2nd DSTU Draft For Comment

This page is part of the FHIR Specification (v0.4.0: DSTU 2 Draft). The current version which supercedes this version is 5.0.0. For a full list of available versions, see the Directory of published versions

Profile: DAFVitalSigns

The official URL for this profile is: 

http://hl7.org/fhir/Profile/observation-daf-vitalsigns-dafvitalsigns

. Defines constraints and extensions on the Observation resource for use in querying and retrieving Vital Signs information. : U.S. Data Access Framework (DAF) Vital Signs Profile

This profile was published on Thu, Aug 21, 2014 00:00+1000 as a draft by U.S. Office of the National Coordinator (ONC).

Summary

Terminology Bindings

  • Observation.code must come from This identifies the vital sign result type.
  • Observation.valueQuantity.code should come from Common UCUM units for recording Vital Signs

Required/Prohibited Elements

  • The element Observation is required
  • The element Observation.code is required
  • The element Observation.valueQuantity.system is required
  • The element Observation.applies[x] is required
  • The element Observation.status is required
  • The element Observation.reliability is required
  • The element Observation.identifier is required
  • The element Observation.subject is required
  • The element Observation.specimen is prohibited
  • The element Observation.device is prohibited
  • The element Observation.referenceRange.low.system is required
  • The element Observation.referenceRange.high.system is required
  • The element Observation.related.type is required
  • The element Observation.related.target is required

Fixed Values

  • The element Observation.valueQuantity.system value has been fixed to http://unitsofmeasure.org
  • The element Observation.reliability value has been fixed to ok
  • The element Observation.referenceRange.low.system value has been fixed to http://unitsofmeasure.org
  • The element Observation.referenceRange.high.system value has been fixed to http://unitsofmeasure.org

Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots, and how the XML and JSON presentations work.

Differential View

This structure is derived from Observation.

NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation 1..1
... code S1..1CodeableConceptCoded Responses from C-CDA Vital Sign Results
Binding: CCDAVitalSignResult (required, extensible)
... valueQuantity S0..1QuantityVital Sign Value recorded with UCUM
.... value S0..1decimal
.... units S0..1string
.... system S1..1uriFixed Value: http://unitsofmeasure.org
.... code S0..1codeCoded responses from the common UCUM units for vital signs value set.
Binding: CommonUCUMunitsVitals (preferred, extensible)
... dataAbsentReason S0..1code
... applies[x] S1..1dateTime, PeriodOften just a dateTime for Vital Signs
... status S1..1code
... reliability S1..1codeFixed Value: ok
... identifier S1..*Identifier
... subject S1..1patient-daf-dafpatient
... specimen 0..0
... performer S0..1Practitioner, Device, Patient, RelatedPerson
... device 0..0
... encounter S0..1encounter-daf-dafencounter
... referenceRange S0..1Element
.... low S0..1Quantity
..... value S0..1decimal
..... comparator S0..1code
..... units S0..1string
..... system S1..1uriFixed Value: http://unitsofmeasure.org
..... code S0..1code
.... high S0..1Quantity
..... value S0..1decimal
..... comparator S0..1code
..... units S0..1string
..... system S1..1uriFixed Value: http://unitsofmeasure.org
..... code S0..1code
.... meaning S0..1CodeableConcept
.... text S0..1string
... related S0..1ElementUsed when reporting systolic and diastolic blood pressure.
.... type S1..1code
.... target S1..1Observation

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation I1..1Measurements and simple assertions
obs-6: Shall only be present if Observation.value[x] is not present
... id 0..1idLogical id of this artefact
... meta 0..1MetaMetadata about the resource
... implicitRules M0..1uriA set of rules under which this content was created
... language 0..1codeLanguage of the resource content
Binding: Language (required, not extensible)
... text I0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... extension 0..*ExtensionAdditional Content defined by implementations
... modifierExtension 0..*ExtensionExtensions that cannot be ignored
... code S1..1CodeableConceptCoded Responses from C-CDA Vital Sign Results
Binding: CCDAVitalSignResult (required, extensible)
... valueQuantity S0..1QuantityVital Sign Value recorded with UCUM
.... id 0..1idxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
.... value S0..1decimalNumerical value (with implicit precision)
.... comparator M0..1code< | <= | >= | > - how to understand the value
Binding: QuantityComparator (required, not extensible)
.... units S0..1stringUnit representation
.... system S I1..1uriSystem that defines coded unit form
Fixed Value: http://unitsofmeasure.org
.... code S0..1codeCoded responses from the common UCUM units for vital signs value set.
Binding: CommonUCUMunitsVitals (preferred, extensible)
... dataAbsentReason S I0..1codeunknown | asked | temp | notasked +
Binding: DataAbsentReason (required, not extensible)
Example: unknown
... interpretation 0..1CodeableConceptHigh, low, normal, etc.
Binding: ObservationInterpretation (preferred, extensible)
... comments 0..1stringComments about result
... applies[x] S1..1dateTime, PeriodOften just a dateTime for Vital Signs
... issued 0..1instantDate/Time this was made available
... status M S1..1coderegistered | preliminary | final | amended +
Binding: ObservationStatus (required, not extensible)
... reliability M S1..1codeok | ongoing | early | questionable | calibrating | error +
Binding: ObservationReliability (required, not extensible)
Fixed Value: ok
... bodySite[x] 0..1CodeableConcept, BodySiteObserved body part
Binding: BodySite (example, extensible)
... method 0..1CodeableConceptHow it was done
Binding: ObservationMethod (example, extensible)
... identifier S1..*IdentifierUnique Id for this particular observation
... subject S1..1patient-daf-dafpatientWho and/or what this is about
... performer S0..1Practitioner, Device, Patient, RelatedPersonWho did the observation
... encounter S0..1encounter-daf-dafencounterHealthcare event during which this observation is made
... referenceRange S I0..1ElementProvides guide for interpretation
obs-3: Must have at least a low or a high or text
.... id 0..1idxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
.... modifierExtension 0..*ExtensionExtensions that cannot be ignored
.... low S I0..1QuantityLow Range, if relevant
obs-4: Low range comparators can only be '>' or '>=' or empty
..... id 0..1idxml:id (or equivalent in JSON)
..... extension 0..*ExtensionAdditional Content defined by implementations
..... value S0..1decimalNumerical value (with implicit precision)
..... comparator M S0..1code< | <= | >= | > - how to understand the value
Binding: QuantityComparator (required, not extensible)
..... units S0..1stringUnit representation
..... system S I1..1uriSystem that defines coded unit form
Fixed Value: http://unitsofmeasure.org
..... code S0..1codeCoded form of the unit
.... high S I0..1QuantityHigh Range, if relevant
obs-5: High range comparators can only be '<' or '<=' or empty
..... id 0..1idxml:id (or equivalent in JSON)
..... extension 0..*ExtensionAdditional Content defined by implementations
..... value S0..1decimalNumerical value (with implicit precision)
..... comparator M S0..1code< | <= | >= | > - how to understand the value
Binding: QuantityComparator (required, not extensible)
..... units S0..1stringUnit representation
..... system S I1..1uriSystem that defines coded unit form
Fixed Value: http://unitsofmeasure.org
..... code S0..1codeCoded form of the unit
.... meaning S0..1CodeableConceptIndicates the meaning/use of this range of this range
Binding: ObservationRangeMeaning (example, extensible)
.... age 0..1RangeApplicable age range, if relevant
.... text S0..1stringText based reference range in an observation
... related S0..1ElementUsed when reporting systolic and diastolic blood pressure.
.... id 0..1idxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
.... modifierExtension 0..*ExtensionExtensions that cannot be ignored
.... type S1..1codehas-component | has-member | derived-from | sequel-to | replaces | qualified-by | interfered-by
Binding: ObservationRelationshipType (required, not extensible)
.... target S1..1ObservationObservation that is related to this one

XML Template

JSON Template

todo

Differential View

This structure is derived from Observation.

NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation 1..1
... code S1..1CodeableConceptCoded Responses from C-CDA Vital Sign Results
Binding: CCDAVitalSignResult (required, extensible)
... valueQuantity S0..1QuantityVital Sign Value recorded with UCUM
.... value S0..1decimal
.... units S0..1string
.... system S1..1uriFixed Value: http://unitsofmeasure.org
.... code S0..1codeCoded responses from the common UCUM units for vital signs value set.
Binding: CommonUCUMunitsVitals (preferred, extensible)
... dataAbsentReason S0..1code
... applies[x] S1..1dateTime, PeriodOften just a dateTime for Vital Signs
... status S1..1code
... reliability S1..1codeFixed Value: ok
... identifier S1..*Identifier
... subject S1..1patient-daf-dafpatient
... specimen 0..0
... performer S0..1Practitioner, Device, Patient, RelatedPerson
... device 0..0
... encounter S0..1encounter-daf-dafencounter
... referenceRange S0..1Element
.... low S0..1Quantity
..... value S0..1decimal
..... comparator S0..1code
..... units S0..1string
..... system S1..1uriFixed Value: http://unitsofmeasure.org
..... code S0..1code
.... high S0..1Quantity
..... value S0..1decimal
..... comparator S0..1code
..... units S0..1string
..... system S1..1uriFixed Value: http://unitsofmeasure.org
..... code S0..1code
.... meaning S0..1CodeableConcept
.... text S0..1string
... related S0..1ElementUsed when reporting systolic and diastolic blood pressure.
.... type S1..1code
.... target S1..1Observation

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation I1..1Measurements and simple assertions
obs-6: Shall only be present if Observation.value[x] is not present
... id 0..1idLogical id of this artefact
... meta 0..1MetaMetadata about the resource
... implicitRules M0..1uriA set of rules under which this content was created
... language 0..1codeLanguage of the resource content
Binding: Language (required, not extensible)
... text I0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... extension 0..*ExtensionAdditional Content defined by implementations
... modifierExtension 0..*ExtensionExtensions that cannot be ignored
... code S1..1CodeableConceptCoded Responses from C-CDA Vital Sign Results
Binding: CCDAVitalSignResult (required, extensible)
... valueQuantity S0..1QuantityVital Sign Value recorded with UCUM
.... id 0..1idxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
.... value S0..1decimalNumerical value (with implicit precision)
.... comparator M0..1code< | <= | >= | > - how to understand the value
Binding: QuantityComparator (required, not extensible)
.... units S0..1stringUnit representation
.... system S I1..1uriSystem that defines coded unit form
Fixed Value: http://unitsofmeasure.org
.... code S0..1codeCoded responses from the common UCUM units for vital signs value set.
Binding: CommonUCUMunitsVitals (preferred, extensible)
... dataAbsentReason S I0..1codeunknown | asked | temp | notasked +
Binding: DataAbsentReason (required, not extensible)
Example: unknown
... interpretation 0..1CodeableConceptHigh, low, normal, etc.
Binding: ObservationInterpretation (preferred, extensible)
... comments 0..1stringComments about result
... applies[x] S1..1dateTime, PeriodOften just a dateTime for Vital Signs
... issued 0..1instantDate/Time this was made available
... status M S1..1coderegistered | preliminary | final | amended +
Binding: ObservationStatus (required, not extensible)
... reliability M S1..1codeok | ongoing | early | questionable | calibrating | error +
Binding: ObservationReliability (required, not extensible)
Fixed Value: ok
... bodySite[x] 0..1CodeableConcept, BodySiteObserved body part
Binding: BodySite (example, extensible)
... method 0..1CodeableConceptHow it was done
Binding: ObservationMethod (example, extensible)
... identifier S1..*IdentifierUnique Id for this particular observation
... subject S1..1patient-daf-dafpatientWho and/or what this is about
... performer S0..1Practitioner, Device, Patient, RelatedPersonWho did the observation
... encounter S0..1encounter-daf-dafencounterHealthcare event during which this observation is made
... referenceRange S I0..1ElementProvides guide for interpretation
obs-3: Must have at least a low or a high or text
.... id 0..1idxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
.... modifierExtension 0..*ExtensionExtensions that cannot be ignored
.... low S I0..1QuantityLow Range, if relevant
obs-4: Low range comparators can only be '>' or '>=' or empty
..... id 0..1idxml:id (or equivalent in JSON)
..... extension 0..*ExtensionAdditional Content defined by implementations
..... value S0..1decimalNumerical value (with implicit precision)
..... comparator M S0..1code< | <= | >= | > - how to understand the value
Binding: QuantityComparator (required, not extensible)
..... units S0..1stringUnit representation
..... system S I1..1uriSystem that defines coded unit form
Fixed Value: http://unitsofmeasure.org
..... code S0..1codeCoded form of the unit
.... high S I0..1QuantityHigh Range, if relevant
obs-5: High range comparators can only be '<' or '<=' or empty
..... id 0..1idxml:id (or equivalent in JSON)
..... extension 0..*ExtensionAdditional Content defined by implementations
..... value S0..1decimalNumerical value (with implicit precision)
..... comparator M S0..1code< | <= | >= | > - how to understand the value
Binding: QuantityComparator (required, not extensible)
..... units S0..1stringUnit representation
..... system S I1..1uriSystem that defines coded unit form
Fixed Value: http://unitsofmeasure.org
..... code S0..1codeCoded form of the unit
.... meaning S0..1CodeableConceptIndicates the meaning/use of this range of this range
Binding: ObservationRangeMeaning (example, extensible)
.... age 0..1RangeApplicable age range, if relevant
.... text S0..1stringText based reference range in an observation
... related S0..1ElementUsed when reporting systolic and diastolic blood pressure.
.... id 0..1idxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
.... modifierExtension 0..*ExtensionExtensions that cannot be ignored
.... type S1..1codehas-component | has-member | derived-from | sequel-to | replaces | qualified-by | interfered-by
Binding: ObservationRelationshipType (required, not extensible)
.... target S1..1ObservationObservation that is related to this one

XML Template

JSON Template

todo

 

Other definitions: (todo)

Terminology Bindings

PathNameConformanceValueSet
Observation.languageLanguagerequiredhttp://tools.ietf.org/html/bcp47
Observation.codeCCDAVitalSignResultrequired (extensible)C-CDA Vital Sign Result
Observation.valueQuantity.comparatorQuantityComparatorrequiredQuantityComparator
Observation.valueQuantity.codeCommonUCUMunitsVitalspreferred (extensible)Common UCUM units
Observation.dataAbsentReasonDataAbsentReasonrequiredDataAbsentReason
Observation.interpretationObservationInterpretationpreferred (extensible)Observation Interpretation Codes
Observation.statusObservationStatusrequiredObservationStatus
Observation.reliabilityObservationReliabilityrequiredObservationReliability
Observation.bodySite[x]BodySiteexample (extensible)SNOMED CT Body Structures
Observation.methodObservationMethodexample (extensible)Observation Methods
Observation.referenceRange.low.comparatorQuantityComparatorrequiredQuantityComparator
Observation.referenceRange.high.comparatorQuantityComparatorrequiredQuantityComparator
Observation.referenceRange.meaningObservationRangeMeaningexample (extensible)Observation Reference Range Meaning Codes
Observation.related.typeObservationRelationshipTyperequiredObservationRelationshipType

Constraints

IdPathNameDetails
obs-6Observationdata absent reasonShall only be present if Observation.value[x] is not present
XPath: not(exists(f:dataAbsentReason)) or (not(exists(*[starts-with(local-name(.), 'value')])))
obs-3Observation.referenceRangereference rangeMust have at least a low or a high or text
XPath: (exists(f:low) or exists(f:high)or exists(f:text))
obs-4Observation.referenceRange.lowlow range comparatorsLow range comparators can only be '>' or '>=' or empty
XPath: not(exists(f:comparator)) or boolean(f:comparator/@value = '<') or boolean(f:comparator/@value = '<=')
obs-5Observation.referenceRange.highhigh range comparatorsHigh range comparators can only be '<' or '<=' or empty
XPath: not(exists(f:comparator)) or boolean(f:comparator/@value = '>') or boolean(f:comparator/@value = '>=')
.