Release 4B Snapshot #1

This page is part of the FHIR Specification v4.3.0-snapshot1: R4B Snapshot to support the Jan 2022 Connectathon. About the R4B version of FHIR. The current officially released version is 4.3.0. For a full list of available versions, see the Directory of published versions . Page versions: R5 R4B R4 R3

10.1.14.88 StructureDefinition: observation-bp

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

The official URL for this profile is: 

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

FHIR Blood Pressure Profile

This profile was published on Mon, Nov 17, 2014 00:00+1100 as a draft by Health Level Seven International (Health Care Devices).

10.1.14.88.1 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

10.1.14.88.2 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 structure is derived from observation-vitalsigns.

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
NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation I0..*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)
Max Binding: All Languages: IETF language tag

... text 0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... extension 0..*ExtensionAdditional content defined by implementations
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... identifier Σ0..*IdentifierBusiness Identifier for observation
... basedOn Σ0..*Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest)Fulfills plan, proposal or order
... partOf Σ0..*Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy)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..1stringUnique id for inter-element referencing
..... Slices for extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
..... coding S1..*CodingCode defined by a terminology system
...... id 0..1stringUnique id for inter-element referencing
...... Slices for extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
...... system S1..1uriIdentity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category
...... version 0..1stringVersion of the system - if relevant
...... code S1..1codeSymbol in syntax defined by the system
Fixed Value: vital-signs
...... display 0..1stringRepresentation defined by the system
...... userSelected 0..1booleanIf this coding was chosen directly by the user
..... text 0..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..1stringUnique id for inter-element referencing
.... Slices for extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
.... 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
...... id 0..1stringUnique id for inter-element referencing
...... Slices for extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
...... system 1..1uriIdentity of the terminology system
Fixed Value: http://loinc.org
...... version 0..1stringVersion of the system - if relevant
...... code 1..1codeSymbol in syntax defined by the system
Fixed Value: 85354-9
...... display 0..1stringRepresentation defined by the system
...... userSelected 0..1booleanIf this coding was chosen directly by the user
.... text 0..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] SΣI1..1Often just a dateTime for Vital Signs
vs-1: if Observation.effective[x] is dateTime and has a value then that value shall be precise to the day
.... 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] SΣI0..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 SI0..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

... method 0..1CodeableConceptHow it was done
Binding: Observation Methods (example): Methods for simple observations.

... specimen 0..1Reference(Specimen)Specimen used for this observation
... device 0..1Reference(Device | DeviceMetric)(Measurement) Device
... referenceRange I0..*BackboneElementProvides guide for interpretation
.... id 0..1idUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... low I0..1SimpleQuantityLow Range, if relevant
.... high I0..1SimpleQuantityHigh Range, if relevant
.... 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 | Media | QuestionnaireResponse | MolecularSequence | Vital Signs Profile)Related measurements the observation is made from
... Slices for component SΣI2..*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..1idUnique 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] SΣI0..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
..... dataAbsentReason SI0..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 SΣI1..1BackboneElementUsed when reporting systolic and diastolic blood pressure.
..... id 0..1idUnique 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..1stringUnique id for inter-element referencing
...... Slices for extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
...... Slices for coding 0..*CodingSystolic Blood Pressure
Slice: Unordered, Open by value:code, value:system
....... coding:SBPCode 1..1CodingSystolic Blood Pressure
........ id 0..1stringUnique id for inter-element referencing
........ Slices for extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
........ system 1..1uriIdentity of the terminology system
Fixed Value: http://loinc.org
........ version 0..1stringVersion of the system - if relevant
........ code 1..1codeSymbol in syntax defined by the system
Fixed Value: 8480-6
........ display 0..1stringRepresentation defined by the system
........ userSelected 0..1booleanIf this coding was chosen directly by the user
...... text 0..1stringPlain text representation of the concept
..... value[x] SΣI0..1QuantityVital Sign Value recorded with UCUM
Binding: Vital Signs Units (required): Commonly encountered UCUM units for recording Vital Signs.

...... id 0..1stringUnique id for inter-element referencing
...... Slices for extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
...... value S1..1decimalNumerical value (with implicit precision)
...... comparator ?!0..1code< | <= | >= | > - how to understand the value
Binding: QuantityComparator (required)
...... unit S1..1stringUnit representation
...... system SI1..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]
..... dataAbsentReason SI0..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 SΣI1..1BackboneElementUsed when reporting systolic and diastolic blood pressure.
..... id 0..1idUnique 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..1stringUnique id for inter-element referencing
...... Slices for extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
...... Slices for coding 0..*CodingDiastolic Blood Pressure
Slice: Unordered, Open by value:code, value:system
....... coding:DBPCode 1..1CodingDiastolic Blood Pressure
........ id 0..1stringUnique id for inter-element referencing
........ Slices for extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
........ system 1..1uriIdentity of the terminology system
Fixed Value: http://loinc.org
........ version 0..1stringVersion of the system - if relevant
........ code 1..1codeSymbol in syntax defined by the system
Fixed Value: 8462-4
........ display 0..1stringRepresentation defined by the system
........ userSelected 0..1booleanIf this coding was chosen directly by the user
...... text 0..1stringPlain text representation of the concept
..... value[x] SΣI0..1QuantityVital Sign Value recorded with UCUM
Binding: Vital Signs Units (required): Commonly encountered UCUM units for recording Vital Signs.

...... id 0..1stringUnique id for inter-element referencing
...... Slices for extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
...... value S1..1decimalNumerical value (with implicit precision)
...... comparator ?!0..1code< | <= | >= | > - how to understand the value
Binding: QuantityComparator (required)
...... unit S1..1stringUnit representation
...... system SI1..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]
..... dataAbsentReason SI0..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><!-- ?? 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>
 <-- valueQuantity sliced by type:$this  in the specified orderClosed-->
 <valueQuantity><!-- ?? 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><!-- ?? 0..1 CodeableConcept Why the result is missing   --></dataAbsentReason>
 <interpretation><!-- ?? 0..* CodeableConcept High, low, normal, etc.   --></interpretation>
 <note><!-- ?? 0..* Annotation Comments about the observation --></note>
 <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 even 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 even 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 http://hl7.org/fhir/StructureDefinition/Observation#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 even 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 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 }, // C?Metadata about the resource
    "implicitRules" : "<uri>", // C?A set of rules under which this content was created
    "language" : "<code>", // C?Language of the resource content
    "text" : { Narrative }, // C?Text summary of the resource, for human interpretation
    "contained" : [{ Resource }], //Contained, inline Resources
    "modifierExtension" : [{ Extension }], // C?Extensions that cannot be ignored
    "identifier" : [{ Identifier }], // C?Business Identifier for observation
    "basedOn" : [{ Reference(CarePlan) }], // C?Fulfills plan, proposal or order
    "partOf" : [{ Reference(MedicationAdministration) }], // C?Part of referenced event
    "status" : "<code>", // C? R! registered | preliminary | final | amended +
    "category" : [ //  sliced by value:coding.code, value:coding.system  in the specified order, Open 
      { // Classification of  type of observation // C? R! 
        // from Element: extension
        "extension" : [ //  sliced by value:url  in the specified order, Open ]
        "coding" : [{ Coding }], // C? R! Code defined by a terminology system
        "text" : "<string>" // C?Plain text representation of the concept
      }
    ],
    "code" : { CodeableConcept }, // C? R! Blood Pressure
    "subject" : { Reference(Patient) }, // C? R! Who and/or what the observation is about
    "focus" : [{ Reference(Resource) }], // C?What the observation is about, when it is not about the subject of record
    "encounter" : { Reference(Encounter) }, // C?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>", // C?Date/Time this version was made available
    "performer" : [{ Reference(Practitioner) }], // C?Who 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. // C?
        // from Element: extension
      }
    ],
    "dataAbsentReason" : { CodeableConcept }, // C?Why the result is missing
    "interpretation" : [{ CodeableConcept }], // C?High, low, normal, etc.
    "note" : [{ Annotation }], // C?Comments about the observation
    "bodySite" : { CodeableConcept }, // C?Observed body part
    "method" : { CodeableConcept }, // C?How it was done
    "specimen" : { Reference(Specimen) }, // C?Specimen used for this observation
    "device" : { Reference(Device) }, // C?(Measurement) Device
    "referenceRange" : [{ BackboneElement }], // C?Provides guide for interpretation
    "hasMember" : [{ Reference(QuestionnaireResponse) }], // C?Used when reporting vital signs panel components
    "derivedFrom" : [{ Reference(DocumentReference) }], // C?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 }], // C?Extensions that cannot be ignored even if unrecognized
        "code" : { CodeableConcept }, // C? R! Type of component observation (code / type)
        "valueQuantity" : { Quantity }, // C?Vital Sign Value recorded with UCUM
        "dataAbsentReason" : { CodeableConcept }, // C?Why the component result is missing
        "interpretation" : [{ CodeableConcept }], // C?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 }], // C?Extensions that cannot be ignored even if unrecognized
        "code" : { CodeableConcept }, // C? R! Type of component observation (code / type)
        "valueQuantity" : { Quantity }, // C?Vital Sign Value recorded with UCUM
        "dataAbsentReason" : { CodeableConcept }, // C?Why the component result is missing
        "interpretation" : [{ CodeableConcept }], // C?High, low, normal, etc.
// value[x]: Provides guide for interpretation of component result. One of these 0:
      }
    ],
  }

This structure is derived from observation-vitalsigns.

Summary

10.1.14.88.3 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 structure is derived from observation-vitalsigns.

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

NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation I0..*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)
Max Binding: All Languages: IETF language tag

... text 0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... extension 0..*ExtensionAdditional content defined by implementations
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... identifier Σ0..*IdentifierBusiness Identifier for observation
... basedOn Σ0..*Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest)Fulfills plan, proposal or order
... partOf Σ0..*Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy)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..1stringUnique id for inter-element referencing
..... Slices for extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
..... coding S1..*CodingCode defined by a terminology system
...... id 0..1stringUnique id for inter-element referencing
...... Slices for extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
...... system S1..1uriIdentity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category
...... version 0..1stringVersion of the system - if relevant
...... code S1..1codeSymbol in syntax defined by the system
Fixed Value: vital-signs
...... display 0..1stringRepresentation defined by the system
...... userSelected 0..1booleanIf this coding was chosen directly by the user
..... text 0..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..1stringUnique id for inter-element referencing
.... Slices for extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
.... 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
...... id 0..1stringUnique id for inter-element referencing
...... Slices for extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
...... system 1..1uriIdentity of the terminology system
Fixed Value: http://loinc.org
...... version 0..1stringVersion of the system - if relevant
...... code 1..1codeSymbol in syntax defined by the system
Fixed Value: 85354-9
...... display 0..1stringRepresentation defined by the system
...... userSelected 0..1booleanIf this coding was chosen directly by the user
.... text 0..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] SΣI1..1Often just a dateTime for Vital Signs
vs-1: if Observation.effective[x] is dateTime and has a value then that value shall be precise to the day
.... 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] SΣI0..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 SI0..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

... method 0..1CodeableConceptHow it was done
Binding: Observation Methods (example): Methods for simple observations.

... specimen 0..1Reference(Specimen)Specimen used for this observation
... device 0..1Reference(Device | DeviceMetric)(Measurement) Device
... referenceRange I0..*BackboneElementProvides guide for interpretation
.... id 0..1idUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... low I0..1SimpleQuantityLow Range, if relevant
.... high I0..1SimpleQuantityHigh Range, if relevant
.... 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 | Media | QuestionnaireResponse | MolecularSequence | Vital Signs Profile)Related measurements the observation is made from
... Slices for component SΣI2..*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..1idUnique 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] SΣI0..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
..... dataAbsentReason SI0..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 SΣI1..1BackboneElementUsed when reporting systolic and diastolic blood pressure.
..... id 0..1idUnique 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..1stringUnique id for inter-element referencing
...... Slices for extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
...... Slices for coding 0..*CodingSystolic Blood Pressure
Slice: Unordered, Open by value:code, value:system
....... coding:SBPCode 1..1CodingSystolic Blood Pressure
........ id 0..1stringUnique id for inter-element referencing
........ Slices for extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
........ system 1..1uriIdentity of the terminology system
Fixed Value: http://loinc.org
........ version 0..1stringVersion of the system - if relevant
........ code 1..1codeSymbol in syntax defined by the system
Fixed Value: 8480-6
........ display 0..1stringRepresentation defined by the system
........ userSelected 0..1booleanIf this coding was chosen directly by the user
...... text 0..1stringPlain text representation of the concept
..... value[x] SΣI0..1QuantityVital Sign Value recorded with UCUM
Binding: Vital Signs Units (required): Commonly encountered UCUM units for recording Vital Signs.

...... id 0..1stringUnique id for inter-element referencing
...... Slices for extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
...... value S1..1decimalNumerical value (with implicit precision)
...... comparator ?!0..1code< | <= | >= | > - how to understand the value
Binding: QuantityComparator (required)
...... unit S1..1stringUnit representation
...... system SI1..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]
..... dataAbsentReason SI0..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 SΣI1..1BackboneElementUsed when reporting systolic and diastolic blood pressure.
..... id 0..1idUnique 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..1stringUnique id for inter-element referencing
...... Slices for extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
...... Slices for coding 0..*CodingDiastolic Blood Pressure
Slice: Unordered, Open by value:code, value:system
....... coding:DBPCode 1..1CodingDiastolic Blood Pressure
........ id 0..1stringUnique id for inter-element referencing
........ Slices for extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
........ system 1..1uriIdentity of the terminology system
Fixed Value: http://loinc.org
........ version 0..1stringVersion of the system - if relevant
........ code 1..1codeSymbol in syntax defined by the system
Fixed Value: 8462-4
........ display 0..1stringRepresentation defined by the system
........ userSelected 0..1booleanIf this coding was chosen directly by the user
...... text 0..1stringPlain text representation of the concept
..... value[x] SΣI0..1QuantityVital Sign Value recorded with UCUM
Binding: Vital Signs Units (required): Commonly encountered UCUM units for recording Vital Signs.

...... id 0..1stringUnique id for inter-element referencing
...... Slices for extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
...... value S1..1decimalNumerical value (with implicit precision)
...... comparator ?!0..1code< | <= | >= | > - how to understand the value
Binding: QuantityComparator (required)
...... unit S1..1stringUnit representation
...... system SI1..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]
..... dataAbsentReason SI0..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><!-- ?? 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>
 <-- valueQuantity sliced by type:$this  in the specified orderClosed-->
 <valueQuantity><!-- ?? 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><!-- ?? 0..1 CodeableConcept Why the result is missing   --></dataAbsentReason>
 <interpretation><!-- ?? 0..* CodeableConcept High, low, normal, etc.   --></interpretation>
 <note><!-- ?? 0..* Annotation Comments about the observation --></note>
 <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 even 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 even 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 http://hl7.org/fhir/StructureDefinition/Observation#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 even 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 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 }, // C?Metadata about the resource
    "implicitRules" : "<uri>", // C?A set of rules under which this content was created
    "language" : "<code>", // C?Language of the resource content
    "text" : { Narrative }, // C?Text summary of the resource, for human interpretation
    "contained" : [{ Resource }], //Contained, inline Resources
    "modifierExtension" : [{ Extension }], // C?Extensions that cannot be ignored
    "identifier" : [{ Identifier }], // C?Business Identifier for observation
    "basedOn" : [{ Reference(CarePlan) }], // C?Fulfills plan, proposal or order
    "partOf" : [{ Reference(MedicationAdministration) }], // C?Part of referenced event
    "status" : "<code>", // C? R! registered | preliminary | final | amended +
    "category" : [ //  sliced by value:coding.code, value:coding.system  in the specified order, Open 
      { // Classification of  type of observation // C? R! 
        // from Element: extension
        "extension" : [ //  sliced by value:url  in the specified order, Open ]
        "coding" : [{ Coding }], // C? R! Code defined by a terminology system
        "text" : "<string>" // C?Plain text representation of the concept
      }
    ],
    "code" : { CodeableConcept }, // C? R! Blood Pressure
    "subject" : { Reference(Patient) }, // C? R! Who and/or what the observation is about
    "focus" : [{ Reference(Resource) }], // C?What the observation is about, when it is not about the subject of record
    "encounter" : { Reference(Encounter) }, // C?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>", // C?Date/Time this version was made available
    "performer" : [{ Reference(Practitioner) }], // C?Who 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. // C?
        // from Element: extension
      }
    ],
    "dataAbsentReason" : { CodeableConcept }, // C?Why the result is missing
    "interpretation" : [{ CodeableConcept }], // C?High, low, normal, etc.
    "note" : [{ Annotation }], // C?Comments about the observation
    "bodySite" : { CodeableConcept }, // C?Observed body part
    "method" : { CodeableConcept }, // C?How it was done
    "specimen" : { Reference(Specimen) }, // C?Specimen used for this observation
    "device" : { Reference(Device) }, // C?(Measurement) Device
    "referenceRange" : [{ BackboneElement }], // C?Provides guide for interpretation
    "hasMember" : [{ Reference(QuestionnaireResponse) }], // C?Used when reporting vital signs panel components
    "derivedFrom" : [{ Reference(DocumentReference) }], // C?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 }], // C?Extensions that cannot be ignored even if unrecognized
        "code" : { CodeableConcept }, // C? R! Type of component observation (code / type)
        "valueQuantity" : { Quantity }, // C?Vital Sign Value recorded with UCUM
        "dataAbsentReason" : { CodeableConcept }, // C?Why the component result is missing
        "interpretation" : [{ CodeableConcept }], // C?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 }], // C?Extensions that cannot be ignored even if unrecognized
        "code" : { CodeableConcept }, // C? R! Type of component observation (code / type)
        "valueQuantity" : { Quantity }, // C?Vital Sign Value recorded with UCUM
        "dataAbsentReason" : { CodeableConcept }, // C?Why the component result is missing
        "interpretation" : [{ CodeableConcept }], // C?High, low, normal, etc.
// value[x]: Provides guide for interpretation of component result. One of these 0:
      }
    ],
  }

 

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

10.1.14.88.4 Terminology Bindings

PathNameConformanceValueSet
Observation.languageCommon LanguagespreferredCommon Languages
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.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

10.1.14.88.5 Constraints

Rule
IdPathDetailsRequirements
vs-1Observation.effective[x]if Observation.effective[x] is dateTime and has a value then that value shall be precise to the day
Expression : ($this as dateTime).toString().length() >= 8
.