HL7 FHIR® US Core Implementation Guide STU3 Release 3.1.1

This page is part of the US Core (v3.1.1: STU3) based on FHIR R4. The current version which supercedes this version is 6.1.0. For a full list of available versions, see the Directory of published versions. Page versions: STU6.1 STU6 STU5 STU4 STU3

StructureDefinition-us-core-pulse-oximetry

This profile sets minimum expectations for the Observation resource to record, search, and fetch pulse oximetry and inspired oxygen observations associated with a patient. It is based on the FHIR Vital Signs Profile and identifies the additional mandatory core elements, extensions, vocabularies and value sets which SHALL be present in the Observation resource when using this profile.

Example Usage Scenarios:

The following are example usage scenarios for the US Core Pulse Oximetry Profile:

  • Query for pulse oximety observations for a patient
  • Record or update pulse oximety observations belonging to a patient

Mandatory and Must Support Data Elements

In addition to the mandatory and must support data elements in the FHIR Oxygen Saturation Profile, the following data-elements are mandatory (i.e data MUST be present) or must be supported if the data is present in the sending system (Must Support definition). They are presented below in a simple human-readable explanation. Profile specific guidance and examples are provided as well. The Formal Profile Definition below provides the formal summary, definitions, and terminology requirements.

Each Observation must have:

  1. a fixed code for oxygen saturation in arterial blood as defined in the FHIR oxygen saturation profile
  2. a additional coding for oxygen saturation in arterial blood by pulse oximetry

Each Observation must support:

  1. a code for inspired oxygen concentration
  2. a value for inspired oxygen concentration

Profile specific implementation guidance:

  • Inspired oxygen therapy may be represented with component observations when measured at the same time as the pulse oximetry measurements. They are expressed as inhaled oxygen flow rate (e.g., 6 liters/min) and as inhaled oxygen concentration (e.g., 40% oxygen).
  • Many pulse oximetry readings are taken while the patient is breathing room air. The concept of “room air” (unmodified, ambient air) should be represented as an inhaled oxygen flow rate of 0 liters/min.
  • A pulse oximetry reading without component inspired oxygen observations may imply that the measurement was performed while the patient was breathing room air or that the inspired oxygen reading was omitted. To remove this uncertainty, the inspired oxygen component observations should be used.

Examples

Formal Views of Profile Content

Description of Profiles, Differentials, and Snapshots.

The official URL for this profile is: http://hl7.org/fhir/us/core/StructureDefinition/us-core-pulse-oximetry

Published on Mon Jun 29 00:00:00 AEST 2020 as active by the HL7 US Realm Steering Committee.

This profile builds on observation-oxygensat


Observation

Summary of the Mandatory Requirements

  1. A CodeableConcept in Observation.code with an extensible binding to Vital Signs
    • which should have one or more Coding values in Observation.code.coding
    • which must have at least a Coding value in Observation.code.coding
      • which must have a fixed Observation.code.coding.system = http://loinc.org
      • which must have a fixed Observation.code.coding.code = 59408-5

Summary of the Must Support Requirements

  1. One or more Components in Observation.component with the following constraints: If there is no a value a data absent reason must be present
  2. A Component in Observation.component with the following constraints: If there is no a value a data absent reason must be present
    • which must have a CodeableConcept value in Observation.component.code with an extensible binding to Vital Signs
    • which should have one or more Coding values in Observation.component.code.coding
    • which must have a fixed Observation.component.code.coding.system = http://loinc.org
    • which must have a fixed Observation.component.code.coding.code = 3151-8
    • which should have a Quantity value in Observation.component.valueQuantity with a required binding to Vital Signs Units
    • which must have a decimal value in Observation.component.valueQuantity.value
    • which must have a string value in Observation.component.valueQuantity.unit
    • which must have a fixed Observation.component.valueQuantity.system = http://unitsofmeasure.org
    • which must have a fixed Observation.component.valueQuantity.code = L/min
  3. A Component in Observation.component with the following constraints: If there is no a value a data absent reason must be present
    • which must have a CodeableConcept value in Observation.component.code with an extensible binding to Vital Signs
    • which should have one or more Coding values in Observation.component.code.coding
    • which must have a fixed Observation.component.code.coding.system = http://loinc.org
    • which must have a fixed Observation.component.code.coding.code = 3150-0
    • which should have a Quantity value in Observation.component.valueQuantity with a required binding to Vital Signs Units
    • which must have a decimal value in Observation.component.valueQuantity.value
    • which must have a string value in Observation.component.valueQuantity.unit
    • which must have a fixed Observation.component.valueQuantity.system = http://unitsofmeasure.org
    • which must have a fixed Observation.component.valueQuantity.code = %

Summary of Constraints

  1. If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present
  2. dataAbsentReason SHALL only be present if Observation.value[x] is not present
  3. If there is no component or hasMember element then either a value[x] or a data absent reason must be present.
  4. If there is no a value a data absent reason must be present
NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation 0..*observation-oxygensatFHIR Oxygen Saturation Profile
... code S1..1CodeableConceptOxygen Saturation by Pulse Oximetry
.... coding S0..*(Slice Definition)Code defined by a terminology system
Slice: Unordered, Open by value:code, value:system
..... coding:PulseOx S1..1CodingCode defined by a terminology system
...... system S1..1uriIdentity of the terminology system
Fixed Value: http://loinc.org
...... code S1..1codeSymbol in syntax defined by the system
Fixed Value: 59408-5
... component S0..*(Slice Definition)Used when reporting systolic and diastolic blood pressure.
Slice: Unordered, Open by pattern:code
.... component:FlowRate S0..1BackboneElementInhaled oxygen flow rate
..... code S1..1CodeableConceptType of component observation (code / type)
Required Pattern: At least the following
...... coding1..*CodingCode defined by a terminology system
Fixed Value: (complex)
....... system1..1uriIdentity of the terminology system
Fixed Value: http://loinc.org
....... code1..1codeSymbol in syntax defined by the system
Fixed Value: 3151-8
..... valueQuantity S0..1QuantityVital Sign Value recorded with UCUM
...... value S1..1decimalNumerical value (with implicit precision)
...... unit S1..1stringUnit representation
...... system S1..1uriSystem that defines coded unit form
Fixed Value: http://unitsofmeasure.org
...... code S1..1codeCoded form of the unit
Fixed Value: L/min
.... component:Concentration S0..1BackboneElementInhaled oxygen concentration
..... code S1..1CodeableConceptType of component observation (code / type)
Required Pattern: At least the following
...... coding1..*CodingCode defined by a terminology system
Fixed Value: (complex)
....... system1..1uriIdentity of the terminology system
Fixed Value: http://loinc.org
....... code1..1codeSymbol in syntax defined by the system
Fixed Value: 3150-0
..... valueQuantity S0..1QuantityVital Sign Value recorded with UCUM
...... value S1..1decimalNumerical value (with implicit precision)
...... unit S1..1stringUnit representation
...... system S1..1uriSystem that defines coded unit form
Fixed Value: http://unitsofmeasure.org
...... code S1..1codeCoded form of the unit
Fixed Value: %

doco Documentation for this format
NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation I0..*observation-oxygensatFHIR Oxygen Saturation Profile
... id Σ0..1stringLogical id of this artifact
... meta ΣI0..1MetaMetadata about the resource
... implicitRules ?!ΣI0..1uriA set of rules under which this content was created
... language I0..1codeLanguage of the resource content
Binding: CommonLanguages (preferred)
Max Binding: AllLanguages
... text I0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... extension I0..*ExtensionAdditional content defined by implementations
... modifierExtension ?!I0..*ExtensionExtensions that cannot be ignored
... identifier ΣI0..*IdentifierBusiness Identifier for observation
... basedOn ΣI0..*Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest)Fulfills plan, proposal or order
... partOf ΣI0..*Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy)Part of referenced event
... status ?!SΣI1..1coderegistered | preliminary | final | amended +
Binding: ObservationStatus (required)
... category SI1..*(Slice Definition)Classification of type of observation
Slice: Unordered, Open by value:coding.code, value:coding.system
Binding: ObservationCategoryCodes (preferred)
.... category:VSCat SI1..1CodeableConceptClassification of type of observation
Binding: ObservationCategoryCodes (preferred)
..... id 0..1stringUnique id for inter-element referencing
..... extension I0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
..... coding SΣI1..*CodingCode defined by a terminology system
...... id 0..1stringUnique id for inter-element referencing
...... extension I0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
...... system SΣI1..1uriIdentity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category
...... version ΣI0..1stringVersion of the system - if relevant
...... code SΣI1..1codeSymbol in syntax defined by the system
Fixed Value: vital-signs
...... display ΣI0..1stringRepresentation defined by the system
...... userSelected ΣI0..1booleanIf this coding was chosen directly by the user
..... text ΣI0..1stringPlain text representation of the concept
... code SΣI1..1CodeableConceptOxygen Saturation by Pulse Oximetry
Binding: VitalSigns (extensible)
.... id 0..1stringUnique id for inter-element referencing
.... extension I0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
.... coding SΣI0..*(Slice Definition)Code defined by a terminology system
Slice: Unordered, Open by value:code, value:system
..... coding:OxygenSatCode ΣI1..1CodingCode defined by a terminology system
...... id 0..1stringUnique id for inter-element referencing
...... extension I0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
...... system ΣI1..1uriIdentity of the terminology system
Fixed Value: http://loinc.org
...... version ΣI0..1stringVersion of the system - if relevant
...... code ΣI1..1codeSymbol in syntax defined by the system
Fixed Value: 2708-6
...... display ΣI0..1stringRepresentation defined by the system
...... userSelected ΣI0..1booleanIf this coding was chosen directly by the user
..... coding:PulseOx SΣI1..1CodingCode defined by a terminology system
...... id 0..1stringUnique id for inter-element referencing
...... extension I0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
...... system SΣI1..1uriIdentity of the terminology system
Fixed Value: http://loinc.org
...... version ΣI0..1stringVersion of the system - if relevant
...... code SΣI1..1codeSymbol in syntax defined by the system
Fixed Value: 59408-5
...... display ΣI0..1stringRepresentation defined by the system
...... userSelected ΣI0..1booleanIf this coding was chosen directly by the user
.... text ΣI0..1stringPlain text representation of the concept
... subject SΣI1..1Reference(Patient)Who and/or what the observation is about
... focus ΣI0..*Reference(Resource)What the observation is about, when it is not about the subject of record
... encounter ΣI0..1Reference(Encounter)Healthcare event during which this observation is made
... effective[x] SΣI1..1Often just a dateTime for Vital Signs
vs-1: if Observation.effective[x] is dateTime and has a value then that value shall be precise to the day
.... effectiveDateTimedateTime
.... effectivePeriodPeriod
... issued ΣI0..1instantDate/Time this version was made available
... performer ΣI0..*Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson)Who is responsible for the observation
... value[x] SΣI0..1(Slice Definition)Vital Signs value are recorded using the Quantity data type. For supporting observations such as Cuff size could use other datatypes such as CodeableConcept.
Slice: Unordered, Closed by type:$this
.... value[x]:valueQuantity SΣI0..1QuantityVital Signs value are recorded using the Quantity data type. For supporting observations such as Cuff size could use other datatypes such as CodeableConcept.
..... id 0..1stringUnique id for inter-element referencing
..... extension I0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
..... value SΣI1..1decimalNumerical value (with implicit precision)
..... comparator ?!ΣI0..1code< | <= | >= | > - how to understand the value
Binding: QuantityComparator (required)
..... unit SΣI1..1stringUnit representation
..... system SΣI1..1uriSystem that defines coded unit form
Fixed Value: http://unitsofmeasure.org
..... code SΣI1..1codeCoded responses from the common UCUM units for vital signs value set.
Fixed Value: %
... dataAbsentReason SI0..1CodeableConceptWhy the result is missing
Binding: DataAbsentReason (extensible)
... interpretation I0..*CodeableConceptHigh, low, normal, etc.
Binding: ObservationInterpretationCodes (extensible)
... note I0..*AnnotationComments about the observation
... bodySite I0..1CodeableConceptObserved body part
Binding: SNOMEDCTBodyStructures (example)
... method I0..1CodeableConceptHow it was done
Binding: ObservationMethods (example)
... specimen I0..1Reference(Specimen)Specimen used for this observation
... device I0..1Reference(Device | DeviceMetric)(Measurement) Device
... referenceRange I0..*BackboneElementProvides guide for interpretation
obs-3: Must have at least a low or a high or text
.... id 0..1stringUnique id for inter-element referencing
.... extension I0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!ΣI0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... low I0..1SimpleQuantityLow Range, if relevant
.... high I0..1SimpleQuantityHigh Range, if relevant
.... type I0..1CodeableConceptReference range qualifier
Binding: ObservationReferenceRangeMeaningCodes (preferred)
.... appliesTo I0..*CodeableConceptReference range population
Binding: ObservationReferenceRangeAppliesToCodes (example)
.... age I0..1RangeApplicable age range, if relevant
.... text I0..1stringText based reference range in an observation
... hasMember ΣI0..*Reference(QuestionnaireResponse | MolecularSequence | Vital Signs Profile)Used when reporting vital signs panel components
... derivedFrom ΣI0..*Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | MolecularSequence | Vital Signs Profile)Related measurements the observation is made from
... component SΣI0..*(Slice Definition)Used when reporting systolic and diastolic blood pressure.
Slice: Unordered, Open by pattern:code
.... component:All Slices Content/Rules for all slices
..... id 0..1stringUnique id for inter-element referencing
..... extension I0..*ExtensionAdditional content defined by implementations
..... modifierExtension ?!ΣI0..*ExtensionExtensions that cannot be ignored even if unrecognized
..... code SΣI1..1CodeableConceptType of component observation (code / type)
Binding: VitalSigns (extensible)
..... value[x] SΣI0..1Vital Sign Value recorded with UCUM
Binding: VitalSignsUnits (required)
...... valueQuantityQuantity
...... valueCodeableConceptCodeableConcept
...... valueStringstring
...... valueBooleanboolean
...... valueIntegerinteger
...... valueRangeRange
...... valueRatioRatio
...... valueSampledDataSampledData
...... valueTimetime
...... valueDateTimedateTime
...... valuePeriodPeriod
..... dataAbsentReason SI0..1CodeableConceptWhy the component result is missing
Binding: DataAbsentReason (extensible)
..... interpretation I0..*CodeableConceptHigh, low, normal, etc.
Binding: ObservationInterpretationCodes (extensible)
..... referenceRange I0..*See referenceRangeProvides guide for interpretation of component result
.... component:FlowRate SΣI0..1BackboneElementInhaled oxygen flow rate
..... id 0..1stringUnique id for inter-element referencing
..... extension I0..*ExtensionAdditional content defined by implementations
..... modifierExtension ?!ΣI0..*ExtensionExtensions that cannot be ignored even if unrecognized
..... code SΣI1..1CodeableConceptType of component observation (code / type)
Binding: VitalSigns (extensible)
Required Pattern: At least the following
...... id0..1stringUnique id for inter-element referencing
...... extension0..*ExtensionAdditional content defined by implementations
...... coding1..*CodingCode defined by a terminology system
Fixed Value: (complex)
....... id0..1stringUnique id for inter-element referencing
....... extension0..*ExtensionAdditional content defined by implementations
....... system1..1uriIdentity of the terminology system
Fixed Value: http://loinc.org
....... version0..1stringVersion of the system - if relevant
....... code1..1codeSymbol in syntax defined by the system
Fixed Value: 3151-8
....... display0..1stringRepresentation defined by the system
....... userSelected0..1booleanIf this coding was chosen directly by the user
...... text0..1stringPlain text representation of the concept
..... value[x] SΣI0..1QuantityVital Sign Value recorded with UCUM
Binding: VitalSignsUnits (required)
...... id 0..1stringUnique id for inter-element referencing
...... extension I0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
...... value SΣI1..1decimalNumerical value (with implicit precision)
...... comparator ?!ΣI0..1code< | <= | >= | > - how to understand the value
Binding: QuantityComparator (required)
...... unit SΣI1..1stringUnit representation
...... system SΣI1..1uriSystem that defines coded unit form
Fixed Value: http://unitsofmeasure.org
...... code SΣI1..1codeCoded form of the unit
Fixed Value: L/min
..... dataAbsentReason SI0..1CodeableConceptWhy the component result is missing
Binding: DataAbsentReason (extensible)
..... interpretation I0..*CodeableConceptHigh, low, normal, etc.
Binding: ObservationInterpretationCodes (extensible)
..... referenceRange I0..*See referenceRangeProvides guide for interpretation of component result
.... component:Concentration SΣI0..1BackboneElementInhaled oxygen concentration
..... id 0..1stringUnique id for inter-element referencing
..... extension I0..*ExtensionAdditional content defined by implementations
..... modifierExtension ?!ΣI0..*ExtensionExtensions that cannot be ignored even if unrecognized
..... code SΣI1..1CodeableConceptType of component observation (code / type)
Binding: VitalSigns (extensible)
Required Pattern: At least the following
...... id0..1stringUnique id for inter-element referencing
...... extension0..*ExtensionAdditional content defined by implementations
...... coding1..*CodingCode defined by a terminology system
Fixed Value: (complex)
....... id0..1stringUnique id for inter-element referencing
....... extension0..*ExtensionAdditional content defined by implementations
....... system1..1uriIdentity of the terminology system
Fixed Value: http://loinc.org
....... version0..1stringVersion of the system - if relevant
....... code1..1codeSymbol in syntax defined by the system
Fixed Value: 3150-0
....... display0..1stringRepresentation defined by the system
....... userSelected0..1booleanIf this coding was chosen directly by the user
...... text0..1stringPlain text representation of the concept
..... value[x] SΣI0..1QuantityVital Sign Value recorded with UCUM
Binding: VitalSignsUnits (required)
...... id 0..1stringUnique id for inter-element referencing
...... extension I0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
...... value SΣI1..1decimalNumerical value (with implicit precision)
...... comparator ?!ΣI0..1code< | <= | >= | > - how to understand the value
Binding: QuantityComparator (required)
...... unit SΣI1..1stringUnit representation
...... system SΣI1..1uriSystem that defines coded unit form
Fixed Value: http://unitsofmeasure.org
...... code SΣI1..1codeCoded form of the unit
Fixed Value: %
..... dataAbsentReason SI0..1CodeableConceptWhy the component result is missing
Binding: DataAbsentReason (extensible)
..... interpretation I0..*CodeableConceptHigh, low, normal, etc.
Binding: ObservationInterpretationCodes (extensible)
..... referenceRange I0..*See referenceRangeProvides guide for interpretation of component result

doco Documentation for this format

Observation

Summary of the Mandatory Requirements

  1. A CodeableConcept in Observation.code with an extensible binding to Vital Signs
    • which should have one or more Coding values in Observation.code.coding
    • which must have at least a Coding value in Observation.code.coding
      • which must have a fixed Observation.code.coding.system = http://loinc.org
      • which must have a fixed Observation.code.coding.code = 59408-5

Summary of the Must Support Requirements

  1. One or more Components in Observation.component with the following constraints: If there is no a value a data absent reason must be present
  2. A Component in Observation.component with the following constraints: If there is no a value a data absent reason must be present
    • which must have a CodeableConcept value in Observation.component.code with an extensible binding to Vital Signs
    • which should have one or more Coding values in Observation.component.code.coding
    • which must have a fixed Observation.component.code.coding.system = http://loinc.org
    • which must have a fixed Observation.component.code.coding.code = 3151-8
    • which should have a Quantity value in Observation.component.valueQuantity with a required binding to Vital Signs Units
    • which must have a decimal value in Observation.component.valueQuantity.value
    • which must have a string value in Observation.component.valueQuantity.unit
    • which must have a fixed Observation.component.valueQuantity.system = http://unitsofmeasure.org
    • which must have a fixed Observation.component.valueQuantity.code = L/min
  3. A Component in Observation.component with the following constraints: If there is no a value a data absent reason must be present
    • which must have a CodeableConcept value in Observation.component.code with an extensible binding to Vital Signs
    • which should have one or more Coding values in Observation.component.code.coding
    • which must have a fixed Observation.component.code.coding.system = http://loinc.org
    • which must have a fixed Observation.component.code.coding.code = 3150-0
    • which should have a Quantity value in Observation.component.valueQuantity with a required binding to Vital Signs Units
    • which must have a decimal value in Observation.component.valueQuantity.value
    • which must have a string value in Observation.component.valueQuantity.unit
    • which must have a fixed Observation.component.valueQuantity.system = http://unitsofmeasure.org
    • which must have a fixed Observation.component.valueQuantity.code = %

Summary of Constraints

  1. If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present
  2. dataAbsentReason SHALL only be present if Observation.value[x] is not present
  3. If there is no component or hasMember element then either a value[x] or a data absent reason must be present.
  4. If there is no a value a data absent reason must be present

Differential View

NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation 0..*observation-oxygensatFHIR Oxygen Saturation Profile
... code S1..1CodeableConceptOxygen Saturation by Pulse Oximetry
.... coding S0..*(Slice Definition)Code defined by a terminology system
Slice: Unordered, Open by value:code, value:system
..... coding:PulseOx S1..1CodingCode defined by a terminology system
...... system S1..1uriIdentity of the terminology system
Fixed Value: http://loinc.org
...... code S1..1codeSymbol in syntax defined by the system
Fixed Value: 59408-5
... component S0..*(Slice Definition)Used when reporting systolic and diastolic blood pressure.
Slice: Unordered, Open by pattern:code
.... component:FlowRate S0..1BackboneElementInhaled oxygen flow rate
..... code S1..1CodeableConceptType of component observation (code / type)
Required Pattern: At least the following
...... coding1..*CodingCode defined by a terminology system
Fixed Value: (complex)
....... system1..1uriIdentity of the terminology system
Fixed Value: http://loinc.org
....... code1..1codeSymbol in syntax defined by the system
Fixed Value: 3151-8
..... valueQuantity S0..1QuantityVital Sign Value recorded with UCUM
...... value S1..1decimalNumerical value (with implicit precision)
...... unit S1..1stringUnit representation
...... system S1..1uriSystem that defines coded unit form
Fixed Value: http://unitsofmeasure.org
...... code S1..1codeCoded form of the unit
Fixed Value: L/min
.... component:Concentration S0..1BackboneElementInhaled oxygen concentration
..... code S1..1CodeableConceptType of component observation (code / type)
Required Pattern: At least the following
...... coding1..*CodingCode defined by a terminology system
Fixed Value: (complex)
....... system1..1uriIdentity of the terminology system
Fixed Value: http://loinc.org
....... code1..1codeSymbol in syntax defined by the system
Fixed Value: 3150-0
..... valueQuantity S0..1QuantityVital Sign Value recorded with UCUM
...... value S1..1decimalNumerical value (with implicit precision)
...... unit S1..1stringUnit representation
...... system S1..1uriSystem that defines coded unit form
Fixed Value: http://unitsofmeasure.org
...... code S1..1codeCoded form of the unit
Fixed Value: %

doco Documentation for this format

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation I0..*observation-oxygensatFHIR Oxygen Saturation Profile
... id Σ0..1stringLogical id of this artifact
... meta ΣI0..1MetaMetadata about the resource
... implicitRules ?!ΣI0..1uriA set of rules under which this content was created
... language I0..1codeLanguage of the resource content
Binding: CommonLanguages (preferred)
Max Binding: AllLanguages
... text I0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... extension I0..*ExtensionAdditional content defined by implementations
... modifierExtension ?!I0..*ExtensionExtensions that cannot be ignored
... identifier ΣI0..*IdentifierBusiness Identifier for observation
... basedOn ΣI0..*Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest)Fulfills plan, proposal or order
... partOf ΣI0..*Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy)Part of referenced event
... status ?!SΣI1..1coderegistered | preliminary | final | amended +
Binding: ObservationStatus (required)
... category SI1..*(Slice Definition)Classification of type of observation
Slice: Unordered, Open by value:coding.code, value:coding.system
Binding: ObservationCategoryCodes (preferred)
.... category:VSCat SI1..1CodeableConceptClassification of type of observation
Binding: ObservationCategoryCodes (preferred)
..... id 0..1stringUnique id for inter-element referencing
..... extension I0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
..... coding SΣI1..*CodingCode defined by a terminology system
...... id 0..1stringUnique id for inter-element referencing
...... extension I0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
...... system SΣI1..1uriIdentity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category
...... version ΣI0..1stringVersion of the system - if relevant
...... code SΣI1..1codeSymbol in syntax defined by the system
Fixed Value: vital-signs
...... display ΣI0..1stringRepresentation defined by the system
...... userSelected ΣI0..1booleanIf this coding was chosen directly by the user
..... text ΣI0..1stringPlain text representation of the concept
... code SΣI1..1CodeableConceptOxygen Saturation by Pulse Oximetry
Binding: VitalSigns (extensible)
.... id 0..1stringUnique id for inter-element referencing
.... extension I0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
.... coding SΣI0..*(Slice Definition)Code defined by a terminology system
Slice: Unordered, Open by value:code, value:system
..... coding:OxygenSatCode ΣI1..1CodingCode defined by a terminology system
...... id 0..1stringUnique id for inter-element referencing
...... extension I0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
...... system ΣI1..1uriIdentity of the terminology system
Fixed Value: http://loinc.org
...... version ΣI0..1stringVersion of the system - if relevant
...... code ΣI1..1codeSymbol in syntax defined by the system
Fixed Value: 2708-6
...... display ΣI0..1stringRepresentation defined by the system
...... userSelected ΣI0..1booleanIf this coding was chosen directly by the user
..... coding:PulseOx SΣI1..1CodingCode defined by a terminology system
...... id 0..1stringUnique id for inter-element referencing
...... extension I0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
...... system SΣI1..1uriIdentity of the terminology system
Fixed Value: http://loinc.org
...... version ΣI0..1stringVersion of the system - if relevant
...... code SΣI1..1codeSymbol in syntax defined by the system
Fixed Value: 59408-5
...... display ΣI0..1stringRepresentation defined by the system
...... userSelected ΣI0..1booleanIf this coding was chosen directly by the user
.... text ΣI0..1stringPlain text representation of the concept
... subject SΣI1..1Reference(Patient)Who and/or what the observation is about
... focus ΣI0..*Reference(Resource)What the observation is about, when it is not about the subject of record
... encounter ΣI0..1Reference(Encounter)Healthcare event during which this observation is made
... effective[x] SΣI1..1Often just a dateTime for Vital Signs
vs-1: if Observation.effective[x] is dateTime and has a value then that value shall be precise to the day
.... effectiveDateTimedateTime
.... effectivePeriodPeriod
... issued ΣI0..1instantDate/Time this version was made available
... performer ΣI0..*Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson)Who is responsible for the observation
... value[x] SΣI0..1(Slice Definition)Vital Signs value are recorded using the Quantity data type. For supporting observations such as Cuff size could use other datatypes such as CodeableConcept.
Slice: Unordered, Closed by type:$this
.... value[x]:valueQuantity SΣI0..1QuantityVital Signs value are recorded using the Quantity data type. For supporting observations such as Cuff size could use other datatypes such as CodeableConcept.
..... id 0..1stringUnique id for inter-element referencing
..... extension I0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
..... value SΣI1..1decimalNumerical value (with implicit precision)
..... comparator ?!ΣI0..1code< | <= | >= | > - how to understand the value
Binding: QuantityComparator (required)
..... unit SΣI1..1stringUnit representation
..... system SΣI1..1uriSystem that defines coded unit form
Fixed Value: http://unitsofmeasure.org
..... code SΣI1..1codeCoded responses from the common UCUM units for vital signs value set.
Fixed Value: %
... dataAbsentReason SI0..1CodeableConceptWhy the result is missing
Binding: DataAbsentReason (extensible)
... interpretation I0..*CodeableConceptHigh, low, normal, etc.
Binding: ObservationInterpretationCodes (extensible)
... note I0..*AnnotationComments about the observation
... bodySite I0..1CodeableConceptObserved body part
Binding: SNOMEDCTBodyStructures (example)
... method I0..1CodeableConceptHow it was done
Binding: ObservationMethods (example)
... specimen I0..1Reference(Specimen)Specimen used for this observation
... device I0..1Reference(Device | DeviceMetric)(Measurement) Device
... referenceRange I0..*BackboneElementProvides guide for interpretation
obs-3: Must have at least a low or a high or text
.... id 0..1stringUnique id for inter-element referencing
.... extension I0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!ΣI0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... low I0..1SimpleQuantityLow Range, if relevant
.... high I0..1SimpleQuantityHigh Range, if relevant
.... type I0..1CodeableConceptReference range qualifier
Binding: ObservationReferenceRangeMeaningCodes (preferred)
.... appliesTo I0..*CodeableConceptReference range population
Binding: ObservationReferenceRangeAppliesToCodes (example)
.... age I0..1RangeApplicable age range, if relevant
.... text I0..1stringText based reference range in an observation
... hasMember ΣI0..*Reference(QuestionnaireResponse | MolecularSequence | Vital Signs Profile)Used when reporting vital signs panel components
... derivedFrom ΣI0..*Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | MolecularSequence | Vital Signs Profile)Related measurements the observation is made from
... component SΣI0..*(Slice Definition)Used when reporting systolic and diastolic blood pressure.
Slice: Unordered, Open by pattern:code
.... component:All Slices Content/Rules for all slices
..... id 0..1stringUnique id for inter-element referencing
..... extension I0..*ExtensionAdditional content defined by implementations
..... modifierExtension ?!ΣI0..*ExtensionExtensions that cannot be ignored even if unrecognized
..... code SΣI1..1CodeableConceptType of component observation (code / type)
Binding: VitalSigns (extensible)
..... value[x] SΣI0..1Vital Sign Value recorded with UCUM
Binding: VitalSignsUnits (required)
...... valueQuantityQuantity
...... valueCodeableConceptCodeableConcept
...... valueStringstring
...... valueBooleanboolean
...... valueIntegerinteger
...... valueRangeRange
...... valueRatioRatio
...... valueSampledDataSampledData
...... valueTimetime
...... valueDateTimedateTime
...... valuePeriodPeriod
..... dataAbsentReason SI0..1CodeableConceptWhy the component result is missing
Binding: DataAbsentReason (extensible)
..... interpretation I0..*CodeableConceptHigh, low, normal, etc.
Binding: ObservationInterpretationCodes (extensible)
..... referenceRange I0..*See referenceRangeProvides guide for interpretation of component result
.... component:FlowRate SΣI0..1BackboneElementInhaled oxygen flow rate
..... id 0..1stringUnique id for inter-element referencing
..... extension I0..*ExtensionAdditional content defined by implementations
..... modifierExtension ?!ΣI0..*ExtensionExtensions that cannot be ignored even if unrecognized
..... code SΣI1..1CodeableConceptType of component observation (code / type)
Binding: VitalSigns (extensible)
Required Pattern: At least the following
...... id0..1stringUnique id for inter-element referencing
...... extension0..*ExtensionAdditional content defined by implementations
...... coding1..*CodingCode defined by a terminology system
Fixed Value: (complex)
....... id0..1stringUnique id for inter-element referencing
....... extension0..*ExtensionAdditional content defined by implementations
....... system1..1uriIdentity of the terminology system
Fixed Value: http://loinc.org
....... version0..1stringVersion of the system - if relevant
....... code1..1codeSymbol in syntax defined by the system
Fixed Value: 3151-8
....... display0..1stringRepresentation defined by the system
....... userSelected0..1booleanIf this coding was chosen directly by the user
...... text0..1stringPlain text representation of the concept
..... value[x] SΣI0..1QuantityVital Sign Value recorded with UCUM
Binding: VitalSignsUnits (required)
...... id 0..1stringUnique id for inter-element referencing
...... extension I0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
...... value SΣI1..1decimalNumerical value (with implicit precision)
...... comparator ?!ΣI0..1code< | <= | >= | > - how to understand the value
Binding: QuantityComparator (required)
...... unit SΣI1..1stringUnit representation
...... system SΣI1..1uriSystem that defines coded unit form
Fixed Value: http://unitsofmeasure.org
...... code SΣI1..1codeCoded form of the unit
Fixed Value: L/min
..... dataAbsentReason SI0..1CodeableConceptWhy the component result is missing
Binding: DataAbsentReason (extensible)
..... interpretation I0..*CodeableConceptHigh, low, normal, etc.
Binding: ObservationInterpretationCodes (extensible)
..... referenceRange I0..*See referenceRangeProvides guide for interpretation of component result
.... component:Concentration SΣI0..1BackboneElementInhaled oxygen concentration
..... id 0..1stringUnique id for inter-element referencing
..... extension I0..*ExtensionAdditional content defined by implementations
..... modifierExtension ?!ΣI0..*ExtensionExtensions that cannot be ignored even if unrecognized
..... code SΣI1..1CodeableConceptType of component observation (code / type)
Binding: VitalSigns (extensible)
Required Pattern: At least the following
...... id0..1stringUnique id for inter-element referencing
...... extension0..*ExtensionAdditional content defined by implementations
...... coding1..*CodingCode defined by a terminology system
Fixed Value: (complex)
....... id0..1stringUnique id for inter-element referencing
....... extension0..*ExtensionAdditional content defined by implementations
....... system1..1uriIdentity of the terminology system
Fixed Value: http://loinc.org
....... version0..1stringVersion of the system - if relevant
....... code1..1codeSymbol in syntax defined by the system
Fixed Value: 3150-0
....... display0..1stringRepresentation defined by the system
....... userSelected0..1booleanIf this coding was chosen directly by the user
...... text0..1stringPlain text representation of the concept
..... value[x] SΣI0..1QuantityVital Sign Value recorded with UCUM
Binding: VitalSignsUnits (required)
...... id 0..1stringUnique id for inter-element referencing
...... extension I0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
...... value SΣI1..1decimalNumerical value (with implicit precision)
...... comparator ?!ΣI0..1code< | <= | >= | > - how to understand the value
Binding: QuantityComparator (required)
...... unit SΣI1..1stringUnit representation
...... system SΣI1..1uriSystem that defines coded unit form
Fixed Value: http://unitsofmeasure.org
...... code SΣI1..1codeCoded form of the unit
Fixed Value: %
..... dataAbsentReason SI0..1CodeableConceptWhy the component result is missing
Binding: DataAbsentReason (extensible)
..... interpretation I0..*CodeableConceptHigh, low, normal, etc.
Binding: ObservationInterpretationCodes (extensible)
..... referenceRange I0..*See referenceRangeProvides guide for interpretation of component result

doco Documentation for this format

Downloads: StructureDefinition: (XML, JSON), Schema: XML Schematron


Quick Start

Below is an overview of the required set of Server RESTful FHIR interactions - for example, search and read operations - for this profile. See the Conformance requirements for a complete list of supported RESTful interactions for this IG.

  • See the General Guidance section for additional rules and expectations when a server requires status parameters.

See the Vital Signs Quick Start section for how to search by vital signs.