Codesystem-observation-category.xml

Definition for Code SystemObservationCategoryCodes

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

<CodeSystem xmlns="http://hl7.org/fhir">
  <id value="observation-category"/> 
  <meta> 
    <lastUpdated value="2022-05-28T12:47:40.239+10:00"/> 
    <profile value="http://hl7.org/fhir/StructureDefinition/shareablecodesystem"/> 
  </meta> 
  <text> 
    <status value="generated"/> 
    <div xmlns="http://www.w3.org/1999/xhtml">
      <p> This code system http://terminology.hl7.org/CodeSystem/observation-category defines the
         following codes:</p> 
      <table class="codes">
        <tr> 
          <td style="white-space:nowrap">
            <b> Code</b> 
          </td> 
          <td> 
            <b> Display</b> 
          </td> 
          <td> 
            <b> Definition</b> 
          </td> 
        </tr> 
        <tr> 
          <td style="white-space:nowrap">social-history
            <a name="observation-category-social-history"> </a> 
          </td> 
          <td> Social History</td> 
          <td> Social History Observations define the patient's occupational, personal (e.g., lifestyle),
             social, familial, and environmental history and health risk factors that may impact the
             patient's health.</td> 
        </tr> 
        <tr> 
          <td style="white-space:nowrap">vital-signs
            <a name="observation-category-vital-signs"> </a> 
          </td> 
          <td> Vital Signs</td> 
          <td>  Clinical observations measure the body's basic functions such as blood pressure, heart
             rate, respiratory rate, height, weight, body mass index, head circumference, pulse oximetry,
             temperature, and body surface area.</td> 
        </tr> 
        <tr> 
          <td style="white-space:nowrap">imaging
            <a name="observation-category-imaging"> </a> 
          </td> 
          <td> Imaging</td> 
          <td> Observations generated by imaging. The scope includes observations regarding plain x-ray,
             ultrasound, CT, MRI, angiography, echocardiography, and nuclear medicine.</td> 
        </tr> 
        <tr> 
          <td style="white-space:nowrap">laboratory
            <a name="observation-category-laboratory"> </a> 
          </td> 
          <td> Laboratory</td> 
          <td> The results of observations generated by laboratories.  Laboratory results are typically
             generated by laboratories providing analytic services in areas such as chemistry, hematology,
             serology, histology, cytology, anatomic pathology (including digital pathology), microbiology,
             and/or virology. These observations are based on analysis of specimens obtained from the
             patient and submitted to the laboratory.</td> 
        </tr> 
        <tr> 
          <td style="white-space:nowrap">procedure
            <a name="observation-category-procedure"> </a> 
          </td> 
          <td> Procedure</td> 
          <td> Observations generated by other procedures.  This category includes observations resulting
             from interventional and non-interventional procedures excluding laboratory and imaging
             (e.g., cardiology catheterization, endoscopy, electrodiagnostics, etc.).  Procedure results
             are typically generated by a clinician to provide more granular information about component
             observations made during a procedure.  An example would be when a gastroenterologist reports
             the size of a polyp observed during a colonoscopy.</td> 
        </tr> 
        <tr> 
          <td style="white-space:nowrap">survey
            <a name="observation-category-survey"> </a> 
          </td> 
          <td> Survey</td> 
          <td> Assessment tool/survey instrument observations (e.g., Apgar Scores, Montreal Cognitive
             Assessment (MoCA)).</td> 
        </tr> 
        <tr> 
          <td style="white-space:nowrap">exam
            <a name="observation-category-exam"> </a> 
          </td> 
          <td> Exam</td> 
          <td> Observations generated by physical exam findings including direct observations made by
             a clinician and use of simple instruments and the result of simple maneuvers performed
             directly on the patient's body.</td> 
        </tr> 
        <tr> 
          <td style="white-space:nowrap">therapy
            <a name="observation-category-therapy"> </a> 
          </td> 
          <td> Therapy</td> 
          <td> Observations generated by non-interventional treatment protocols (e.g. occupational, physical,
             radiation, nutritional and medication therapy)</td> 
        </tr> 
        <tr> 
          <td style="white-space:nowrap">activity
            <a name="observation-category-activity"> </a> 
          </td> 
          <td> Activity</td> 
          <td> Observations that measure or record any bodily activity that enhances or maintains physical
             fitness and overall health and wellness.  Not under direct supervision of practitioner
             such as a physical therapist. (e.g., laps swum, steps, sleep data)</td> 
        </tr> 
      </table> 
    </div> 
  </text> 
  <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-wg">
    <valueCode value="oo"/> 
  </extension> 
  <url value="http://terminology.hl7.org/CodeSystem/observation-category"/> 
  <identifier> 
    <system value="urn:ietf:rfc:3986"/> 
    <value value="urn:oid:2.16.840.1.113883.4.642.1.1125"/> 
  </identifier> 
  <version value="4.3.0"/> 
  <name value="ObservationCategoryCodes"/> 
  <title value="Observation Category Codes"/> 
  <status value="draft"/> 
  <experimental value="false"/> 
  <description value="Observation Category codes."/> 
  <caseSensitive value="true"/> 
  <valueSet value="http://hl7.org/fhir/ValueSet/observation-category"/> 
  <content value="complete"/> 
  <concept> 
    <code value="social-history"/> 
    <display value="Social History"/> 
    <definition value="Social History Observations define the patient's occupational, personal (e.g., lifestyle),
     social, familial, and environmental history and health risk factors that may impact the
     patient's health."/> 
  </concept> 
  <concept> 
    <code value="vital-signs"/> 
    <display value="Vital Signs"/> 
    <definition value=" Clinical observations measure the body's basic functions such as blood pressure, heart
     rate, respiratory rate, height, weight, body mass index, head circumference, pulse oximetry,
     temperature, and body surface area."/> 
  </concept> 
  <concept> 
    <code value="imaging"/> 
    <display value="Imaging"/> 
    <definition value="Observations generated by imaging. The scope includes observations regarding plain x-ray,
     ultrasound, CT, MRI, angiography, echocardiography, and nuclear medicine."/> 
  </concept> 
  <concept> 
    <code value="laboratory"/> 
    <display value="Laboratory"/> 
    <definition value="The results of observations generated by laboratories.  Laboratory results are typically
     generated by laboratories providing analytic services in areas such as chemistry, hematology,
     serology, histology, cytology, anatomic pathology (including digital pathology), microbiology,
     and/or virology. These observations are based on analysis of specimens obtained from the
     patient and submitted to the laboratory."/> 
  </concept> 
  <concept> 
    <code value="procedure"/> 
    <display value="Procedure"/> 
    <definition value="Observations generated by other procedures.  This category includes observations resulting
     from interventional and non-interventional procedures excluding laboratory and imaging
     (e.g., cardiology catheterization, endoscopy, electrodiagnostics, etc.).  Procedure results
     are typically generated by a clinician to provide more granular information about component
     observations made during a procedure.  An example would be when a gastroenterologist reports
     the size of a polyp observed during a colonoscopy."/> 
  </concept> 
  <concept> 
    <code value="survey"/> 
    <display value="Survey"/> 
    <definition value="Assessment tool/survey instrument observations (e.g., Apgar Scores, Montreal Cognitive
     Assessment (MoCA))."/> 
  </concept> 
  <concept> 
    <code value="exam"/> 
    <display value="Exam"/> 
    <definition value="Observations generated by physical exam findings including direct observations made by
     a clinician and use of simple instruments and the result of simple maneuvers performed
     directly on the patient's body."/> 
  </concept> 
  <concept> 
    <code value="therapy"/> 
    <display value="Therapy"/> 
    <definition value="Observations generated by non-interventional treatment protocols (e.g. occupational, physical,
     radiation, nutritional and medication therapy)"/> 
  </concept> 
  <concept> 
    <code value="activity"/> 
    <display value="Activity"/> 
    <definition value="Observations that measure or record any bodily activity that enhances or maintains physical
     fitness and overall health and wellness.  Not under direct supervision of practitioner
     such as a physical therapist. (e.g., laps swum, steps, sleep data)"/> 
  </concept> 
</CodeSystem>