Observation-example-glasgow.xml

Clinical assessment tool example - GCS using related Observations (id = "glasgow")

<Observation xmlns="http://hl7.org/fhir">
  <id value="glasgow"/> 
  <text> <status value="generated"/> <div xmlns="http://www.w3.org/1999/xhtml"><p> <b> Generated Narrative with Details</b> </p> <p> <b> id</b> : glasgow</p> <p> <b> contained</b> : , , </p> <p> <b> status</b> : final</p> <p> <b> code</b> : Glasgow Coma Scale , (GCS) <span> (Details : {LOINC code '9269-2' = 'Glasgow coma score total', given as 'Glasgow coma score
           total'})</span> </p> <p> <b> subject</b> : <a> Peter James Chalmers</a> </p> <p> <b> effective</b> : 11/12/2014 4:44:16 AM</p> <p> <b> value</b> : 13 {score}<span>  (Details: UCUM code {score} = '{score}')</span> </p> <blockquote> <p> <b> referenceRange</b> </p> <p> <b> high</b> : 8 {score}<span>  (Details: UCUM code {score} = '{score}')</span> </p> <p> <b> type</b> : Severe TBI <span> (Details )</span> </p> </blockquote> <blockquote> <p> <b> referenceRange</b> </p> <p> <b> low</b> : 9 {score}<span>  (Details: UCUM code {score} = '{score}')</span> </p> <p> <b> high</b> : 12 {score}<span>  (Details: UCUM code {score} = '{score}')</span> </p> <p> <b> type</b> : Moderate TBI <span> (Details )</span> </p> </blockquote> <blockquote> <p> <b> referenceRange</b> </p> <p> <b> low</b> : 13 {score}<span>  (Details: UCUM code {score} = '{score}')</span> </p> <p> <b> type</b> : Mild TBI <span> (Details )</span> </p> </blockquote> <blockquote> <p> <b> related</b> </p> <p> <b> type</b> : derived-from</p> <p> <b> target</b> : Motor score. Generated Summary: id: motor; status: final; GCS motor <span> (Details : {LOINC code '9268-4' = 'Glasgow coma score motor', given as 'Glasgow coma score
             motor'})</span> ; ????; effective: 11/12/2014 4:44:16 AM; 5 (Localizes painful stimuli) <span> (Details : {http:/acme.ec/gcsmotor code '5' = '5', given as 'Localizes painful stimuli'};
             {LOINC code 'LA6566-9' = 'Localizing pain', given as 'Localizing pain'})</span> </p> </blockquote> <blockquote> <p> <b> related</b> </p> <p> <b> type</b> : derived-from</p> <p> <b> target</b> : Verbal score. Generated Summary: id: verbal; status: final; Verbal <span> (Details : {LOINC code '9270-0' = 'Glasgow coma score verbal', given as 'Glasgow coma
             score verbal'})</span> ; ????; effective: 11/12/2014 4:44:16 AM; 4 (Confused, disoriented) <span> (Details : {http:/acme.ec/gcsverbal code '4' = '4', given as 'Confused, disoriented'};
             {LOINC code 'LA6560-2' = 'Confused', given as 'Confused'})</span> </p> </blockquote> <blockquote> <p> <b> related</b> </p> <p> <b> type</b> : derived-from</p> <p> <b> target</b> : Eyes score. Generated Summary: id: eyes; status: final; Eyes <span> (Details : {LOINC code '9267-6' = 'Glasgow coma score eye opening', given as 'Glasgow
             coma score eye opening'})</span> ; ????; effective: 11/12/2014 4:44:16 AM; 4 (Opens eyes spontaneously) <span> (Details : {http:/acme.ec/gcseye code '4' = '4', given as 'Opens eyes spontaneously'};
             {LOINC code 'LA6556-0' = 'Eyes open spontaneously', given as 'Eyes open spontaneously'})</span> </p> </blockquote> </div> </text> <contained> 
  <!--     FHIR build is generating the narratives
<text>
    <status value="generated"></status>
     <div xmlns="http://www.w3.org/1999/xhtml">
     <h2>Observation: Glasgow Coma Scale , (GCS)</h2>
  <h3>Date Time: 2014-12-11 20:44PM</h3>
  <h3>Patient Name: Peter James Chalmers</h3>

    <ul>
      <li>
        <b>Glasgow Coma Scale , (GCS)=</b>13<ul>
          <li>
            <b>Motor=</b>5</li>
          <li>
            <b>Verbal=</b>4</li>
          <li>
            <b>Eyes=</b>4</li>
        </ul></li>
    </ul>

     </div>
  </text>
    -->
  <!--     Note: will use contained elements for this example but could just as easily use external
     or bundled elements..    -->
  <!--     First contained element = Motor component.     -->
    <Observation> 
      <id value="motor"/> 
      <status value="final"/> 
      <code> 
        <coding> 
          <system value="http://loinc.org"/> 
          <code value="9268-4"/> 
          <display value="Glasgow coma score motor"/> 
        </coding> 
        <text value="GCS motor"/> 
      </code> 
      <subject> 
        <reference value="Patient/example"/> 
      </subject> 
      <effectiveDateTime value="2014-12-11T04:44:16Z"/> 
      <valueCodeableConcept> 
        <coding> 
          <system value="http:/acme.ec/gcsmotor"/> 
          <code value="5"/> 
          <display value="Localizes painful stimuli"/> 
        </coding> 
        <coding> 
        <!--      This example has the extension which maps a numeric score to the code this may already
           be known and unecessary in the Observation resource     -->
          <extension url="http://hl7.org/fhir/StructureDefinition/iso21090-CO-value">
          <!--     from Element: extension     -->
            <valueDecimal value="5"/> 
          <!--     0..1 Value of extension     -->
          </extension> 
          <system value="http://loinc.org"/> 
          <code value="LA6566-9"/> 
          <display value="Localizing pain"/> 
        </coding> 
        <text value="5 (Localizes painful stimuli)"/> 
      </valueCodeableConcept> 
    </Observation> 
  </contained> 
  <contained> 
  <!--     Second contained element = Verbal component.     -->
    <Observation> 
      <id value="verbal"/> 
      <status value="final"/> 
      <code> 
        <coding> 
          <system value="http://loinc.org"/> 
          <code value="9270-0"/> 
          <display value="Glasgow coma score verbal"/> 
        </coding> 
        <text value="Verbal"/> 
      </code> 
      <subject> 
        <reference value="Patient/example"/> 
      </subject> 
      <effectiveDateTime value="2014-12-11T04:44:16Z"/> 
      <valueCodeableConcept> 
        <coding> 
          <system value="http:/acme.ec/gcsverbal"/> 
          <code value="4"/> 
          <display value="Confused, disoriented"/> 
        </coding> 
        <coding> 
        <!--      This example has the extension which maps a numeric score to the code this may already
           be known and unecessary in the Observation resource     -->
          <extension url="http://hl7.org/fhir/StructureDefinition/iso21090-CO-value">
          <!--     from Element: extension     -->
            <valueDecimal value="4"/> 
          <!--     0..1 Value of extension     -->
          </extension> 
          <system value="http://loinc.org"/> 
        <!--    technicallly the code is '5' and the LA is the identifier to do hav e both  would require
           an extention    -->
          <code value="LA6560-2"/> 
          <display value="Confused"/> 
        </coding> 
        <text value="4 (Confused, disoriented)"/> 
      </valueCodeableConcept> 
    </Observation> 
  </contained> 
  <contained> 
  <!--     Third contained element = Eyes component.     -->
    <Observation> 
      <id value="eyes"/> 
      <status value="final"/> 
      <code> 
        <coding> 
          <system value="http://loinc.org"/> 
          <code value="9267-6"/> 
          <display value="Glasgow coma score eye opening"/> 
        </coding> 
        <text value="Eyes"/> 
      </code> 
      <subject> 
        <reference value="Patient/example"/> 
      </subject> 
      <effectiveDateTime value="2014-12-11T04:44:16Z"/> 
      <valueCodeableConcept> 
        <coding> 
          <system value="http:/acme.ec/gcseye"/> 
          <code value="4"/> 
          <display value="Opens eyes spontaneously"/> 
        </coding> 
        <coding> 
        <!--      This example has the extension which maps a numeric score to the code this may already
           be known and unecessary in the Observation resource     -->
          <extension url="http://hl7.org/fhir/StructureDefinition/iso21090-CO-value">
          <!--     from Element: extension     -->
            <valueDecimal value="4"/> 
          <!--     0..1 Value of extension     -->
          </extension> 
          <system value="http://loinc.org"/> 
        <!--    technicallly the code is '4' and the LA is the identifier to do hav e both  would require
           an extention    -->
          <code value="LA6556-0"/> 
          <display value="Eyes open spontaneously"/> 
        </coding> 
        <text value="4 (Opens eyes spontaneously)"/> 
      </valueCodeableConcept> 
    </Observation> 
  </contained> 
<!--     the mandatory quality flags:     -->
  <status value="final"/> 
<!--    
    Observations are often coded in multiple code systems.
      - LOINC
    - or SNOMED
      -and/or the source system may provides its own "local" code, which may be less or
   more granular than LOINC.
  In this example there is only LOINC
      -->
  <code> 
  <!--     LOINC - always recommended to have a LOINC code     -->
    <coding> 
      <system value="http://loinc.org"/> 
      <code value="9269-2"/> 
      <display value="Glasgow coma score total"/> 
    </coding> 
    <text value="Glasgow Coma Scale , (GCS)"/> 
  </code> 
  <subject> 
    <reference value="Patient/example"/> 
    <display value="Peter James Chalmers"/> 
  </subject> 
  <effectiveDateTime value="2014-12-11T04:44:16Z"/> 
<!--     In FHIR, units may be represented twice. Once in the
    agreed human representation, and once in a coded form.
    In this example the UCUM unit is provided but no human representation since this is
   often not displayed
       -->
  <valueQuantity> 
    <value value="13"/> 
    <system value="http://unitsofmeasure.org"/> 
    <code value="{score}"/> 
  </valueQuantity> 
  <referenceRange> 
    <high> 
      <value value="8"/> 
      <system value="http://unitsofmeasure.org"/> 
      <code value="{score}"/> 
    </high> 
  <!--     meaning as text     -->
    <type> 
      <text value="Severe TBI"/> 
    </type> 
  </referenceRange> 
  <referenceRange> 
    <low> 
      <value value="9"/> 
      <system value="http://unitsofmeasure.org"/> 
      <code value="{score}"/> 
    </low> 
    <high> 
      <value value="12"/> 
      <system value="http://unitsofmeasure.org"/> 
      <code value="{score}"/> 
    </high> 
  <!--     meaning as text     -->
    <type> 
      <text value="Moderate TBI"/> 
    </type> 
  </referenceRange> 
  <referenceRange> 
    <low> 
      <value value="13"/> 
      <system value="http://unitsofmeasure.org"/> 
      <code value="{score}"/> 
    </low> 
  <!--     meaning as text     -->
    <type> 
      <text value="Mild TBI"/> 
    </type> 
  </referenceRange> 
<!--     put the references to the contained components here using the derived-From type  
      -->
  <related> 
    <type value="derived-from"/> 
    <target> 
      <reference value="#motor"/> 
      <display value="Motor score"/> 
    </target> 
  </related> 
  <related> 
    <type value="derived-from"/> 
    <target> 
      <reference value="#verbal"/> 
      <display value="Verbal score"/> 
    </target> 
  </related> 
  <related> 
    <type value="derived-from"/> 
    <target> 
      <reference value="#eyes"/> 
      <display value="Eyes score"/> 
    </target> 
  </related> 
</Observation>