This page is part of the Vital Records Common Profile Library (v2.0.0-ballot: STU 2 Ballot 1) based on FHIR (HL7® FHIR® Standard) R4. The current version which supersedes this version is 1.1.0. For a full list of available versions, see the Directory of published versions

Change Log

STU 2.0 January 2024

Jira Issue	Description of Change	Changes Made
-	Restrict birth sex for newborn to M,F,U	Added ValueSetBirthSexChildVitalRecords, and referenced from PatientChildVitalRecords
-	Addition of abstract patient profile	Added PatientVitalRecords, which is derived from USCorePatient. Child profiles of Patient: PatientChildVitalRecords, PatientDecedentFetusVitalRecords, PatientMotherVitalRecords
-	Generalization of Parent Education Level to Education Level	ObservationEducationLevelVitalRecords now accomodates use cases in VRDR and BFDR, with subject now a generalized PatientVitalRecords, focus can now be a RelatedPersonParentVitalRecords or Mother (rather than just Mother/Father), and the addition of a bypass edit flag
-	(re)moving of profiles	ObservationParentEducationLevelVitalRecords and related example was removed (doesn’t add value given ObservationEducationLevelVitalRecords exists). PatientDecedentFetusVitalRecords and related examples moved to BFDR. RelatedPersonMotherGestationalVitalRecords and related example was removed (doesn’t add value given ObservationEducationLevelVitalRecords exists).

See the Content Transitions page for more details on movement of and changes to content.

STU 1.1 Update, July 2023

Jira Issue	Description of Change	Changes Made
FHIR-40844	Add change log	Add change log (this page)
FHIR-40845	Add death-related profiles shared by VRDR & MDI	See Vital Records Common Resources Added to this Library for STU 1.1, July 2023 below
FHIR-40846	Update to latest version of US Core (5.0.1)	All profiles that are based on US Core templates are affected.
FHIR-40848	The Observation - Pregnancy Risk Factor has a value set containing a mix of Conditions, Observations, and Procedures have been used in the IG. This is not how the data is represented in the real world. Split the Observation into separate profiles using the appropriate resource.	Removed profile: Observation - Pregnancy Risk Factor Added: Condition - Prepregnancy Diabetes Vital Records Condition - Gestational Diabetes Vital Records Condition - Prepregnancy Hypertension Vital Records Condition - Gestational Hypertension Vital Records Condition - Eclampsia Hypertension Vital Records Observation - Previous Preterm Birth Vital Records Procedure - Infertility Treatment Vital Records Procedure - Artificial Insemination Vital Records Procedure - Assissted Fertilization Vital Records Observation - Previous Cesarean Vital Records Observation - None Of Specified Pregnancy Risk Factors Vital Records
FHIR-40928	Revisit profile focus/subject mappings (mother and child/fetus) and update where needed. Ensure all Observation subject/focus mappings are current and update where needed.	Revisted all profiles and updated subject/focus mappings where needed. (See also FHIR-41593)
FHIR-41324	Update narrative pages for project info, correct external links etc.	Updated as suggested
FHIR-41363	Patient Plurality: add patient-multipleBirthTotal extension / Pregnancy Plurality: update Plurality Observation: Plurality is both a characteristic of a pregnancy and a characteristic of a patient (e.g., single, twin, triplet etc. and includes the number of fetuses delivered live or dead at any time in the pregnancy) The VRCPL has a Plurality Observation profile (http://build.fhir.org/ig/HL7/vr-common-library/branches/master/StructureDefinition-Observation-plurality-vr.html) that has the mother, child, and fetus as subjects. FHIR Patient only has the ability to record Patient.multipleBirth[x]. This piece of information by itself does not give you enough information about the set – plurality also needs to be captured. On consultation with the Patient Administration WG at the WGM about the recommended way to represent Plurality for a patient, they pointed us to their new patient-multipleBirthTotal extension (http://hl7.org/fhir/extensions/1.0.0/StructureDefinition-patient-multipleBirthTotal.html) (added in FHIR R5): this extension is to be used on the Patient.multipleBirth[x] element it is now possible to use R5 extensions in R4 IGs IG update actions: For Plurality as a characteristic of a Patient who is part of a multiple delivery: add the patient-multipleBirthTotal extension to the VRCPL Patient profiles (on Patient.multipleBirth[x]) For Plurality as a characteristic of a pregnancy: update the current Plurality Observation profile (http://build.fhir.org/ig/HL7/vr-common-library/branches/master/StructureDefinition-Observation-plurality-vr.html) to only have the mother as the subject (remove child and fetus subject)	Updated as suggested
FHIR-41388	Add “reported age” resource for father/mother as an optional additional item	Added Reported Age as an extension on Patient and RelatedPerson
FHIR-41389	Add guidance on usage of ODH profiles	Added guidance on usage of ODH profiles and mapped to the IJE fields
FHIR-41531	Observation - Parent Education: Clarify the use of the subject and focus fields.	Updated subject/focus mappings to subject = baby and focus = mother/father as part of FHIR-40928
FHIR-41531	Observation - Apgar Score: Should the Observation - Apgar Score profile profile be based on http://hl7.org/fhir/us/core/STU5.0.1/StructureDefinition-us-core-observation-survey.html?	Updated Observation - Apgar Score to be based on http://hl7.org/fhir/us/core/STU5.0.1/StructureDefinition-us-core-observation-survey.html
FHIR-41648	Drop Date Part Absent Reason extension: In VRDR there’s an extension that allows conveying each of the different parts of a date as separate elements with an ability to provide an absent reason for each. This is more scalable than the approach here as it allows conveying month and day with no year (a common use-case). There shouldn’t be two different mechanisms to solve this problem.	Deleted Date Part Absent Reason extension and associated value set. Referenced to Extension - Partial Date - Vital Records. Updated example.

Vital Records Common Resources Added to this Library for STU 1.1, July 2023

Resources were added to this Library to support future versions of the Vital Records Death Reporting (VRDR) FHIR IG and the Medicolegal Death Investigation (MDI) FHIR IG.

Profiles

VRDR STU 2	MDI STU 1	VRCPL 1.1
Autopsy Performed Indicator (Observation)	Observation - Autopsy Performed Indicator	Observation - Autopsy Performed Indicator Vital Records
Date of death (Observation)	Observation - Death Date	Observation - Death Date Vital Records
Decedent Pregnancy Status (Observation)	Observation - Decedent Pregnancy	Observation - Decedent Pregnancy Vital Records
Injury Incident (Observation)	Observation - How Death Injury Occurred	Observation - Injury Incident Vital Records
Tobacco Use Contributed To Death (Observation)	Observation - Tobacco Use Contributed to Death	Observation - Tobacco Use Contributed to Death Vital Records
Manner of Death (Observation)	Observation - Manner of Death	Observation - Manner of Death Vital Records
Cause of death Part 1 (Observation)	Observation - Cause of Death Part 1	Observation - Cause of Death Part 1 Vital Records
Cause of death Part 2 (Observation)	Observation - Contributing Cause of Death Part 2	Observation - Contributing Cause of Death Part 2 Vital Records
Death Location (USCoreLocation)	Location - Death	Location - Death Vital Records
Injury Location (USCoreLocation)	Location - Injury	Location - Injury Vital Records
Death Certification Procedure	Procedure - Death Certification	Procedure - Death Certification Vital Records

Extensions

VRDR STU 2	MDI STU 1	VRCPL 1.1
Date Day	Extension - Date Day	Extension - Date Day Vital Records
Date Month	Extension - Date Month	Extension - Date Month Vital Records
Date Time	Extension - Date Time	Extension - Date Time Vital Records
Date Year	Extension - Date Year	Extension - Date Year Vital Records
Partial Date Time	Extension - Partial DateTime	Extension - Partial DateTime Vital Records

Code Systems

VRDR STU 2	MDI STU 1	VRCPL 1.1
Local Component Codes	CodeSystem - Local Component Codes	CodeSystem - Local Components Codes Vital Records
Pregnancy Status Codes	CodeSystem - Death Pregnancy Status	CodeSystem - Death Pregnancy Status Vital Records

Value Sets

VRDR STU 2	MDI STU 1	VRCPL 1.1
Local Component Codes	CodeSystem - Local Component Codes	CodeSystem - Local Components Codes Vital Records
Tobacco Use Contributed To Death	ValueSet - Contributory Tobacco Use	ValueSet - Contributory Tobacco Use Vital Records
Certifier Types VS	ValueSet - Certifier Types	ValueSet - Certifier Types Vital Records
Date of Death Determination Methods Value Set	ValueSet - Date Establishment Approach	ValueSet - Date Establishment Approach Vital Records
Pregnancy Status	ValueSet - Death Pregnancy Status	ValueSet - Death Pregnancy Status Vital Records
Manner of Death VS	ValueSet - Manner of Death	ValueSet - Manner of Death Vital Records
Place of Death VS – PHVS_PlaceOfDeath_NCHS	ValueSet - Place of Death	ValueSet - Place of Death Vital Records
Transportation Incident Role	ValueSet - Transportation Incident Role	ValueSet - Transportation Incident Role Vital Records
Units of Age	ValueSet - Units of Age	ValueSet - Units of Age Vital Records
Yes No Unknown	ValueSet - Yes No Unknown	ValueSet - Yes No Unknown Vital Records
Yes No Unknown NotApplicable	ValueSet - Yes No Unknown NotApplicable	ValueSet - Yes No Unknown NotApplicable Vital Records