Release 5 Preview #1

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Observation-example-bloodpressure-cancel.xml

Orders and Observations Work GroupMaturity Level: N/AStandards Status: InformativeCompartments: Device, Encounter, Patient, Practitioner, RelatedPerson

Raw XML (canonical form + also see XML Format Specification)

Jump past Narrative

Blood Pressure Measurement cancelled (id = "blood-pressure-cancel")

<?xml version="1.0" encoding="UTF-8"?>

<Observation xmlns="http://hl7.org/fhir">
  <id value="blood-pressure-cancel"/> 
  <meta> 
    <profile value="http://hl7.org/fhir/StructureDefinition/vitalsigns"/> 
  </meta> <!--     EH  Narrative created by build
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml">Sept 17, 2012: Systolic Blood pressure 107/60
   mmHg (low)</div>
  </text>
   --><text> <status value="generated"/> <div xmlns="http://www.w3.org/1999/xhtml"><p> <b> Generated Narrative with Details</b> </p> <p> <b> id</b> : blood-pressure-cancel</p> <p> <b> meta</b> : </p> <p> <b> identifier</b> : urn:uuid:187e0c12-8dd2-67e2-99b2-bf273c878281</p> <p> <b> status</b> : cancelled</p> <p> <b> category</b> : Vital Signs <span> (Details : {http://terminology.hl7.org/CodeSystem/observation-category code 'vital-signs'
           = 'Vital Signs', given as 'Vital Signs'})</span> </p> <p> <b> code</b> : Blood pressure systolic &amp; diastolic <span> (Details : {LOINC code '85354-9' = 'Blood pressure panel with all children optional',
           given as 'Blood pressure panel with all children optional'})</span> </p> <p> <b> subject</b> : <a> Patient/example</a> </p> <p> <b> effective</b> : 2012-09-17</p> <p> <b> performer</b> : <a> Practitioner/example</a> </p> <p> <b> interpretation</b> : Below low normal <span> (Details : {http://terminology.hl7.org/CodeSystem/v3-ObservationInterpretation code 'L'
           = 'Low', given as 'low'})</span> </p> <p> <b> note</b> : In this example, the blood pressure measurements are not available due to cancellation
         of the order.  Data absent reason is present for each component</p> <p> <b> bodySite</b> : Right arm <span> (Details : {SNOMED CT code '368209003' = 'Right upper arm', given as 'Right arm'})</span> </p> <blockquote> <p> <b> component</b> </p> <p> <b> code</b> : Systolic blood pressure <span> (Details : {LOINC code '8480-6' = 'Systolic blood pressure', given as 'Systolic blood
             pressure'}; {SNOMED CT code '271649006' = 'Systolic blood pressure', given as 'Systolic
             blood pressure'}; {http://acme.org/devices/clinical-codes code 'bp-s' = 'bp-s', given
             as 'Systolic Blood pressure'})</span> </p> <p> <b> dataAbsentReason</b> : Not Asked <span> (Details : {http://terminology.hl7.org/CodeSystem/data-absent-reason code 'not-asked'
             = 'Not Asked', given as 'Not Asked'})</span> </p> </blockquote> <blockquote> <p> <b> component</b> </p> <p> <b> code</b> : Diastolic blood pressure <span> (Details : {LOINC code '8462-4' = 'Diastolic blood pressure', given as 'Diastolic blood
             pressure'})</span> </p> <p> <b> dataAbsentReason</b> : Not Asked <span> (Details : {http://terminology.hl7.org/CodeSystem/data-absent-reason code 'not-asked'
             = 'Not Asked', given as 'Not Asked'})</span> </p> </blockquote> </div> </text> <identifier> 
    <system value="urn:ietf:rfc:3986"/> 
    <value value="urn:uuid:187e0c12-8dd2-67e2-99b2-bf273c878281"/> 
  </identifier> 
  <status value="cancelled"/> 
  <category> 
    <coding> 
      <system value="http://terminology.hl7.org/CodeSystem/observation-category"/> 
      <code value="vital-signs"/> 
      <display value="Vital Signs"/> 
    </coding> 
  </category> 
  <code> <!--    replaced by 85354-9
    <coding>
      <system value="http://loinc.org"/>
      <code value="85354-9"/>
      <display value="Blood pressure systolic &amp; diastolic"/>
    </coding>
   --><coding> 
      <system value="http://loinc.org"/> 
      <code value="85354-9"/> 
      <display value="Blood pressure panel with all children optional"/> 
    </coding> 
    <text value="Blood pressure systolic &amp; diastolic"/> 
  </code> 
  <subject> 
    <reference value="Patient/example"/> 
  </subject> 
  <effectiveDateTime value="2012-09-17"/> 
  <performer> 
    <reference value="Practitioner/example"/> 
  </performer> <!--    an interpretation offered to the combination observation
        generally, it would only be appropriate to offer an interpretation
        of an observation that has no value if it has "COMP" (component)
        observations    --><interpretation> 
    <coding> 
      <system value="http://terminology.hl7.org/CodeSystem/v3-ObservationInterpretation"/> 
      <code value="L"/> 
      <display value="low"/> 
    </coding> 
    <text value="Below low normal"/> 
  </interpretation> 
  <note> <text value="In this example, the blood pressure measurements are not available due to cancellation
     of the order.  Data absent reason is present for each component"/> </note> <!--    for an observation with components, these cannot disagree with the flags on the components
      --><bodySite> 
    <coding> 
      <system value="http://snomed.info/sct"/> 
      <code value="368209003"/> 
      <display value="Right arm"/> 
    </coding> 
  </bodySite> 
  <component> <!--   
           Observations are often coded in multiple code systems.
           - LOINC provides a very specific code (though not usefully 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 instance shows the concept. The other codes only have a LOINC code    --><code> <!--    LOINC - always recommended to have a LOINC code    --><coding> 
        <system value="http://loinc.org"/> 
        <code value="8480-6"/> 
        <display value="Systolic blood pressure"/> 
      </coding> <!--    SNOMED CT Codes - becoming more common    --><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> <!--    that shows the concept. The next two names only have a LOINC code    --></code> <!--    no value due to some error
    <valueQuantity>
      <value value="107"/>
      <unit value="mm[Hg]"/>
    </valueQuantity>
   --><dataAbsentReason> 
      <coding> 
        <system value="http://terminology.hl7.org/CodeSystem/data-absent-reason"/> 
        <code value="not-asked"/> 
        <display value="Not Asked"/> 
      </coding> 
    </dataAbsentReason> 
  </component> 
  <component> 
    <code> 
      <coding> 
        <system value="http://loinc.org"/> 
        <code value="8462-4"/> 
        <display value="Diastolic blood pressure"/> 
      </coding> 
    </code> <!--    no value due to some error
    <valueQuantity>
      <value value="60"/>
      <unit value="mm[Hg]"/>
    </valueQuantity>
   --><dataAbsentReason> 
      <coding> 
        <system value="http://terminology.hl7.org/CodeSystem/data-absent-reason"/> 
        <code value="not-asked"/> 
        <display value="Not Asked"/> 
      </coding> 
    </dataAbsentReason> 
  </component> 
</Observation> 

Usage note: every effort has been made to ensure that the examples are correct and useful, but they are not a normative part of the specification.