R4 Draft for Comment

This page is part of the FHIR Specification (v3.2.0: R4 Ballot 1). 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

10.1.18.4.4 StructureDefinition: VitalSigns - Mappings

(No assigned work group) Maturity Level: 1Informative Use Context: Any

Mappings:

Workflow Pattern

SNOMED CT Concept Domain Binding

HL7 v2 Mapping

RIM Mapping

W5 Mapping

SNOMED CT Attribute Binding

Mappings for the vitalsigns Profile.

10.1.18.5 Mappings for Workflow Pattern (http://hl7.org/fhir/workflow)

Vital Signs Profile
ObservationEvent
   id
   meta
   implicitRules
   language
   text
   contained
   extension
   modifierExtension
   identifierEvent.identifier
   basedOnEvent.basedOn
   partOfEvent.partOF
   statusEvent.status
   category
   codeEvent.code
   subjectEvent.subject
   contextEvent.context
   effective[x]Event.occurrence[x]
   issued
   performerEvent.performer
   valueQuantityEvent.notDone, Event.notDoneReason {maps to value[x] or dataAbsentReason}
      id
      extension
      value
      comparator
      unit
      system
      code
   dataAbsentReasonEvent.notDone, Event.notDoneReason {maps to value[x] or dataAbsentReason}
   interpretation
   commentEvent.note
   bodySite
   method
   specimen
   device
   referenceRange
      id
      extension
      modifierExtension
      low
      high
      type
      appliesTo
      age
      text
   hasMember
   derivedFrom
   component
      id
      extension
      modifierExtension
      code
      valueQuantity
         id
         extension
         value
         comparator
         unit
         system
         code
      dataAbsentReason
      interpretation
      referenceRange

10.1.18.6 Mappings for SNOMED CT Concept Domain Binding (http://snomed.info/conceptdomain)

Concept domain bindings link a resource or an element to a set of SNOMED CT concepts that represent the intended semantics of the instances (whether or not SNOMED CT is used to encode that data element). This set of concepts is represented using a SNOMED CT expression constraint. Note that the 'Concept domain binding' may be a superset of the 'value set binding'. These bindings help to support:

  • Quality checking FHIR resources by ensuring that (a) the intended semantics of the instances matches the valid range of the corresponding SNOMED CT attribute, and (b) the intended value set is appropriate for the intended semantics of the instances
  • Semantic checking of data instances by helping to detect potential inconsistencies caused by overlap between the semantics incorporated in two concept domains
Vital Signs Profile
Observation< 363787002 |Observable entity|
   id
   meta
   implicitRules
   language
   text
   contained
   extension
   modifierExtension
   identifier
   basedOn
   partOf
   status< 445584004 |Report by finality status|
   category
   code< 363787002 |Observable entity| OR < 386053000 |Evaluation procedure|
   subject
   context
   effective[x]
   issued
   performer
   valueQuantity< 441742003 |Evaluation finding|
      id
      extension
      value
      comparator
      unit
      system
      code
   dataAbsentReason
   interpretation< 260245000 |Findings values|
   comment
   bodySite< 123037004 |Body structure|
   method
   specimen< 123038009 |Specimen|
   device< 49062001 |Device|
   referenceRange
      id
      extension
      modifierExtension
      low
      high
      type< 260245000 |Findings values| OR < 365860008 |General clinical state finding| OR < 250171008 |Clinical history or observation findings| OR < 415229000 |Racial group| OR < 365400002 |Finding of puberty stage| OR < 443938003 |Procedure carried out on subject|
      appliesTo< 260245000 |Findings values| OR < 365860008 |General clinical state finding| OR < 250171008 |Clinical history or observation findings| OR < 415229000 |Racial group| OR < 365400002 |Finding of puberty stage| OR < 443938003 |Procedure carried out on subject|
      age
      text
   hasMember
   derivedFrom
   component
      id
      extension
      modifierExtension
      code< 363787002 |Observable entity| OR < 386053000 |Evaluation procedure|
      valueQuantity363714003 |Interprets| < 441742003 |Evaluation finding|
         id
         extension
         value
         comparator
         unit
         system
         code
      dataAbsentReason
      interpretation< 260245000 |Findings values|
      referenceRange

10.1.18.7 Mappings for HL7 v2 Mapping (http://hl7.org/v2)

Vital Signs Profile
ObservationOBX
   id
   meta
   implicitRules
   language
   text
   contained
   extension
   modifierExtension
   identifierOBX.21 For OBX segments from systems without OBX-21 support a combination of ORC/OBR and OBX must be negotiated between trading partners to uniquely identify the OBX segment. Depending on how V2 has been implemented each of these may be an option: 1) OBR-3 + OBX-3 + OBX-4 or 2) OBR-3 + OBR-4 + OBX-3 + OBX-4 or 2) some other way to uniquely ID the OBR/ORC + OBX-3 + OBX-4.
   basedOnORC
   partOfVaries by domain
   statusOBX-11
   category
   codeOBX-3
   subjectPID-3
   contextPV1
   effective[x]OBX-14, and/or OBX-19 after v2.4 (depends on who observation made)
   issuedOBR.22 (or MSH.7), or perhaps OBX-19 (depends on who observation made)
   performerOBX.15 / (Practitioner) OBX-16, PRT-5:PRT-4='RO' / (Device) OBX-18 , PRT-10:PRT-4='EQUIP' / (Organization) OBX-23, PRT-8:PRT-4='PO'
   valueQuantityOBX.2, OBX.5, OBX.6
      id
      extension
      valueSN.2 / CQ - N/A
      comparatorSN.1 / CQ.1
      unit(see OBX.6 etc.) / CQ.2
      system(see OBX.6 etc.) / CQ.2
      code(see OBX.6 etc.) / CQ.2
   dataAbsentReasonN/A
   interpretationOBX-8
   commentNTE.3 (partner NTE to OBX, or sometimes another (child?) OBX)
   bodySiteOBX-20
   methodOBX-17
   specimenSPM segment
   deviceOBX-17 / PRT -10
   referenceRangeOBX.7
      id
      extension
      modifierExtension
      lowOBX-7
      highOBX-7
      typeOBX-10
      appliesToOBX-10
      age
      textOBX-7
   hasMemberRelationships established by OBX-4 usage
   derivedFromRelationships established by OBX-4 usage
   componentcontainment by OBX-4?
      id
      extension
      modifierExtension
      codeOBX-3
      valueQuantityOBX.2, OBX.5, OBX.6
         id
         extension
         valueSN.2 / CQ - N/A
         comparatorSN.1 / CQ.1
         unit(see OBX.6 etc.) / CQ.2
         system(see OBX.6 etc.) / CQ.2
         code(see OBX.6 etc.) / CQ.2
      dataAbsentReasonN/A
      interpretationOBX-8
      referenceRangeOBX.7

10.1.18.8 Mappings for RIM Mapping (http://hl7.org/v3)

Vital Signs Profile
ObservationEntity. Role, or Act
   id
   meta
   implicitRules
   language
   textAct.text?
   containedN/A
   extensionN/A
   modifierExtensionN/A
   identifierid
   basedOn.inboundRelationship[typeCode=COMP].source[moodCode=EVN]
   partOf.outboundRelationship[typeCode=FLFS].target
   statusstatus Amended & Final are differentiated by whether it is the subject of a ControlAct event with a type of "revise"
   category.outboundRelationship[typeCode="COMP].target[classCode="LIST", moodCode="EVN"].code
   codecode
   subjectparticipation[typeCode=SBJ]
   contextinboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN]
   effective[x]effectiveTime
   issuedparticipation[typeCode=AUT].time
   performerparticipation[typeCode=PRF]
   valueQuantityvalue
      idn/a
      extensionn/a
      valuePQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value
      comparatorIVL properties
      unitPQ.unit
      systemCO.codeSystem, PQ.translation.codeSystem
      codePQ.code, MO.currency, PQ.translation.code
   dataAbsentReasonvalue.nullFlavor
   interpretationinterpretationCode
   commentsubjectOf.observationEvent[code="annotation"].value
   bodySitetargetSiteCode
   methodmethodCode
   specimenparticipation[typeCode=SPC].specimen
   deviceparticipation[typeCode=DEV]
   referenceRangeoutboundRelationship[typeCode=REFV]/target[classCode=OBS, moodCode=EVN]
      idn/a
      extensionn/a
      modifierExtensionN/A
      lowvalue:IVL_PQ.low
      highvalue:IVL_PQ.high
      typeinterpretationCode
      appliesTointerpretationCode
      ageoutboundRelationship[typeCode=PRCN].targetObservationCriterion[code="age"].value
      textvalue:ST
   hasMemberoutBoundRelationship
   derivedFrom.targetObservation
   componentoutBoundRelationship[typeCode=COMP]
      idn/a
      extensionn/a
      modifierExtensionN/A
      codecode
      valueQuantityvalue
         idn/a
         extensionn/a
         valuePQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value
         comparatorIVL properties
         unitPQ.unit
         systemCO.codeSystem, PQ.translation.codeSystem
         codePQ.code, MO.currency, PQ.translation.code
      dataAbsentReasonvalue.nullFlavor
      interpretationinterpretationCode
      referenceRangeoutboundRelationship[typeCode=REFV]/target[classCode=OBS, moodCode=EVN]

10.1.18.9 Mappings for W5 Mapping (http://hl7.org/fhir/w5)

Vital Signs Profile
Observationclinical.diagnostics
   id
   meta
   implicitRules
   language
   text
   contained
   extension
   modifierExtension
   identifierFiveWs.identifier
   basedOn
   partOf
   statusFiveWs.status
   categoryFiveWs.class
   codeFiveWs.what[x]
   subjectFiveWs.subject[x]
   contextFiveWs.context
   effective[x]FiveWs.done[x]
   issuedFiveWs.recorded
   performerFiveWs.actor
   valueQuantity
      id
      extension
      value
      comparator
      unit
      system
      code
   dataAbsentReason
   interpretation
   comment
   bodySite
   method
   specimen
   device
   referenceRange
      id
      extension
      modifierExtension
      low
      high
      type
      appliesTo
      age
      text
   hasMember
   derivedFrom
   component
      id
      extension
      modifierExtension
      codeFiveWs.what[x]
      valueQuantity
         id
         extension
         value
         comparator
         unit
         system
         code
      dataAbsentReason
      interpretation
      referenceRange

10.1.18.10 Mappings for SNOMED CT Attribute Binding (http://snomed.info/sct)

Attribute bindings link coded data elements in FHIR resources to a corresponding attribute in the SNOMED CT concept model. These bindings help to support:

  • clarifying the intended meaning of the data element
  • Quality checking the alignment between FHIR resource design and any coresponding SNOMED CT concept model
  • Composition and decomposition of data instances by indicating the SNOMED CT concept model attribute whose value may be used to decompose a precoordinated concept into this data element
Vital Signs Profile
Observation
   id
   meta
   implicitRules
   language
   text
   contained
   extension
   modifierExtension
   identifier
   basedOn
   partOf
   status
   category
   code116680003 |Is a|
   subject
   context
   effective[x]
   issued
   performer
   valueQuantity363714003 |Interprets|
      id
      extension
      value
      comparator
      unit
      system
      code
   dataAbsentReason
   interpretation363713009 |Has interpretation|
   comment
   bodySite718497002 |Inherent location|
   method
   specimen704319004 |Inherent in|
   device424226004 |Using device|
   referenceRange
      id
      extension
      modifierExtension
      low
      high
      type
      appliesTo
      age
      text
   hasMember
   derivedFrom
   component
      id
      extension
      modifierExtension
      code
      valueQuantity363714003 |Interprets|
         id
         extension
         value
         comparator
         unit
         system
         code
      dataAbsentReason
      interpretation363713009 |Has interpretation|
      referenceRange