital Signs.

...... valueQuantityQuantity
...... valueCodeableConceptCodeableConcept
...... valueStringstring
...... valueBooleanboolean
...... valueIntegerinteger
...... valueRangeRange
...... valueRatioRatio
...... valueSampledDataSampledData
...... valueTimetime
...... valueDateTimedateTime
...... valuePeriodPeriod
...... valueAttachmentAttachment
..... dataAbsentReason SC icon0..1CodeableConceptWhy the component result is missing
Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.

..... interpretation 0..*CodeableConceptHigh, low, normal, etc.
Binding: Observation Interpretation Codes (extensible): Codes identifying interpretations of observations.


..... referenceRange 0..*See referenceRange (Observation)Provides guide for interpretation of component result
.... component:SystolicBP SΣC icon1..1BackboneElementUsed when reporting systolic and diastolic blood pressure.
..... id 0..1stringUnique id for inter-element referencing
..... extension 0..*ExtensionAdditional content defined by implementations
..... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
..... code SΣ1..1CodeableConceptType of component observation (code / type)
Binding: Vital Signs (extensible): This identifies the vital sign result type. Original source C-CDA R1.1 , HITSP Vital Sign Result Type.

...... id 0..1idUnique id for inter-element referencing
...... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
...... Slices for coding Σ0..*CodingSystolic Blood Pressure
Slice: Unordered, Open by value:code, value:system
....... coding:SBPCode Σ1..1CodingSystolic Blood Pressure
........ id 0..1idUnique id for inter-element referencing
........ extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
........ system Σ1..1uriIdentity of the terminology system
Fixed Value: http://loinc.org
........ version Σ0..1stringVersion of the system - if relevant
........ code Σ1..1codeSymbol in syntax defined by the system
Fixed Value: 8480-6
........ display Σ0..1stringRepresentation defined by the system
........ userSelected Σ0..1booleanIf this coding was chosen directly by the user
...... text Σ0..1stringPlain text representation of the concept
..... value[x] SΣC icon0..1QuantityVital Sign Value recorded with UCUM
Binding: Vital Signs Units (required): Commonly encountered UCUM units for recording Vital Signs.

...... id 0..1idUnique id for inter-element referencing
...... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
...... value SΣ1..1decimalNumerical value (with implicit precision)
...... comparator ?!Σ0..1code< | <= | >= | > | ad - how to understand the value
Binding: QuantityComparator (required)
...... unit SΣ1..1stringUnit representation
...... system SΣC icon1..1uriSystem that defines coded unit form
Fixed Value: http://unitsofmeasure.org
...... code SΣ1..1codeCoded responses from the common UCUM units for vital signs value set.
Fixed Value: mm[Hg]
..... dataAbsentReason SC icon0..1CodeableConceptWhy the component result is missing
Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.

..... interpretation 0..*CodeableConceptHigh, low, normal, etc.
Binding: Observation Interpretation Codes (extensible): Codes identifying interpretations of observations.


..... referenceRange 0..*See referenceRange (Observation)Provides guide for interpretation of component result
.... component:DiastolicBP SΣC icon1..1BackboneElementUsed when reporting systolic and diastolic blood pressure.
..... id 0..1stringUnique id for inter-element referencing
..... extension 0..*ExtensionAdditional content defined by implementations
..... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
..... code SΣ1..1CodeableConceptType of component observation (code / type)
Binding: Vital Signs (extensible): This identifies the vital sign result type. Original source C-CDA R1.1 , HITSP Vital Sign Result Type.

...... id 0..1idUnique id for inter-element referencing
...... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
...... Slices for coding Σ0..*CodingDiastolic Blood Pressure
Slice: Unordered, Open by value:code, value:system
....... coding:DBPCode Σ1..1CodingDiastolic Blood Pressure
........ id 0..1idUnique id for inter-element referencing
........ extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
........ system Σ1..1uriIdentity of the terminology system
Fixed Value: http://loinc.org
........ version Σ0..1stringVersion of the system - if relevant
........ code Σ1..1codeSymbol in syntax defined by the system
Fixed Value: 8462-4
........ display Σ0..1stringRepresentation defined by the system
........ userSelected Σ0..1booleanIf this coding was chosen directly by the user
...... text Σ0..1stringPlain text representation of the concept
..... value[x] SΣC icon0..1QuantityVital Sign Value recorded with UCUM
Binding: Vital Signs Units (required): Commonly encountered UCUM units for recording Vital Signs.

...... id 0..1idUnique id for inter-element referencing
...... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
...... value SΣ1..1decimalNumerical value (with implicit precision)
...... comparator ?!Σ0..1code< | <= | >= | > | ad - how to understand the value
Binding: QuantityComparator (required)
...... unit SΣ1..1stringUnit representation
...... system SΣC icon1..1uriSystem that defines coded unit form
Fixed Value: http://unitsofmeasure.org
...... code SΣ1..1codeCoded responses from the common UCUM units for vital signs value set.
Fixed Value: mm[Hg]
..... dataAbsentReason SC icon0..1CodeableConceptWhy the component result is missing
Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.

..... interpretation 0..*CodeableConceptHigh, low, normal, etc.
Binding: Observation Interpretation Codes (extensible): Codes identifying interpretations of observations.


..... referenceRange 0..*See referenceRange (Observation)Provides guide for interpretation of component result

doco Documentation for this format
<!-- observation-bp -->doco

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

{ // observation-bp
  // from Element: extension
    "meta" : { Meta }, // IMetadata about the resource
    "implicitRules" : "<uri>", // IA set of rules under which this content was created
    "language" : "<code>", // ILanguage of the resource content
    "text" : { Narrative }, // IText summary of the resource, for human interpretation
    "contained" : [{ Resource }], //Contained, inline Resources
    "modifierExtension" : [{ Extension }], // IExtensions that cannot be ignored
    "identifier" : [{ Identifier }], // IBusiness Identifier for observation
  // value[x]: Instantiates FHIR ObservationDefinition. One of these 2:
    "instantiatesCanonical" : "<canonical>", // IInstantiates FHIR ObservationDefinition
    "instantiatesReference" : { Reference(ObservationDefinition) }, // IInstantiates FHIR ObservationDefinition
    "basedOn" : [{ Reference(CarePlan) }], // IFulfills plan, proposal or order
    "triggeredBy" : [{ BackboneElement }], // ITriggering observation(s)
    "partOf" : [{ Reference(MedicationAdministration) }], // IPart of referenced event
    "status" : "<code>", // I R! registered | preliminary | final | amended +
    "category" : [ //  sliced by value:coding.code, value:coding.system  in the specified order, Open 
      { // Classification of  type of observation // I R! 
        // from Element: extension
        "extension" : [ //  sliced by value:url  in the specified order, Open ]
        "coding" : [{ Coding }], // I R! Code defined by a terminology system
        "text" : "<string>" // IPlain text representation of the concept
      }
    ],
    "code" : { CodeableConcept }, // I R! Blood Pressure
    "subject" : { Reference(Patient) }, // I R! Who and/or what the observation is about
    "focus" : [{ Reference(Resource) }], // IWhat the observation is about, when it is not about the subject of record
    "encounter" : { Reference(Encounter) }, // IHealthcare event during which this observation is made
  // value[x]: Often just a dateTime for Vital Signs. One of these 2:
    "effectiveDateTime" : "<dateTime>", // I R! Often just a dateTime for Vital Signs
    "effectivePeriod" : { Period }, // I R! Often just a dateTime for Vital Signs
    "issued" : "<instant>", // IDate/Time this version was made available
    "performer" : [{ Reference(Practitioner) }], // IWho is responsible for the observation
    "valueQuantity" : [ //  sliced by type:$this  in the specified order, Closed 
      { // Vital Signs value are recorded using the Quantity data type. For supporting observations such as Cuff size could use other datatypes such as CodeableConcept. // I
        // from Element: extension
      }
    ],
    "dataAbsentReason" : { CodeableConcept }, // IWhy the result is missing
    "interpretation" : [{ CodeableConcept }], // IHigh, low, normal, etc.
    "note" : [{ Annotation }], // IComments about the observation
    "bodySite" : { CodeableConcept }, // IObserved body part
    "bodyStructure" : { Reference(BodyStructure) }, // IObserved body structure
    "method" : { CodeableConcept }, // IHow it was done
    "specimen" : { Reference(Specimen) }, // ISpecimen used for this observation
    "device" : { Reference(Device) }, // I(Measurement) Device
    "referenceRange" : [{ BackboneElement }], // IProvides guide for interpretation
    "hasMember" : [{ Reference(QuestionnaireResponse) }], // IUsed when reporting vital signs panel components
    "derivedFrom" : [{ Reference(DocumentReference) }], // IRelated resource from which the observation is made
    "component" : [ //  sliced by value:code.coding.code, value:code.coding.system  in the specified order, Open 
      { // Used when reporting systolic and diastolic blood pressure. // I R! 
        // from Element: extension
        "modifierExtension" : [{ Extension }], // IExtensions that cannot be ignored even if unrecognized
        "code" : { CodeableConcept }, // I R! Type of component observation (code / type)
        "valueQuantity" : { Quantity }, // IVital Sign Value recorded with UCUM
        "dataAbsentReason" : { CodeableConcept }, // IWhy the component result is missing
        "interpretation" : [{ CodeableConcept }], // IHigh, low, normal, etc.
// value[x]: Provides guide for interpretation of component result. One of these 0:
      }
      { // Used when reporting systolic and diastolic blood pressure. // I R! 
        // from Element: extension
        "modifierExtension" : [{ Extension }], // IExtensions that cannot be ignored even if unrecognized
        "code" : { CodeableConcept }, // I R! Type of component observation (code / type)
        "valueQuantity" : { Quantity }, // IVital Sign Value recorded with UCUM
        "dataAbsentReason" : { CodeableConcept }, // IWhy the component result is missing
        "interpretation" : [{ CodeableConcept }], // IHigh, low, normal, etc.
// value[x]: Provides guide for interpretation of component result. One of these 0:
      },
    ],
  }

This structure is derived from observation-vitalsigns.

Summary

10.1.19.44.3 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

Differential View

This indicates the differences between this profile and the base observation-vitalsigns structure.

NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation 0..*observation-vitalsignsFHIR Blood Pressure Profile
... code 1..1CodeableConceptBlood Pressure
.... Slices for coding 0..*CodingCode defined by a terminology system
Slice: Unordered, Open by value:code, value:system
..... coding:BPCode 1..1CodingCode defined by a terminology system
...... system 1..1uriIdentity of the terminology system
Fixed Value: http://loinc.org
...... code 1..1codeSymbol in syntax defined by the system
Fixed Value: 85354-9
... valueQuantity 0..0
... Slices for component 2..*BackboneElementUsed when reporting systolic and diastolic blood pressure.
Slice: Unordered, Open by value:code.coding.code, value:code.coding.system
.... component:SystolicBP 1..1BackboneElementUsed when reporting systolic and diastolic blood pressure.
..... code 1..1CodeableConceptType of component observation (code / type)
...... Slices for coding 0..*CodingSystolic Blood Pressure
Slice: Unordered, Open by value:code, value:system
....... coding:SBPCode 1..1CodingSystolic Blood Pressure
........ system 1..1uriIdentity of the terminology system
Fixed Value: http://loinc.org
........ code 1..1codeSymbol in syntax defined by the system
Fixed Value: 8480-6
..... valueQuantity 0..1QuantityVital Sign Value recorded with UCUM
...... value S1..1decimalNumerical value (with implicit precision)
...... unit S1..1stringUnit representation
...... system S1..1uriSystem that defines coded unit form
Fixed Value: http://unitsofmeasure.org
...... code S1..1codeCoded responses from the common UCUM units for vital signs value set.
Fixed Value: mm[Hg]
.... component:DiastolicBP 1..1BackboneElementUsed when reporting systolic and diastolic blood pressure.
..... code 1..1CodeableConceptType of component observation (code / type)
...... Slices for coding 0..*CodingDiastolic Blood Pressure
Slice: Unordered, Open by value:code, value:system
....... coding:DBPCode 1..1CodingDiastolic Blood Pressure
........ system 1..1uriIdentity of the terminology system
Fixed Value: http://loinc.org
........ code 1..1codeSymbol in syntax defined by the system
Fixed Value: 8462-4
..... valueQuantity 0..1QuantityVital Sign Value recorded with UCUM
...... value S1..1decimalNumerical value (with implicit precision)
...... unit S1..1stringUnit representation
...... system S1..1uriSystem that defines coded unit form
Fixed Value: http://unitsofmeasure.org
...... code S1..1codeCoded responses from the common UCUM units for vital signs value set.
Fixed Value: mm[Hg]

doco Documentation for this format

Snapshot View

This provides the consolidated view (aka snapshot) of the profile after applying the changes in this profile to the base observation-vitalsigns structure.

NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation C icon0..*observation-vitalsignsFHIR Blood Pressure Profile
... id Σ0..1idLogical id of this artifact
... meta Σ0..1MetaMetadata about the resource
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... language 0..1codeLanguage of the resource content
Binding: Common Languages (preferred): IETF language tag

Additional BindingsPurpose
All LanguagesMax Binding
... text 0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... extension 0..*ExtensionAdditional content defined by implementations
... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored
... identifier Σ0..*IdentifierBusiness Identifier for observation
... instantiates[x] Σ0..1canonical(ObservationDefinition), Reference(ObservationDefinition)Instantiates FHIR ObservationDefinition
... basedOn Σ0..*Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest)Fulfills plan, proposal or order
... triggeredBy 0..*BackboneElementTriggering observation(s)
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... observation Σ1..1Reference(Observation)Triggering observation
.... type Σ1..1codereflex | repeat | re-run
Binding: triggeredBytype (required): The type of TriggeredBy Observation.

.... reason 0..1stringReason that the observation was triggered
... partOf Σ0..*Reference(MedicationAdministration | MedicationDispense | MedicationUsage | Procedure | Immunization | ImagingStudy | GenomicStudy)Part of referenced event
... status ?!SΣ1..1coderegistered | preliminary | final | amended +
Binding: ObservationStatus (required)
... Slices for category S1..*CodeableConceptClassification of type of observation
Slice: Unordered, Open by value:coding.code, value:coding.system
Binding: Observation Category Codes (preferred): Codes for high level observation categories.


.... category:VSCat S1..1CodeableConceptClassification of type of observation
Binding: Observation Category Codes (preferred): Codes for high level observation categories.


..... id 0..1idUnique id for inter-element referencing
..... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
..... coding SΣ1..*CodingCode defined by a terminology system
...... id 0..1idUnique id for inter-element referencing
...... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
...... system SΣ1..1uriIdentity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category
...... version Σ0..1stringVersion of the system - if relevant
...... code SΣ1..1codeSymbol in syntax defined by the system
Fixed Value: vital-signs
...... display Σ0..1stringRepresentation defined by the system
...... userSelected Σ0..1booleanIf this coding was chosen directly by the user
..... text Σ0..1stringPlain text representation of the concept
... code SΣ1..1CodeableConceptBlood Pressure
Binding: Vital Signs (extensible): This identifies the vital sign result type. Original source C-CDA R1.1 , HITSP Vital Sign Result Type.

.... id 0..1idUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
.... Slices for coding Σ0..*CodingCode defined by a terminology system
Slice: Unordered, Open by value:code, value:system
..... coding:BPCode Σ1..1CodingCode defined by a terminology system
...... id 0..1idUnique id for inter-element referencing
...... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
...... system Σ1..1uriIdentity of the terminology system
Fixed Value: http://loinc.org
...... version Σ0..1stringVersion of the system - if relevant
...... code Σ1..1codeSymbol in syntax defined by the system
Fixed Value: 85354-9
...... display Σ0..1stringRepresentation defined by the system
...... userSelected Σ0..1booleanIf this coding was chosen directly by the user
.... text Σ0..1stringPlain text representation of the concept
... subject SΣ1..1Reference(Patient)Who and/or what the observation is about
... focus Σ0..*Reference(Resource)What the observation is about, when it is not about the subject of record
... encounter Σ0..1Reference(Encounter)Healthcare event during which this observation is made
... effective[x] SΣC icon1..1Often just a dateTime for Vital Signs
.... effectiveDateTimedateTime
.... effectivePeriodPeriod
... issued Σ0..1instantDate/Time this version was made available
... performer Σ0..*Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson)Who is responsible for the observation
... Slices for value[x] SΣC icon0..1QuantityVital Signs value are recorded using the Quantity data type. For supporting observations such as Cuff size could use other datatypes such as CodeableConcept.
Slice: Unordered, Closed by type:$this
... dataAbsentReason SC icon0..1CodeableConceptWhy the result is missing
Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.

... interpretation 0..*CodeableConceptHigh, low, normal, etc.
Binding: Observation Interpretation Codes (extensible): Codes identifying interpretations of observations.


... note 0..*AnnotationComments about the observation
... bodySite 0..1CodeableConceptObserved body part
Binding: SNOMED CT Body Structures (example): SNOMED CT Body site concepts

... bodyStructure C icon0..1Reference(BodyStructure)Observed body structure
... method 0..1CodeableConceptHow it was done
Binding: Observation Methods (example): Methods for simple observations.

... specimen C icon0..1Reference(Specimen | Group)Specimen used for this observation
... device 0..1Reference(Device | DeviceMetric)(Measurement) Device
... referenceRange C icon0..*BackboneElementProvides guide for interpretation
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... low C icon0..1SimpleQuantityLow Range, if relevant
.... high C icon0..1SimpleQuantityHigh Range, if relevant
.... normalValue C icon0..1CodeableConceptNormal value, if relevant
Binding: Observation Reference Range Normal Value Codes (extensible): Codes identifying the normal value of the observation.

.... type 0..1CodeableConceptReference range qualifier
Binding: Observation Reference Range Meaning Codes (preferred): Code for the meaning of a reference range.

.... appliesTo 0..*CodeableConceptReference range population
Binding: Observation Reference Range Applies To Codes (example): Codes identifying the population the reference range applies to.


.... age 0..1RangeApplicable age range, if relevant
.... text 0..1stringText based reference range in an observation
... hasMember Σ0..*Reference(QuestionnaireResponse | MolecularSequence | Vital Signs Profile)Used when reporting vital signs panel components
... derivedFrom Σ0..*Reference(DocumentReference | ImagingStudy | QuestionnaireResponse | MolecularSequence | Vital Signs Profile)Related resource from which the observation is made
... Slices for component SΣC icon2..*BackboneElementUsed when reporting systolic and diastolic blood pressure.
Slice: Unordered, Open by value:code.coding.code, value:code.coding.system
.... component:All Slices Content/Rules for all slices
..... id 0..1stringUnique id for inter-element referencing
..... extension 0..*ExtensionAdditional content defined by implementations
..... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
..... code SΣ1..1CodeableConceptType of component observation (code / type)
Binding: Vital Signs (extensible): This identifies the vital sign result type. Original source C-CDA R1.1 , HITSP Vital Sign Result Type.

..... value[x] SΣC icon0..1Vital Sign Value recorded with UCUM
Binding: Vital Signs Units (required): Commonly encountered UCUM units for recording Vital Signs.

...... valueQuantityQuantity
...... valueCodeableConceptCodeableConcept
...... valueStringstring
...... valueBooleanboolean
...... valueIntegerinteger
...... valueRangeRange
...... valueRatioRatio
...... valueSampledDataSampledData
...... valueTimetime
...... valueDateTimedateTime
...... valuePeriodPeriod
...... valueAttachmentAttachment
..... dataAbsentReason SC icon0..1CodeableConceptWhy the component result is missing
Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.

..... interpretation 0..*CodeableConceptHigh, low, normal, etc.
Binding: Observation Interpretation Codes (extensible): Codes identifying interpretations of observations.


..... referenceRange 0..*See referenceRange (Observation)Provides guide for interpretation of component result
.... component:SystolicBP SΣC icon1..1BackboneElementUsed when reporting systolic and diastolic blood pressure.
..... id 0..1stringUnique id for inter-element referencing
..... extension 0..*ExtensionAdditional content defined by implementations
..... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
..... code SΣ1..1CodeableConceptType of component observation (code / type)
Binding: Vital Signs (extensible): This identifies the vital sign result type. Original source C-CDA R1.1 , HITSP Vital Sign Result Type.

...... id 0..1idUnique id for inter-element referencing
...... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
...... Slices for coding Σ0..*CodingSystolic Blood Pressure
Slice: Unordered, Open by value:code, value:system
....... coding:SBPCode Σ1..1CodingSystolic Blood Pressure
........ id 0..1idUnique id for inter-element referencing
........ extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
........ system Σ1..1uriIdentity of the terminology system
Fixed Value: http://loinc.org
........ version Σ0..1stringVersion of the system - if relevant
........ code Σ1..1codeSymbol in syntax defined by the system
Fixed Value: 8480-6
........ display Σ0..1stringRepresentation defined by the system
........ userSelected Σ0..1booleanIf this coding was chosen directly by the user
...... text Σ0..1stringPlain text representation of the concept
..... value[x] SΣC icon0..1QuantityVital Sign Value recorded with UCUM
Binding: Vital Signs Units (required): Commonly encountered UCUM units for recording Vital Signs.

...... id 0..1idUnique id for inter-element referencing
...... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
...... value SΣ1..1decimalNumerical value (with implicit precision)
...... comparator ?!Σ0..1code< | <= | >= | > | ad - how to understand the value
Binding: QuantityComparator (required)
...... unit SΣ1..1stringUnit representation
...... system SΣC icon1..1uriSystem that defines coded unit form
Fixed Value: http://unitsofmeasure.org
...... code SΣ1..1codeCoded responses from the common UCUM units for vital signs value set.
Fixed Value: mm[Hg]
..... dataAbsentReason SC icon0..1CodeableConceptWhy the component result is missing
Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.

..... interpretation 0..*CodeableConceptHigh, low, normal, etc.
Binding: Observation Interpretation Codes (extensible): Codes identifying interpretations of observations.


..... referenceRange 0..*See referenceRange (Observation)Provides guide for interpretation of component result
.... component:DiastolicBP SΣC icon1..1BackboneElementUsed when reporting systolic and diastolic blood pressure.
..... id 0..1stringUnique id for inter-element referencing
..... extension 0..*ExtensionAdditional content defined by implementations
..... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
..... code SΣ1..1CodeableConceptType of component observation (code / type)
Binding: Vital Signs (extensible): This identifies the vital sign result type. Original source C-CDA R1.1 , HITSP Vital Sign Result Type.

...... id 0..1idUnique id for inter-element referencing
...... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
...... Slices for coding Σ0..*CodingDiastolic Blood Pressure
Slice: Unordered, Open by value:code, value:system
....... coding:DBPCode Σ1..1CodingDiastolic Blood Pressure
........ id 0..1idUnique id for inter-element referencing
........ extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
........ system Σ1..1uriIdentity of the terminology system
Fixed Value: http://loinc.org
........ version Σ0..1stringVersion of the system - if relevant
........ code Σ1..1codeSymbol in syntax defined by the system
Fixed Value: 8462-4
........ display Σ0..1stringRepresentation defined by the system
........ userSelected Σ0..1booleanIf this coding was chosen directly by the user
...... text Σ0..1stringPlain text representation of the concept
..... value[x] SΣC icon0..1QuantityVital Sign Value recorded with UCUM
Binding: Vital Signs Units (required): Commonly encountered UCUM units for recording Vital Signs.

...... id 0..1idUnique id for inter-element referencing
...... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
...... value SΣ1..1decimalNumerical value (with implicit precision)
...... comparator ?!Σ0..1code< | <= | >= | > | ad - how to understand the value
Binding: QuantityComparator (required)
...... unit SΣ1..1stringUnit representation
...... system SΣC icon1..1uriSystem that defines coded unit form
Fixed Value: http://unitsofmeasure.org
...... code SΣ1..1codeCoded responses from the common UCUM units for vital signs value set.
Fixed Value: mm[Hg]
..... dataAbsentReason SC icon0..1CodeableConceptWhy the component result is missing
Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.

..... interpretation 0..*CodeableConceptHigh, low, normal, etc.
Binding: Observation Interpretation Codes (extensible): Codes identifying interpretations of observations.


..... referenceRange 0..*See referenceRange (Observation)Provides guide for interpretation of component result

doco Documentation for this format

XML Template

<!-- observation-bp -->doco

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

JSON Template

{ // observation-bp
  // from Element: extension
    "meta" : { Meta }, // IMetadata about the resource
    "implicitRules" : "<uri>", // IA set of rules under which this content was created
    "language" : "<code>", // ILanguage of the resource content
    "text" : { Narrative }, // IText summary of the resource, for human interpretation
    "contained" : [{ Resource }], //Contained, inline Resources
    "modifierExtension" : [{ Extension }], // IExtensions that cannot be ignored
    "identifier" : [{ Identifier }], // IBusiness Identifier for observation
  // value[x]: Instantiates FHIR ObservationDefinition. One of these 2:
    "instantiatesCanonical" : "<canonical>", // IInstantiates FHIR ObservationDefinition
    "instantiatesReference" : { Reference(ObservationDefinition) }, // IInstantiates FHIR ObservationDefinition
    "basedOn" : [{ Reference(CarePlan) }], // IFulfills plan, proposal or order
    "triggeredBy" : [{ BackboneElement }], // ITriggering observation(s)
    "partOf" : [{ Reference(MedicationAdministration) }], // IPart of referenced event
    "status" : "<code>", // I R! registered | preliminary | final | amended +
    "category" : [ //  sliced by value:coding.code, value:coding.system  in the specified order, Open 
      { // Classification of  type of observation // I R! 
        // from Element: extension
        "extension" : [ //  sliced by value:url  in the specified order, Open ]
        "coding" : [{ Coding }], // I R! Code defined by a terminology system
        "text" : "<string>" // IPlain text representation of the concept
      }
    ],
    "code" : { CodeableConcept }, // I R! Blood Pressure
    "subject" : { Reference(Patient) }, // I R! Who and/or what the observation is about
    "focus" : [{ Reference(Resource) }], // IWhat the observation is about, when it is not about the subject of record
    "encounter" : { Reference(Encounter) }, // IHealthcare event during which this observation is made
  // value[x]: Often just a dateTime for Vital Signs. One of these 2:
    "effectiveDateTime" : "<dateTime>", // I R! Often just a dateTime for Vital Signs
    "effectivePeriod" : { Period }, // I R! Often just a dateTime for Vital Signs
    "issued" : "<instant>", // IDate/Time this version was made available
    "performer" : [{ Reference(Practitioner) }], // IWho is responsible for the observation
    "valueQuantity" : [ //  sliced by type:$this  in the specified order, Closed 
      { // Vital Signs value are recorded using the Quantity data type. For supporting observations such as Cuff size could use other datatypes such as CodeableConcept. // I
        // from Element: extension
      }
    ],
    "dataAbsentReason" : { CodeableConcept }, // IWhy the result is missing
    "interpretation" : [{ CodeableConcept }], // IHigh, low, normal, etc.
    "note" : [{ Annotation }], // IComments about the observation
    "bodySite" : { CodeableConcept }, // IObserved body part
    "bodyStructure" : { Reference(BodyStructure) }, // IObserved body structure
    "method" : { CodeableConcept }, // IHow it was done
    "specimen" : { Reference(Specimen) }, // ISpecimen used for this observation
    "device" : { Reference(Device) }, // I(Measurement) Device
    "referenceRange" : [{ BackboneElement }], // IProvides guide for interpretation
    "hasMember" : [{ Reference(QuestionnaireResponse) }], // IUsed when reporting vital signs panel components
    "derivedFrom" : [{ Reference(DocumentReference) }], // IRelated resource from which the observation is made
    "component" : [ //  sliced by value:code.coding.code, value:code.coding.system  in the specified order, Open 
      { // Used when reporting systolic and diastolic blood pressure. // I R! 
        // from Element: extension
        "modifierExtension" : [{ Extension }], // IExtensions that cannot be ignored even if unrecognized
        "code" : { CodeableConcept }, // I R! Type of component observation (code / type)
        "valueQuantity" : { Quantity }, // IVital Sign Value recorded with UCUM
        "dataAbsentReason" : { CodeableConcept }, // IWhy the component result is missing
        "interpretation" : [{ CodeableConcept }], // IHigh, low, normal, etc.
// value[x]: Provides guide for interpretation of component result. One of these 0:
      }
      { // Used when reporting systolic and diastolic blood pressure. // I R! 
        // from Element: extension
        "modifierExtension" : [{ Extension }], // IExtensions that cannot be ignored even if unrecognized
        "code" : { CodeableConcept }, // I R! Type of component observation (code / type)
        "valueQuantity" : { Quantity }, // IVital Sign Value recorded with UCUM
        "dataAbsentReason" : { CodeableConcept }, // IWhy the component result is missing
        "interpretation" : [{ CodeableConcept }], // IHigh, low, normal, etc.
// value[x]: Provides guide for interpretation of component result. One of these 0:
      },
    ],
  }

 

Alternate definitions: Master Definition (XML, JSON), Schematron

10.1.19.44.4 Terminology Bindings

PathNameConformanceValueSet
Observation.languageCommon LanguagespreferredCommon Languages
Observation.triggeredBy.typetriggeredBytyperequiredtriggeredBytype
Observation.statusObservationStatusrequiredObservationStatus
Observation.categoryObservation Category CodespreferredObservation Category Codes
Observation.categoryObservation Category CodespreferredObservation Category Codes
Observation.codeVital SignsextensibleVital Signs
Observation.dataAbsentReasonDataAbsentReasonextensibleDataAbsentReason
Observation.interpretationObservation Interpretation CodesextensibleObservation Interpretation Codes
Observation.bodySiteSNOMED CT Body StructuresexampleSNOMED CT Body Structures
Observation.methodObservation MethodsexampleObservation Methods
Observation.referenceRange.normalValueObservation Reference Range Normal Value CodesextensibleObservation Reference Range Normal Value Codes
Observation.referenceRange.typeObservation Reference Range Meaning CodespreferredObservation Reference Range Meaning Codes
Observation.referenceRange.appliesToObservation Reference Range Applies To CodesexampleObservation Reference Range Applies To Codes
Observation.component.codeVital SignsextensibleVital Signs
Observation.component.value[x]Vital Signs UnitsrequiredVital Signs Units
Observation.component.dataAbsentReasonDataAbsentReasonextensibleDataAbsentReason
Observation.component.interpretationObservation Interpretation CodesextensibleObservation Interpretation Codes
Observation.component.codeVital SignsextensibleVital Signs
Observation.component.value[x]Vital Signs UnitsrequiredVital Signs Units
Observation.component.value[x].comparatorQuantityComparatorrequiredQuantityComparator
Observation.component.dataAbsentReasonDataAbsentReasonextensibleDataAbsentReason
Observation.component.interpretationObservation Interpretation CodesextensibleObservation Interpretation Codes
Observation.component.codeVital SignsextensibleVital Signs
Observation.component.value[x]Vital Signs UnitsrequiredVital Signs Units
Observation.component.value[x].comparatorQuantityComparatorrequiredQuantityComparator
Observation.component.dataAbsentReasonDataAbsentReasonextensibleDataAbsentReason
Observation.component.interpretationObservation Interpretation CodesextensibleObservation Interpretation Codes
.