Release 4

This page is part of the FHIR Specification (v4.0.1: R4 - Mixed Normative and STU) in it's permanent home (it will always be available at this URL). 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: 5Trial Use Use Context: Any

The official URL for this profile is:

http://hl7.org/fhir/StructureDefinition/bp

FHIR Blood Pressure Profile

This profile was published on Sat, Aug 11, 2018 00:00+1000 as a draft by Health Level Seven International (Orders and Observations Workgroup).

Description of Profiles, Differentials, Snapshots, and how the XML and JSON presentations work.

This structure is derived from observation-vitalsigns.

Summary

  1. One code in Observation.code which must have
    • a fixed Observation.code.coding.system='http ://loinc.org'
    • a fixed Observation.code.coding.code= 85354-9'
    • Other additional Codings are allowed in Observation.code- e.g. more specific LOINC Codes, SNOMED CT concepts, system specific codes. All codes SHALL have an system value
  2. One Observation.component.code which must have
    • a fixed Observation.component.code.coding.system='http://loinc.org'
    • fixed Observation.component.code.coding.code= '8480-6'
    • Other additional Codings are allowed in Observation.code- e.g. more specific LOINC Codes, SNOMED CT concepts, system specific codes. All codes SHALL have an system value
  3. One Observation.component.code which must have
    • a fixed Observation.component.code.coding.system='http://loinc.org'
    • fixed Observation.component.code.coding.code= '8462-4'
    • Other additional Codings are allowed in Observation.code- e.g. more specific LOINC Codes, SNOMED CT concepts, system specific codes. All codes SHALL have an system value
  4. Either one Observation.valueQuantity or, if there is no value, one code in Observation.DataAbsentReason
    • Each Observation.valueQuantity must have:
      • One numeric value in Observation.valueQuantity.value
      • a fixed Observation.valueQuantity.system="http://unitsofmeasure.org"
      • a UCUM unit code in Observation.valueQuantity.code = 'mm[Hg]'

Mandatory: 11 elements (+8 nested mandatory elements)
Must-Support: 8 elements
Fixed Value: 10 elements
Prohibited: 1 element

Slices

This structure defines the following Slices:

  • The element Observation.code.coding is sliced based on the values of value:code, value:system
  • The element Observation.component is sliced based on the values of value:code.coding.code, value:code.coding.system
  • The element Observation.component.code.coding is sliced based on the values of value:code, value:system

This structure is derived from observation-vitalsigns.

NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation 0..*FHIR Blood Pressure Profile
... code 1..1CodeableConceptBlood Pressure
.... coding (Slice Definition)Slice: Unordered, Open by value:code, value:system
..... coding:BPCode 1..1Coding
...... system 1..1uriFixed Value: http://loinc.org
...... code 1..1codeFixed Value: 85354-9
... valueQuantity 0..0
... component (Slice Definition)Slice: Unordered, Open by value:code.coding.code, value:code.coding.system
.... component:SystolicBP 1..1BackboneElement
..... code 1..1CodeableConcept
...... coding (Slice Definition)Systolic Blood Pressure
Slice: Unordered, Open by value:code, value:system
....... coding:SBPCode 1..1CodingSystolic Blood Pressure
........ system 1..1uriFixed Value: http://loinc.org
........ code 1..1codeFixed Value: 8480-6
..... valueQuantity 0..1Quantity
...... value S1..1decimal
...... unit S1..1string
...... system S1..1uriFixed Value: http://unitsofmeasure.org
...... code S1..1codeCoded responses from the common UCUM units for vital signs value set.
Fixed Value: mm[Hg]
.... component:DiastolicBP 1..1BackboneElement
..... code 1..1CodeableConcept
...... coding (Slice Definition)Diastolic Blood Pressure
Slice: Unordered, Open by value:code, value:system
....... coding:DBPCode 1..1CodingDiastolic Blood Pressure
........ system 1..1uriFixed Value: http://loinc.org
........ code 1..1codeFixed Value: 8462-4
..... valueQuantity 0..1Quantity
...... value S1..1decimal
...... unit S1..1string
...... system S1..1uriFixed Value: http://unitsofmeasure.org
...... code S1..1codeCoded responses from the common UCUM units for vital signs value set.
Fixed Value: mm[Hg]

doco Documentation for this format
NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation I0..*FHIR Blood Pressure Profile
... id Σ0..1stringLogical id of this artifact
... meta ΣI0..1MetaMetadata about the resource
... implicitRules ?!ΣI0..1uriA set of rules under which this content was created
... language I0..1codeLanguage of the resource content
Binding: Common Languages (preferred)
Max Binding: All Languages
... text I0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... extension I0..*ExtensionAdditional content defined by implementations
... modifierExtension ?!I0..*ExtensionExtensions that cannot be ignored
... identifier ΣI0..*IdentifierBusiness Identifier for observation
... basedOn ΣI0..*Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest)Fulfills plan, proposal or order
... partOf ΣI0..*Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy)Part of referenced event
... status ?!SΣI1..1coderegistered | preliminary | final | amended +
Binding: ObservationStatus (required)
... category SI(Slice Definition)Classification of type of observation
Slice: Unordered, Open by value:coding.code, value:coding.system
Binding: Observation Category Codes (preferred)
.... category:VSCat SI1..1CodeableConceptClassification of type of observation
Binding: Observation Category Codes (preferred)
..... id 0..1stringUnique id for inter-element referencing
..... extension I0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
..... coding SΣI1..*CodingCode defined by a terminology system
...... id 0..1stringUnique id for inter-element referencing
...... extension I0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
...... system SΣI1..1uriIdentity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category
...... version ΣI0..1stringVersion of the system - if relevant
...... code SΣI1..1codeSymbol in syntax defined by the system
Fixed Value: vital-signs
...... display ΣI0..1stringRepresentation defined by the system
...... userSelected ΣI0..1booleanIf this coding was chosen directly by the user
..... text ΣI0..1stringPlain text representation of the concept
... code SΣI1..1CodeableConceptBlood Pressure
Binding: Vital Signs (extensible)
.... id 0..1stringUnique id for inter-element referencing
.... extension I0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
.... coding ΣI(Slice Definition)Code defined by a terminology system
Slice: Unordered, Open by value:code, value:system
..... coding:BPCode ΣI1..1CodingCode defined by a terminology system
...... id 0..1stringUnique id for inter-element referencing
...... extension I0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
...... system ΣI1..1uriIdentity of the terminology system
Fixed Value: http://loinc.org
...... version ΣI0..1stringVersion of the system - if relevant
...... code ΣI1..1codeSymbol in syntax defined by the system
Fixed Value: 85354-9
...... display ΣI0..1stringRepresentation defined by the system
...... userSelected ΣI0..1booleanIf this coding was chosen directly by the user
.... text ΣI0..1stringPlain text representation of the concept
... subject SΣI1..1Reference(Patient)Who and/or what the observation is about
... focus ΣI0..*Reference(Resource)What the observation is about, when it is not about the subject of record
... encounter ΣI0..1Reference(Encounter)Healthcare event during which this observation is made
... effective[x] SΣI1..1Often just a dateTime for Vital Signs
vs-1: if Observation.effective[x] is dateTime and has a value then that value shall be precise to the day
.... effectiveDateTimedateTime
.... effectivePeriodPeriod
... issued ΣI0..1instantDate/Time this version was made available
... performer ΣI0..*Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson)Who is responsible for the observation
... value[x] SΣI(Slice Definition)Vital Signs value are recorded using the Quantity data type. For supporting observations such as Cuff size could use other datatypes such as CodeableConcept.
Slice: Unordered, Closed by type:$this
... dataAbsentReason SI0..1CodeableConceptWhy the result is missing
Binding: DataAbsentReason (extensible)
... interpretation I0..*CodeableConceptHigh, low, normal, etc.
Binding: Observation Interpretation Codes (extensible)
... note I0..*AnnotationComments about the observation
... bodySite I0..1CodeableConceptObserved body part
Binding: SNOMED CT Body Structures (example)
... method I0..1CodeableConceptHow it was done
Binding: Observation Methods (example)
... specimen I0..1Reference(Specimen)Specimen used for this observation
... device I0..1Reference(Device | DeviceMetric)(Measurement) Device
... referenceRange I0..*BackboneElementProvides guide for interpretation
obs-3: Must have at least a low or a high or text
.... id 0..1stringUnique id for inter-element referencing
.... extension I0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!ΣI0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... low I0..1SimpleQuantityLow Range, if relevant
.... high I0..1SimpleQuantityHigh Range, if relevant
.... type I0..1CodeableConceptReference range qualifier
Binding: Observation Reference Range Meaning Codes (preferred)
.... appliesTo I0..*CodeableConceptReference range population
Binding: Observation Reference Range Applies To Codes (example)
.... age I0..1RangeApplicable age range, if relevant
.... text I0..1stringText based reference range in an observation
... hasMember ΣI0..*Reference(QuestionnaireResponse | MolecularSequence | Vital Signs Profile)Used when reporting vital signs panel components
... derivedFrom ΣI0..*Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | MolecularSequence | Vital Signs Profile)Related measurements the observation is made from
... component SΣI(Slice Definition)Used when reporting systolic and diastolic blood pressure.
Slice: Unordered, Open by value:code.coding.code, value:code.coding.system
.... (All Slices) Content/Rules for all slices
..... id 0..1stringUnique id for inter-element referencing
..... extension I0..*ExtensionAdditional content defined by implementations
..... modifierExtension ?!ΣI0..*ExtensionExtensions that cannot be ignored even if unrecognized
..... code SΣI1..1CodeableConceptType of component observation (code / type)
Binding: Vital Signs (extensible)
..... value[x] SΣI0..1Vital Sign Value recorded with UCUM
Binding: Vital Signs Units (required)
...... valueQuantityQuantity
...... valueCodeableConceptCodeableConcept
...... valueStringstring
...... valueBooleanboolean
...... valueIntegerinteger
...... valueRangeRange
...... valueRatioRatio
...... valueSampledDataSampledData
...... valueTimetime
...... valueDateTimedateTime
...... valuePeriodPeriod
..... dataAbsentReason SI0..1CodeableConceptWhy the component result is missing
Binding: DataAbsentReason (extensible)
..... interpretation I0..*CodeableConceptHigh, low, normal, etc.
Binding: Observation Interpretation Codes (extensible)
..... referenceRange I0..*Unknown reference to #Observation.referenceRange
Provides guide for interpretation of component result
.... component:SystolicBP SΣI1..1BackboneElementUsed when reporting systolic and diastolic blood pressure.
..... id 0..1stringUnique id for inter-element referencing
..... extension I0..*ExtensionAdditional content defined by implementations
..... modifierExtension ?!ΣI0..*ExtensionExtensions that cannot be ignored even if unrecognized
..... code SΣI1..1CodeableConceptType of component observation (code / type)
Binding: Vital Signs (extensible)
...... id 0..1stringUnique id for inter-element referencing
...... extension I0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
...... coding ΣI(Slice Definition)Systolic Blood Pressure
Slice: Unordered, Open by value:code, value:system
....... coding:SBPCode ΣI1..1CodingSystolic Blood Pressure
........ id 0..1stringUnique id for inter-element referencing
........ extension I0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
........ system ΣI1..1uriIdentity of the terminology system
Fixed Value: http://loinc.org
........ version ΣI0..1stringVersion of the system - if relevant
........ code ΣI1..1codeSymbol in syntax defined by the system
Fixed Value: 8480-6
........ display ΣI0..1stringRepresentation defined by the system
........ userSelected ΣI0..1booleanIf this coding was chosen directly by the user
...... text ΣI0..1stringPlain text representation of the concept
..... value[x] SΣI0..1QuantityVital Sign Value recorded with UCUM
Binding: Vital Signs Units (required)
...... id 0..1stringUnique id for inter-element referencing
...... extension I0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
...... value SΣI1..1decimalNumerical value (with implicit precision)
...... comparator ?!ΣI0..1code< | <= | >= | > - how to understand the value
Binding: QuantityComparator (required)
...... unit SΣI1..1stringUnit representation
...... system SΣI1..1uriSystem that defines coded unit form
Fixed Value: http://unitsofmeasure.org
...... code SΣI1..1codeCoded responses from the common UCUM units for vital signs value set.
Fixed Value: mm[Hg]
..... dataAbsentReason SI0..1CodeableConceptWhy the component result is missing
Binding: DataAbsentReason (extensible)
..... interpretation I0..*CodeableConceptHigh, low, normal, etc.
Binding: Observation Interpretation Codes (extensible)
..... referenceRange I0..*Unknown reference to #Observation.referenceRange
Provides guide for interpretation of component result
.... component:DiastolicBP SΣI1..1BackboneElementUsed when reporting systolic and diastolic blood pressure.
..... id 0..1stringUnique id for inter-element referencing
..... extension I0..*ExtensionAdditional content defined by implementations
..... modifierExtension ?!ΣI0..*ExtensionExtensions that cannot be ignored even if unrecognized
..... code SΣI1..1CodeableConceptType of component observation (code / type)
Binding: Vital Signs (extensible)
...... id 0..1stringUnique id for inter-element referencing
...... extension I0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
...... coding ΣI(Slice Definition)Diastolic Blood Pressure
Slice: Unordered, Open by value:code, value:system
....... coding:DBPCode ΣI1..1CodingDiastolic Blood Pressure
........ id 0..1stringUnique id for inter-element referencing
........ extension I0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
........ system ΣI1..1uriIdentity of the terminology system
Fixed Value: http://loinc.org
........ version ΣI0..1stringVersion of the system - if relevant
........ code ΣI1..1codeSymbol in syntax defined by the system
Fixed Value: 8462-4
........ display ΣI0..1stringRepresentation defined by the system
........ userSelected ΣI0..1booleanIf this coding was chosen directly by the user
...... text ΣI0..1stringPlain text representation of the concept
..... value[x] SΣI0..1QuantityVital Sign Value recorded with UCUM
Binding: Vital Signs Units (required)
...... id 0..1stringUnique id for inter-element referencing
...... extension I0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
...... value SΣI1..1decimalNumerical value (with implicit precision)
...... comparator ?!ΣI0..1code< | <= | >= | > - how to understand the value
Binding: QuantityComparator (required)
...... unit SΣI1..1stringUnit representation
...... system SΣI1..1uriSystem that defines coded unit form
Fixed Value: http://unitsofmeasure.org
...... code SΣI1..1codeCoded responses from the common UCUM units for vital signs value set.
Fixed Value: mm[Hg]
..... dataAbsentReason SI0..1CodeableConceptWhy the component result is missing
Binding: DataAbsentReason (extensible)
..... interpretation I0..*CodeableConceptHigh, low, normal, etc.
Binding: Observation Interpretation Codes (extensible)
..... referenceRange I0..*Unknown reference to #Observation.referenceRange
Provides guide for interpretation of component result

doco Documentation for this format
<!-- observation-bp -->doco

<Observation xmlns="http://hl7.org/fhir"
>
  <!-- from Element: extension -->
 <id><!-- 0..1 string Logical id of this artifact --></id>
 <meta><!-- ?? 0..1 Meta Metadata about the resource --></meta>
 <implicitRules value="[uri]"/><!-- ?? 0..1 A set of rules under which this content was created -->
 <language value="[code]"/><!-- ?? 0..1 Language of the resource content   -->
 <text><!-- ?? 0..1 Narrative 
     Text summary of the resource, for human interpretation --></text>
 <contained><!-- 0..* Resource Contained, inline Resources --></contained>
 <modifierExtension><!-- ?? 0..* Extension  Extensions that cannot be ignored  --></modifierExtension>
 <identifier><!-- ?? 0..* Identifier 
     Business Identifier for observation --></identifier>
 <basedOn><!-- ?? 0..* Reference(CarePlan) Fulfills plan, proposal or order --></basedOn>
 <partOf><!-- ?? 0..* Reference(MedicationAdministration) Part of referenced event --></partOf>
 <status value="[code]"/><!-- ?? 1..1 registered | preliminary | final | amended +   -->
 <-- category sliced by value:coding.code, value:coding.system  in the specified orderOpen-->
 <category> ?? 1..1 CodeableConcept  <!-- ?? 1..1 Classification of  type of observation -->
  <coding> ?? 1..* Coding  <!-- ?? 1..* Code defined by a terminology system -->
   <system value="[uri]"/><!-- ?? 1..1 Identity of the terminology system -->
   <version value="[string]"/><!-- ?? 0..1 Version of the system - if relevant -->
   <code value="[code]"/><!-- ?? 1..1 Symbol in syntax defined by the system -->
   <display value="[string]"/><!-- ?? 0..1 Representation defined by the system -->
   <userSelected value="[boolean]"/><!-- ?? 0..1 If this coding was chosen directly by the user -->
  </coding>
  <text value="[string]"/><!-- ?? 0..1 Plain text representation of the concept -->
 </category>
 <code> ?? 1..1 CodeableConcept  <!-- ?? 1..1 Blood Pressure -->
  <-- coding sliced by value:code, value:system  in the specified orderOpen-->
  <coding> ?? 1..1 Coding  <!-- ?? 1..1 Code defined by a terminology system -->
   <system value="[uri]"/><!-- ?? 1..1 Identity of the terminology system -->
   <version value="[string]"/><!-- ?? 0..1 Version of the system - if relevant -->
   <code value="[code]"/><!-- ?? 1..1 Symbol in syntax defined by the system -->
   <display value="[string]"/><!-- ?? 0..1 Representation defined by the system -->
   <userSelected value="[boolean]"/><!-- ?? 0..1 If this coding was chosen directly by the user -->
  </coding>
  <text value="[string]"/><!-- ?? 0..1 Plain text representation of the concept -->
 </code>
 <subject><!-- ?? 1..1 Reference(Patient) 
     Who and/or what the observation is about --></subject>
 <focus><!-- ?? 0..* Reference(Resource) 
     What the observation is about, when it is not about the subject of record --></focus>
 <encounter><!-- ?? 0..1 Reference(Encounter) 
     Healthcare event during which this observation is made --></encounter>
 <effective[x]><!-- ?? 1..1 dateTime|Period 
     Often just a dateTime for Vital Signs --></effective[x]>
 <issued value="[instant]"/><!-- ?? 0..1 Date/Time this version was made available -->
 <performer><!-- ?? 0..* Reference(Practitioner) 
     Who is responsible for the observation --></performer>
 <-- valueQuantity sliced by type:$this  in the specified orderClosed-->
 <valueQuantity><!-- ?? 0..0 Quantity 
     Vital Signs value are recorded using the Quantity data type. For supporting observations such as Cuff size could use other datatypes such as CodeableConcept. --></valueQuantity>
 <dataAbsentReason><!-- ?? 0..1 CodeableConcept Why the result is missing   --></dataAbsentReason>
 <interpretation><!-- ?? 0..* CodeableConcept High, low, normal, etc.   --></interpretation>
 <note><!-- ?? 0..* Annotation Comments about the observation --></note>
 <bodySite><!-- ?? 0..1 CodeableConcept Observed body part   --></bodySite>
 <method><!-- ?? 0..1 CodeableConcept How it was done   --></method>
 <specimen><!-- ?? 0..1 Reference(Specimen) Specimen used for this observation --></specimen>
 <device><!-- ?? 0..1 Reference(Device) (Measurement) Device --></device>
 <referenceRange> ?? 0..* BackboneElement  <!-- ?? 0..* Provides guide for interpretation -->
  <modifierExtension><!-- ?? 0..* Extension  Extensions that cannot be ignored even if unrecognized  --></modifierExtension>
  <low><!-- ?? 0..1 Quantity 
      Low Range, if relevant --></low>
  <high><!-- ?? 0..1 Quantity 
      High Range, if relevant --></high>
  <type><!-- ?? 0..1 CodeableConcept Reference range qualifier   --></type>
  <appliesTo><!-- ?? 0..* CodeableConcept Reference range population   --></appliesTo>
  <age><!-- ?? 0..1 Range 
      Applicable age range, if relevant --></age>
  <text value="[string]"/><!-- ?? 0..1 Text based reference range in an observation -->
 </referenceRange>
 <hasMember><!-- ?? 0..* Reference(QuestionnaireResponse) 
     Used when reporting vital signs panel components --></hasMember>
 <derivedFrom><!-- ?? 0..* Reference(DocumentReference) 
     Related measurements the observation is made from --></derivedFrom>
 <-- component sliced by value:code.coding.code, value:code.coding.system  in the specified orderOpen-->
 <component> ?? 1..1 BackboneElement  <!-- ?? 1..1 Used when reporting systolic and diastolic blood pressure. -->
  <modifierExtension><!-- ?? 0..* Extension  Extensions that cannot be ignored even if unrecognized  --></modifierExtension>
  <code> ?? 1..1 CodeableConcept  <!-- ?? 1..1 Type of component observation (code / type) -->
   <-- coding sliced by value:code, value:system  in the specified orderOpen-->
   <coding> ?? 1..1 Coding  <!-- ?? 1..1 Systolic Blood Pressure -->
    <system value="[uri]"/><!-- ?? 1..1 Identity of the terminology system -->
    <version value="[string]"/><!-- ?? 0..1 Version of the system - if relevant -->
    <code value="[code]"/><!-- ?? 1..1 Symbol in syntax defined by the system -->
    <display value="[string]"/><!-- ?? 0..1 Representation defined by the system -->
    <userSelected value="[boolean]"/><!-- ?? 0..1 If this coding was chosen directly by the user -->
   </coding>
   <text value="[string]"/><!-- ?? 0..1 Plain text representation of the concept -->
  </code>
  <valueQuantity> ?? 0..1 Quantity  <!-- ?? 0..1 Vital Sign Value recorded with UCUM -->
   <value value="[decimal]"/><!-- ?? 1..1 Numerical value (with implicit precision) -->
   <comparator value="[code]"/><!-- ?? 0..1 < | <= | >= | > - how to understand the value   -->
   <unit value="[string]"/><!-- ?? 1..1 Unit representation -->
   <system value="[uri]"/><!-- ?? 1..1 System that defines coded unit form -->
   <code value="[code]"/><!-- ?? 1..1 
       Coded responses from the common UCUM units for vital signs value set. -->
  </valueQuantity>
  <dataAbsentReason><!-- ?? 0..1 CodeableConcept Why the component result is missing   --></dataAbsentReason>
  <interpretation><!-- ?? 0..* CodeableConcept High, low, normal, etc.   --></interpretation>
  <referenceRange><!-- See #Observation.referenceRange  Provides guide for interpretation of component result --></referenceRange>
 </component>
 <component> ?? 1..1 BackboneElement  <!-- ?? 1..1 Used when reporting systolic and diastolic blood pressure. -->
  <modifierExtension><!-- ?? 0..* Extension  Extensions that cannot be ignored even if unrecognized  --></modifierExtension>
  <code> ?? 1..1 CodeableConcept  <!-- ?? 1..1 Type of component observation (code / type) -->
   <-- coding sliced by value:code, value:system  in the specified orderOpen-->
   <coding> ?? 1..1 Coding  <!-- ?? 1..1 Diastolic Blood Pressure -->
    <system value="[uri]"/><!-- ?? 1..1 Identity of the terminology system -->
    <version value="[string]"/><!-- ?? 0..1 Version of the system - if relevant -->
    <code value="[code]"/><!-- ?? 1..1 Symbol in syntax defined by the system -->
    <display value="[string]"/><!-- ?? 0..1 Representation defined by the system -->
    <userSelected value="[boolean]"/><!-- ?? 0..1 If this coding was chosen directly by the user -->
   </coding>
   <text value="[string]"/><!-- ?? 0..1 Plain text representation of the concept -->
  </code>
  <valueQuantity> ?? 0..1 Quantity  <!-- ?? 0..1 Vital Sign Value recorded with UCUM -->
   <value value="[decimal]"/><!-- ?? 1..1 Numerical value (with implicit precision) -->
   <comparator value="[code]"/><!-- ?? 0..1 < | <= | >= | > - how to understand the value   -->
   <unit value="[string]"/><!-- ?? 1..1 Unit representation -->
   <system value="[uri]"/><!-- ?? 1..1 System that defines coded unit form -->
   <code value="[code]"/><!-- ?? 1..1 
       Coded responses from the common UCUM units for vital signs value set. -->
  </valueQuantity>
  <dataAbsentReason><!-- ?? 0..1 CodeableConcept Why the component result is missing   --></dataAbsentReason>
  <interpretation><!-- ?? 0..* CodeableConcept High, low, normal, etc.   --></interpretation>
  <referenceRange><!-- See #Observation.referenceRange  Provides guide for interpretation of component result --></referenceRange>
 </component>
</Observation>
{ // observation-bp
  // from Element: extension
    "meta" : { Meta }, // C?Metadata about the resource
    "implicitRules" : "<uri>", // C?A set of rules under which this content was created
    "language" : "<code>", // C?Language of the resource content
    "text" : { Narrative }, // C?Text summary of the resource, for human interpretation
    "contained" : [{ Resource }], //Contained, inline Resources
    "modifierExtension" : [{ Extension }], // C?Extensions that cannot be ignored
    "identifier" : [{ Identifier }], // C?Business Identifier for observation
    "basedOn" : [{ Reference(CarePlan) }], // C?Fulfills plan, proposal or order
    "partOf" : [{ Reference(MedicationAdministration) }], // C?Part of referenced event
    "status" : "<code>", // C? R! registered | preliminary | final | amended +
    "category" : [ //  sliced by value:coding.code, value:coding.system  in the specified order, Open 
      { // Classification of  type of observation // C? R! 
        // from Element: extension
        "extension" : [ //  sliced by value:url  in the specified order, Open ]
        "coding" : [{ Coding }], // C? R! Code defined by a terminology system
        "text" : "<string>" // C?Plain text representation of the concept
      }
    ],
    "code" : { CodeableConcept }, // C? R! Blood Pressure
    "subject" : { Reference(Patient) }, // C? R! Who and/or what the observation is about
    "focus" : [{ Reference(Resource) }], // C?What the observation is about, when it is not about the subject of record
    "encounter" : { Reference(Encounter) }, // C?Healthcare event during which this observation is made
// value[x]: Often just a dateTime for Vital Signs. One of these 2:
    "effectiveDateTime" : "<dateTime>", // C? R! Often just a dateTime for Vital Signs
    "effectivePeriod" : { Period }, // C? R! Often just a dateTime for Vital Signs
    "issued" : "<instant>", // C?Date/Time this version was made available
    "performer" : [{ Reference(Practitioner) }], // C?Who is responsible for the observation
    "valueQuantity" : [ //  sliced by type:$this  in the specified order, Closed 
      { // Vital Signs value are recorded using the Quantity data type. For supporting observations such as Cuff size could use other datatypes such as CodeableConcept. // C?
        // from Element: extension
      }
    ],
    "dataAbsentReason" : { CodeableConcept }, // C?Why the result is missing
    "interpretation" : [{ CodeableConcept }], // C?High, low, normal, etc.
    "note" : [{ Annotation }], // C?Comments about the observation
    "bodySite" : { CodeableConcept }, // C?Observed body part
    "method" : { CodeableConcept }, // C?How it was done
    "specimen" : { Reference(Specimen) }, // C?Specimen used for this observation
    "device" : { Reference(Device) }, // C?(Measurement) Device
    "referenceRange" : [{ BackboneElement }], // C?Provides guide for interpretation
    "hasMember" : [{ Reference(QuestionnaireResponse) }], // C?Used when reporting vital signs panel components
    "derivedFrom" : [{ Reference(DocumentReference) }], // C?Related measurements the observation is made from
    "component" : [ //  sliced by value:code.coding.code, value:code.coding.system  in the specified order, Open 
      { // Used when reporting systolic and diastolic blood pressure. // C? R! 
        // from Element: extension
        "modifierExtension" : [{ Extension }], // C?Extensions that cannot be ignored even if unrecognized
        "code" : { CodeableConcept }, // C? R! Type of component observation (code / type)
        "valueQuantity" : { Quantity }, // C?Vital Sign Value recorded with UCUM
        "dataAbsentReason" : { CodeableConcept }, // C?Why the component result is missing
        "interpretation" : [{ CodeableConcept }], // C?High, low, normal, etc.
// value[x]: Provides guide for interpretation of component result. One of these 0:
      },
      { // Used when reporting systolic and diastolic blood pressure. // C? R! 
        // from Element: extension
        "modifierExtension" : [{ Extension }], // C?Extensions that cannot be ignored even if unrecognized
        "code" : { CodeableConcept }, // C? R! Type of component observation (code / type)
        "valueQuantity" : { Quantity }, // C?Vital Sign Value recorded with UCUM
        "dataAbsentReason" : { CodeableConcept }, // C?Why the component result is missing
        "interpretation" : [{ CodeableConcept }], // C?High, low, normal, etc.
// value[x]: Provides guide for interpretation of component result. One of these 0:
      }
    ],
  }

This structure is derived from observation-vitalsigns.

Summary

  1. One code in Observation.code which must have
    • a fixed Observation.code.coding.system='http ://loinc.org'
    • a fixed Observation.code.coding.code= 85354-9'
    • Other additional Codings are allowed in Observation.code- e.g. more specific LOINC Codes, SNOMED CT concepts, system specific codes. All codes SHALL have an system value
  2. One Observation.component.code which must have
    • a fixed Observation.component.code.coding.system='http://loinc.org'
    • fixed Observation.component.code.coding.code= '8480-6'
    • Other additional Codings are allowed in Observation.code- e.g. more specific LOINC Codes, SNOMED CT concepts, system specific codes. All codes SHALL have an system value
  3. One Observation.component.code which must have
    • a fixed Observation.component.code.coding.system='http://loinc.org'
    • fixed Observation.component.code.coding.code= '8462-4'
    • Other additional Codings are allowed in Observation.code- e.g. more specific LOINC Codes, SNOMED CT concepts, system specific codes. All codes SHALL have an system value
  4. Either one Observation.valueQuantity or, if there is no value, one code in Observation.DataAbsentReason
    • Each Observation.valueQuantity must have:
      • One numeric value in Observation.valueQuantity.value
      • a fixed Observation.valueQuantity.system="http://unitsofmeasure.org"
      • a UCUM unit code in Observation.valueQuantity.code = 'mm[Hg]'

Mandatory: 11 elements (+8 nested mandatory elements)
Must-Support: 8 elements
Fixed Value: 10 elements
Prohibited: 1 element

Slices

This structure defines the following Slices:

  • The element Observation.code.coding is sliced based on the values of value:code, value:system
  • The element Observation.component is sliced based on the values of value:code.coding.code, value:code.coding.system
  • The element Observation.component.code.coding is sliced based on the values of value:code, value:system

Differential View

This structure is derived from observation-vitalsigns.

NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation 0..*FHIR Blood Pressure Profile
... code 1..1CodeableConceptBlood Pressure
.... coding (Slice Definition)Slice: Unordered, Open by value:code, value:system
..... coding:BPCode 1..1Coding
...... system 1..1uriFixed Value: http://loinc.org
...... code 1..1codeFixed Value: 85354-9
... valueQuantity 0..0
... component (Slice Definition)Slice: Unordered, Open by value:code.coding.code, value:code.coding.system
.... component:SystolicBP 1..1BackboneElement
..... code 1..1CodeableConcept
...... coding (Slice Definition)Systolic Blood Pressure
Slice: Unordered, Open by value:code, value:system
....... coding:SBPCode 1..1CodingSystolic Blood Pressure
........ system 1..1uriFixed Value: http://loinc.org
........ code 1..1codeFixed Value: 8480-6
..... valueQuantity 0..1Quantity
...... value S1..1decimal
...... unit S1..1string
...... system S1..1uriFixed Value: http://unitsofmeasure.org
...... code S1..1codeCoded responses from the common UCUM units for vital signs value set.
Fixed Value: mm[Hg]
.... component:DiastolicBP 1..1BackboneElement
..... code 1..1CodeableConcept
...... coding (Slice Definition)Diastolic Blood Pressure
Slice: Unordered, Open by value:code, value:system
....... coding:DBPCode 1..1CodingDiastolic Blood Pressure
........ system 1..1uriFixed Value: http://loinc.org
........ code 1..1codeFixed Value: 8462-4
..... valueQuantity 0..1Quantity
...... value S1..1decimal
...... unit S1..1string
...... system S1..1uriFixed Value: http://unitsofmeasure.org
...... code S1..1codeCoded responses from the common UCUM units for vital signs value set.
Fixed Value: mm[Hg]

doco Documentation for this format

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation I0..*FHIR Blood Pressure Profile
... id Σ0..1stringLogical id of this artifact
... meta ΣI0..1MetaMetadata about the resource
... implicitRules ?!ΣI0..1uriA set of rules under which this content was created
... language I0..1codeLanguage of the resource content
Binding: Common Languages (preferred)
Max Binding: All Languages
... text I0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... extension I0..*ExtensionAdditional content defined by implementations
... modifierExtension ?!I0..*ExtensionExtensions that cannot be ignored
... identifier ΣI0..*IdentifierBusiness Identifier for observation
... basedOn ΣI0..*Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest)Fulfills plan, proposal or order
... partOf ΣI0..*Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy)Part of referenced event
... status ?!SΣI1..1coderegistered | preliminary | final | amended +
Binding: ObservationStatus (required)
... category SI(Slice Definition)Classification of type of observation
Slice: Unordered, Open by value:coding.code, value:coding.system
Binding: Observation Category Codes (preferred)
.... category:VSCat SI1..1CodeableConceptClassification of type of observation
Binding: Observation Category Codes (preferred)
..... id 0..1stringUnique id for inter-element referencing
..... extension I0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
..... coding SΣI1..*CodingCode defined by a terminology system
...... id 0..1stringUnique id for inter-element referencing
...... extension I0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
...... system SΣI1..1uriIdentity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category
...... version ΣI0..1stringVersion of the system - if relevant
...... code SΣI1..1codeSymbol in syntax defined by the system
Fixed Value: vital-signs
...... display ΣI0..1stringRepresentation defined by the system
...... userSelected ΣI0..1booleanIf this coding was chosen directly by the user
..... text ΣI0..1stringPlain text representation of the concept
... code SΣI1..1CodeableConceptBlood Pressure
Binding: Vital Signs (extensible)
.... id 0..1stringUnique id for inter-element referencing
.... extension I0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
.... coding ΣI(Slice Definition)Code defined by a terminology system
Slice: Unordered, Open by value:code, value:system
..... coding:BPCode ΣI1..1CodingCode defined by a terminology system
...... id 0..1stringUnique id for inter-element referencing
...... extension I0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
...... system ΣI1..1uriIdentity of the terminology system
Fixed Value: http://loinc.org
...... version ΣI0..1stringVersion of the system - if relevant
...... code ΣI1..1codeSymbol in syntax defined by the system
Fixed Value: 85354-9
...... display ΣI0..1stringRepresentation defined by the system
...... userSelected ΣI0..1booleanIf this coding was chosen directly by the user
.... text ΣI0..1stringPlain text representation of the concept
... subject SΣI1..1Reference(Patient)Who and/or what the observation is about
... focus ΣI0..*Reference(Resource)What the observation is about, when it is not about the subject of record
... encounter ΣI0..1Reference(Encounter)Healthcare event during which this observation is made
... effective[x] SΣI1..1Often just a dateTime for Vital Signs
vs-1: if Observation.effective[x] is dateTime and has a value then that value shall be precise to the day
.... effectiveDateTimedateTime
.... effectivePeriodPeriod
... issued ΣI0..1instantDate/Time this version was made available
... performer ΣI0..*Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson)Who is responsible for the observation
... value[x] SΣI(Slice Definition)Vital Signs value are recorded using the Quantity data type. For supporting observations such as Cuff size could use other datatypes such as CodeableConcept.
Slice: Unordered, Closed by type:$this
... dataAbsentReason SI0..1CodeableConceptWhy the result is missing
Binding: DataAbsentReason (extensible)
... interpretation I0..*CodeableConceptHigh, low, normal, etc.
Binding: Observation Interpretation Codes (extensible)
... note I0..*AnnotationComments about the observation
... bodySite I0..1CodeableConceptObserved body part
Binding: SNOMED CT Body Structures (example)
... method I0..1CodeableConceptHow it was done
Binding: Observation Methods (example)
... specimen I0..1Reference(Specimen)Specimen used for this observation
... device I0..1Reference(Device | DeviceMetric)(Measurement) Device
... referenceRange I0..*BackboneElementProvides guide for interpretation
obs-3: Must have at least a low or a high or text
.... id 0..1stringUnique id for inter-element referencing
.... extension I0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!ΣI0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... low I0..1SimpleQuantityLow Range, if relevant
.... high I0..1SimpleQuantityHigh Range, if relevant
.... type I0..1CodeableConceptReference range qualifier
Binding: Observation Reference Range Meaning Codes (preferred)
.... appliesTo I0..*CodeableConceptReference range population
Binding: Observation Reference Range Applies To Codes (example)
.... age I0..1RangeApplicable age range, if relevant
.... text I0..1stringText based reference range in an observation
... hasMember ΣI0..*Reference(QuestionnaireResponse | MolecularSequence | Vital Signs Profile)Used when reporting vital signs panel components
... derivedFrom ΣI0..*Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | MolecularSequence | Vital Signs Profile)Related measurements the observation is made from
... component SΣI(Slice Definition)Used when reporting systolic and diastolic blood pressure.
Slice: Unordered, Open by value:code.coding.code, value:code.coding.system
.... (All Slices) Content/Rules for all slices
..... id 0..1stringUnique id for inter-element referencing
..... extension I0..*ExtensionAdditional content defined by implementations
..... modifierExtension ?!ΣI0..*ExtensionExtensions that cannot be ignored even if unrecognized
..... code SΣI1..1CodeableConceptType of component observation (code / type)
Binding: Vital Signs (extensible)
..... value[x] SΣI0..1Vital Sign Value recorded with UCUM
Binding: Vital Signs Units (required)
...... valueQuantityQuantity
...... valueCodeableConceptCodeableConcept
...... valueStringstring
...... valueBooleanboolean
...... valueIntegerinteger
...... valueRangeRange
...... valueRatioRatio
...... valueSampledDataSampledData
...... valueTimetime
...... valueDateTimedateTime
...... valuePeriodPeriod
..... dataAbsentReason SI0..1CodeableConceptWhy the component result is missing
Binding: DataAbsentReason (extensible)
..... interpretation I0..*CodeableConceptHigh, low, normal, etc.
Binding: Observation Interpretation Codes (extensible)
..... referenceRange I0..*Unknown reference to #Observation.referenceRange
Provides guide for interpretation of component result
.... component:SystolicBP SΣI1..1BackboneElementUsed when reporting systolic and diastolic blood pressure.
..... id 0..1stringUnique id for inter-element referencing
..... extension I0..*ExtensionAdditional content defined by implementations
..... modifierExtension ?!ΣI0..*ExtensionExtensions that cannot be ignored even if unrecognized
..... code SΣI1..1CodeableConceptType of component observation (code / type)
Binding: Vital Signs (extensible)
...... id 0..1stringUnique id for inter-element referencing
...... extension I0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
...... coding ΣI(Slice Definition)Systolic Blood Pressure
Slice: Unordered, Open by value:code, value:system
....... coding:SBPCode ΣI1..1CodingSystolic Blood Pressure
........ id 0..1stringUnique id for inter-element referencing
........ extension I0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
........ system ΣI1..1uriIdentity of the terminology system
Fixed Value: http://loinc.org
........ version ΣI0..1stringVersion of the system - if relevant
........ code ΣI1..1codeSymbol in syntax defined by the system
Fixed Value: 8480-6
........ display ΣI0..1stringRepresentation defined by the system
........ userSelected ΣI0..1booleanIf this coding was chosen directly by the user
...... text ΣI0..1stringPlain text representation of the concept
..... value[x] SΣI0..1QuantityVital Sign Value recorded with UCUM
Binding: Vital Signs Units (required)
...... id 0..1stringUnique id for inter-element referencing
...... extension I0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
...... value SΣI1..1decimalNumerical value (with implicit precision)
...... comparator ?!ΣI0..1code< | <= | >= | > - how to understand the value
Binding: QuantityComparator (required)
...... unit SΣI1..1stringUnit representation
...... system SΣI1..1uriSystem that defines coded unit form
Fixed Value: http://unitsofmeasure.org
...... code SΣI1..1codeCoded responses from the common UCUM units for vital signs value set.
Fixed Value: mm[Hg]
..... dataAbsentReason SI0..1CodeableConceptWhy the component result is missing
Binding: DataAbsentReason (extensible)
..... interpretation I0..*CodeableConceptHigh, low, normal, etc.
Binding: Observation Interpretation Codes (extensible)
..... referenceRange I0..*Unknown reference to #Observation.referenceRange
Provides guide for interpretation of component result
.... component:DiastolicBP SΣI1..1BackboneElementUsed when reporting systolic and diastolic blood pressure.
..... id 0..1stringUnique id for inter-element referencing
..... extension I0..*ExtensionAdditional content defined by implementations
..... modifierExtension ?!ΣI0..*ExtensionExtensions that cannot be ignored even if unrecognized
..... code SΣI1..1CodeableConceptType of component observation (code / type)
Binding: Vital Signs (extensible)
...... id 0..1stringUnique id for inter-element referencing
...... extension I0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
...... coding ΣI(Slice Definition)Diastolic Blood Pressure
Slice: Unordered, Open by value:code, value:system
....... coding:DBPCode ΣI1..1CodingDiastolic Blood Pressure
........ id 0..1stringUnique id for inter-element referencing
........ extension I0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
........ system ΣI1..1uriIdentity of the terminology system
Fixed Value: http://loinc.org
........ version ΣI0..1stringVersion of the system - if relevant
........ code ΣI1..1codeSymbol in syntax defined by the system
Fixed Value: 8462-4
........ display ΣI0..1stringRepresentation defined by the system
........ userSelected ΣI0..1booleanIf this coding was chosen directly by the user
...... text ΣI0..1stringPlain text representation of the concept
..... value[x] SΣI0..1QuantityVital Sign Value recorded with UCUM
Binding: Vital Signs Units (required)
...... id 0..1stringUnique id for inter-element referencing
...... extension I0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
...... value SΣI1..1decimalNumerical value (with implicit precision)
...... comparator ?!ΣI0..1code< | <= | >= | > - how to understand the value
Binding: QuantityComparator (required)
...... unit SΣI1..1stringUnit representation
...... system SΣI1..1uriSystem that defines coded unit form
Fixed Value: http://unitsofmeasure.org
...... code SΣI1..1codeCoded responses from the common UCUM units for vital signs value set.
Fixed Value: mm[Hg]
..... dataAbsentReason SI0..1CodeableConceptWhy the component result is missing
Binding: DataAbsentReason (extensible)
..... interpretation I0..*CodeableConceptHigh, low, normal, etc.
Binding: Observation Interpretation Codes (extensible)
..... referenceRange I0..*Unknown reference to #Observation.referenceRange
Provides guide for interpretation of component result

doco Documentation for this format

XML Template

<!-- observation-bp -->doco

<Observation xmlns="http://hl7.org/fhir"
>
  <!-- from Element: extension -->
 <id><!-- 0..1 string Logical id of this artifact --></id>
 <meta><!-- ?? 0..1 Meta Metadata about the resource --></meta>
 <implicitRules value="[uri]"/><!-- ?? 0..1 A set of rules under which this content was created -->
 <language value="[code]"/><!-- ?? 0..1 Language of the resource content   -->
 <text><!-- ?? 0..1 Narrative 
     Text summary of the resource, for human interpretation --></text>
 <contained><!-- 0..* Resource Contained, inline Resources --></contained>
 <modifierExtension><!-- ?? 0..* Extension  Extensions that cannot be ignored  --></modifierExtension>
 <identifier><!-- ?? 0..* Identifier 
     Business Identifier for observation --></identifier>
 <basedOn><!-- ?? 0..* Reference(CarePlan) Fulfills plan, proposal or order --></basedOn>
 <partOf><!-- ?? 0..* Reference(MedicationAdministration) Part of referenced event --></partOf>
 <status value="[code]"/><!-- ?? 1..1 registered | preliminary | final | amended +   -->
 <-- category sliced by value:coding.code, value:coding.system  in the specified orderOpen-->
 <category> ?? 1..1 CodeableConcept  <!-- ?? 1..1 Classification of  type of observation -->
  <coding> ?? 1..* Coding  <!-- ?? 1..* Code defined by a terminology system -->
   <system value="[uri]"/><!-- ?? 1..1 Identity of the terminology system -->
   <version value="[string]"/><!-- ?? 0..1 Version of the system - if relevant -->
   <code value="[code]"/><!-- ?? 1..1 Symbol in syntax defined by the system -->
   <display value="[string]"/><!-- ?? 0..1 Representation defined by the system -->
   <userSelected value="[boolean]"/><!-- ?? 0..1 If this coding was chosen directly by the user -->
  </coding>
  <text value="[string]"/><!-- ?? 0..1 Plain text representation of the concept -->
 </category>
 <code> ?? 1..1 CodeableConcept  <!-- ?? 1..1 Blood Pressure -->
  <-- coding sliced by value:code, value:system  in the specified orderOpen-->
  <coding> ?? 1..1 Coding  <!-- ?? 1..1 Code defined by a terminology system -->
   <system value="[uri]"/><!-- ?? 1..1 Identity of the terminology system -->
   <version value="[string]"/><!-- ?? 0..1 Version of the system - if relevant -->
   <code value="[code]"/><!-- ?? 1..1 Symbol in syntax defined by the system -->
   <display value="[string]"/><!-- ?? 0..1 Representation defined by the system -->
   <userSelected value="[boolean]"/><!-- ?? 0..1 If this coding was chosen directly by the user -->
  </coding>
  <text value="[string]"/><!-- ?? 0..1 Plain text representation of the concept -->
 </code>
 <subject><!-- ?? 1..1 Reference(Patient) 
     Who and/or what the observation is about --></subject>
 <focus><!-- ?? 0..* Reference(Resource) 
     What the observation is about, when it is not about the subject of record --></focus>
 <encounter><!-- ?? 0..1 Reference(Encounter) 
     Healthcare event during which this observation is made --></encounter>
 <effective[x]><!-- ?? 1..1 dateTime|Period 
     Often just a dateTime for Vital Signs --></effective[x]>
 <issued value="[instant]"/><!-- ?? 0..1 Date/Time this version was made available -->
 <performer><!-- ?? 0..* Reference(Practitioner) 
     Who is responsible for the observation --></performer>
 <-- valueQuantity sliced by type:$this  in the specified orderClosed-->
 <valueQuantity><!-- ?? 0..0 Quantity 
     Vital Signs value are recorded using the Quantity data type. For supporting observations such as Cuff size could use other datatypes such as CodeableConcept. --></valueQuantity>
 <dataAbsentReason><!-- ?? 0..1 CodeableConcept Why the result is missing   --></dataAbsentReason>
 <interpretation><!-- ?? 0..* CodeableConcept High, low, normal, etc.   --></interpretation>
 <note><!-- ?? 0..* Annotation Comments about the observation --></note>
 <bodySite><!-- ?? 0..1 CodeableConcept Observed body part   --></bodySite>
 <method><!-- ?? 0..1 CodeableConcept How it was done   --></method>
 <specimen><!-- ?? 0..1 Reference(Specimen) Specimen used for this observation --></specimen>
 <device><!-- ?? 0..1 Reference(Device) (Measurement) Device --></device>
 <referenceRange> ?? 0..* BackboneElement  <!-- ?? 0..* Provides guide for interpretation -->
  <modifierExtension><!-- ?? 0..* Extension  Extensions that cannot be ignored even if unrecognized  --></modifierExtension>
  <low><!-- ?? 0..1 Quantity 
      Low Range, if relevant --></low>
  <high><!-- ?? 0..1 Quantity 
      High Range, if relevant --></high>
  <type><!-- ?? 0..1 CodeableConcept Reference range qualifier   --></type>
  <appliesTo><!-- ?? 0..* CodeableConcept Reference range population   --></appliesTo>
  <age><!-- ?? 0..1 Range 
      Applicable age range, if relevant --></age>
  <text value="[string]"/><!-- ?? 0..1 Text based reference range in an observation -->
 </referenceRange>
 <hasMember><!-- ?? 0..* Reference(QuestionnaireResponse) 
     Used when reporting vital signs panel components --></hasMember>
 <derivedFrom><!-- ?? 0..* Reference(DocumentReference) 
     Related measurements the observation is made from --></derivedFrom>
 <-- component sliced by value:code.coding.code, value:code.coding.system  in the specified orderOpen-->
 <component> ?? 1..1 BackboneElement  <!-- ?? 1..1 Used when reporting systolic and diastolic blood pressure. -->
  <modifierExtension><!-- ?? 0..* Extension  Extensions that cannot be ignored even if unrecognized  --></modifierExtension>
  <code> ?? 1..1 CodeableConcept  <!-- ?? 1..1 Type of component observation (code / type) -->
   <-- coding sliced by value:code, value:system  in the specified orderOpen-->
   <coding> ?? 1..1 Coding  <!-- ?? 1..1 Systolic Blood Pressure -->
    <system value="[uri]"/><!-- ?? 1..1 Identity of the terminology system -->
    <version value="[string]"/><!-- ?? 0..1 Version of the system - if relevant -->
    <code value="[code]"/><!-- ?? 1..1 Symbol in syntax defined by the system -->
    <display value="[string]"/><!-- ?? 0..1 Representation defined by the system -->
    <userSelected value="[boolean]"/><!-- ?? 0..1 If this coding was chosen directly by the user -->
   </coding>
   <text value="[string]"/><!-- ?? 0..1 Plain text representation of the concept -->
  </code>
  <valueQuantity> ?? 0..1 Quantity  <!-- ?? 0..1 Vital Sign Value recorded with UCUM -->
   <value value="[decimal]"/><!-- ?? 1..1 Numerical value (with implicit precision) -->
   <comparator value="[code]"/><!-- ?? 0..1 < | <= | >= | > - how to understand the value   -->
   <unit value="[string]"/><!-- ?? 1..1 Unit representation -->
   <system value="[uri]"/><!-- ?? 1..1 System that defines coded unit form -->
   <code value="[code]"/><!-- ?? 1..1 
       Coded responses from the common UCUM units for vital signs value set. -->
  </valueQuantity>
  <dataAbsentReason><!-- ?? 0..1 CodeableConcept Why the component result is missing   --></dataAbsentReason>
  <interpretation><!-- ?? 0..* CodeableConcept High, low, normal, etc.   --></interpretation>
  <referenceRange><!-- See #Observation.referenceRange  Provides guide for interpretation of component result --></referenceRange>
 </component>
 <component> ?? 1..1 BackboneElement  <!-- ?? 1..1 Used when reporting systolic and diastolic blood pressure. -->
  <modifierExtension><!-- ?? 0..* Extension  Extensions that cannot be ignored even if unrecognized  --></modifierExtension>
  <code> ?? 1..1 CodeableConcept  <!-- ?? 1..1 Type of component observation (code / type) -->
   <-- coding sliced by value:code, value:system  in the specified orderOpen-->
   <coding> ?? 1..1 Coding  <!-- ?? 1..1 Diastolic Blood Pressure -->
    <system value="[uri]"/><!-- ?? 1..1 Identity of the terminology system -->
    <version value="[string]"/><!-- ?? 0..1 Version of the system - if relevant -->
    <code value="[code]"/><!-- ?? 1..1 Symbol in syntax defined by the system -->
    <display value="[string]"/><!-- ?? 0..1 Representation defined by the system -->
    <userSelected value="[boolean]"/><!-- ?? 0..1 If this coding was chosen directly by the user -->
   </coding>
   <text value="[string]"/><!-- ?? 0..1 Plain text representation of the concept -->
  </code>
  <valueQuantity> ?? 0..1 Quantity  <!-- ?? 0..1 Vital Sign Value recorded with UCUM -->
   <value value="[decimal]"/><!-- ?? 1..1 Numerical value (with implicit precision) -->
   <comparator value="[code]"/><!-- ?? 0..1 < | <= | >= | > - how to understand the value   -->
   <unit value="[string]"/><!-- ?? 1..1 Unit representation -->
   <system value="[uri]"/><!-- ?? 1..1 System that defines coded unit form -->
   <code value="[code]"/><!-- ?? 1..1 
       Coded responses from the common UCUM units for vital signs value set. -->
  </valueQuantity>
  <dataAbsentReason><!-- ?? 0..1 CodeableConcept Why the component result is missing   --></dataAbsentReason>
  <interpretation><!-- ?? 0..* CodeableConcept High, low, normal, etc.   --></interpretation>
  <referenceRange><!-- See #Observation.referenceRange  Provides guide for interpretation of component result --></referenceRange>
 </component>
</Observation>

JSON Template

{ // observation-bp
  // from Element: extension
    "meta" : { Meta }, // C?Metadata about the resource
    "implicitRules" : "<uri>", // C?A set of rules under which this content was created
    "language" : "<code>", // C?Language of the resource content
    "text" : { Narrative }, // C?Text summary of the resource, for human interpretation
    "contained" : [{ Resource }], //Contained, inline Resources
    "modifierExtension" : [{ Extension }], // C?Extensions that cannot be ignored
    "identifier" : [{ Identifier }], // C?Business Identifier for observation
    "basedOn" : [{ Reference(CarePlan) }], // C?Fulfills plan, proposal or order
    "partOf" : [{ Reference(MedicationAdministration) }], // C?Part of referenced event
    "status" : "<code>", // C? R! registered | preliminary | final | amended +
    "category" : [ //  sliced by value:coding.code, value:coding.system  in the specified order, Open 
      { // Classification of  type of observation // C? R! 
        // from Element: extension
        "extension" : [ //  sliced by value:url  in the specified order, Open ]
        "coding" : [{ Coding }], // C? R! Code defined by a terminology system
        "text" : "<string>" // C?Plain text representation of the concept
      }
    ],
    "code" : { CodeableConcept }, // C? R! Blood Pressure
    "subject" : { Reference(Patient) }, // C? R! Who and/or what the observation is about
    "focus" : [{ Reference(Resource) }], // C?What the observation is about, when it is not about the subject of record
    "encounter" : { Reference(Encounter) }, // C?Healthcare event during which this observation is made
// value[x]: Often just a dateTime for Vital Signs. One of these 2:
    "effectiveDateTime" : "<dateTime>", // C? R! Often just a dateTime for Vital Signs
    "effectivePeriod" : { Period }, // C? R! Often just a dateTime for Vital Signs
    "issued" : "<instant>", // C?Date/Time this version was made available
    "performer" : [{ Reference(Practitioner) }], // C?Who is responsible for the observation
    "valueQuantity" : [ //  sliced by type:$this  in the specified order, Closed 
      { // Vital Signs value are recorded using the Quantity data type. For supporting observations such as Cuff size could use other datatypes such as CodeableConcept. // C?
        // from Element: extension
      }
    ],
    "dataAbsentReason" : { CodeableConcept }, // C?Why the result is missing
    "interpretation" : [{ CodeableConcept }], // C?High, low, normal, etc.
    "note" : [{ Annotation }], // C?Comments about the observation
    "bodySite" : { CodeableConcept }, // C?Observed body part
    "method" : { CodeableConcept }, // C?How it was done
    "specimen" : { Reference(Specimen) }, // C?Specimen used for this observation
    "device" : { Reference(Device) }, // C?(Measurement) Device
    "referenceRange" : [{ BackboneElement }], // C?Provides guide for interpretation
    "hasMember" : [{ Reference(QuestionnaireResponse) }], // C?Used when reporting vital signs panel components
    "derivedFrom" : [{ Reference(DocumentReference) }], // C?Related measurements the observation is made from
    "component" : [ //  sliced by value:code.coding.code, value:code.coding.system  in the specified order, Open 
      { // Used when reporting systolic and diastolic blood pressure. // C? R! 
        // from Element: extension
        "modifierExtension" : [{ Extension }], // C?Extensions that cannot be ignored even if unrecognized
        "code" : { CodeableConcept }, // C? R! Type of component observation (code / type)
        "valueQuantity" : { Quantity }, // C?Vital Sign Value recorded with UCUM
        "dataAbsentReason" : { CodeableConcept }, // C?Why the component result is missing
        "interpretation" : [{ CodeableConcept }], // C?High, low, normal, etc.
// value[x]: Provides guide for interpretation of component result. One of these 0:
      },
      { // Used when reporting systolic and diastolic blood pressure. // C? R! 
        // from Element: extension
        "modifierExtension" : [{ Extension }], // C?Extensions that cannot be ignored even if unrecognized
        "code" : { CodeableConcept }, // C? R! Type of component observation (code / type)
        "valueQuantity" : { Quantity }, // C?Vital Sign Value recorded with UCUM
        "dataAbsentReason" : { CodeableConcept }, // C?Why the component result is missing
        "interpretation" : [{ CodeableConcept }], // C?High, low, normal, etc.
// value[x]: Provides guide for interpretation of component result. One of these 0:
      }
    ],
  }

 

Alternate definitions: Master Definition (XML, JSON), Schematron

PathNameConformanceValueSet
Observation.languageCommon LanguagespreferredCommon Languages
Observation.statusObservationStatusrequiredObservationStatus
Observation.categoryObservation Category CodespreferredObservation Category Codes
Observation.categoryObservation Category CodespreferredObservation Category Codes
Observation.codeVital SignsextensibleVital Signs
Observation.dataAbsentReasonDataAbsentReasonextensibleDataAbsentReason
Observation.interpretationObservation Interpretation CodesextensibleObservation Interpretation Codes
Observation.bodySiteSNOMED CT Body StructuresexampleSNOMED CT Body Structures
Observation.methodObservation MethodsexampleObservation Methods
Observation.referenceRange.typeObservation Reference Range Meaning CodespreferredObservation Reference Range Meaning Codes
Observation.referenceRange.appliesToObservation Reference Range Applies To CodesexampleObservation Reference Range Applies To Codes
Observation.component.codeVital SignsextensibleVital Signs
Observation.component.value[x]Vital Signs UnitsrequiredVital Signs Units
Observation.component.dataAbsentReasonDataAbsentReasonextensibleDataAbsentReason
Observation.component.interpretationObservation Interpretation CodesextensibleObservation Interpretation Codes
Observation.component.codeVital SignsextensibleVital Signs
Observation.component.value[x]Vital Signs UnitsrequiredVital Signs Units
Observation.component.value[x].comparatorQuantityComparatorrequiredQuantityComparator
Observation.component.dataAbsentReasonDataAbsentReasonextensibleDataAbsentReason
Observation.component.interpretationObservation Interpretation CodesextensibleObservation Interpretation Codes
Observation.component.codeVital SignsextensibleVital Signs
Observation.component.value[x]Vital Signs UnitsrequiredVital Signs Units
Observation.component.value[x].comparatorQuantityComparatorrequiredQuantityComparator
Observation.component.dataAbsentReasonDataAbsentReasonextensibleDataAbsentReason
Observation.component.interpretationObservation Interpretation CodesextensibleObservation Interpretation Codes
RuleRule
IdPathDetailsRequirements
vs-1Observation.effective[x]if Observation.effective[x] is dateTime and has a value then that value shall be precise to the day
Expression : ($this as dateTime).toString().length() >= 8
obs-3Observation.referenceRangeMust have at least a low or a high or text
Expression : low.exists() or high.exists() or text.exists()
.