Vital Signs Implementation Guide version 0.1.0 (Release 0.1.0 Ballot )

This page is part of the Vital Signs FHIR IG (v0.1.0: STU 1 Ballot 1) based on FHIR R4. The current version which supercedes this version is 1.0.0. For a full list of available versions, see the Directory of published versions

StructureDefinition-BloodPressurePanel

The Blood Pressure Panel profile contains three observations, systolic, diastolic, and mean arterial blood pressures. These are slices of the component element (Observation.component) and the value (Observation.value) has been constrained out (cardinality set to 0). Systolic and Diastolic blood pressures are commonly stored together as a “blood pressure”. There are times when a mean arterial pressure needs to be stored also, so it was included. The only required observation of the three is Systolic BP. By doing so the panel may be used to record any combination of Systolic + Diastolic, Systolic only , or all three. This negates the need to create individual FHIR profiles for any of the three.

In addition, the Blood Pressure Panel profile contains the following qualifying observations with associated SNOMED CT value sets: Body Position (e.g. standing, sitting, Trendelenburg); Blood Pressure Measurement Site (Note that this value set contains both the artery, such as brachial artery, and the external cuff location); Blood Pressure Method (e.g. auscultation, doppler); Exercise Association Reference Set (e.g. before exercise, after exercise); Sleep status (e.g. awake, asleep); and Vital Signs Associated Precondition (e.g. before cardioversion, after cardioversion). Blood Pressure Cuff Size (from size 1 for premature babies up to thigh cuff) and Blood Pressure Device Type (e.g. aneroid sphygmomanometer, arterial line) have been combined into a single extension, Measurement Device Ext.

Examples

The following examples are provided to illustrate conformant resource content to this profile.


Scope and Usage

Use Cases

1. Blood pressure taken while in a lying position

FHIR resource path Text Description Code Terminology
Observation.code Blood Pressure Panel with all children optional 85354-9 LOINC
Observation.component.code Systolic Blood Pressure 8480-6 LOINC
Observation.component.code Diastolic BloodPressure Meas 8462-4 LOINC
Body Position extension bindings
Observation.extension(bodyPositionExt) mapping Body position with respect to gravity 8361-8 LOINC
Observation.extension(bodyPositionExt).value value sets Body Position reference set (foundation metadata concept) 881000205109 SNOMED Solor Extension
Body position reference set 2.16.840.1.113762.1.4.1181.38 VSAC
Observation.extension(bodyPositionExt).value Supine body position (finding) 40199007 SNOMED CT


2. Blood Pressure taken with an adult size cuff via left brachial artery

FHIR resource path Text Description Code Terminology
Observation.code Blood Pressure Panel with all children optional 85354-9 LOINC
Observation.component.code Systolic blood pressure 8480-6 LOINC
Cuff size bindings
MeasurementDeviceExt.code value sets Blood Pressure device cuff size reference set (foundation metadata concept) 1481000205107 SNOMED CT Solor extension
Blood pressure device cuff size reference set 2.16.840.1.113762.1.4.1181.41 VSAC
MeasurementDeviceExt.value Blood pressure cuff, adult size large 720738005 SNOMED CT
Body Site bindings
Observation.bodySite Body location qualifier 39112-8 LOINC
bodySite value sets Blood pressure measurement site reference set (foundation metadata concept) 901000205107 SNOMED CT Solor extension
Blood pressure measurement site reference set 2.16.840.1.113762.1.4.1181.43 VSAC
bodySite.value Structure of left brachial artery (body structure) 723961002 SNOMED CT


Value sets

Value Set Purpose VSAC OID
Body Position This reference set contains concepts used to result the patient's body position, referencing the SNOMED Code 397155001 Body position (observable entity) and the LOINC term "Body position with respect to gravity" 8361-8. 2.16.840.1.113762.1.4.1181.38
Blood Pressure Device Type This reference set contains concepts used to result the type of device used to measure a body blood pressure, referencing the SNOMED Code 23591000205102 “Blood pressure device type (observable entity)" and the LOINC term “Type of Blood pressure device” 41901-0. This refset needs to be updated in Solor
Blood Pressure Measurement Site This reference set contains a constrained list body location values used to result the body location where a blood pressure was measured, referencing the SNOMED Code 2281000205100 “Blood pressure measurement site (observable entity)” and the LOINC term "Blood pressure measurement site", 41904-4. 2.16.840.1.113762.1.4.1181.21
Blood Pressure Method This reference set contains concepts used to result the method used for a blood pressure measurement, referencing the SNOMED Code 2291000205103 “Blood pressure method (observable entity)” and the LOINC term "Blood pressure method" 8357-6. 2.16.840.1.113762.1.4.1181.45
Exertion Phase Reference Set The purpose of the reference set is to document exercise associated with a measurement. Resulting LOINC code 74008-4 "Exercise intensity". 2.16.840.1.113762.1.4.1181.36
Sleep Status This reference set contains values used to indicate the state of wakefulness during measurement. 2.16.840.1.113762.1.4.1181.23


Mandatory and Must Support Data Elements

Each resource must have:

  • Observation.category (fixed to Vital Signs category)
  • Observation.code (fixed to LOINC code 85354-9)
  • Observation.subject
  • Observation.effective
  • Observation.component (Systolic Blood Pressure, LOINC 8450-6)
  • Observation.component (Diastolic Blood Pressure, LOINC 8462-4)

Each resource must support:

  • Body Position extension
  • Measurement Device extension
  • Blood Pressure Cuff Size extension
  • Sleep Status extension
  • Associated Precondition extension
  • status
  • category
  • subject
  • effecitve
  • all components, including component.code and component.valueQuantity (value, unit, system, and code)


Formal Views of Profile Content

Description of Profiles, Differentials, and Snapshots.

The official URL for this profile is: http://hl7.org/fhir/us/vitals/StructureDefinition/BloodPressurePanel

Published on Wed May 29 00:00:00 UTC 2019 as a draft by Logica Health.

This profile builds on observation-vitalsigns

Summary

Mandatory: 3 elements (12 nested mandatory elements)
Must-Support: 28 elements
Fixed Value: 6 elements
Prohibited: 2 elements

Structures

This structure refers to these other structures:

Extensions

This structure refers to these extensions:

Slices

This structure defines the following Slices:

  • The element Observation.component is sliced based on the value of pattern:code
NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation 0..*observation-vitalsignsBloodPressurePanel
... BodyPositionExt S0..1CodeableConceptBody Position
URL: http://hl7.org/fhir/us/vitals/StructureDefinition/BodyPositionExt
Binding: Body Position value set (preferred)
... MeasurementDeviceExt S0..*CodeableConceptMeasurement Device
URL: http://hl7.org/fhir/us/vitals/StructureDefinition/MeasurementDeviceExt
Binding: Blood Pressure Measurement Device and Cuff Size value set (preferred)
... SleepStatusExt S0..1CodeableConceptSleep Status
URL: http://hl7.org/fhir/us/vitals/StructureDefinition/SleepStatusExt
Binding: Sleep Status value set (preferred)
... ExerciseAssociationExt S0..1CodeableConceptExercise Association
URL: http://hl7.org/fhir/us/vitals/StructureDefinition/ExerciseAssociationExt
Binding: Exertion Phase value set (preferred)
... MeasurementSettingExt 0..1CodeableConceptMeasurement setting
URL: http://hl7.org/fhir/us/vitals/StructureDefinition/MeasurementSettingExt
Binding: Measurement Setting value set (preferred)
... MeasurementProtocolExt 0..1CodeableConceptAlgorithm for Blood Pressure
URL: http://hl7.org/fhir/us/vitals/StructureDefinition/MeasurementProtocolExt
Binding: MeasurementProtocolVS (preferred)
... status S1..1coderegistered | preliminary | final | amended +
... code 1..1CodeableConceptCoded Responses from C-CDA Vital Sign Results
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: 85354-9
..... display1..1stringRepresentation defined by the system
Fixed Value: Blood pressure panel with all children optional
... subject S1..1Reference(US Core Patient Profile)Who and/or what the observation is about
... effective[x] S1..1dateTime, PeriodOften just a dateTime for Vital Signs
... value[x] 0..0
... bodySite 0..1CodeableConceptObserved body part
Binding: Blood Pressure Measurement Body Location Precoodinated value set (preferred)
... method 0..1CodeableConceptHow it was done
Binding: Blood Pressure Measurement Method value set (preferred)
... specimen 0..0
... device S0..1Reference(BloodPressureDevice)Blood Pressure Device
... component S0..*(Slice Definition)Blood pressure components
Slice: Unordered, Open by pattern:code
.... component:SystolicBP 1..1BackboneElementSystolic Blood Pressure
..... 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: 8480-6
....... display1..1stringRepresentation defined by the system
Fixed Value: Systolic blood pressure
..... valueQuantity S0..1QuantityVital Sign Value recorded with UCUM
...... value S1..1decimalNumerical value (with implicit precision)
...... unit S1..1stringUnit representation
...... system S1..1uriPrimitive Type uri
Fixed Value: http://unitsofmeasure.org
...... code S1..1codePrimitive Type code
Fixed Value: mm[Hg]
.... component:DiastolicBP 0..1BackboneElementDiastolic Blood Pressure
..... 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: 8462-4
....... display1..1stringRepresentation defined by the system
Fixed Value: Diastolic blood pressure
..... valueQuantity S0..1QuantityVital Sign Value recorded with UCUM
...... value S1..1decimalNumerical value (with implicit precision)
...... unit S1..1stringUnit representation
...... system S1..1uriPrimitive Type uri
Fixed Value: http://unitsofmeasure.org
...... code S1..1codePrimitive Type code
Fixed Value: mm[Hg]
.... component:MeanArterialBP S0..1BackboneElementMean Arterial Blood Pressure
..... 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: 8478-0
....... display1..1stringRepresentation defined by the system
Fixed Value: Mean blood pressure
..... valueQuantity S0..1QuantityVital Sign Value recorded with UCUM
...... value S1..1decimalNumerical value (with implicit precision)
...... unit S1..1stringUnit representation
...... system S1..1uriPrimitive Type uri
Fixed Value: http://unitsofmeasure.org
...... code S1..1codePrimitive Type code
Fixed Value: mm[Hg]

doco Documentation for this format
NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation I0..*observation-vitalsignsBloodPressurePanel
... 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..*ExtensionExtension
Slice: Unordered, Open by value:url
... BodyPositionExt SI0..1CodeableConceptBody Position
URL: http://hl7.org/fhir/us/vitals/StructureDefinition/BodyPositionExt
... MeasurementDeviceExt SI0..*CodeableConceptMeasurement Device
URL: http://hl7.org/fhir/us/vitals/StructureDefinition/MeasurementDeviceExt
... SleepStatusExt SI0..1CodeableConceptSleep Status
URL: http://hl7.org/fhir/us/vitals/StructureDefinition/SleepStatusExt
... ExerciseAssociationExt SI0..1CodeableConceptExercise Association
URL: http://hl7.org/fhir/us/vitals/StructureDefinition/ExerciseAssociationExt
... MeasurementSettingExt I0..1CodeableConceptMeasurement setting
URL: http://hl7.org/fhir/us/vitals/StructureDefinition/MeasurementSettingExt
... MeasurementProtocolExt I0..1CodeableConceptAlgorithm for Blood Pressure
URL: http://hl7.org/fhir/us/vitals/StructureDefinition/MeasurementProtocolExt
Binding: MeasurementProtocolVS (preferred)
... 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..1CodeableConceptCoded Responses from C-CDA Vital Sign Results
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: 85354-9
..... display1..1stringRepresentation defined by the system
Fixed Value: Blood pressure panel with all children optional
..... userSelected0..1booleanIf this coding was chosen directly by the user
.... text0..1stringPlain text representation of the concept
... subject SΣI1..1Reference(US Core Patient Profile)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
.... 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
... 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: Blood Pressure Measurement Body Location Precoodinated value set (preferred)
... method I0..1CodeableConceptHow it was done
Binding: Blood Pressure Measurement Method value set (preferred)
... device SI0..1Reference(BloodPressureDevice)Blood Pressure 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)Blood pressure components
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:SystolicBP SΣI1..1BackboneElementSystolic Blood Pressure
..... 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: 8480-6
....... display1..1stringRepresentation defined by the system
Fixed Value: Systolic blood pressure
....... 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 SI1..1uriPrimitive Type uri
Fixed Value: http://unitsofmeasure.org
...... code SI1..1codePrimitive Type code
Fixed Value: mm[Hg]
..... 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:DiastolicBP SΣI0..1BackboneElementDiastolic Blood Pressure
..... 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: 8462-4
....... display1..1stringRepresentation defined by the system
Fixed Value: Diastolic blood pressure
....... 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 SI1..1uriPrimitive Type uri
Fixed Value: http://unitsofmeasure.org
...... code SI1..1codePrimitive Type code
Fixed Value: mm[Hg]
..... 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:MeanArterialBP SΣI0..1BackboneElementMean Arterial Blood Pressure
..... 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: 8478-0
....... display1..1stringRepresentation defined by the system
Fixed Value: Mean blood pressure
....... 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 SI1..1uriPrimitive Type uri
Fixed Value: http://unitsofmeasure.org
...... code SI1..1codePrimitive Type code
Fixed Value: mm[Hg]
..... 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

Summary

Mandatory: 3 elements (12 nested mandatory elements)
Must-Support: 28 elements
Fixed Value: 6 elements
Prohibited: 2 elements

Structures

This structure refers to these other structures:

Extensions

This structure refers to these extensions:

Slices

This structure defines the following Slices:

  • The element Observation.component is sliced based on the value of pattern:code

Differential View

NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation 0..*observation-vitalsignsBloodPressurePanel
... BodyPositionExt S0..1CodeableConceptBody Position
URL: http://hl7.org/fhir/us/vitals/StructureDefinition/BodyPositionExt
Binding: Body Position value set (preferred)
... MeasurementDeviceExt S0..*CodeableConceptMeasurement Device
URL: http://hl7.org/fhir/us/vitals/StructureDefinition/MeasurementDeviceExt
Binding: Blood Pressure Measurement Device and Cuff Size value set (preferred)
... SleepStatusExt S0..1CodeableConceptSleep Status
URL: http://hl7.org/fhir/us/vitals/StructureDefinition/SleepStatusExt
Binding: Sleep Status value set (preferred)
... ExerciseAssociationExt S0..1CodeableConceptExercise Association
URL: http://hl7.org/fhir/us/vitals/StructureDefinition/ExerciseAssociationExt
Binding: Exertion Phase value set (preferred)
... MeasurementSettingExt 0..1CodeableConceptMeasurement setting
URL: http://hl7.org/fhir/us/vitals/StructureDefinition/MeasurementSettingExt
Binding: Measurement Setting value set (preferred)
... MeasurementProtocolExt 0..1CodeableConceptAlgorithm for Blood Pressure
URL: http://hl7.org/fhir/us/vitals/StructureDefinition/MeasurementProtocolExt
Binding: MeasurementProtocolVS (preferred)
... status S1..1coderegistered | preliminary | final | amended +
... code 1..1CodeableConceptCoded Responses from C-CDA Vital Sign Results
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: 85354-9
..... display1..1stringRepresentation defined by the system
Fixed Value: Blood pressure panel with all children optional
... subject S1..1Reference(US Core Patient Profile)Who and/or what the observation is about
... effective[x] S1..1dateTime, PeriodOften just a dateTime for Vital Signs
... value[x] 0..0
... bodySite 0..1CodeableConceptObserved body part
Binding: Blood Pressure Measurement Body Location Precoodinated value set (preferred)
... method 0..1CodeableConceptHow it was done
Binding: Blood Pressure Measurement Method value set (preferred)
... specimen 0..0
... device S0..1Reference(BloodPressureDevice)Blood Pressure Device
... component S0..*(Slice Definition)Blood pressure components
Slice: Unordered, Open by pattern:code
.... component:SystolicBP 1..1BackboneElementSystolic Blood Pressure
..... 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: 8480-6
....... display1..1stringRepresentation defined by the system
Fixed Value: Systolic blood pressure
..... valueQuantity S0..1QuantityVital Sign Value recorded with UCUM
...... value S1..1decimalNumerical value (with implicit precision)
...... unit S1..1stringUnit representation
...... system S1..1uriPrimitive Type uri
Fixed Value: http://unitsofmeasure.org
...... code S1..1codePrimitive Type code
Fixed Value: mm[Hg]
.... component:DiastolicBP 0..1BackboneElementDiastolic Blood Pressure
..... 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: 8462-4
....... display1..1stringRepresentation defined by the system
Fixed Value: Diastolic blood pressure
..... valueQuantity S0..1QuantityVital Sign Value recorded with UCUM
...... value S1..1decimalNumerical value (with implicit precision)
...... unit S1..1stringUnit representation
...... system S1..1uriPrimitive Type uri
Fixed Value: http://unitsofmeasure.org
...... code S1..1codePrimitive Type code
Fixed Value: mm[Hg]
.... component:MeanArterialBP S0..1BackboneElementMean Arterial Blood Pressure
..... 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: 8478-0
....... display1..1stringRepresentation defined by the system
Fixed Value: Mean blood pressure
..... valueQuantity S0..1QuantityVital Sign Value recorded with UCUM
...... value S1..1decimalNumerical value (with implicit precision)
...... unit S1..1stringUnit representation
...... system S1..1uriPrimitive Type uri
Fixed Value: http://unitsofmeasure.org
...... code S1..1codePrimitive Type code
Fixed Value: mm[Hg]

doco Documentation for this format

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation I0..*observation-vitalsignsBloodPressurePanel
... 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..*ExtensionExtension
Slice: Unordered, Open by value:url
... BodyPositionExt SI0..1CodeableConceptBody Position
URL: http://hl7.org/fhir/us/vitals/StructureDefinition/BodyPositionExt
... MeasurementDeviceExt SI0..*CodeableConceptMeasurement Device
URL: http://hl7.org/fhir/us/vitals/StructureDefinition/MeasurementDeviceExt
... SleepStatusExt SI0..1CodeableConceptSleep Status
URL: http://hl7.org/fhir/us/vitals/StructureDefinition/SleepStatusExt
... ExerciseAssociationExt SI0..1CodeableConceptExercise Association
URL: http://hl7.org/fhir/us/vitals/StructureDefinition/ExerciseAssociationExt
... MeasurementSettingExt I0..1CodeableConceptMeasurement setting
URL: http://hl7.org/fhir/us/vitals/StructureDefinition/MeasurementSettingExt
... MeasurementProtocolExt I0..1CodeableConceptAlgorithm for Blood Pressure
URL: http://hl7.org/fhir/us/vitals/StructureDefinition/MeasurementProtocolExt
Binding: MeasurementProtocolVS (preferred)
... 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..1CodeableConceptCoded Responses from C-CDA Vital Sign Results
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: 85354-9
..... display1..1stringRepresentation defined by the system
Fixed Value: Blood pressure panel with all children optional
..... userSelected0..1booleanIf this coding was chosen directly by the user
.... text0..1stringPlain text representation of the concept
... subject SΣI1..1Reference(US Core Patient Profile)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
.... 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
... 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: Blood Pressure Measurement Body Location Precoodinated value set (preferred)
... method I0..1CodeableConceptHow it was done
Binding: Blood Pressure Measurement Method value set (preferred)
... device SI0..1Reference(BloodPressureDevice)Blood Pressure 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)Blood pressure components
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:SystolicBP SΣI1..1BackboneElementSystolic Blood Pressure
..... 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: 8480-6
....... display1..1stringRepresentation defined by the system
Fixed Value: Systolic blood pressure
....... 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 SI1..1uriPrimitive Type uri
Fixed Value: http://unitsofmeasure.org
...... code SI1..1codePrimitive Type code
Fixed Value: mm[Hg]
..... 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:DiastolicBP SΣI0..1BackboneElementDiastolic Blood Pressure
..... 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: 8462-4
....... display1..1stringRepresentation defined by the system
Fixed Value: Diastolic blood pressure
....... 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 SI1..1uriPrimitive Type uri
Fixed Value: http://unitsofmeasure.org
...... code SI1..1codePrimitive Type code
Fixed Value: mm[Hg]
..... 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:MeanArterialBP SΣI0..1BackboneElementMean Arterial Blood Pressure
..... 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: 8478-0
....... display1..1stringRepresentation defined by the system
Fixed Value: Mean blood pressure
....... 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 SI1..1uriPrimitive Type uri
Fixed Value: http://unitsofmeasure.org
...... code SI1..1codePrimitive Type code
Fixed Value: mm[Hg]
..... 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

Terminology Bindings

PathConformanceValueSet / Code
Observation.languagepreferredCommonLanguages
Max Binding: AllLanguages
Observation.statusrequiredObservationStatus
Observation.categorypreferredObservationCategoryCodes
Observation.category:VSCatpreferredObservationCategoryCodes
Observation.codeextensiblePattern: LOINC code 85354-9("Blood pressure panel with all children optional")
Observation.dataAbsentReasonextensibleDataAbsentReason
Observation.interpretationextensibleObservationInterpretationCodes
Observation.bodySitepreferredBloodPressureMeasurementBodyLocationPrecoodinated
Observation.methodpreferredBloodPressureMeasurementMethodvalueset
Observation.referenceRange.typepreferredObservationReferenceRangeMeaningCodes
Observation.referenceRange.appliesToexampleObservationReferenceRangeAppliesToCodes
Observation.component.codeextensibleVitalSigns
Observation.component.value[x]requiredVitalSignsUnits
Observation.component.dataAbsentReasonextensibleDataAbsentReason
Observation.component.interpretationextensibleObservationInterpretationCodes
Observation.component:SystolicBP.codeextensiblePattern: LOINC code 8480-6("Systolic blood pressure")
Observation.component:SystolicBP.value[x]requiredVitalSignsUnits
Observation.component:SystolicBP.value[x].comparatorrequiredQuantityComparator
Observation.component:SystolicBP.dataAbsentReasonextensibleDataAbsentReason
Observation.component:SystolicBP.interpretationextensibleObservationInterpretationCodes
Observation.component:DiastolicBP.codeextensiblePattern: LOINC code 8462-4("Diastolic blood pressure")
Observation.component:DiastolicBP.value[x]requiredVitalSignsUnits
Observation.component:DiastolicBP.value[x].comparatorrequiredQuantityComparator
Observation.component:DiastolicBP.dataAbsentReasonextensibleDataAbsentReason
Observation.component:DiastolicBP.interpretationextensibleObservationInterpretationCodes
Observation.component:MeanArterialBP.codeextensiblePattern: LOINC code 8478-0("Mean blood pressure")
Observation.component:MeanArterialBP.value[x]requiredVitalSignsUnits
Observation.component:MeanArterialBP.value[x].comparatorrequiredQuantityComparator
Observation.component:MeanArterialBP.dataAbsentReasonextensibleDataAbsentReason
Observation.component:MeanArterialBP.interpretationextensibleObservationInterpretationCodes

Constraints

IdPathDetailsRequirements
dom-2ObservationIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3ObservationIf the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource
: contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4ObservationIf a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
: contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5ObservationIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6ObservationA resource should have narrative for robust management
: text.`div`.exists()
obs-6ObservationdataAbsentReason SHALL only be present if Observation.value[x] is not present
: dataAbsentReason.empty() or value.empty()
obs-7ObservationIf Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present
: value.empty() or component.code.where(coding.intersect(%resource.code.coding).exists()).empty()
vs-2ObservationIf there is no component or hasMember element then either a value[x] or a data absent reason must be present.
: (component.empty() and hasMember.empty()) implies (dataAbsentReason.exists() or value.exists())
ele-1Observation.metaAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Observation.implicitRulesAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Observation.languageAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Observation.textAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Observation.extensionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1Observation.extensionMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1Observation.extension:BodyPositionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1Observation.extension:BodyPositionMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1Observation.extension:measurementDeviceAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1Observation.extension:measurementDeviceMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1Observation.extension:sleepStatusAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1Observation.extension:sleepStatusMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1Observation.extension:exerciseAssociationAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1Observation.extension:exerciseAssociationMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1Observation.extension:MeasurementSettingAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1Observation.extension:MeasurementSettingMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1Observation.extension:MeasurementProtocolAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1Observation.extension:MeasurementProtocolMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1Observation.modifierExtensionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1Observation.modifierExtensionMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1Observation.identifierAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Observation.basedOnAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Observation.partOfAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Observation.statusAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Observation.categoryAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Observation.category:VSCatAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Observation.category:VSCat.extensionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1Observation.category:VSCat.extensionMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1Observation.category:VSCat.codingAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Observation.category:VSCat.coding.extensionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1Observation.category:VSCat.coding.extensionMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1Observation.category:VSCat.coding.systemAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Observation.category:VSCat.coding.versionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Observation.category:VSCat.coding.codeAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Observation.category:VSCat.coding.displayAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Observation.category:VSCat.coding.userSelectedAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Observation.category:VSCat.textAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Observation.codeAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Observation.subjectAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Observation.focusAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Observation.encounterAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Observation.effective[x]All FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
vs-1Observation.effective[x]if Observation.effective[x] is dateTime and has a value then that value shall be precise to the day
: ($this as dateTime).toString().length() >= 8
ele-1Observation.issuedAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Observation.performerAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Observation.dataAbsentReasonAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Observation.interpretationAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Observation.noteAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Observation.bodySiteAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Observation.methodAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Observation.deviceAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Observation.referenceRangeAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
obs-3Observation.referenceRangeMust have at least a low or a high or text
: low.exists() or high.exists() or text.exists()
ele-1Observation.referenceRange.extensionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1Observation.referenceRange.extensionMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1Observation.referenceRange.modifierExtensionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1Observation.referenceRange.modifierExtensionMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1Observation.referenceRange.lowAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Observation.referenceRange.highAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Observation.referenceRange.typeAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Observation.referenceRange.appliesToAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Observation.referenceRange.ageAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Observation.referenceRange.textAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Observation.hasMemberAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Observation.derivedFromAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Observation.componentAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
vs-3Observation.componentIf there is no a value a data absent reason must be present
: value.exists() or dataAbsentReason.exists()
ele-1Observation.component.extensionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1Observation.component.extensionMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1Observation.component.modifierExtensionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1Observation.component.modifierExtensionMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1Observation.component.codeAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Observation.component.value[x]All FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Observation.component.dataAbsentReasonAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Observation.component.interpretationAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Observation.component.referenceRangeAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Observation.component:SystolicBPAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
vs-3Observation.component:SystolicBPIf there is no a value a data absent reason must be present
: value.exists() or dataAbsentReason.exists()
ele-1Observation.component:SystolicBP.extensionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1Observation.component:SystolicBP.extensionMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1Observation.component:SystolicBP.modifierExtensionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1Observation.component:SystolicBP.modifierExtensionMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1Observation.component:SystolicBP.codeAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Observation.component:SystolicBP.value[x]All FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Observation.component:SystolicBP.value[x].extensionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1Observation.component:SystolicBP.value[x].extensionMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1Observation.component:SystolicBP.value[x].valueAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Observation.component:SystolicBP.value[x].comparatorAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Observation.component:SystolicBP.value[x].unitAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Observation.component:SystolicBP.value[x].systemAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Observation.component:SystolicBP.value[x].codeAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Observation.component:SystolicBP.dataAbsentReasonAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Observation.component:SystolicBP.interpretationAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Observation.component:SystolicBP.referenceRangeAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Observation.component:DiastolicBPAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
vs-3Observation.component:DiastolicBPIf there is no a value a data absent reason must be present
: value.exists() or dataAbsentReason.exists()
ele-1Observation.component:DiastolicBP.extensionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1Observation.component:DiastolicBP.extensionMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1Observation.component:DiastolicBP.modifierExtensionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1Observation.component:DiastolicBP.modifierExtensionMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1Observation.component:DiastolicBP.codeAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Observation.component:DiastolicBP.value[x]All FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Observation.component:DiastolicBP.value[x].extensionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1Observation.component:DiastolicBP.value[x].extensionMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1Observation.component:DiastolicBP.value[x].valueAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Observation.component:DiastolicBP.value[x].comparatorAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Observation.component:DiastolicBP.value[x].unitAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Observation.component:DiastolicBP.value[x].systemAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Observation.component:DiastolicBP.value[x].codeAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Observation.component:DiastolicBP.dataAbsentReasonAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Observation.component:DiastolicBP.interpretationAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Observation.component:DiastolicBP.referenceRangeAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Observation.component:MeanArterialBPAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
vs-3Observation.component:MeanArterialBPIf there is no a value a data absent reason must be present
: value.exists() or dataAbsentReason.exists()
ele-1Observation.component:MeanArterialBP.extensionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1Observation.component:MeanArterialBP.extensionMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1Observation.component:MeanArterialBP.modifierExtensionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1Observation.component:MeanArterialBP.modifierExtensionMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1Observation.component:MeanArterialBP.codeAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Observation.component:MeanArterialBP.value[x]All FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Observation.component:MeanArterialBP.value[x].extensionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1Observation.component:MeanArterialBP.value[x].extensionMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1Observation.component:MeanArterialBP.value[x].valueAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Observation.component:MeanArterialBP.value[x].comparatorAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Observation.component:MeanArterialBP.value[x].unitAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Observation.component:MeanArterialBP.value[x].systemAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Observation.component:MeanArterialBP.value[x].codeAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Observation.component:MeanArterialBP.dataAbsentReasonAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Observation.component:MeanArterialBP.interpretationAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Observation.component:MeanArterialBP.referenceRangeAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())