This page is part of the US Core (v3.1.0: STU3) 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-pediatric-bmi-for-age
This profile sets minimum expectations for the Observation resource to record, search, and fetch pediatric body mass index (BMI) per age and gender 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 Pediatric BMI for Age Observation Profile:
- Query for BMI observations belonging to a pediatric patient
- Record or update BMI observations belonging to a pediatric patient
Mandatory and Must Support Data Elements
In addition to the mandatory and must support data elements in the FHIR Vital Signs 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:
- a fixed code for pediatric BMI per age and gender measurement
- a result value
Profile specific implementation guidance:
- none
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/pediatric-bmi-for-age
Published on Sat Aug 31 00:00:00 AEST 2019 as active by the HL7 US Realm Steering Committee.
This profile builds on observation-vitalsigns
Observation
Summary of the Mandatory Requirements
- A CodeableConcept in
Observation.code
with an extensible binding to Vital Signs- which must 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
=59576-9
- which must have a fixed
- which must have one or more Coding values in
- A Quantity in
Observation.valueQuantity
- which must have a decimal value in
Observation.valueQuantity.value
- which must have a string value in
Observation.valueQuantity.unit
- which must have a fixed
Observation.valueQuantity.system
=http://unitsofmeasure.org
- which must have a fixed
Observation.valueQuantity.code
=%
- which must have a decimal value in
Summary of Constraints
- If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present
- dataAbsentReason SHALL only be present if Observation.value[x] is not present
- If there is no component or hasMember element then either a value[x] or a data absent reason must be present.
Name | Flags | Card. | Type | Description & Constraints |
---|---|---|---|---|
Observation | 0..* | |||
code | 1..1 | CodeableConcept | BMI percentile per age and sex for youth 2-20 Required Pattern: At least the following | |
coding | 1..* | Coding | Code defined by a terminology system Fixed Value: (complex) | |
system | 1..1 | uri | Identity of the terminology system Fixed Value: http://loinc.org | |
code | 1..1 | code | Symbol in syntax defined by the system Fixed Value: 59576-9 | |
valueQuantity | 1..1 | Quantity | ||
value | S | 1..1 | decimal | |
unit | S | 1..1 | string | |
system | S | 1..1 | uri | Fixed Value: http://unitsofmeasure.org |
code | S | 1..1 | code | Coded responses from the common UCUM units for vital signs value set. Fixed Value: % |
Documentation for this format |
Name | Flags | Card. | Type | Description & Constraints |
---|---|---|---|---|
Observation | I | 0..* | FHIR Vital Signs Profile | |
id | Σ | 0..1 | string | Logical id of this artifact |
meta | ΣI | 0..1 | Meta | Metadata about the resource |
implicitRules | ?!ΣI | 0..1 | uri | A set of rules under which this content was created |
language | I | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred) Max Binding: AllLanguages |
text | I | 0..1 | Narrative | Text summary of the resource, for human interpretation |
contained | 0..* | Resource | Contained, inline Resources | |
extension | I | 0..* | Extension | Additional content defined by implementations |
modifierExtension | ?!I | 0..* | Extension | Extensions that cannot be ignored |
identifier | ΣI | 0..* | Identifier | Business Identifier for observation |
basedOn | ΣI | 0..* | Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest) | Fulfills plan, proposal or order |
partOf | ΣI | 0..* | Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy) | Part of referenced event |
status | ?!SΣI | 1..1 | code | registered | preliminary | final | amended + Binding: ObservationStatus (required) |
category | SI | 1..* | (Slice Definition) | Classification of type of observation Slice: Unordered, Open by value:coding.code, value:coding.system Binding: ObservationCategoryCodes (preferred) |
category:VSCat | SI | 1..1 | CodeableConcept | Classification of type of observation Binding: ObservationCategoryCodes (preferred) |
id | 0..1 | string | Unique id for inter-element referencing | |
extension | I | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url |
coding | SΣI | 1..* | Coding | Code defined by a terminology system |
id | 0..1 | string | Unique id for inter-element referencing | |
extension | I | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url |
system | SΣI | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category |
version | ΣI | 0..1 | string | Version of the system - if relevant |
code | SΣI | 1..1 | code | Symbol in syntax defined by the system Fixed Value: vital-signs |
display | ΣI | 0..1 | string | Representation defined by the system |
userSelected | ΣI | 0..1 | boolean | If this coding was chosen directly by the user |
text | ΣI | 0..1 | string | Plain text representation of the concept |
code | ΣI | 1..1 | CodeableConcept | BMI percentile per age and sex for youth 2-20 Binding: VitalSigns (extensible) Required Pattern: At least the following |
id | 0..1 | string | Unique id for inter-element referencing | |
extension | 0..* | Extension | Additional content defined by implementations | |
coding | 1..* | Coding | Code defined by a terminology system Fixed Value: (complex) | |
id | 0..1 | string | Unique id for inter-element referencing | |
extension | 0..* | Extension | Additional content defined by implementations | |
system | 1..1 | uri | Identity of the terminology system Fixed Value: http://loinc.org | |
version | 0..1 | string | Version of the system - if relevant | |
code | 1..1 | code | Symbol in syntax defined by the system Fixed Value: 59576-9 | |
display | 0..1 | string | Representation defined by the system | |
userSelected | 0..1 | boolean | If this coding was chosen directly by the user | |
text | 0..1 | string | Plain text representation of the concept | |
subject | SΣI | 1..1 | Reference(Patient) | Who and/or what the observation is about |
focus | ΣI | 0..* | Reference(Resource) | What the observation is about, when it is not about the subject of record |
encounter | ΣI | 0..1 | Reference(Encounter) | Healthcare event during which this observation is made |
effective[x] | SΣI | 1..1 | Often 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 | |
effectiveDateTime | dateTime | |||
effectivePeriod | Period | |||
issued | ΣI | 0..1 | instant | Date/Time this version was made available |
performer | ΣI | 0..* | Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson) | Who is responsible for the observation |
value[x] | SΣI | 0..1 | (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 |
value[x]:valueQuantity | ΣI | 1..1 | 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. |
id | 0..1 | string | Unique id for inter-element referencing | |
extension | I | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url |
value | SΣI | 1..1 | decimal | Numerical value (with implicit precision) |
comparator | ?!ΣI | 0..1 | code | < | <= | >= | > - how to understand the value Binding: QuantityComparator (required) |
unit | SΣI | 1..1 | string | Unit representation |
system | SΣI | 1..1 | uri | System that defines coded unit form Fixed Value: http://unitsofmeasure.org |
code | SΣI | 1..1 | code | Coded responses from the common UCUM units for vital signs value set. Fixed Value: % |
dataAbsentReason | SI | 0..1 | CodeableConcept | Why the result is missing Binding: DataAbsentReason (extensible) |
interpretation | I | 0..* | CodeableConcept | High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible) |
note | I | 0..* | Annotation | Comments about the observation |
bodySite | I | 0..1 | CodeableConcept | Observed body part Binding: SNOMEDCTBodyStructures (example) |
method | I | 0..1 | CodeableConcept | How it was done Binding: ObservationMethods (example) |
specimen | I | 0..1 | Reference(Specimen) | Specimen used for this observation |
device | I | 0..1 | Reference(Device | DeviceMetric) | (Measurement) Device |
referenceRange | I | 0..* | BackboneElement | Provides guide for interpretation obs-3: Must have at least a low or a high or text |
id | 0..1 | string | Unique id for inter-element referencing | |
extension | I | 0..* | Extension | Additional content defined by implementations |
modifierExtension | ?!ΣI | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
low | I | 0..1 | SimpleQuantity | Low Range, if relevant |
high | I | 0..1 | SimpleQuantity | High Range, if relevant |
type | I | 0..1 | CodeableConcept | Reference range qualifier Binding: ObservationReferenceRangeMeaningCodes (preferred) |
appliesTo | I | 0..* | CodeableConcept | Reference range population Binding: ObservationReferenceRangeAppliesToCodes (example) |
age | I | 0..1 | Range | Applicable age range, if relevant |
text | I | 0..1 | string | Text based reference range in an observation |
hasMember | ΣI | 0..* | Reference(QuestionnaireResponse | MolecularSequence | Vital Signs Profile) | Used when reporting vital signs panel components |
derivedFrom | ΣI | 0..* | Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | MolecularSequence | Vital Signs Profile) | Related measurements the observation is made from |
component | SΣI | 0..* | BackboneElement | Used when reporting systolic and diastolic blood pressure. vs-3: If there is no a value a data absent reason must be present |
id | 0..1 | string | Unique id for inter-element referencing | |
extension | I | 0..* | Extension | Additional content defined by implementations |
modifierExtension | ?!ΣI | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
code | SΣI | 1..1 | CodeableConcept | Type of component observation (code / type) Binding: VitalSigns (extensible) |
value[x] | SΣI | 0..1 | Vital Sign Value recorded with UCUM Binding: VitalSignsUnits (required) | |
valueQuantity | Quantity | |||
valueCodeableConcept | CodeableConcept | |||
valueString | string | |||
valueBoolean | boolean | |||
valueInteger | integer | |||
valueRange | Range | |||
valueRatio | Ratio | |||
valueSampledData | SampledData | |||
valueTime | time | |||
valueDateTime | dateTime | |||
valuePeriod | Period | |||
dataAbsentReason | SI | 0..1 | CodeableConcept | Why the component result is missing Binding: DataAbsentReason (extensible) |
interpretation | I | 0..* | CodeableConcept | High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible) |
referenceRange | I | 0..* | Unknown reference to #Observation.referenceRange Provides guide for interpretation of component result | |
Documentation for this format |
Observation
Summary of the Mandatory Requirements
- A CodeableConcept in
Observation.code
with an extensible binding to Vital Signs- which must 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
=59576-9
- which must have a fixed
- which must have one or more Coding values in
- A Quantity in
Observation.valueQuantity
- which must have a decimal value in
Observation.valueQuantity.value
- which must have a string value in
Observation.valueQuantity.unit
- which must have a fixed
Observation.valueQuantity.system
=http://unitsofmeasure.org
- which must have a fixed
Observation.valueQuantity.code
=%
- which must have a decimal value in
Summary of Constraints
- If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present
- dataAbsentReason SHALL only be present if Observation.value[x] is not present
- If there is no component or hasMember element then either a value[x] or a data absent reason must be present.
Differential View
Name | Flags | Card. | Type | Description & Constraints |
---|---|---|---|---|
Observation | 0..* | |||
code | 1..1 | CodeableConcept | BMI percentile per age and sex for youth 2-20 Required Pattern: At least the following | |
coding | 1..* | Coding | Code defined by a terminology system Fixed Value: (complex) | |
system | 1..1 | uri | Identity of the terminology system Fixed Value: http://loinc.org | |
code | 1..1 | code | Symbol in syntax defined by the system Fixed Value: 59576-9 | |
valueQuantity | 1..1 | Quantity | ||
value | S | 1..1 | decimal | |
unit | S | 1..1 | string | |
system | S | 1..1 | uri | Fixed Value: http://unitsofmeasure.org |
code | S | 1..1 | code | Coded responses from the common UCUM units for vital signs value set. Fixed Value: % |
Documentation for this format |
Snapshot View
Name | Flags | Card. | Type | Description & Constraints |
---|---|---|---|---|
Observation | I | 0..* | FHIR Vital Signs Profile | |
id | Σ | 0..1 | string | Logical id of this artifact |
meta | ΣI | 0..1 | Meta | Metadata about the resource |
implicitRules | ?!ΣI | 0..1 | uri | A set of rules under which this content was created |
language | I | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred) Max Binding: AllLanguages |
text | I | 0..1 | Narrative | Text summary of the resource, for human interpretation |
contained | 0..* | Resource | Contained, inline Resources | |
extension | I | 0..* | Extension | Additional content defined by implementations |
modifierExtension | ?!I | 0..* | Extension | Extensions that cannot be ignored |
identifier | ΣI | 0..* | Identifier | Business Identifier for observation |
basedOn | ΣI | 0..* | Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest) | Fulfills plan, proposal or order |
partOf | ΣI | 0..* | Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy) | Part of referenced event |
status | ?!SΣI | 1..1 | code | registered | preliminary | final | amended + Binding: ObservationStatus (required) |
category | SI | 1..* | (Slice Definition) | Classification of type of observation Slice: Unordered, Open by value:coding.code, value:coding.system Binding: ObservationCategoryCodes (preferred) |
category:VSCat | SI | 1..1 | CodeableConcept | Classification of type of observation Binding: ObservationCategoryCodes (preferred) |
id | 0..1 | string | Unique id for inter-element referencing | |
extension | I | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url |
coding | SΣI | 1..* | Coding | Code defined by a terminology system |
id | 0..1 | string | Unique id for inter-element referencing | |
extension | I | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url |
system | SΣI | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category |
version | ΣI | 0..1 | string | Version of the system - if relevant |
code | SΣI | 1..1 | code | Symbol in syntax defined by the system Fixed Value: vital-signs |
display | ΣI | 0..1 | string | Representation defined by the system |
userSelected | ΣI | 0..1 | boolean | If this coding was chosen directly by the user |
text | ΣI | 0..1 | string | Plain text representation of the concept |
code | ΣI | 1..1 | CodeableConcept | BMI percentile per age and sex for youth 2-20 Binding: VitalSigns (extensible) Required Pattern: At least the following |
id | 0..1 | string | Unique id for inter-element referencing | |
extension | 0..* | Extension | Additional content defined by implementations | |
coding | 1..* | Coding | Code defined by a terminology system Fixed Value: (complex) | |
id | 0..1 | string | Unique id for inter-element referencing | |
extension | 0..* | Extension | Additional content defined by implementations | |
system | 1..1 | uri | Identity of the terminology system Fixed Value: http://loinc.org | |
version | 0..1 | string | Version of the system - if relevant | |
code | 1..1 | code | Symbol in syntax defined by the system Fixed Value: 59576-9 | |
display | 0..1 | string | Representation defined by the system | |
userSelected | 0..1 | boolean | If this coding was chosen directly by the user | |
text | 0..1 | string | Plain text representation of the concept | |
subject | SΣI | 1..1 | Reference(Patient) | Who and/or what the observation is about |
focus | ΣI | 0..* | Reference(Resource) | What the observation is about, when it is not about the subject of record |
encounter | ΣI | 0..1 | Reference(Encounter) | Healthcare event during which this observation is made |
effective[x] | SΣI | 1..1 | Often 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 | |
effectiveDateTime | dateTime | |||
effectivePeriod | Period | |||
issued | ΣI | 0..1 | instant | Date/Time this version was made available |
performer | ΣI | 0..* | Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson) | Who is responsible for the observation |
value[x] | SΣI | 0..1 | (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 |
value[x]:valueQuantity | ΣI | 1..1 | 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. |
id | 0..1 | string | Unique id for inter-element referencing | |
extension | I | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url |
value | SΣI | 1..1 | decimal | Numerical value (with implicit precision) |
comparator | ?!ΣI | 0..1 | code | < | <= | >= | > - how to understand the value Binding: QuantityComparator (required) |
unit | SΣI | 1..1 | string | Unit representation |
system | SΣI | 1..1 | uri | System that defines coded unit form Fixed Value: http://unitsofmeasure.org |
code | SΣI | 1..1 | code | Coded responses from the common UCUM units for vital signs value set. Fixed Value: % |
dataAbsentReason | SI | 0..1 | CodeableConcept | Why the result is missing Binding: DataAbsentReason (extensible) |
interpretation | I | 0..* | CodeableConcept | High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible) |
note | I | 0..* | Annotation | Comments about the observation |
bodySite | I | 0..1 | CodeableConcept | Observed body part Binding: SNOMEDCTBodyStructures (example) |
method | I | 0..1 | CodeableConcept | How it was done Binding: ObservationMethods (example) |
specimen | I | 0..1 | Reference(Specimen) | Specimen used for this observation |
device | I | 0..1 | Reference(Device | DeviceMetric) | (Measurement) Device |
referenceRange | I | 0..* | BackboneElement | Provides guide for interpretation obs-3: Must have at least a low or a high or text |
id | 0..1 | string | Unique id for inter-element referencing | |
extension | I | 0..* | Extension | Additional content defined by implementations |
modifierExtension | ?!ΣI | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
low | I | 0..1 | SimpleQuantity | Low Range, if relevant |
high | I | 0..1 | SimpleQuantity | High Range, if relevant |
type | I | 0..1 | CodeableConcept | Reference range qualifier Binding: ObservationReferenceRangeMeaningCodes (preferred) |
appliesTo | I | 0..* | CodeableConcept | Reference range population Binding: ObservationReferenceRangeAppliesToCodes (example) |
age | I | 0..1 | Range | Applicable age range, if relevant |
text | I | 0..1 | string | Text based reference range in an observation |
hasMember | ΣI | 0..* | Reference(QuestionnaireResponse | MolecularSequence | Vital Signs Profile) | Used when reporting vital signs panel components |
derivedFrom | ΣI | 0..* | Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | MolecularSequence | Vital Signs Profile) | Related measurements the observation is made from |
component | SΣI | 0..* | BackboneElement | Used when reporting systolic and diastolic blood pressure. vs-3: If there is no a value a data absent reason must be present |
id | 0..1 | string | Unique id for inter-element referencing | |
extension | I | 0..* | Extension | Additional content defined by implementations |
modifierExtension | ?!ΣI | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
code | SΣI | 1..1 | CodeableConcept | Type of component observation (code / type) Binding: VitalSigns (extensible) |
value[x] | SΣI | 0..1 | Vital Sign Value recorded with UCUM Binding: VitalSignsUnits (required) | |
valueQuantity | Quantity | |||
valueCodeableConcept | CodeableConcept | |||
valueString | string | |||
valueBoolean | boolean | |||
valueInteger | integer | |||
valueRange | Range | |||
valueRatio | Ratio | |||
valueSampledData | SampledData | |||
valueTime | time | |||
valueDateTime | dateTime | |||
valuePeriod | Period | |||
dataAbsentReason | SI | 0..1 | CodeableConcept | Why the component result is missing Binding: DataAbsentReason (extensible) |
interpretation | I | 0..* | CodeableConcept | High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible) |
referenceRange | I | 0..* | Unknown reference to #Observation.referenceRange Provides guide for interpretation of component result | |
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.