HL7 FHIR® US Core Implementation Guide (Release 3.0.1 STU3 Update for Comment)

This page is part of the US Core (v3.0.1: STU3 Ballot 3) based on FHIR R4. The current version which supercedes this version is 5.0.1. For a full list of available versions, see the Directory of published versions

StructureDefinition-us-core-pulse-oximetry

This profile sets minimum expectations for the Observation resource to record, search and fetch pulse oximetry and inspired oxygen observations associated with a patient. It is based on the FHIR Vital Signs Profile and identifies the additional mandatory core elements, extensions, vocabularies and value sets which SHALL be present in the Observation resource when using this profile.

Example Usage Scenarios:

The following are example usage scenarios for the US Core Pulse Oximetry Profile:

  • Query for pulse oximety observations for a patient
  • Record pulse oximety observations belonging to a patient

Mandatory and Must Support Data Elements

In addition to the mandatory and must support data elements in the FHIR Oxygen Saturation Profile, the following data-elements are mandatory (i.e data MUST be present) or must be supported if the data is present in the sending system (Must Support definition). They are presented below in a simple human-readable explanation. Profile specific guidance and examples are provided as well. The Formal Profile Definition below provides the formal summary, definitions, and terminology requirements.

Each Observation must have:

  1. a fixed code for oxygen saturation in arterial blood as defined in the FHIR oxygen saturation profile
  2. a additional coding for oxygen saturation in arterial blood by pulse oximetry

Each Observation must support:

  1. a code for inspired oxygen concentration
  2. a value for inspired oxygen concentration

Profile specific implementation guidance:

  • inspired oxygen concentration may be expressed as [component observations] when measured at the same time as the pulse oximetry measurements. They are expressed as either inhaled oxygen flow rate (e.g. 6 liters/min) or as inhaled oxygen concentration ( e.g. 40% oxygen)

Examples

Formal Views of Profile Content

Description of Profiles, Differentials, and Snapshots.

The official URL for this profile is: http://hl7.org/fhir/us/core/StructureDefinition/us-core-pulse-oximetry

Published on Tue Aug 20 00:00:00 EDT 2019 as active by the HL7 US Realm Steering Committee.

This profile builds on observation-oxygensat

Observation

Summary of the Mandatory Requirements

  1. A CodeableConcept in Observation.code with an extensible binding to Vital Signs
    • which should have one or more Coding values in Observation.code.coding
    • which must have at least a Coding value in Observation.code.coding
      • which must have a fixed Observation.code.coding.system = http://loinc.org
      • which must have a fixed Observation.code.coding.code = 59408-5

Summary of the Must Support Requirements

  1. One or more Components in Observation.component with the following constraints: If there is no a value a data absent reason must be present
  2. A Component in Observation.component with the following constraints: If there is no a value a data absent reason must be present
    • which must have a CodeableConcept value in Observation.component.code with an extensible binding to Vital Signs
    • which should have one or more Coding values in Observation.component.code.coding
    • which must have a fixed Observation.component.code.coding.system = http://loinc.org
    • which must have a fixed Observation.component.code.coding.code = 3151-8
    • which should have a Quantity value in Observation.component.valueQuantity with a required binding to Vital Signs Units
    • which should have a decimal value in Observation.component.valueQuantity.value
    • which should have a string value in Observation.component.valueQuantity.unit
    • which must have a fixed Observation.component.valueQuantity.system = http://unitsofmeasure.org
    • which must have a fixed Observation.component.valueQuantity.code = l/min
  3. A Component in Observation.component with the following constraints: If there is no a value a data absent reason must be present
    • which must have a CodeableConcept value in Observation.component.code with an extensible binding to Vital Signs
    • which should have one or more Coding values in Observation.component.code.coding
    • which must have a fixed Observation.component.code.coding.system = http://loinc.org
    • which must have a fixed Observation.component.code.coding.code = 3150-0
    • which should have a Quantity value in Observation.component.valueQuantity with a required binding to Vital Signs Units
    • which should have a decimal value in Observation.component.valueQuantity.value
    • which should have a string value in Observation.component.valueQuantity.unit
    • which must have a fixed Observation.component.valueQuantity.system = http://unitsofmeasure.org
    • which must have a fixed Observation.component.valueQuantity.code = l/min

Summary of Constraints

  1. If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present
  2. dataAbsentReason SHALL only be present if Observation.value[x] is not present
  3. If there is no component or hasMember element then either a value[x] or a data absent reason must be present.
  4. If there is no a value a data absent reason must be present
NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation 0..*
... code S1..1CodeableConceptOxygen Saturation by Pulse Oximetry
.... coding S0..*(Slice Definition)Slice: Unordered, Open by value:code, value:system
..... coding:PulseOx S1..1Coding
...... system S1..1uriFixed Value: http://loinc.org
...... code S1..1codeFixed Value: 59408-5
... component S0..*(Slice Definition)Slice: Unordered, Open by pattern:code
.... component:FlowRate S0..1BackboneElementInhaled oxygen flow rate
..... code S1..1CodeableConceptRequired Pattern: At least the following
...... coding1..*CodingCode defined by a terminology system
Fixed Value: (complex)
....... system1..1uriIdentity of the terminology system
Fixed Value: http://loinc.org
....... code1..1codeSymbol in syntax defined by the system
Fixed Value: 3151-8
..... valueQuantity S0..1Quantity
...... value S0..1decimal
...... unit S0..1string
...... system S1..1uriFixed Value: http://unitsofmeasure.org
...... code S1..1codeFixed Value: l/min
.... component:Concentration S0..1BackboneElementInhaled oxygen concentration
..... code S1..1CodeableConceptRequired Pattern: At least the following
...... coding1..*CodingCode defined by a terminology system
Fixed Value: (complex)
....... system1..1uriIdentity of the terminology system
Fixed Value: http://loinc.org
....... code1..1codeSymbol in syntax defined by the system
Fixed Value: 3150-0
..... valueQuantity S0..1Quantity
...... value S0..1decimal
...... unit S0..1string
...... system S1..1uriFixed Value: http://unitsofmeasure.org
...... code S1..1codeFixed Value: %

doco Documentation for this format
NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation I0..*FHIR Oxygen Saturation Profile
... id Σ0..1idLogical id of this artifact
... meta Σ0..1MetaMetadata about the resource
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... language 0..1codeLanguage of the resource content
Binding: CommonLanguages (preferred)
Max Binding: AllLanguages
... text 0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... extension 0..*ExtensionAdditional content defined by implementations
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... identifier Σ0..*IdentifierBusiness Identifier for observation
... basedOn Σ0..*Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest)Fulfills plan, proposal or order
... partOf Σ0..*Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy)Part of referenced event
... status ?!SΣ1..1coderegistered | preliminary | final | amended +
Binding: ObservationStatus (required)
... category S1..*(Slice Definition)Classification of type of observation
Slice: Unordered, Open by value:coding.code, value:coding.system
Binding: ObservationCategoryCodes (preferred)
.... category:VSCat S1..1CodeableConceptClassification of type of observation
Binding: ObservationCategoryCodes (preferred)
..... id 0..1stringUnique id for inter-element referencing
..... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
..... coding SΣ1..*CodingCode defined by a terminology system
...... id 0..1stringUnique id for inter-element referencing
...... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
...... system SΣ1..1uriIdentity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category
...... version Σ0..1stringVersion of the system - if relevant
...... code SΣ1..1codeSymbol in syntax defined by the system
Fixed Value: vital-signs
...... display Σ0..1stringRepresentation defined by the system
...... userSelected Σ0..1booleanIf this coding was chosen directly by the user
..... text Σ0..1stringPlain text representation of the concept
... code SΣ1..1CodeableConceptOxygen Saturation by Pulse Oximetry
Binding: VitalSigns (extensible)
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
.... coding SΣ0..*(Slice Definition)Code defined by a terminology system
Slice: Unordered, Open by value:code, value:system
..... coding:OxygenSatCode Σ1..1CodingCode defined by a terminology system
...... id 0..1stringUnique id for inter-element referencing
...... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
...... system Σ1..1uriIdentity of the terminology system
Fixed Value: http://loinc.org
...... version Σ0..1stringVersion of the system - if relevant
...... code Σ1..1codeSymbol in syntax defined by the system
Fixed Value: 2708-6
...... display Σ0..1stringRepresentation defined by the system
...... userSelected Σ0..1booleanIf this coding was chosen directly by the user
..... coding:PulseOx SΣ1..1CodingCode defined by a terminology system
...... id 0..1stringUnique id for inter-element referencing
...... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
...... system SΣ1..1uriIdentity of the terminology system
Fixed Value: http://loinc.org
...... version Σ0..1stringVersion of the system - if relevant
...... code SΣ1..1codeSymbol in syntax defined by the system
Fixed Value: 59408-5
...... display Σ0..1stringRepresentation defined by the system
...... userSelected Σ0..1booleanIf this coding was chosen directly by the user
.... text Σ0..1stringPlain text representation of the concept
... subject SΣ1..1Reference(Patient)Who and/or what the observation is about
... focus Σ0..*Reference(Resource)What the observation is about, when it is not about the subject of record
... encounter Σ0..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 Σ0..1instantDate/Time this version was made available
... performer Σ0..*Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson)Who is responsible for the observation
... value[x] SΣI0..1QuantityVital Signs value are recorded using the Quantity data type. For supporting observations such as Cuff size could use other datatypes such as CodeableConcept.
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
.... value SΣ1..1decimalNumerical value (with implicit precision)
.... comparator ?!Σ0..1code< | <= | >= | > - how to understand the value
Binding: QuantityComparator (required)
.... unit SΣ1..1stringUnit representation
.... system SΣI1..1uriSystem that defines coded unit form
Fixed Value: http://unitsofmeasure.org
.... code SΣ1..1codeCoded responses from the common UCUM units for vital signs value set.
Fixed Value: %
... dataAbsentReason SI0..1CodeableConceptWhy the result is missing
Binding: DataAbsentReason (extensible)
... interpretation 0..*CodeableConceptHigh, low, normal, etc.
Binding: ObservationInterpretationCodes (extensible)
... note 0..*AnnotationComments about the observation
... bodySite 0..1CodeableConceptObserved body part
Binding: SNOMEDCTBodyStructures (example)
... method 0..1CodeableConceptHow it was done
Binding: ObservationMethods (example)
... specimen 0..1Reference(Specimen)Specimen used for this observation
... device 0..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 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... low I0..1SimpleQuantityLow Range, if relevant
.... high I0..1SimpleQuantityHigh Range, if relevant
.... type 0..1CodeableConceptReference range qualifier
Binding: ObservationReferenceRangeMeaningCodes (preferred)
.... appliesTo 0..*CodeableConceptReference range population
Binding: ObservationReferenceRangeAppliesToCodes (example)
.... age 0..1RangeApplicable age range, if relevant
.... text 0..1stringText based reference range in an observation
... hasMember Σ0..*Reference(QuestionnaireResponse | MolecularSequence | Vital Signs Profile)Used when reporting vital signs panel components
... derivedFrom Σ0..*Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | MolecularSequence | Vital Signs Profile)Related measurements the observation is made from
... component SΣI0..*(Slice Definition)Used when reporting systolic and diastolic blood pressure.
Slice: Unordered, Open by pattern:code
.... component:All Slices Content/Rules for all slices
..... id 0..1stringUnique id for inter-element referencing
..... extension 0..*ExtensionAdditional content defined by implementations
..... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
..... code SΣ1..1CodeableConceptType of component observation (code / type)
Binding: VitalSigns (extensible)
..... value[x] SΣ0..1Vital Sign Value recorded with UCUM
Binding: VitalSignsUnits (required)
...... valueQuantityQuantity
...... valueCodeableConceptCodeableConcept
...... valueStringstring
...... valueBooleanboolean
...... valueIntegerinteger
...... valueRangeRange
...... valueRatioRatio
...... valueSampledDataSampledData
...... valueTimetime
...... valueDateTimedateTime
...... valuePeriodPeriod
..... dataAbsentReason SI0..1CodeableConceptWhy the component result is missing
Binding: DataAbsentReason (extensible)
..... interpretation 0..*CodeableConceptHigh, low, normal, etc.
Binding: ObservationInterpretationCodes (extensible)
..... referenceRange 0..*Unknown reference to #Observation.referenceRange
Provides guide for interpretation of component result
.... component:FlowRate SΣI0..1BackboneElementInhaled oxygen flow rate
..... id 0..1stringUnique id for inter-element referencing
..... extension 0..*ExtensionAdditional content defined by implementations
..... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
..... code SΣ1..1CodeableConceptType of component observation (code / type)
Binding: VitalSigns (extensible)
Required Pattern: At least the following
...... id0..1stringUnique id for inter-element referencing
...... extension0..*ExtensionAdditional content defined by implementations
...... coding1..*CodingCode defined by a terminology system
Fixed Value: (complex)
....... id0..1stringUnique id for inter-element referencing
....... extension0..*ExtensionAdditional content defined by implementations
....... system1..1uriIdentity of the terminology system
Fixed Value: http://loinc.org
....... version0..1stringVersion of the system - if relevant
....... code1..1codeSymbol in syntax defined by the system
Fixed Value: 3151-8
....... display0..1stringRepresentation defined by the system
....... userSelected0..1booleanIf this coding was chosen directly by the user
...... text0..1stringPlain text representation of the concept
..... value[x] SΣ0..1QuantityVital Sign Value recorded with UCUM
Binding: VitalSignsUnits (required)
...... id 0..1stringUnique id for inter-element referencing
...... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
...... value SΣ0..1decimalNumerical value (with implicit precision)
...... comparator ?!Σ0..1code< | <= | >= | > - how to understand the value
Binding: QuantityComparator (required)
...... unit SΣ0..1stringUnit representation
...... system SΣI1..1uriSystem that defines coded unit form
Fixed Value: http://unitsofmeasure.org
...... code SΣ1..1codeCoded form of the unit
Fixed Value: l/min
..... dataAbsentReason SI0..1CodeableConceptWhy the component result is missing
Binding: DataAbsentReason (extensible)
..... interpretation 0..*CodeableConceptHigh, low, normal, etc.
Binding: ObservationInterpretationCodes (extensible)
..... referenceRange 0..*Unknown reference to #Observation.referenceRange
Provides guide for interpretation of component result
.... component:Concentration SΣI0..1BackboneElementInhaled oxygen concentration
..... id 0..1stringUnique id for inter-element referencing
..... extension 0..*ExtensionAdditional content defined by implementations
..... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
..... code SΣ1..1CodeableConceptType of component observation (code / type)
Binding: VitalSigns (extensible)
Required Pattern: At least the following
...... id0..1stringUnique id for inter-element referencing
...... extension0..*ExtensionAdditional content defined by implementations
...... coding1..*CodingCode defined by a terminology system
Fixed Value: (complex)
....... id0..1stringUnique id for inter-element referencing
....... extension0..*ExtensionAdditional content defined by implementations
....... system1..1uriIdentity of the terminology system
Fixed Value: http://loinc.org
....... version0..1stringVersion of the system - if relevant
....... code1..1codeSymbol in syntax defined by the system
Fixed Value: 3150-0
....... display0..1stringRepresentation defined by the system
....... userSelected0..1booleanIf this coding was chosen directly by the user
...... text0..1stringPlain text representation of the concept
..... value[x] SΣ0..1QuantityVital Sign Value recorded with UCUM
Binding: VitalSignsUnits (required)
...... id 0..1stringUnique id for inter-element referencing
...... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
...... value SΣ0..1decimalNumerical value (with implicit precision)
...... comparator ?!Σ0..1code< | <= | >= | > - how to understand the value
Binding: QuantityComparator (required)
...... unit SΣ0..1stringUnit representation
...... system SΣI1..1uriSystem that defines coded unit form
Fixed Value: http://unitsofmeasure.org
...... code SΣ1..1codeCoded form of the unit
Fixed Value: %
..... dataAbsentReason SI0..1CodeableConceptWhy the component result is missing
Binding: DataAbsentReason (extensible)
..... interpretation 0..*CodeableConceptHigh, low, normal, etc.
Binding: ObservationInterpretationCodes (extensible)
..... referenceRange 0..*Unknown reference to #Observation.referenceRange
Provides guide for interpretation of component result

doco Documentation for this format

Observation

Summary of the Mandatory Requirements

  1. A CodeableConcept in Observation.code with an extensible binding to Vital Signs
    • which should have one or more Coding values in Observation.code.coding
    • which must have at least a Coding value in Observation.code.coding
      • which must have a fixed Observation.code.coding.system = http://loinc.org
      • which must have a fixed Observation.code.coding.code = 59408-5

Summary of the Must Support Requirements

  1. One or more Components in Observation.component with the following constraints: If there is no a value a data absent reason must be present
  2. A Component in Observation.component with the following constraints: If there is no a value a data absent reason must be present
    • which must have a CodeableConcept value in Observation.component.code with an extensible binding to Vital Signs
    • which should have one or more Coding values in Observation.component.code.coding
    • which must have a fixed Observation.component.code.coding.system = http://loinc.org
    • which must have a fixed Observation.component.code.coding.code = 3151-8
    • which should have a Quantity value in Observation.component.valueQuantity with a required binding to Vital Signs Units
    • which should have a decimal value in Observation.component.valueQuantity.value
    • which should have a string value in Observation.component.valueQuantity.unit
    • which must have a fixed Observation.component.valueQuantity.system = http://unitsofmeasure.org
    • which must have a fixed Observation.component.valueQuantity.code = l/min
  3. A Component in Observation.component with the following constraints: If there is no a value a data absent reason must be present
    • which must have a CodeableConcept value in Observation.component.code with an extensible binding to Vital Signs
    • which should have one or more Coding values in Observation.component.code.coding
    • which must have a fixed Observation.component.code.coding.system = http://loinc.org
    • which must have a fixed Observation.component.code.coding.code = 3150-0
    • which should have a Quantity value in Observation.component.valueQuantity with a required binding to Vital Signs Units
    • which should have a decimal value in Observation.component.valueQuantity.value
    • which should have a string value in Observation.component.valueQuantity.unit
    • which must have a fixed Observation.component.valueQuantity.system = http://unitsofmeasure.org
    • which must have a fixed Observation.component.valueQuantity.code = l/min

Summary of Constraints

  1. If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present
  2. dataAbsentReason SHALL only be present if Observation.value[x] is not present
  3. If there is no component or hasMember element then either a value[x] or a data absent reason must be present.
  4. If there is no a value a data absent reason must be present

Differential View

NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation 0..*
... code S1..1CodeableConceptOxygen Saturation by Pulse Oximetry
.... coding S0..*(Slice Definition)Slice: Unordered, Open by value:code, value:system
..... coding:PulseOx S1..1Coding
...... system S1..1uriFixed Value: http://loinc.org
...... code S1..1codeFixed Value: 59408-5
... component S0..*(Slice Definition)Slice: Unordered, Open by pattern:code
.... component:FlowRate S0..1BackboneElementInhaled oxygen flow rate
..... code S1..1CodeableConceptRequired Pattern: At least the following
...... coding1..*CodingCode defined by a terminology system
Fixed Value: (complex)
....... system1..1uriIdentity of the terminology system
Fixed Value: http://loinc.org
....... code1..1codeSymbol in syntax defined by the system
Fixed Value: 3151-8
..... valueQuantity S0..1Quantity
...... value S0..1decimal
...... unit S0..1string
...... system S1..1uriFixed Value: http://unitsofmeasure.org
...... code S1..1codeFixed Value: l/min
.... component:Concentration S0..1BackboneElementInhaled oxygen concentration
..... code S1..1CodeableConceptRequired Pattern: At least the following
...... coding1..*CodingCode defined by a terminology system
Fixed Value: (complex)
....... system1..1uriIdentity of the terminology system
Fixed Value: http://loinc.org
....... code1..1codeSymbol in syntax defined by the system
Fixed Value: 3150-0
..... valueQuantity S0..1Quantity
...... value S0..1decimal
...... unit S0..1string
...... system S1..1uriFixed Value: http://unitsofmeasure.org
...... code S1..1codeFixed Value: %

doco Documentation for this format

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation I0..*FHIR Oxygen Saturation Profile
... id Σ0..1idLogical id of this artifact
... meta Σ0..1MetaMetadata about the resource
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... language 0..1codeLanguage of the resource content
Binding: CommonLanguages (preferred)
Max Binding: AllLanguages
... text 0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... extension 0..*ExtensionAdditional content defined by implementations
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... identifier Σ0..*IdentifierBusiness Identifier for observation
... basedOn Σ0..*Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest)Fulfills plan, proposal or order
... partOf Σ0..*Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy)Part of referenced event
... status ?!SΣ1..1coderegistered | preliminary | final | amended +
Binding: ObservationStatus (required)
... category S1..*(Slice Definition)Classification of type of observation
Slice: Unordered, Open by value:coding.code, value:coding.system
Binding: ObservationCategoryCodes (preferred)
.... category:VSCat S1..1CodeableConceptClassification of type of observation
Binding: ObservationCategoryCodes (preferred)
..... id 0..1stringUnique id for inter-element referencing
..... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
..... coding SΣ1..*CodingCode defined by a terminology system
...... id 0..1stringUnique id for inter-element referencing
...... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
...... system SΣ1..1uriIdentity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category
...... version Σ0..1stringVersion of the system - if relevant
...... code SΣ1..1codeSymbol in syntax defined by the system
Fixed Value: vital-signs
...... display Σ0..1stringRepresentation defined by the system
...... userSelected Σ0..1booleanIf this coding was chosen directly by the user
..... text Σ0..1stringPlain text representation of the concept
... code SΣ1..1CodeableConceptOxygen Saturation by Pulse Oximetry
Binding: VitalSigns (extensible)
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
.... coding SΣ0..*(Slice Definition)Code defined by a terminology system
Slice: Unordered, Open by value:code, value:system
..... coding:OxygenSatCode Σ1..1CodingCode defined by a terminology system
...... id 0..1stringUnique id for inter-element referencing
...... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
...... system Σ1..1uriIdentity of the terminology system
Fixed Value: http://loinc.org
...... version Σ0..1stringVersion of the system - if relevant
...... code Σ1..1codeSymbol in syntax defined by the system
Fixed Value: 2708-6
...... display Σ0..1stringRepresentation defined by the system
...... userSelected Σ0..1booleanIf this coding was chosen directly by the user
..... coding:PulseOx SΣ1..1CodingCode defined by a terminology system
...... id 0..1stringUnique id for inter-element referencing
...... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
...... system SΣ1..1uriIdentity of the terminology system
Fixed Value: http://loinc.org
...... version Σ0..1stringVersion of the system - if relevant
...... code SΣ1..1codeSymbol in syntax defined by the system
Fixed Value: 59408-5
...... display Σ0..1stringRepresentation defined by the system
...... userSelected Σ0..1booleanIf this coding was chosen directly by the user
.... text Σ0..1stringPlain text representation of the concept
... subject SΣ1..1Reference(Patient)Who and/or what the observation is about
... focus Σ0..*Reference(Resource)What the observation is about, when it is not about the subject of record
... encounter Σ0..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 Σ0..1instantDate/Time this version was made available
... performer Σ0..*Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson)Who is responsible for the observation
... value[x] SΣI0..1QuantityVital Signs value are recorded using the Quantity data type. For supporting observations such as Cuff size could use other datatypes such as CodeableConcept.
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
.... value SΣ1..1decimalNumerical value (with implicit precision)
.... comparator ?!Σ0..1code< | <= | >= | > - how to understand the value
Binding: QuantityComparator (required)
.... unit SΣ1..1stringUnit representation
.... system SΣI1..1uriSystem that defines coded unit form
Fixed Value: http://unitsofmeasure.org
.... code SΣ1..1codeCoded responses from the common UCUM units for vital signs value set.
Fixed Value: %
... dataAbsentReason SI0..1CodeableConceptWhy the result is missing
Binding: DataAbsentReason (extensible)
... interpretation 0..*CodeableConceptHigh, low, normal, etc.
Binding: ObservationInterpretationCodes (extensible)
... note 0..*AnnotationComments about the observation
... bodySite 0..1CodeableConceptObserved body part
Binding: SNOMEDCTBodyStructures (example)
... method 0..1CodeableConceptHow it was done
Binding: ObservationMethods (example)
... specimen 0..1Reference(Specimen)Specimen used for this observation
... device 0..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 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... low I0..1SimpleQuantityLow Range, if relevant
.... high I0..1SimpleQuantityHigh Range, if relevant
.... type 0..1CodeableConceptReference range qualifier
Binding: ObservationReferenceRangeMeaningCodes (preferred)
.... appliesTo 0..*CodeableConceptReference range population
Binding: ObservationReferenceRangeAppliesToCodes (example)
.... age 0..1RangeApplicable age range, if relevant
.... text 0..1stringText based reference range in an observation
... hasMember Σ0..*Reference(QuestionnaireResponse | MolecularSequence | Vital Signs Profile)Used when reporting vital signs panel components
... derivedFrom Σ0..*Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | MolecularSequence | Vital Signs Profile)Related measurements the observation is made from
... component SΣI0..*(Slice Definition)Used when reporting systolic and diastolic blood pressure.
Slice: Unordered, Open by pattern:code
.... component:All Slices Content/Rules for all slices
..... id 0..1stringUnique id for inter-element referencing
..... extension 0..*ExtensionAdditional content defined by implementations
..... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
..... code SΣ1..1CodeableConceptType of component observation (code / type)
Binding: VitalSigns (extensible)
..... value[x] SΣ0..1Vital Sign Value recorded with UCUM
Binding: VitalSignsUnits (required)
...... valueQuantityQuantity
...... valueCodeableConceptCodeableConcept
...... valueStringstring
...... valueBooleanboolean
...... valueIntegerinteger
...... valueRangeRange
...... valueRatioRatio
...... valueSampledDataSampledData
...... valueTimetime
...... valueDateTimedateTime
...... valuePeriodPeriod
..... dataAbsentReason SI0..1CodeableConceptWhy the component result is missing
Binding: DataAbsentReason (extensible)
..... interpretation 0..*CodeableConceptHigh, low, normal, etc.
Binding: ObservationInterpretationCodes (extensible)
..... referenceRange 0..*Unknown reference to #Observation.referenceRange
Provides guide for interpretation of component result
.... component:FlowRate SΣI0..1BackboneElementInhaled oxygen flow rate
..... id 0..1stringUnique id for inter-element referencing
..... extension 0..*ExtensionAdditional content defined by implementations
..... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
..... code SΣ1..1CodeableConceptType of component observation (code / type)
Binding: VitalSigns (extensible)
Required Pattern: At least the following
...... id0..1stringUnique id for inter-element referencing
...... extension0..*ExtensionAdditional content defined by implementations
...... coding1..*CodingCode defined by a terminology system
Fixed Value: (complex)
....... id0..1stringUnique id for inter-element referencing
....... extension0..*ExtensionAdditional content defined by implementations
....... system1..1uriIdentity of the terminology system
Fixed Value: http://loinc.org
....... version0..1stringVersion of the system - if relevant
....... code1..1codeSymbol in syntax defined by the system
Fixed Value: 3151-8
....... display0..1stringRepresentation defined by the system
....... userSelected0..1booleanIf this coding was chosen directly by the user
...... text0..1stringPlain text representation of the concept
..... value[x] SΣ0..1QuantityVital Sign Value recorded with UCUM
Binding: VitalSignsUnits (required)
...... id 0..1stringUnique id for inter-element referencing
...... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
...... value SΣ0..1decimalNumerical value (with implicit precision)
...... comparator ?!Σ0..1code< | <= | >= | > - how to understand the value
Binding: QuantityComparator (required)
...... unit SΣ0..1stringUnit representation
...... system SΣI1..1uriSystem that defines coded unit form
Fixed Value: http://unitsofmeasure.org
...... code SΣ1..1codeCoded form of the unit
Fixed Value: l/min
..... dataAbsentReason SI0..1CodeableConceptWhy the component result is missing
Binding: DataAbsentReason (extensible)
..... interpretation 0..*CodeableConceptHigh, low, normal, etc.
Binding: ObservationInterpretationCodes (extensible)
..... referenceRange 0..*Unknown reference to #Observation.referenceRange
Provides guide for interpretation of component result
.... component:Concentration SΣI0..1BackboneElementInhaled oxygen concentration
..... id 0..1stringUnique id for inter-element referencing
..... extension 0..*ExtensionAdditional content defined by implementations
..... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
..... code SΣ1..1CodeableConceptType of component observation (code / type)
Binding: VitalSigns (extensible)
Required Pattern: At least the following
...... id0..1stringUnique id for inter-element referencing
...... extension0..*ExtensionAdditional content defined by implementations
...... coding1..*CodingCode defined by a terminology system
Fixed Value: (complex)
....... id0..1stringUnique id for inter-element referencing
....... extension0..*ExtensionAdditional content defined by implementations
....... system1..1uriIdentity of the terminology system
Fixed Value: http://loinc.org
....... version0..1stringVersion of the system - if relevant
....... code1..1codeSymbol in syntax defined by the system
Fixed Value: 3150-0
....... display0..1stringRepresentation defined by the system
....... userSelected0..1booleanIf this coding was chosen directly by the user
...... text0..1stringPlain text representation of the concept
..... value[x] SΣ0..1QuantityVital Sign Value recorded with UCUM
Binding: VitalSignsUnits (required)
...... id 0..1stringUnique id for inter-element referencing
...... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
...... value SΣ0..1decimalNumerical value (with implicit precision)
...... comparator ?!Σ0..1code< | <= | >= | > - how to understand the value
Binding: QuantityComparator (required)
...... unit SΣ0..1stringUnit representation
...... system SΣI1..1uriSystem that defines coded unit form
Fixed Value: http://unitsofmeasure.org
...... code SΣ1..1codeCoded form of the unit
Fixed Value: %
..... dataAbsentReason SI0..1CodeableConceptWhy the component result is missing
Binding: DataAbsentReason (extensible)
..... interpretation 0..*CodeableConceptHigh, low, normal, etc.
Binding: ObservationInterpretationCodes (extensible)
..... referenceRange 0..*Unknown reference to #Observation.referenceRange
Provides guide for interpretation of component result

doco Documentation for this format

Downloads: StructureDefinition: (XML, JSON), Schema: XML Schematron


Quick Start

Below is an overview of the required set of RESTful FHIR interactions - for example, search and read operations - for this profile. See the Conformance requirements for a complete list of supported RESTful interactions for this IG.

  • See the General Guidance section for additional rules and expectations when a server requires status parameters.

See the Vital Signs Quick Start section for how to search by vital signs.