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Orders and Observations Work Group | Maturity Level: N/A | Standards Status: Informative | Compartments: Device, Encounter, Patient, Practitioner, RelatedPerson |
Raw JSON (canonical form + also see JSON Format Specification)
Example of a 2 minute Apgar score with individual score as components
{ "resourceType": "Observation", "id": "2minute-apgar-score", "text": { "status": "generated", "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative</b></p><div><p>Resource "2minute-apgar-score" </p></div><p><b>status</b>: final</p><p><b>category</b>: Survey <span> (<a>Observation Category Codes</a>#survey)</span></p><p><b>code</b>: 2 minute Apgar Score <span> (<a>LOINC</a>#9273-4)</span></p><p><b>subject</b>: <a> </a></p><blockquote><div><p>Resource "newborn" </p></div><p><b>identifier</b>: id: 12345</p><p><b>active</b>: true</p><p><b>name</b>: Peter James Chalmers </p><p><b>gender</b>: male</p><p><b>birthDate</b>: 2016-05-18</p></blockquote><p><b>effective</b>: 2016-05-18T22:33:22Z</p><p><b>performer</b>: <a>Practitioner/example</a> "Adam CAREFUL"</p><p><b>value</b>: 5 {score}<span> (Details: UCUM code {score} = '{score}')</span></p><blockquote><p><b>component</b></p><p><b>code</b>: Apgar color score <span> (<a>SNOMED CT</a>#249227004)</span></p><p><b>value</b>: 1. Good color in body with bluish hands or feet <span> (<a>LOINC</a>#LA6723-6 "Good color in body with bluish hands or feet"; apgarcolor#1)</span></p></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: Apgar respiratory effort score <span> (<a>SNOMED CT</a>#249223000 "Apgar heart rate score")</span></p><p><b>value</b>: 1. Fewer than 100 beats per minute <span> (<a>LOINC</a>#LA6720-2 "Fewer than 100 beats per minute"; apgarheartrate#1)</span></p></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: Apgar response to stimulus score <span> (<a>SNOMED CT</a>#249226008)</span></p><p><b>value</b>: 1. Grimace during suctioning <span> (<a>LOINC</a>#LA6721-0 "Grimace during suctioning"; apgarreflexirritability#1)</span></p></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: Apgar muscle tone score <span> (<a>SNOMED CT</a>#249225007)</span></p><p><b>value</b>: 1. Some flexion of arms and legs <span> (<a>LOINC</a>#LA6714-5 "Some flexion of arms and legs"; apgarmuscletone#1)</span></p></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: Apgar respiratory effort score <span> (<a>SNOMED CT</a>#249224006)</span></p><p><b>value</b>: 1. Weak cry; may sound like whimpering, slow or irregular breathing <span> (<a>LOINC</a>#LA6726-9 "Weak cry; may sound like whimpering, slow or irregular breathing"; apgarrespiratoryeffort#1)</span></p></blockquote></div>" }, "contained": [ { "resourceType": "Patient", "id": "newborn", "identifier": [ { "system": "http://acmehealthcare/org/mrns", "value": "12345" } ], "active": true, "name": [ { "family": "Chalmers", "given": [ "Peter", "James" ] } ], "gender": "male", "birthDate": "2016-05-18", "_birthDate": { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/patient-birthTime", "valueDateTime": "2016-05-18T10:28:45Z" } ] } } ], "status": "final", "category": [ { "coding": [ { "system": "http://terminology.hl7.org/CodeSystem/observation-category", "code": "survey", "display": "Survey" } ], "text": "Survey" } ], "code": { "coding": [ { "system": "http://loinc.org", "code": "9273-4", "display": "2 minute Apgar Score" } ], "text": "2 minute Apgar Score" }, "subject": { "reference": "#newborn" }, "effectiveDateTime": "2016-05-18T22:33:22Z", "performer": [ { "reference": "Practitioner/example" } ], "valueQuantity": { "value": 5, "system": "http://unitsofmeasure.org", "code": "{score}" }, "component": [ { "code": { "coding": [ { "system": "http://snomed.info/sct", "code": "249227004", "display": "Apgar color score" } ], "text": "Apgar color score" }, "valueCodeableConcept": { "coding": [ { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/ordinalValue", "valueDecimal": 1 } ], "system": "http://loinc.org", "code": "LA6723-6", "display": "Good color in body with bluish hands or feet" }, { "system": "http://acme.ped/apgarcolor", "code": "1" } ], "text": "1. Good color in body with bluish hands or feet" } }, { "code": { "coding": [ { "system": "http://snomed.info/sct", "code": "249223000", "display": "Apgar heart rate score" } ], "text": "Apgar respiratory effort score" }, "valueCodeableConcept": { "coding": [ { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/ordinalValue", "valueDecimal": 1 } ], "system": "http://loinc.org", "code": "LA6720-2", "display": "Fewer than 100 beats per minute" }, { "system": "http://acme.ped/apgarheartrate", "code": "1" } ], "text": "1. Fewer than 100 beats per minute" } }, { "code": { "coding": [ { "system": "http://snomed.info/sct", "code": "249226008", "display": "Apgar response to stimulus score" } ], "text": "Apgar response to stimulus score" }, "valueCodeableConcept": { "coding": [ { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/ordinalValue", "valueDecimal": 1 } ], "system": "http://loinc.org", "code": "LA6721-0", "display": "Grimace during suctioning" }, { "system": "http://acme.ped/apgarreflexirritability", "code": "1" } ], "text": "1. Grimace during suctioning" } }, { "code": { "coding": [ { "system": "http://snomed.info/sct", "code": "249225007", "display": "Apgar muscle tone score" } ], "text": "Apgar muscle tone score" }, "valueCodeableConcept": { "coding": [ { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/ordinalValue", "valueDecimal": 1 } ], "system": "http://loinc.org", "code": "LA6714-5", "display": "Some flexion of arms and legs" }, { "system": "http://acme.ped/apgarmuscletone", "code": "1" } ], "text": "1. Some flexion of arms and legs" } }, { "code": { "coding": [ { "system": "http://snomed.info/sct", "code": "249224006", "display": "Apgar respiratory effort score" } ], "text": "Apgar respiratory effort score" }, "valueCodeableConcept": { "coding": [ { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/ordinalValue", "valueDecimal": 1 } ], "system": "http://loinc.org", "code": "LA6726-9", "display": "Weak cry; may sound like whimpering, slow or irregular breathing" }, { "system": "http://acme.ped/apgarrespiratoryeffort", "code": "1" } ], "text": "1. Weak cry; may sound like whimpering, slow or irregular breathing" } } ] }
Usage note: every effort has been made to ensure that the examples are correct and useful, but they are not a normative part of the specification.