Blood Pressure Measurement cancelled (id = "blood-pressure-cancel")

<?xml version="1.0" encoding="UTF-8"?>

<!--  
 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


  --><Observation xmlns="http://hl7.org/fhir">
  <id value="blood-pressure-cancel"/> 
  <meta> 
    <profile value="http://hl7.org/fhir/StructureDefinition/vitalsigns"/> 
  </meta> 
  <!--    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>
  -->
  <identifier> 
    <system value="urn:ietf:rfc:3986"/> 
    <value value="urn:uuid:187e0c12-8dd2-67e2-99b2-bf273c878281"/> 
  </identifier> 
  <status value="cancelled"/> 
  <category> 
    <coding> 
      <system value="http://terminology.hl7.org/CodeSystem/observation-category"/> 
      <code value="vital-signs"/> 
      <display value="Vital Signs"/> 
    </coding> 
  </category> 
  <category> 
    <coding> 
      <system value="http://loinc.org"/> 
      <code value="85354-9"/> 
      <display value="Blood pressure panel with all children optional"/> 
    </coding> 
  </category> 
  <code> 
    <!--   replaced by 85354-9
    <coding>
      <system value="http://loinc.org"/>
      <code value="85354-9"/>
      <display value="Blood pressure systolic &amp; diastolic"/>
    </coding>
  -->
    <coding> 
      <system value="http://loinc.org"/> 
      <code value="85354-9"/> 
      <display value="Blood pressure panel with all children optional"/> 
    </coding> 
    <text value="Blood pressure systolic &amp; diastolic"/> 
  </code> 
  <subject> 
    <reference value="Patient/example"/> 
  </subject> 
  <effectiveDateTime value="2012-09-17"/> 
  <performer> 
    <reference value="Practitioner/example"/> 
  </performer> 
  <!--   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   -->
  <interpretation> 
    <coding> 
      <system value="http://terminology.hl7.org/CodeSystem/v3-ObservationInterpretation"/> 
      <code value="L"/> 
      <display value="low"/> 
    </coding> 
    <text value="Below low normal"/> 
  </interpretation> 
  <note> 
    <text value="In this example, the blood pressure measurements are not available due to cancellation
     of the order.  Data absent reason is present for each component"/> 
  </note> 
  <!--   for an observation with components, these cannot disagree with the flags on the
   components   -->
  <bodySite> 
    <coding> 
      <system value="http://snomed.info/sct"/> 
      <code value="368209003"/> 
      <display value="Right arm"/> 
    </coding> 
  </bodySite> 
  <component> 
    <extension url="http://hl7.org/fhir/StructureDefinition/observation-componentCategory">
      <valueCodeableConcept> 
        <coding> 
          <system value="http://loinc.org"/> 
          <code value="8480-6"/> 
          <display value="Systolic blood pressure"/> 
        </coding> 
      </valueCodeableConcept> 
    </extension> 
    <!--  
           Observations are often coded in multiple code systems.
           - LOINC provides a very specific code (though not usefully more specific
     in this particular case)
           - snomed provides a clinically relevant code that is usually less granular
     than LOINC
           - the source system provides its own code, which may be less or more
     granular than LOINC
   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   -->
    <code> 
      <!--   LOINC - always recommended to have a LOINC code   -->
      <coding> 
        <system value="http://loinc.org"/> 
        <code value="8480-6"/> 
        <display value="Systolic blood pressure"/> 
      </coding> 
      <!--   SNOMED CT Codes - becoming more common   -->
      <coding> 
        <system value="http://snomed.info/sct"/> 
        <code value="271649006"/> 
        <display value="Systolic blood pressure"/> 
      </coding> 
      <!--   Also, a local code specific to the source system   -->
      <coding> 
        <system value="http://acme.org/devices/clinical-codes"/> 
        <code value="bp-s"/> 
        <display value="Systolic Blood pressure"/> 
      </coding> 
    </code> 
    <!--   no value due to some error
    <valueQuantity>
      <value value="107"/>
      <unit value="mm[Hg]"/>
    </valueQuantity>
  -->
    <dataAbsentReason> 
      <coding> 
        <system value="http://terminology.hl7.org/CodeSystem/data-absent-reason"/> 
        <code value="not-asked"/> 
        <display value="Not Asked"/> 
      </coding> 
    </dataAbsentReason> 
  </component> 
  <component> 
    <extension url="http://hl7.org/fhir/StructureDefinition/observation-componentCategory">
      <valueCodeableConcept> 
        <coding> 
          <system value="http://loinc.org"/> 
          <code value="8462-4"/> 
          <display value="Diastolic blood pressure"/> 
        </coding> 
      </valueCodeableConcept> 
    </extension> 
    <code> 
      <coding> 
        <system value="http://loinc.org"/> 
        <code value="8462-4"/> 
        <display value="Diastolic blood pressure"/> 
      </coding> 
    </code> 
    <!--   no value due to some error
    <valueQuantity>
      <value value="60"/>
      <unit value="mm[Hg]"/>
    </valueQuantity>
  -->
    <dataAbsentReason> 
      <coding> 
        <system value="http://terminology.hl7.org/CodeSystem/data-absent-reason"/> 
        <code value="not-asked"/> 
        <display value="Not Asked"/> 
      </coding> 
    </dataAbsentReason> 
  </component> 
</Observation>