QI-Core Implementation Guide
4.1.1 - STU 4.1.1 US

This page is part of the Quality Improvement Core Framework (v4.1.1: STU 4) based on FHIR R4. This is the current published version in its permanent home (it will always be available at this URL). For a full list of available versions, see the Directory of published versions

: Observation example - XML Representation

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<Observation xmlns="http://hl7.org/fhir">
  <id value="example"/>
  <meta>
    <profile
             value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-observation"/>
  </meta>
  <text>
    <status value="extensions"/>
    <div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative</b></p><div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%"><p style="margin-bottom: 0px">Resource "example" </p><p style="margin-bottom: 0px">Profile: <a href="StructureDefinition-qicore-observation.html">QICoreObservation</a></p></div><p><b>bodyPosition</b>: Sitting position (finding) <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="https://browser.ihtsdotools.org/">SNOMED CT</a>#33586001)</span></p><p><b>delta</b>: Decreased (qualifier value) <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="https://browser.ihtsdotools.org/">SNOMED CT</a>#1250004)</span></p><p><b>status</b>: final</p><p><b>category</b>: Vital Signs <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://terminology.hl7.org/3.1.0/CodeSystem-observation-category.html">Observation Category Codes</a>#vital-signs)</span></p><p><b>code</b>: Hemoglobin [Mass/volume] in Venous blood <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="https://loinc.org/">LOINC</a>#30350-3)</span></p><p><b>subject</b>: <a href="Patient-example.html">Patient/example</a> " CHALMERS"</p><p><b>encounter</b>: <a href="Encounter-example.html">Encounter/example</a></p><p><b>effective</b>: 2013-04-02 10:30:10+0100 --&gt; 2013-04-05 10:30:10+0100</p><p><b>issued</b>: Apr 3, 2013 2:30:10 PM</p><p><b>value</b>: 7.2 g/dl<span style="background: LightGoldenRodYellow"> (Details: UCUM code g/dL = 'g/dL')</span></p><p><b>interpretation</b>: Below low normal <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://hl7.org/fhir/R4/v2/0078/index.html">v2 ABNORMAL FLAGS</a>#L "Low")</span></p><p><b>bodySite</b>: Superficial forearm vein <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="https://browser.ihtsdotools.org/">SNOMED CT</a>#308046002)</span></p><p><b>method</b>: Injection to forearm <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="https://browser.ihtsdotools.org/">SNOMED CT</a>#120220003)</span></p><p><b>specimen</b>: <a href="Specimen-example.html">Specimen/example</a></p><p><b>derivedFrom</b>: <a href="Observation-example.html">Observation/example</a></p><blockquote><p><b>component</b></p><p><b>code</b>: Systolic blood pressure <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="https://loinc.org/">LOINC</a>#8480-6; <a href="https://browser.ihtsdotools.org/">SNOMED CT</a>#271649006; clinical-codes#bp-s "Systolic Blood pressure")</span></p><p><b>value</b>: 107 mmHg<span style="background: LightGoldenRodYellow"> (Details: UCUM code mm[Hg] = 'mm[Hg]')</span></p><p><b>interpretation</b>: Normal <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://hl7.org/fhir/R4/v2/0078/index.html">v2 ABNORMAL FLAGS</a>#N "normal")</span></p></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: Diastolic blood pressure <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="https://loinc.org/">LOINC</a>#8462-4)</span></p><p><b>value</b>: 60 mmHg<span style="background: LightGoldenRodYellow"> (Details: UCUM code mm[Hg] = 'mm[Hg]')</span></p><p><b>interpretation</b>: Below low normal <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://hl7.org/fhir/R4/v2/0078/index.html">v2 ABNORMAL FLAGS</a>#L "low")</span></p></blockquote></div>
  </text>
  <extension
             url="http://hl7.org/fhir/StructureDefinition/observation-bodyPosition">
    <valueCodeableConcept>
      <coding>
        <system value="http://snomed.info/sct"/>
        <code value="33586001"/>
        <display value="Sitting position (finding)"/>
      </coding>
    </valueCodeableConcept>
  </extension>
  <extension url="http://hl7.org/fhir/StructureDefinition/observation-delta">
    <valueCodeableConcept>
      <coding>
        <system value="http://snomed.info/sct"/>
        <code value="1250004"/>
        <display value="Decreased (qualifier value)"/>
      </coding>
    </valueCodeableConcept>
  </extension>
  <status value="final"/>
  <category>
    <coding>
      <system value="http://terminology.hl7.org/CodeSystem/observation-category"/>
      <code value="vital-signs"/>
      <display value="Vital Signs"/>
    </coding>
  </category>
  <code>
    <coding>
      <system value="http://loinc.org"/>
      <code value="30350-3"/>
      <display value="Hemoglobin [Mass/volume] in Venous blood"/>
    </coding>
  </code>
  <subject>
    <reference value="Patient/example"/>
  </subject>
  <encounter>
    <reference value="Encounter/example"/>
  </encounter>
  <effectivePeriod>
    <start value="2013-04-02T10:30:10+01:00"/>
    <end value="2013-04-05T10:30:10+01:00"/>
  </effectivePeriod>
  <issued value="2013-04-03T15:30:10+01:00"/>
  <valueQuantity>
    <value value="7.2"/>
    <unit value="g/dl"/>
    <system value="http://unitsofmeasure.org"/>
    <code value="g/dL"/>
  </valueQuantity>
  <interpretation>
    <coding>
      <system value="http://terminology.hl7.org/CodeSystem/v2-0078"/>
      <code value="L"/>
      <display value="Low"/>
    </coding>
    <text value="Below low normal"/>
  </interpretation>
  <bodySite>
    <coding>
      <system value="http://snomed.info/sct"/>
      <code value="308046002"/>
      <display value="Superficial forearm vein"/>
    </coding>
  </bodySite>
  <method>
    <coding>
      <system value="http://snomed.info/sct"/>
      <code value="120220003"/>
      <display value="Injection to forearm"/>
    </coding>
  </method>
  <specimen>
    <reference value="Specimen/example"/>
  </specimen>
  <derivedFrom>
    <reference value="Observation/example"/>
  </derivedFrom>
<!--        Should have a refrange as well      -->
  <component>
  <!-- 
           Observations are often coded in multiple code systems.
           - LOINC provides a very specific code (though not more specific in this particular
     case)
           - snomed provides a clinically relevant code that is usually less granular
     than LOINC
           - the source system provides its own code, which may be less or more granular
     than LOINC

this is shown here to demonstrate  the concept of translations within the codeableConcept
     datatype. The diastolic code below only has a LOINC code
               -->
    <code>
    <!--       LOINC -code       -->
      <coding>
        <system value="http://loinc.org"/>
        <code value="8480-6"/>
        <display value="Systolic blood pressure"/>
      </coding>
    <!--       SNOMED CT Codes       -->
      <coding>
        <system value="http://snomed.info/sct"/>
        <code value="271649006"/>
        <display value="Systolic blood pressure"/>
      </coding>
    <!--       Also, a local code specific to the source system       -->
      <coding>
        <system value="http://acme.org/devices/clinical-codes"/>
        <code value="bp-s"/>
        <display value="Systolic Blood pressure"/>
      </coding>
    </code>
    <valueQuantity>
      <value value="107"/>
      <unit value="mmHg"/>
      <system value="http://unitsofmeasure.org"/>
      <code value="mm[Hg]"/>
    </valueQuantity>
  <!--       an interpretation for the individual composite observation     -->
    <interpretation>
      <coding>
        <system value="http://terminology.hl7.org/CodeSystem/v2-0078"/>
        <code value="N"/>
        <display value="normal"/>
      </coding>
      <text value="Normal"/>
    </interpretation>
  </component>
<!--        Should have a refrange as well      -->
  <component>
  <!--       this codes only has a LOINC code       -->
    <code>
      <coding>
        <system value="http://loinc.org"/>
        <code value="8462-4"/>
        <display value="Diastolic blood pressure"/>
      </coding>
    </code>
    <valueQuantity>
      <value value="60"/>
      <unit value="mmHg"/>
      <system value="http://unitsofmeasure.org"/>
      <code value="mm[Hg]"/>
    </valueQuantity>
  <!--       an interpretation for the individual composite observation     -->
    <interpretation>
      <coding>
        <system value="http://terminology.hl7.org/CodeSystem/v2-0078"/>
        <code value="L"/>
        <display value="low"/>
      </coding>
      <text value="Below low normal"/>
    </interpretation>
  </component>
</Observation>