R5 Final QA
DiagnosticsThis page is part of the FHIR Specification (v5.0.0-draft-final: Final QA Preview for R5 - 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
| 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 5 minute Apgar score with individual score as components
{
"resourceType" : "Observation",
"id" : "5minute-apgar-score",
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Observation</b><a name=\"5minute-apgar-score\"> </a></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Resource Observation "5minute-apgar-score" </p></div><p><b>status</b>: final</p><p><b>category</b>: Survey <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/4.0.0/CodeSystem-observation-category.html\">Observation Category Codes</a>#survey)</span></p><p><b>code</b>: 5 minute Apgar Score <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://loinc.org/\">LOINC</a>#9274-2; <a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#169909004 "Apgar at 5 minutes")</span></p><p><b>subject</b>: <a name=\"newborn\"> </a></p><blockquote><p style=\"border: 1px #661aff solid; background-color: #e6e6ff; padding: 10px;\"><b>Peter James Chalmers </b> male, DoB: 2016-05-18 ( id: 12345)</p><hr/><table class=\"grid\"><tr><td style=\"background-color: #f3f5da\" title=\"Record is active\">Active:</td><td colspan=\"3\">true</td></tr></table></blockquote><p><b>effective</b>: 2016-05-18T22:33:22Z</p><p><b>performer</b>: <a href=\"practitioner-example.html\">Practitioner/example</a> "Adam CAREFUL"</p><p><b>value</b>: 10 {score}<span style=\"background: LightGoldenRodYellow\"> (Details: UCUM code {score} = '{score}')</span></p><blockquote><p><b>component</b></p><p><b>code</b>: Apgar color score <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://loinc.org/\">LOINC</a>#32411-1 "5 minute Apgar Color"; <a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#249227004)</span></p><p><b>value</b>: 2. Good color all over <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://loinc.org/\">LOINC</a>#LA6724-4 "Good color all over"; apgarcolor#2)</span></p></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: Apgar respiratory effort score <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://loinc.org/\">LOINC</a>#32412-9 "5 minute Apgar Heart Rate"; <a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#249223000 "Apgar heart rate score")</span></p><p><b>value</b>: 2. At least 100 beats per minute <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://loinc.org/\">LOINC</a>#LA6718-6 "At least 100 beats per minute"; apgarheartrate#2)</span></p></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: Apgar response to stimulus score <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://loinc.org/\">LOINC</a>#32414-5 "5 minute Apgar Reflex Irritability"; <a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#249226008)</span></p><p><b>value</b>: 2. Grimace and pulling away, cough, or sneeze during suctioning <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://loinc.org/\">LOINC</a>#LA6721-0 "Grimace and pulling away, cough, or sneeze during suctioning"; apgarreflexirritability#2)</span></p></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: Apgar muscle tone score <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://loinc.org/\">LOINC</a>#32413-7 "5 minute Apgar Muscle Tone"; <a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#249225007)</span></p><p><b>value</b>: 2. Active motion <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://loinc.org/\">LOINC</a>#LA6715-2 "Active motion"; apgarmuscletone#2)</span></p></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: Apgar respiratory effort score <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://loinc.org/\">LOINC</a>#32415-2 "5 minute Apgar Respiratory effort"; <a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#249224006)</span></p><p><b>value</b>: 2. Good, strong cry; normal rate and effort of breathing <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://loinc.org/\">LOINC</a>#LA6727-7 "Good, strong cry; normal rate and effort of breathing"; apgarrespiratoryeffort#2)</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" : "9274-2",
"display" : "5 minute Apgar Score"
},
{
"system" : "http://snomed.info/sct",
"code" : "169909004",
"display" : "Apgar at 5 minutes"
}],
"text" : "5 minute Apgar Score"
},
"subject" : {
"reference" : "#newborn"
},
"effectiveDateTime" : "2016-05-18T22:33:22Z",
"performer" : [{
"reference" : "Practitioner/example"
}],
"valueQuantity" : {
"value" : 10,
"system" : "http://unitsofmeasure.org",
"code" : "{score}"
},
"component" : [{
"code" : {
"coding" : [{
"system" : "http://loinc.org",
"code" : "32411-1",
"display" : "5 minute Apgar Color"
},
{
"system" : "http://snomed.info/sct",
"code" : "249227004",
"display" : "Apgar color score"
}],
"text" : "Apgar color score"
},
"valueCodeableConcept" : {
"coding" : [{
"extension" : [{
"url" : "http://hl7.org/fhir/StructureDefinition/itemWeight",
"valueDecimal" : 2
}],
"system" : "http://loinc.org",
"code" : "LA6724-4",
"display" : "Good color all over"
},
{
"system" : "http://acme.ped/apgarcolor",
"code" : "2"
}],
"text" : "2. Good color all over"
}
},
{
"code" : {
"coding" : [{
"system" : "http://loinc.org",
"code" : "32412-9",
"display" : "5 minute Apgar Heart Rate"
},
{
"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/itemWeight",
"valueDecimal" : 2
}],
"system" : "http://loinc.org",
"code" : "LA6718-6",
"display" : "At least 100 beats per minute"
},
{
"system" : "http://acme.ped/apgarheartrate",
"code" : "2"
}],
"text" : "2. At least 100 beats per minute"
}
},
{
"code" : {
"coding" : [{
"system" : "http://loinc.org",
"code" : "32414-5",
"display" : "5 minute Apgar Reflex Irritability"
},
{
"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/itemWeight",
"valueDecimal" : 2
}],
"system" : "http://loinc.org",
"code" : "LA6721-0",
"display" : "Grimace and pulling away, cough, or sneeze during suctioning"
},
{
"system" : "http://acme.ped/apgarreflexirritability",
"code" : "2"
}],
"text" : "2. Grimace and pulling away, cough, or sneeze during suctioning"
}
},
{
"code" : {
"coding" : [{
"system" : "http://loinc.org",
"code" : "32413-7",
"display" : "5 minute Apgar Muscle Tone"
},
{
"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/itemWeight",
"valueDecimal" : 2
}],
"system" : "http://loinc.org",
"code" : "LA6715-2",
"display" : "Active motion"
},
{
"system" : "http://acme.ped/apgarmuscletone",
"code" : "2"
}],
"text" : "2. Active motion"
}
},
{
"code" : {
"coding" : [{
"system" : "http://loinc.org",
"code" : "32415-2",
"display" : "5 minute Apgar Respiratory effort"
},
{
"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/itemWeight",
"valueDecimal" : 2
}],
"system" : "http://loinc.org",
"code" : "LA6727-7",
"display" : "Good, strong cry; normal rate and effort of breathing"
},
{
"system" : "http://acme.ped/apgarrespiratoryeffort",
"code" : "2"
}],
"text" : "2. Good, strong cry; normal rate and effort of 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.
FHIR ®© HL7.org 2011+. FHIR R5 hl7.fhir.core#5.0.0-draft-final generated on Wed, Mar 1, 2023 23:07+1100.
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