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

10.1.14.18.5 StructureDefinition: observation-vitalsigns - Mappings

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

Mappings:

Workflow Pattern

SNOMED CT Concept Domain Binding

HL7 v2 Mapping

RIM Mapping

FiveWs Pattern Mapping

SNOMED CT Attribute Binding

Mappings for the vitalsigns Profile (see Mappings to Other Standards for further information & status).

10.1.14.19 Workflow Pattern (http://hl7.org/fhir/workflow)

observation-vitalsigns
ObservationEvent
   id
   meta
   implicitRules
   language
   text
   contained
   extension
   modifierExtension
   identifierEvent.identifier
   basedOnEvent.basedOn
   partOfEvent.partOf
   statusEvent.status
   category
   categoryVSCat
      id
      extension
      coding
         id
         extension
         system
         version
         code
         display
         userSelected
      text
   codeEvent.code
   subjectEvent.subject
   focus
   encounterEvent.context
   effective[x]Event.occurrence[x]
   issued
   performerEvent.performer.actor
   value[x]
   dataAbsentReason
   interpretation
   note
   bodySite
   method
   specimen
   device
   referenceRange
      id
      extension
      modifierExtension
      low
      high
      type
      appliesTo
      age
      text
   hasMember
   derivedFrom
   component
      id
      extension
      modifierExtension
      code
      value[x]
      dataAbsentReason
      interpretation
      referenceRange

10.1.14.20 SNOMED CT Concept Domain Binding (http://snomed.info/conceptdomain)

Concept domain bindings link a resource or an element to a set of SNOMED CT concepts that represent the intended semantics of the instances (whether or not SNOMED CT is used to encode that data element). This set of concepts is represented using a SNOMED CT expression constraint. Note that the 'Concept domain binding' may be a superset of the 'value set binding'. These bindings help to support:

  • Quality checking FHIR resources by ensuring that (a) the intended semantics of the instances matches the valid range of the corresponding SNOMED CT attribute, and (b) the intended value set is appropriate for the intended semantics of the instances
  • Semantic checking of data instances by helping to detect potential inconsistencies caused by overlap between the semantics incorporated in two concept domains
observation-vitalsigns
Observation< 363787002 |Observable entity|
   id
   meta
   implicitRules
   language
   text
   contained
   extension
   modifierExtension
   identifier
   basedOn
   partOf
   status< 445584004 |Report by finality status|
   category
   categoryVSCat
      id
      extension
      coding
         id
         extension
         system
         version
         code
         display
         userSelected
      text
   code< 363787002 |Observable entity| OR < 386053000 |Evaluation procedure|
   subject
   focus
   encounter
   effective[x]
   issued
   performer
   value[x]< 441742003 |Evaluation finding|
   dataAbsentReason
   interpretation< 260245000 |Findings values|
   note
   bodySite< 123037004 |Body structure|
   method
   specimen< 123038009 |Specimen|
   device< 49062001 |Device|
   referenceRange
      id
      extension
      modifierExtension
      low
      high
      type< 260245000 |Findings values| OR < 365860008 |General clinical state finding| OR < 250171008 |Clinical history or observation findings| OR < 415229000 |Racial group| OR < 365400002 |Finding of puberty stage| OR < 443938003 |Procedure carried out on subject|
      appliesTo< 260245000 |Findings values| OR < 365860008 |General clinical state finding| OR < 250171008 |Clinical history or observation findings| OR < 415229000 |Racial group| OR < 365400002 |Finding of puberty stage| OR < 443938003 |Procedure carried out on subject|
      age
      text
   hasMember
   derivedFrom
   component
      id
      extension
      modifierExtension
      code< 363787002 |Observable entity| OR < 386053000 |Evaluation procedure|
      value[x]363714003 |Interprets| < 441742003 |Evaluation finding|
      dataAbsentReason
      interpretation< 260245000 |Findings values|
      referenceRange

10.1.14.21 HL7 v2 Mapping (http://hl7.org/v2)

observation-vitalsigns
ObservationOBX
   id
   meta
   implicitRules
   language
   text
   contained
   extension
   modifierExtension
   identifierOBX.21 For OBX segments from systems without OBX-21 support a combination of ORC/OBR and OBX must be negotiated between trading partners to uniquely identify the OBX segment. Depending on how V2 has been implemented each of these may be an option: 1) OBR-3 + OBX-3 + OBX-4 or 2) OBR-3 + OBR-4 + OBX-3 + OBX-4 or 2) some other way to uniquely ID the OBR/ORC + OBX-3 + OBX-4.
   basedOnORC
   partOfVaries by domain
   statusOBX-11
   category
   categoryVSCat
      id
      extension
      codingC*E.1-8, C*E.10-22
         id
         extension
         systemC*E.3
         versionC*E.7
         codeC*E.1
         displayC*E.2 - but note this is not well followed
         userSelectedSometimes implied by being first
      textC*E.9. But note many systems use C*E.2 for this
   codeOBX-3
   subjectPID-3
   focusOBX-3
   encounterPV1
   effective[x]OBX-14, and/or OBX-19 after v2.4 (depends on who observation made)
   issuedOBR.22 (or MSH.7), or perhaps OBX-19 (depends on who observation made)
   performerOBX.15 / (Practitioner) OBX-16, PRT-5:PRT-4='RO' / (Device) OBX-18 , PRT-10:PRT-4='EQUIP' / (Organization) OBX-23, PRT-8:PRT-4='PO'
   value[x]OBX.2, OBX.5, OBX.6
   dataAbsentReasonN/A
   interpretationOBX-8
   noteNTE.3 (partner NTE to OBX, or sometimes another (child?) OBX)
   bodySiteOBX-20
   methodOBX-17
   specimenSPM segment
   deviceOBX-17 / PRT -10
   referenceRangeOBX.7
      id
      extension
      modifierExtension
      lowOBX-7
      highOBX-7
      typeOBX-10
      appliesToOBX-10
      age
      textOBX-7
   hasMemberRelationships established by OBX-4 usage
   derivedFromRelationships established by OBX-4 usage
   componentcontainment by OBX-4?
      id
      extension
      modifierExtension
      codeOBX-3
      value[x]OBX.2, OBX.5, OBX.6
      dataAbsentReasonN/A
      interpretationOBX-8
      referenceRangeOBX.7

10.1.14.22 RIM Mapping (http://hl7.org/v3)

observation-vitalsigns
ObservationEntity. Role, or Act
   id
   meta
   implicitRules
   language
   textAct.text?
   containedN/A
   extensionN/A
   modifierExtensionN/A
   identifierid
   basedOn.inboundRelationship[typeCode=COMP].source[moodCode=EVN]
   partOf.outboundRelationship[typeCode=FLFS].target
   statusstatus Amended & Final are differentiated by whether it is the subject of a ControlAct event with a type of "revise"
   category.outboundRelationship[typeCode="COMP].target[classCode="LIST", moodCode="EVN"].code
   categoryVSCat.outboundRelationship[typeCode="COMP].target[classCode="LIST", moodCode="EVN"].code
      idn/a
      extensionn/a
      codingunion(., ./translation)
         idn/a
         extensionn/a
         system./codeSystem
         version./codeSystemVersion
         code./code
         displayCV.displayName
         userSelectedCD.codingRationale
      text./originalText[mediaType/code="text/plain"]/data
   codecode
   subjectparticipation[typeCode=RTGT]
   focusparticipation[typeCode=SBJ]
   encounterinboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN]
   effective[x]effectiveTime
   issuedparticipation[typeCode=AUT].time
   performerparticipation[typeCode=PRF]
   value[x]value
   dataAbsentReasonvalue.nullFlavor
   interpretationinterpretationCode
   notesubjectOf.observationEvent[code="annotation"].value
   bodySitetargetSiteCode
   methodmethodCode
   specimenparticipation[typeCode=SPC].specimen
   deviceparticipation[typeCode=DEV]
   referenceRangeoutboundRelationship[typeCode=REFV]/target[classCode=OBS, moodCode=EVN]
      idn/a
      extensionn/a
      modifierExtensionN/A
      lowvalue:IVL_PQ.low
      highvalue:IVL_PQ.high
      typeinterpretationCode
      appliesTointerpretationCode
      ageoutboundRelationship[typeCode=PRCN].targetObservationCriterion[code="age"].value
      textvalue:ST
   hasMemberoutBoundRelationship
   derivedFrom.targetObservation
   componentoutBoundRelationship[typeCode=COMP]
      idn/a
      extensionn/a
      modifierExtensionN/A
      codecode
      value[x]value
      dataAbsentReasonvalue.nullFlavor
      interpretationinterpretationCode
      referenceRangeoutboundRelationship[typeCode=REFV]/target[classCode=OBS, moodCode=EVN]

10.1.14.23 FiveWs Pattern Mapping (http://hl7.org/fhir/fivews)

observation-vitalsigns
Observationclinical.diagnostics
   id
   meta
   implicitRules
   language
   text
   contained
   extension
   modifierExtension
   identifierFiveWs.identifier
   basedOn
   partOf
   statusFiveWs.status
   categoryFiveWs.class
   categoryVSCatFiveWs.class
      id
      extension
      coding
         id
         extension
         system
         version
         code
         display
         userSelected
      text
   codeFiveWs.what[x]
   subjectFiveWs.subject[x]
   focusFiveWs.subject[x]
   encounterFiveWs.context
   effective[x]FiveWs.done[x]
   issuedFiveWs.recorded
   performerFiveWs.actor
   value[x]
   dataAbsentReason
   interpretation
   note
   bodySite
   method
   specimen
   device
   referenceRange
      id
      extension
      modifierExtension
      low
      high
      type
      appliesTo
      age
      text
   hasMember
   derivedFrom
   component
      id
      extension
      modifierExtension
      codeFiveWs.what[x]
      value[x]
      dataAbsentReason
      interpretation
      referenceRange

10.1.14.24 SNOMED CT Attribute Binding (http://snomed.org/attributebinding)

Attribute bindings link coded data elements in FHIR resources to a corresponding attribute in the SNOMED CT concept model. These bindings help to support:

  • clarifying the intended meaning of the data element
  • Quality checking the alignment between FHIR resource design and any coresponding SNOMED CT concept model
  • Composition and decomposition of data instances by indicating the SNOMED CT concept model attribute whose value may be used to decompose a precoordinated concept into this data element
observation-vitalsigns
Observation
   id
   meta
   implicitRules
   language
   text
   contained
   extension
   modifierExtension
   identifier
   basedOn
   partOf
   status
   category
   categoryVSCat
      id
      extension
      coding
         id
         extension
         system
         version
         code
         display
         userSelected
      text
   code116680003 |Is a|
   subject
   focus
   encounter
   effective[x]
   issued
   performer
   value[x]363714003 |Interprets|
   dataAbsentReason
   interpretation363713009 |Has interpretation|
   note
   bodySite718497002 |Inherent location|
   method
   specimen704319004 |Inherent in|
   device424226004 |Using device|
   referenceRange
      id
      extension
      modifierExtension
      low
      high
      type
      appliesTo
      age
      text
   hasMember
   derivedFrom
   component
      id
      extension
      modifierExtension
      code
      value[x]363714003 |Interprets|
      dataAbsentReason
      interpretation363713009 |Has interpretation|
      referenceRange