R6 Ballot (2nd Draft)

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Example Observation/blood-pressure-cancel (Turtle)

Orders and Observations Work GroupMaturity Level: N/AStandards Status: InformativeCompartments: Device, Encounter, Patient, Practitioner, RelatedPerson

Raw Turtle (+ also see Turtle/RDF Format Specification)

Blood Pressure Measurement cancelled

@prefix fhir: <http://hl7.org/fhir/> .
@prefix loinc: <https://loinc.org/rdf/> .
@prefix owl: <http://www.w3.org/2002/07/owl#> .
@prefix rdfs: <http://www.w3.org/2000/01/rdf-schema#> .
@prefix sct: <http://snomed.info/id/> .
@prefix xsd: <http://www.w3.org/2001/XMLSchema#> .

# - resource -------------------------------------------------------------------

#  
# This is an example of a cancelled standard blood pressure measurement. with an Observation/component/dataAbsentReason valued due to cancellation.
#
# Blood Pressure is a regarded as a single observation, and
# presented that way in plain text: 120/80. Also, it is usually
# interpreted as a single value, though intepretation can also
# be offered to the parts individually
#
# Technically, though, a blood pressure is a pair of component
# observations. LOINC code 85354-9 notes say:
#   This term is intended as a section header for various
#   blood pressure measurements (e.g. systolic, diastolic).
#   LOINC discourages the reporting of two numbers, such as
#   systolic and diastolic blood pressure (e.g. 120/80),
#   in one observation. They should be reported as two
#   separate variables, systolic (LOINC 8480-6) and
#   diastolic (LOINC 8462-4)
#
# This example shows the standard way to represent a meaurement that cause the expected values to be empty
# single resource, with a narrative in the standard form, and two
# component observations for the actual values with Observation/component/dataAbsentReason valued due to cancellation
#
#
# 

[a fhir:Observation ;
  fhir:nodeRole fhir:treeRoot ;
  fhir:id [ fhir:v "blood-pressure-cancel"] ; # 
  fhir:meta [
     fhir:profile ( [
       fhir:v "http://hl7.org/fhir/StructureDefinition/vitalsigns"^^xsd:anyURI ;
       fhir:link <http://hl7.org/fhir/StructureDefinition/vitalsigns>
     ] )
  ] ; # 
  fhir:identifier ( [
     fhir:system [ fhir:v "urn:ietf:rfc:3986"^^xsd:anyURI ] ;
     fhir:value [ fhir:v "urn:uuid:187e0c12-8dd2-67e2-99b2-bf273c878281" ]
  ] ) ; #  	EH  Narrative created by build
#	<text>
#		<status value="generated"/>
#		<div xmlns="http://www.w3.org/1999/xhtml">Sept 17, 2012: Systolic Blood pressure 107/60 mmHg (low)</div>
#	</text>
# 
  fhir:status [ fhir:v "cancelled"] ; # 
  fhir:category ( [
     fhir:coding ( [
       fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/observation-category"^^xsd:anyURI ] ;
       fhir:code [ fhir:v "vital-signs" ] ;
       fhir:display [ fhir:v "Vital Signs" ]
     ] )
  ] [
     fhir:coding ( [
       a loinc:85354-9 ;
       fhir:system [ fhir:v "http://loinc.org"^^xsd:anyURI ] ;
       fhir:code [ fhir:v "85354-9" ] ;
       fhir:display [ fhir:v "Blood pressure panel with all children optional" ]
     ] )
  ] ) ; # 
  fhir:code [
     fhir:coding ( [
       a loinc:85354-9 ;
       fhir:system [ fhir:v "http://loinc.org"^^xsd:anyURI ] ;
       fhir:code [ fhir:v "85354-9" ] ;
       fhir:display [ fhir:v "Blood pressure panel with all children optional" ]
     ] ) ; #   replaced by 85354-9\n		<coding>\n			<system value=\"http:\/\/loinc.org\"\/>\n			<code value=\"85354-9\"\/>\n			<display value=\"Blood pressure systolic &amp; diastolic\"\/>\n		<\/coding>\n 
     fhir:text [ fhir:v "Blood pressure systolic & diastolic" ]
  ] ; # 
  fhir:subject [
     fhir:reference [ fhir:v "Patient/example" ]
  ] ; # 
  fhir:effective [ fhir:v "2012-09-17"^^xsd:date] ; # 
  fhir:performer ( [
     fhir:reference [ fhir:v "Practitioner/example" ]
  ] ) ; # 
  fhir:interpretation ( [
     fhir:coding ( [
       fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/v3-ObservationInterpretation"^^xsd:anyURI ] ;
       fhir:code [ fhir:v "L" ] ;
       fhir:display [ fhir:v "low" ]
     ] ) ;
     fhir:text [ fhir:v "Below low normal" ]
  ] ) ; #   an interpretation offered to the combination observation
#        generally, it would only be appropriate to offer an interpretation
#        of an observation that has no value if it has "COMP" (component)
#        observations  
  fhir:note ( [
     fhir:text [ fhir:v "In this example, the blood pressure measurements are not available due to cancellation of the order.  Data absent reason is present for each component" ]
  ] ) ; # 
  fhir:bodySite [
     fhir:coding ( [
       a sct:368209003 ;
       fhir:system [ fhir:v "http://snomed.info/sct"^^xsd:anyURI ] ;
       fhir:code [ fhir:v "368209003" ] ;
       fhir:display [ fhir:v "Right arm" ]
     ] )
  ] ; #   for an observation with components, these cannot disagree with the flags on the components  
  fhir:component ( [
     fhir:extension ( [
       fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/observation-componentCategory"^^xsd:anyURI ] ;
       fhir:value [
         a fhir:CodeableConcept ;
         fhir:coding ( [
           a loinc:8480-6 ;
           fhir:system [ fhir:v "http://loinc.org"^^xsd:anyURI ] ;
           fhir:code [ fhir:v "8480-6" ] ;
           fhir:display [ fhir:v "Systolic blood pressure" ]
         ] )
       ]
     ] ) ;
     fhir:code [
       fhir:coding ( [
         a loinc:8480-6 ;
         fhir:system [ fhir:v "http://loinc.org"^^xsd:anyURI ] ;
         fhir:code [ fhir:v "8480-6" ] ;
         fhir:display [ fhir:v "Systolic blood pressure" ]
       ] [
         a sct:271649006 ;
         fhir:system [ fhir:v "http://snomed.info/sct"^^xsd:anyURI ] ;
         fhir:code [ fhir:v "271649006" ] ;
         fhir:display [ fhir:v "Systolic blood pressure" ]
       ] [
         fhir:system [ fhir:v "http://acme.org/devices/clinical-codes"^^xsd:anyURI ] ;
         fhir:code [ fhir:v "bp-s" ] ;
         fhir:display [ fhir:v "Systolic Blood pressure" ]
       ] ) #   LOINC - always recommended to have a LOINC code  
     ] ; #  \n           Observations are often coded in multiple code systems.\n           - LOINC provides a very specific code (though not usefully more specific in this particular case)\n           - snomed provides a clinically relevant code that is usually less granular than LOINC\n           - the source system provides its own code, which may be less or more granular than LOINC\n	 this instance shows the concept. The other codes only have a LOINC code  ,   that shows the concept. The next two names only have a LOINC code  
     fhir:dataAbsentReason [
       fhir:coding ( [
         fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/data-absent-reason"^^xsd:anyURI ] ;
         fhir:code [ fhir:v "not-asked" ] ;
         fhir:display [ fhir:v "Not Asked" ]
       ] )
     ] #   no value due to some error\n    <valueQuantity>\n      <value value=\"107\"\/>\n      <unit value=\"mm[Hg]\"\/>\n    <\/valueQuantity>\n 
  ] [
     fhir:extension ( [
       fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/observation-componentCategory"^^xsd:anyURI ] ;
       fhir:value [
         a fhir:CodeableConcept ;
         fhir:coding ( [
           a loinc:8462-4 ;
           fhir:system [ fhir:v "http://loinc.org"^^xsd:anyURI ] ;
           fhir:code [ fhir:v "8462-4" ] ;
           fhir:display [ fhir:v "Diastolic blood pressure" ]
         ] )
       ]
     ] ) ;
     fhir:code [
       fhir:coding ( [
         a loinc:8462-4 ;
         fhir:system [ fhir:v "http://loinc.org"^^xsd:anyURI ] ;
         fhir:code [ fhir:v "8462-4" ] ;
         fhir:display [ fhir:v "Diastolic blood pressure" ]
       ] )
     ] ;
     fhir:dataAbsentReason [
       fhir:coding ( [
         fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/data-absent-reason"^^xsd:anyURI ] ;
         fhir:code [ fhir:v "not-asked" ] ;
         fhir:display [ fhir:v "Not Asked" ]
       ] )
     ] #   no value due to some error\n    <valueQuantity>\n      <value value=\"60\"\/>\n      <unit value=\"mm[Hg]\"\/>\n    <\/valueQuantity>\n 
  ] )] . # 

# -------------------------------------------------------------------------------------


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.