This page is part of the FHIR Specification (v3.0.2: STU 3). 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
Orders and Observations Work Group | Maturity Level: N/A | Ballot Status: Informative | Compartments: Device, Encounter, Patient, Practitioner, RelatedPerson |
Blood Pressure Measurement with an absent Diastolic measurement (id = "blood-pressure-dar")
<Observation xmlns="http://hl7.org/fhir"> <id value="blood-pressure-dar"/> <meta> <profile value="http://hl7.org/fhir/StructureDefinition/vitalsigns"/> </meta> <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-dar</p> <p> <b> meta</b> : </p> <p> <b> identifier</b> : urn:uuid:187e0c12-8dd2-67e2-99b2-bf273c878281</p> <p> <b> status</b> : final</p> <p> <b> category</b> : Vital Signs <span> (Details : {http://hl7.org/fhir/observation-category code 'vital-signs' = 'Vital Signs', given as 'Vital Signs'})</span> </p> <p> <b> code</b> : Blood pressure systolic & diastolic <span> (Details : {LOINC code '85354-9' = 'lood pressure panel with all children optional', given as 'Bood pressure panel with all children optional'})</span> </p> <p> <b> subject</b> : <a> Patient/example</a> </p> <p> <b> effective</b> : 17/09/2012</p> <p> <b> performer</b> : <a> Practitioner/example</a> </p> <p> <b> interpretation</b> : Below low normal <span> (Details : {http://hl7.org/fhir/v2/0078 code 'L' = 'Low', given as 'low'})</span> </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> value</b> : 107 mmHg<span> (Details: UCUM code mm[Hg] = 'mmHg')</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 Performed <span> (Details : {http://hl7.org/fhir/data-absent-reason code 'not-performed' = 'Not Performed', given as 'Not Performed'})</span> </p> </blockquote> </div> </text> <identifier> <system value="urn:ietf:rfc:3986"/> <value value="urn:uuid:187e0c12-8dd2-67e2-99b2-bf273c878281"/> </identifier> <status value="final"/> <category> <coding> <system value="http://hl7.org/fhir/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="55284-4"/> <display value="Blood pressure systolic & diastolic"/> </coding> --> <coding> <system value="http://loinc.org"/> <code value="85354-9"/> <display value="Bood pressure panel with all children optional"/> </coding> <text value="Blood pressure systolic & 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://hl7.org/fhir/v2/0078"/> <code value="L"/> <display value="low"/> </coding> <text value="Below low normal"/> </interpretation> <!-- The BodySite can be captured in a LOINC code but am showing it here to demonstrate populating the element --> <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 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> <!-- Should have a refrange as well --> </component> <component> <code> <coding> <system value="http://loinc.org"/> <code value="8462-4"/> <display value="Diastolic blood pressure"/> </coding> </code> <!-- Here the Diastolic measurement is missing and we give a reason using the DataAbsentReason element --> <dataAbsentReason> <coding> <system value="http://hl7.org/fhir/data-absent-reason"/> <code value="not-performed"/> <display value="Not Performed"/> </coding> </dataAbsentReason> <!-- Should have a refrange as well --> </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.