Release 4 5 Preview #3
This page is part of the FHIR Specification (v4.0.1: R4 - Mixed Normative and STU ). This is the current published version in it's permanent home (it will always be available at this URL). For a full list of available versions, see the Directory of published versions
Orders and Observations Work Group   Maturity Level : 5 Trial Use Use Context : Any

The official URL for this profile is:

http://hl7.org/fhir/StructureDefinition/vitalsigns

FHIR Vital Signs Profile

This profile was published on Fri, Mar 25, 2016 00:00+1100 00:00+0000 as a draft by Health Level Seven International (Orders and Observations Workgroup).

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

This structure is derived from Observation .

Summary

"#### Complete Summary of the Mandatory Requirements

  1. One status in Observation.status which has a required binding to:

  2. A category in Observation.category which must have:

    • a fixed Observation.category.coding.system ="http://terminology.hl7.org/CodeSystem/observation-category"
    • a fixed Observation.category.coding.code = "vital-signs"
  3. A code in Observation.code

    • a fixed Observation.code.coding.system = "http://loinc.org""
    • a LOINC code in Observation.code.coding.code which has an extensible binding to:
  4. One patient in Observation.subject

  5. A date and time in effectiveDateTime or effectivePeriod

  6. Either one Observation.value[x] or, if there is no value, one code in Observation.DataAbsentReason

    • if a vital sign measure then:
      • One numeric value in Observation.valueQuantity.value
      • a fixed Observation.valueQuantity.system="http://unitsofmeasure.org"
      • a UCUM unit code in Observation.valueQuantity.code which has an required binding to the Vital Signs Units value set.
    • Observation.DataAbsentReason is bound to Observation Value Absent Reason value set.
  7. When using a panel code to group component observations (Note: See the comments regarding blood pressure in the table above), one or more Observation.component.code each of which must have:

    • a fixed Observation.component.code.coding.system =""http://loinc.org""
  8. Either one Observation.component.valueQuantity or, if there is no value, one code in Observation.component.DataAbsentReason

  9. When using a panel code to group observations, one or more reference to Vitals Signs Observations in Observation.related.target

    • a fixed Observation.related.type = "has-member""

Mandatory: 9 elements (+1 nested mandatory element)
Must-Support: 15 elements
Fixed Value: 2 elements

Slices

This structure defines the following Slices :

  • The element Observation.category is sliced based on the values of value:coding.code, value:coding.system

This structure is derived from Observation .

Name Flags Card. Type Description & Constraints doco
. . Observation I 0..* Observation FHIR Vital Signs Profile
vs-2: If there is no component or hasMember element then either a value[x] or a data absent reason must be present.
. . . status S 1..1 code registered | preliminary | final | amended +
Binding: ObservationStatus ( required )
. . . category S 1 .. * (Slice Definition) Classification of type of observation
Slice: Unordered, Open by value:coding.code, value:coding.system
. . . . category:VSCat S 1..1 CodeableConcept Classification of type of observation
. . . . . coding S 1..* Coding Code defined by a terminology system
. . . . . . system S 1..1 uri Identity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category
. . . . . . code S 1..1 code Symbol in syntax defined by the system
Fixed Value: vital-signs
. . . code S 1..1 CodeableConcept Coded Responses from C-CDA Vital Sign Results
Binding: Vital Signs ( extensible )
. . . effective[x] S I 1..1 Often just a dateTime for Vital Signs
vs-1: if Observation.effective[x] is dateTime and has a value then that value shall be precise to the day
. . . . effectiveDateTime dateTime
. . . . effectivePeriod Period
. . . value[x] S I 0..1 Quantity , , CodeableConcept , , string , , boolean , , integer , , Range , , Ratio , , SampledData , , time , , dateTime , , Period , Attachment Vital Signs value are recorded using the Quantity data type. For supporting observations such as Cuff size could use other datatypes such as CodeableConcept.
. . . dataAbsentReason S I 0..1 CodeableConcept Why the result is missing
. . . hasMember 0 .. * Reference ( QuestionnaireResponse | MolecularSequence | Vital Signs Profile ) Used when reporting vital signs panel components
. . . derivedFrom 0 .. * Reference ( DocumentReference | ImagingStudy | Media | QuestionnaireResponse | MolecularSequence | Vital Signs Profile ) Related measurements the observation is made from
. . . component S I 0 .. * BackboneElement Used when reporting systolic and diastolic blood pressure.
vs-3: If there is no a value a data absent reason must be present
. . . . code S 1..1 CodeableConcept Type of component observation (code / type)
Binding: Vital Signs ( extensible )
. . . . value[x] S I 0..1 Quantity , , CodeableConcept , , string , , boolean , , integer , , Range , , Ratio , , SampledData , , time , , dateTime , , Period , Attachment Vital Sign Value recorded with UCUM
Binding: Vital Signs Units ( required )
. . . . dataAbsentReason S I 0..1 CodeableConcept Why the component result is missing

doco Documentation for this format
Name Flags Card. Type Description & Constraints doco
. . Observation I 0..* Observation FHIR Vital Signs Profile
vs-2: If there is no component or hasMember element then either a value[x] or a data absent reason must be present.
. . . id Σ 0..1 string id Logical id of this artifact
. . . meta Σ I 0..1 Meta Metadata about the resource
. . . implicitRules ?! Σ I 0..1 uri A set of rules under which this content was created
. . . language I 0..1 code Language of the resource content
Binding: Common Languages ( preferred )
Max Binding: All Languages
. . . text I 0..1 Narrative Text summary of the resource, for human interpretation
. . . contained 0..* Resource Contained, inline Resources
. . . extension I 0..* Extension Additional content defined by implementations
. . . modifierExtension ?! I 0..* Extension Extensions that cannot be ignored
. . . identifier Σ I 0..* Identifier Business Identifier for observation
. . . basedOn Σ I 0..* Reference ( CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest ) Fulfills plan, proposal or order
. . . partOf Σ I 0..* Reference ( MedicationAdministration | MedicationDispense | MedicationStatement MedicationUsage | Procedure | Immunization | ImagingStudy ) Part of referenced event
. . . status ?! S Σ I 1..1 code registered | preliminary | final | amended +
Binding: ObservationStatus ( required )
. . . category S I 1 .. * (Slice Definition) Classification of type of observation
Slice: Unordered, Open by value:coding.code, value:coding.system
Binding: Observation Category Codes ( preferred )
. . . . category:VSCat S I 1..1 CodeableConcept Classification of type of observation
Binding: Observation Category Codes ( preferred )
. . . . . id 0..1 string Unique id for inter-element referencing
. . . . . extension I 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
. . . . . coding S Σ I 1..* Coding Code defined by a terminology system
. . . . . . id 0..1 string Unique id for inter-element referencing
. . . . . . extension I 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
. . . . . . system S Σ I 1..1 uri Identity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category
. . . . . . version Σ I 0..1 string Version of the system - if relevant
. . . . . . code S Σ I 1..1 code Symbol in syntax defined by the system
Fixed Value: vital-signs
. . . . . . display Σ I 0..1 string Representation defined by the system
. . . . . . userSelected Σ I 0..1 boolean If this coding was chosen directly by the user
. . . . . text Σ I 0..1 string Plain text representation of the concept
. . . code S Σ I 1..1 CodeableConcept Coded Responses from C-CDA Vital Sign Results
Binding: Vital Signs ( extensible )
. . . subject S Σ I 1..1 Reference ( Patient ) Who and/or what the observation is about
. . . focus Σ I 0..* Reference ( Resource ) What the observation is about, when it is not about the subject of record
. . . encounter Σ I 0..1 Reference ( Encounter ) Healthcare event during which this observation is made
. . . effective[x] S Σ I 1..1 Often just a dateTime for Vital Signs
vs-1: if Observation.effective[x] is dateTime and has a value then that value shall be precise to the day
. . . . effectiveDateTime dateTime
. . . . effectivePeriod Period
. . . issued Σ I 0..1 instant Date/Time this version was made available
. . . performer Σ I 0..* Reference ( Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson ) Who is responsible for the observation
. . . value[x] S Σ I 0..1 Vital Signs value are recorded using the Quantity data type. For supporting observations such as Cuff size could use other datatypes such as CodeableConcept.
. . . . valueQuantity Quantity
. . . . valueCodeableConcept CodeableConcept
. . . . valueString string
. . . . valueBoolean boolean
. . . . valueInteger integer
. . . . valueRange Range
. . . . valueRatio Ratio
. . . . valueSampledData SampledData
. . . . valueTime time
. . . . valueDateTime dateTime
. . . . valuePeriod Period
. . . . valueAttachment Attachment
... dataAbsentReason S I 0..1 CodeableConcept Why the result is missing
Binding: DataAbsentReason ( extensible )
. . . interpretation I 0..* CodeableConcept High, low, normal, etc.
Binding: Observation Interpretation Codes ( extensible )
. . . note I 0..* Annotation Comments about the observation
. . . bodySite I 0..1 CodeableConcept Observed body part
Binding: SNOMED CT Body Structures ( example )
. . . method I 0..1 CodeableConcept How it was done
Binding: Observation Methods ( example )
. . . specimen I 0..1 Reference ( Specimen ) Specimen used for this observation
. . . device I 0..1 Reference ( Device | DeviceMetric ) (Measurement) Device
. . . referenceRange I 0..* BackboneElement Provides guide for interpretation
obs-3: Must have at least a low or a high or text
. . . . id 0..1 string id Unique id for inter-element referencing
. . . . extension I 0..* Extension Additional content defined by implementations
. . . . modifierExtension ?! Σ I 0..* Extension Extensions that cannot be ignored even if unrecognized
. . . . low I 0..1 SimpleQuantity Low Range, if relevant
. . . . high I 0..1 SimpleQuantity High Range, if relevant
. . . . type I 0..1 CodeableConcept Reference range qualifier
Binding: Observation Reference Range Meaning Codes ( preferred )
. . . . appliesTo I 0..* CodeableConcept Reference range population
Binding: Observation Reference Range Applies To Codes ( example )
. . . . age I 0..1 Range Applicable age range, if relevant
. . . . text I 0..1 string Text based reference range in an observation
. . . hasMember Σ I 0..* Reference ( QuestionnaireResponse | MolecularSequence | Vital Signs Profile ) Used when reporting vital signs panel components
. . . derivedFrom Σ I 0..* Reference ( DocumentReference | ImagingStudy | Media | QuestionnaireResponse | MolecularSequence | Vital Signs Profile ) Related measurements the observation is made from
. . . component S Σ I 0..* BackboneElement Used when reporting systolic and diastolic blood pressure.
vs-3: If there is no a value a data absent reason must be present
. . . . id 0..1 string id Unique id for inter-element referencing
. . . . extension I 0..* Extension Additional content defined by implementations
. . . . modifierExtension ?! Σ I 0..* Extension Extensions that cannot be ignored even if unrecognized
. . . . code S Σ I 1..1 CodeableConcept Type of component observation (code / type)
Binding: Vital Signs ( extensible )
. . . . value[x] S Σ I 0..1 Vital Sign Value recorded with UCUM
Binding: Vital Signs Units ( required )
. . . . . valueQuantity Quantity
..... valueCodeableConcept Quantity CodeableConcept
. . . . valueCodeableConcept . valueString CodeableConcept string
. . . . . valueString valueBoolean string boolean
. . . . . valueBoolean valueInteger boolean integer
. . . . valueInteger . valueRange integer Range
. . . . . valueRange valueRatio Range Ratio
. . . . . valueRatio valueSampledData Ratio SampledData
. . . . valueSampledData . valueTime SampledData time
. . . . . valueTime valueDateTime time dateTime
. . . . valueDateTime . valuePeriod dateTime Period
. . . . . valuePeriod valueAttachment Period Attachment
. . . . dataAbsentReason S I 0..1 CodeableConcept Why the component result is missing
Binding: DataAbsentReason ( extensible )
. . . . interpretation I 0..* CodeableConcept High, low, normal, etc.
Binding: Observation Interpretation Codes ( extensible )
. . . . referenceRange I 0..* See referenceRange Unknown reference to #Observation.referenceRange Provides guide for interpretation of component result

doco Documentation for this format
<!-- observation-vitalsigns -->doco
<Observation xmlns="http://hl7.org/fhir"
>
  <!-- from Element: extension -->
 <</id>

 <id value="[id]"/><!-- 0..1 Logical id of this artifact -->

 <meta><!-- ?? 0..1 Meta Metadata about the resource --></meta>
 <implicitRules value="[uri]"/><!-- ?? 0..1 A set of rules under which this content was created -->
 <language value="[code]"/><!-- ?? 0..1 Language of the resource content   -->
 <text><!-- ?? 0..1 Narrative 
     Text summary of the resource, for human interpretation --></text>
 <</contained>

 <contained><!-- 0..* Resource Contained, inline Resources --></contained>

 <modifierExtension><!-- ?? 0..* Extension  Extensions that cannot be ignored  --></modifierExtension>
 <identifier><!-- ?? 0..* Identifier 
     Business Identifier for observation --></identifier>
 <basedOn><!-- ?? 0..* Reference(CarePlan) Fulfills plan, proposal or order --></basedOn>
 <partOf><!-- ?? 0..* Reference(MedicationAdministration) Part of referenced event --></partOf>
 <status value="[code]"/><!-- ?? 1..1 registered | preliminary | final | amended +   -->
 <-- category sliced by value:coding.code, value:coding.system  in the specified orderOpen-->
 <category> ?? 1..1 CodeableConcept  <!-- ?? 1..1 Classification of  type of observation -->
  <coding> ?? 1..* Coding  <!-- ?? 1..* Code defined by a terminology system -->
   <system value="[uri]"/><!-- ?? 1..1 Identity of the terminology system -->
   <version value="[string]"/><!-- ?? 0..1 Version of the system - if relevant -->
   <code value="[code]"/><!-- ?? 1..1 Symbol in syntax defined by the system -->
   <display value="[string]"/><!-- ?? 0..1 Representation defined by the system -->
   <userSelected value="[boolean]"/><!-- ?? 0..1 If this coding was chosen directly by the user -->
  </coding>
  <text value="[string]"/><!-- ?? 0..1 Plain text representation of the concept -->
 </category>
 <code><!-- ?? 1..1 CodeableConcept Coded Responses from C-CDA Vital Sign Results   --></code>
 <subject><!-- ?? 1..1 Reference(Patient) 
     Who and/or what the observation is about --></subject>
 <focus><!-- ?? 0..* Reference(Resource) 
     What the observation is about, when it is not about the subject of record --></focus>
 <encounter><!-- ?? 0..1 Reference(Encounter) 
     Healthcare event during which this observation is made --></encounter>
 <effective[x]><!-- ?? 1..1 dateTime|Period 
     Often just a dateTime for Vital Signs --></effective[x]>
 <issued value="[instant]"/><!-- ?? 0..1 Date/Time this version was made available -->
 <performer><!-- ?? 0..* Reference(Practitioner) 
     Who is responsible for the observation --></performer>
 <value[x]><!-- ?? 0..1 Quantity|CodeableConcept|string|boolean|integer|
   

   Range|Ratio|SampledData|time|dateTime|Period|Attachment 
     Vital Signs value are recorded using the Quantity data type. For supporting observations such as Cuff size could use other datatypes such as CodeableConcept. --></value[x]>
 <dataAbsentReason><!-- ?? 0..1 CodeableConcept Why the result is missing   --></dataAbsentReason>
 <interpretation><!-- ?? 0..* CodeableConcept High, low, normal, etc.   --></interpretation>
 <note><!-- ?? 0..* Annotation Comments about the observation --></note>
 <bodySite><!-- ?? 0..1 CodeableConcept Observed body part   --></bodySite>
 <method><!-- ?? 0..1 CodeableConcept How it was done   --></method>
 <specimen><!-- ?? 0..1 Reference(Specimen) Specimen used for this observation --></specimen>
 <device><!-- ?? 0..1 Reference(Device) (Measurement) Device --></device>
 <

 <referenceRange> ?? 0..* BackboneElement  <!-- ?? 0..* Provides guide for interpretation -->

  <modifierExtension><!-- ?? 0..* Extension  Extensions that cannot be ignored even if unrecognized  --></modifierExtension>
  <low><!-- ?? 0..1 Quantity 
      Low Range, if relevant --></low>
  <high><!-- ?? 0..1 Quantity 
      High Range, if relevant --></high>
  <type><!-- ?? 0..1 CodeableConcept Reference range qualifier   --></type>
  <appliesTo><!-- ?? 0..* CodeableConcept Reference range population   --></appliesTo>
  <age><!-- ?? 0..1 Range 
      Applicable age range, if relevant --></age>
  <text value="[string]"/><!-- ?? 0..1 Text based reference range in an observation -->
 </referenceRange>
 <hasMember><!-- ?? 0..* Reference(QuestionnaireResponse) 
     Used when reporting vital signs panel components --></hasMember>
 <derivedFrom><!-- ?? 0..* Reference(DocumentReference) 
     Related measurements the observation is made from --></derivedFrom>
 <

 <component> ?? 0..* BackboneElement  <!-- ?? 0..* Used when reporting systolic and diastolic blood pressure. -->

  <modifierExtension><!-- ?? 0..* Extension  Extensions that cannot be ignored even if unrecognized  --></modifierExtension>
  <code><!-- ?? 1..1 CodeableConcept Type of component observation (code / type)   --></code>
  <value[x]><!-- ?? 0..1 Quantity|CodeableConcept|string|
    </value[x]>

    boolean|integer|Range|Ratio|SampledData|time|dateTime|Period|Attachment Vital Sign Value recorded with UCUM   --></value[x]>
  <dataAbsentReason><!-- ?? 0..1 CodeableConcept Why the component result is missing   --></dataAbsentReason>
  <interpretation><!-- ?? 0..* CodeableConcept High, low, normal, etc.   --></interpretation>
  <referenceRange><!-- See #Observation.referenceRange  Provides guide for interpretation of component result --></referenceRange>
 </component>
</Observation>
{ // observation-vitalsigns
  // from Element: extension
    "meta" : { Meta }, // C?Metadata about the resource
    "implicitRules" : "<uri>", // C?A set of rules under which this content was created
    "language" : "<code>", // C?Language of the resource content
    "text" : { Narrative }, // C?Text summary of the resource, for human interpretation
    "

    "contained" : [{ Resource }], //Contained, inline Resources

    "modifierExtension" : [{ Extension }], // C?Extensions that cannot be ignored
    "identifier" : [{ Identifier }], // C?Business Identifier for observation
    "basedOn" : [{ Reference(CarePlan) }], // C?Fulfills plan, proposal or order
    "partOf" : [{ Reference(MedicationAdministration) }], // C?Part of referenced event
    "status" : "<code>", // C? R! registered | preliminary | final | amended +
    "category" : [ //  sliced by value:coding.code, value:coding.system  in the specified order, Open 
      { // Classification of  type of observation // C? R! 
        // from Element: extension
        "extension" : [ //  sliced by value:url  in the specified order, Open ]
        "coding" : [{ Coding }], // C? R! Code defined by a terminology system
        "text" : "<string>" // C?Plain text representation of the concept
      }
    ],
    "code" : { CodeableConcept }, // C? R! Coded Responses from C-CDA Vital Sign Results
    "subject" : { Reference(Patient) }, // C? R! Who and/or what the observation is about
    "focus" : [{ Reference(Resource) }], // C?What the observation is about, when it is not about the subject of record
    "encounter" : { Reference(Encounter) }, // C?Healthcare event during which this observation is made
// value[x]: Often just a dateTime for Vital Signs. One of these 2:
    "effectiveDateTime" : "<dateTime>", // C? R! Often just a dateTime for Vital Signs
    "effectivePeriod" : { Period }, // C? R! Often just a dateTime for Vital Signs
    "issued" : "<instant>", // C?Date/Time this version was made available
    "performer" : [{ Reference(Practitioner) }], // C?Who is responsible for the observation
// value[x]: Vital Signs value are recorded using the Quantity data type. For supporting observations such as Cuff size could use other datatypes such as CodeableConcept.. One of these 12:
    "valueQuantity" : { Quantity }, // C?Vital Signs value are recorded using the Quantity data type. For supporting observations such as Cuff size could use other datatypes such as CodeableConcept.
    "valueCodeableConcept" : { CodeableConcept }, // C?Vital Signs value are recorded using the Quantity data type. For supporting observations such as Cuff size could use other datatypes such as CodeableConcept.
    "valueString" : "<string>", // C?Vital Signs value are recorded using the Quantity data type. For supporting observations such as Cuff size could use other datatypes such as CodeableConcept.
    "valueBoolean" : <boolean>, // C?Vital Signs value are recorded using the Quantity data type. For supporting observations such as Cuff size could use other datatypes such as CodeableConcept.
    "valueInteger" : <integer>, // C?Vital Signs value are recorded using the Quantity data type. For supporting observations such as Cuff size could use other datatypes such as CodeableConcept.
    "valueRange" : { Range }, // C?Vital Signs value are recorded using the Quantity data type. For supporting observations such as Cuff size could use other datatypes such as CodeableConcept.
    "valueRatio" : { Ratio }, // C?Vital Signs value are recorded using the Quantity data type. For supporting observations such as Cuff size could use other datatypes such as CodeableConcept.
    "valueSampledData" : { SampledData }, // C?Vital Signs value are recorded using the Quantity data type. For supporting observations such as Cuff size could use other datatypes such as CodeableConcept.
    "valueTime" : "<time>", // C?Vital Signs value are recorded using the Quantity data type. For supporting observations such as Cuff size could use other datatypes such as CodeableConcept.
    "valueDateTime" : "<dateTime>", // C?Vital Signs value are recorded using the Quantity data type. For supporting observations such as Cuff size could use other datatypes such as CodeableConcept.
    "valuePeriod" : { Period }, // C?Vital Signs value are recorded using the Quantity data type. For supporting observations such as Cuff size could use other datatypes such as CodeableConcept.
    "

    "valueAttachment" : { Attachment } // C?Vital Signs value are recorded using the Quantity data type. For supporting observations such as Cuff size could use other datatypes such as CodeableConcept.
    "dataAbsentReason" : { CodeableConcept }, // C?Why the result is missing

    "interpretation" : [{ CodeableConcept }], // C?High, low, normal, etc.
    "note" : [{ Annotation }], // C?Comments about the observation
    "bodySite" : { CodeableConcept }, // C?Observed body part
    "method" : { CodeableConcept }, // C?How it was done
    "specimen" : { Reference(Specimen) }, // C?Specimen used for this observation
    "device" : { Reference(Device) }, // C?(Measurement) Device
    "

    "referenceRange" : [{ BackboneElement }], // C?Provides guide for interpretation

    "hasMember" : [{ Reference(QuestionnaireResponse) }], // C?Used when reporting vital signs panel components
    "derivedFrom" : [{ Reference(DocumentReference) }], // C?Related measurements the observation is made from
    "

    "component" : [{ BackboneElement }], // C?Used when reporting systolic and diastolic blood pressure.

  }

This structure is derived from Observation .

Summary

"#### Complete Summary of the Mandatory Requirements

  1. One status in Observation.status which has a required binding to:

  2. A category in Observation.category which must have:

    • a fixed Observation.category.coding.system ="http://terminology.hl7.org/CodeSystem/observation-category"
    • a fixed Observation.category.coding.code = "vital-signs"
  3. A code in Observation.code

    • a fixed Observation.code.coding.system = "http://loinc.org""
    • a LOINC code in Observation.code.coding.code which has an extensible binding to:
  4. One patient in Observation.subject

  5. A date and time in effectiveDateTime or effectivePeriod

  6. Either one Observation.value[x] or, if there is no value, one code in Observation.DataAbsentReason

    • if a vital sign measure then:
      • One numeric value in Observation.valueQuantity.value
      • a fixed Observation.valueQuantity.system="http://unitsofmeasure.org"
      • a UCUM unit code in Observation.valueQuantity.code which has an required binding to the Vital Signs Units value set.
    • Observation.DataAbsentReason is bound to Observation Value Absent Reason value set.
  7. When using a panel code to group component observations (Note: See the comments regarding blood pressure in the table above), one or more Observation.component.code each of which must have:

    • a fixed Observation.component.code.coding.system =""http://loinc.org""
  8. Either one Observation.component.valueQuantity or, if there is no value, one code in Observation.component.DataAbsentReason

  9. When using a panel code to group observations, one or more reference to Vitals Signs Observations in Observation.related.target

    • a fixed Observation.related.type = "has-member""

Mandatory: 9 elements (+1 nested mandatory element)
Must-Support: 15 elements
Fixed Value: 2 elements

Slices

This structure defines the following Slices :

  • The element Observation.category is sliced based on the values of value:coding.code, value:coding.system

Differential View

This structure is derived from Observation .

Name Flags Card. Type Description & Constraints doco
. . Observation I 0..* Observation FHIR Vital Signs Profile
vs-2: If there is no component or hasMember element then either a value[x] or a data absent reason must be present.
. . . status S 1..1 code registered | preliminary | final | amended +
Binding: ObservationStatus ( required )
. . . category S 1 .. * (Slice Definition) Classification of type of observation
Slice: Unordered, Open by value:coding.code, value:coding.system
. . . . category:VSCat S 1..1 CodeableConcept Classification of type of observation
. . . . . coding S 1..* Coding Code defined by a terminology system
. . . . . . system S 1..1 uri Identity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category
. . . . . . code S 1..1 code Symbol in syntax defined by the system
Fixed Value: vital-signs
. . . code S 1..1 CodeableConcept Coded Responses from C-CDA Vital Sign Results
Binding: Vital Signs ( extensible )
. . . effective[x] S I 1..1 Often just a dateTime for Vital Signs
vs-1: if Observation.effective[x] is dateTime and has a value then that value shall be precise to the day
. . . . effectiveDateTime dateTime
. . . . effectivePeriod Period
. . . value[x] S I 0..1 Quantity , , CodeableConcept , , string , , boolean , , integer , , Range , , Ratio , , SampledData , , time , , dateTime , , Period , Attachment Vital Signs value are recorded using the Quantity data type. For supporting observations such as Cuff size could use other datatypes such as CodeableConcept.
. . . dataAbsentReason S I 0..1 CodeableConcept Why the result is missing
. . . hasMember 0 .. * Reference ( QuestionnaireResponse | MolecularSequence | Vital Signs Profile ) Used when reporting vital signs panel components
. . . derivedFrom 0 .. * Reference ( DocumentReference | ImagingStudy | Media | QuestionnaireResponse | MolecularSequence | Vital Signs Profile ) Related measurements the observation is made from
. . . component S I 0 .. * BackboneElement Used when reporting systolic and diastolic blood pressure.
vs-3: If there is no a value a data absent reason must be present
. . . . code S 1..1 CodeableConcept Type of component observation (code / type)
Binding: Vital Signs ( extensible )
. . . . value[x] S I 0..1 Quantity , , CodeableConcept , , string , , boolean , , integer , , Range , , Ratio , , SampledData , , time , , dateTime , , Period , Attachment Vital Sign Value recorded with UCUM
Binding: Vital Signs Units ( required )
. . . . dataAbsentReason S I 0..1 CodeableConcept Why the component result is missing

doco Documentation for this format

Snapshot View

Name Flags Card. Type Description & Constraints doco
. . Observation I 0..* Observation FHIR Vital Signs Profile
vs-2: If there is no component or hasMember element then either a value[x] or a data absent reason must be present.
. . . id Σ 0..1 string id Logical id of this artifact
. . . meta Σ I 0..1 Meta Metadata about the resource
. . . implicitRules ?! Σ I 0..1 uri A set of rules under which this content was created
. . . language I 0..1 code Language of the resource content
Binding: Common Languages ( preferred )
Max Binding: All Languages
. . . text I 0..1 Narrative Text summary of the resource, for human interpretation
. . . contained 0..* Resource Contained, inline Resources
. . . extension I 0..* Extension Additional content defined by implementations
. . . modifierExtension ?! I 0..* Extension Extensions that cannot be ignored
. . . identifier Σ I 0..* Identifier Business Identifier for observation
. . . basedOn Σ I 0..* Reference ( CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest ) Fulfills plan, proposal or order
. . . partOf Σ I 0..* Reference ( MedicationAdministration | MedicationDispense | MedicationStatement MedicationUsage | Procedure | Immunization | ImagingStudy ) Part of referenced event
. . . status ?! S Σ I 1..1 code registered | preliminary | final | amended +
Binding: ObservationStatus ( required )
. . . category S I 1 .. * (Slice Definition) Classification of type of observation
Slice: Unordered, Open by value:coding.code, value:coding.system
Binding: Observation Category Codes ( preferred )
. . . . category:VSCat S I 1..1 CodeableConcept Classification of type of observation
Binding: Observation Category Codes ( preferred )
. . . . . id 0..1 string Unique id for inter-element referencing
. . . . . extension I 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
. . . . . coding S Σ I 1..* Coding Code defined by a terminology system
. . . . . . id 0..1 string Unique id for inter-element referencing
. . . . . . extension I 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
. . . . . . system S Σ I 1..1 uri Identity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category
. . . . . . version Σ I 0..1 string Version of the system - if relevant
. . . . . . code S Σ I 1..1 code Symbol in syntax defined by the system
Fixed Value: vital-signs
. . . . . . display Σ I 0..1 string Representation defined by the system
. . . . . . userSelected Σ I 0..1 boolean If this coding was chosen directly by the user
. . . . . text Σ I 0..1 string Plain text representation of the concept
. . . code S Σ I 1..1 CodeableConcept Coded Responses from C-CDA Vital Sign Results
Binding: Vital Signs ( extensible )
. . . subject S Σ I 1..1 Reference ( Patient ) Who and/or what the observation is about
. . . focus Σ I 0..* Reference ( Resource ) What the observation is about, when it is not about the subject of record
. . . encounter Σ I 0..1 Reference ( Encounter ) Healthcare event during which this observation is made
. . . effective[x] S Σ I 1..1 Often just a dateTime for Vital Signs
vs-1: if Observation.effective[x] is dateTime and has a value then that value shall be precise to the day
. . . . effectiveDateTime dateTime
. . . . effectivePeriod Period
. . . issued Σ I 0..1 instant Date/Time this version was made available
. . . performer Σ I 0..* Reference ( Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson ) Who is responsible for the observation
. . . value[x] S Σ I 0..1 Vital Signs value are recorded using the Quantity data type. For supporting observations such as Cuff size could use other datatypes such as CodeableConcept.
. . . . valueQuantity Quantity
. . . . valueCodeableConcept CodeableConcept
. . . . valueString string
. . . . valueBoolean boolean
. . . . valueInteger integer
. . . . valueRange Range
. . . . valueRatio Ratio
. . . . valueSampledData SampledData
. . . . valueTime time
. . . . valueDateTime dateTime
. . . . valuePeriod Period
. . . . valueAttachment Attachment
... dataAbsentReason S I 0..1 CodeableConcept Why the result is missing
Binding: DataAbsentReason ( extensible )
. . . interpretation I 0..* CodeableConcept High, low, normal, etc.
Binding: Observation Interpretation Codes ( extensible )
. . . note I 0..* Annotation Comments about the observation
. . . bodySite I 0..1 CodeableConcept Observed body part
Binding: SNOMED CT Body Structures ( example )
. . . method I 0..1 CodeableConcept How it was done
Binding: Observation Methods ( example )
. . . specimen I 0..1 Reference ( Specimen ) Specimen used for this observation
. . . device I 0..1 Reference ( Device | DeviceMetric ) (Measurement) Device
. . . referenceRange I 0..* BackboneElement Provides guide for interpretation
obs-3: Must have at least a low or a high or text
. . . . id 0..1 string id Unique id for inter-element referencing
. . . . extension I 0..* Extension Additional content defined by implementations
. . . . modifierExtension ?! Σ I 0..* Extension Extensions that cannot be ignored even if unrecognized
. . . . low I 0..1 SimpleQuantity Low Range, if relevant
. . . . high I 0..1 SimpleQuantity High Range, if relevant
. . . . type I 0..1 CodeableConcept Reference range qualifier
Binding: Observation Reference Range Meaning Codes ( preferred )
. . . . appliesTo I 0..* CodeableConcept Reference range population
Binding: Observation Reference Range Applies To Codes ( example )
. . . . age I 0..1 Range Applicable age range, if relevant
. . . . text I 0..1 string Text based reference range in an observation
. . . hasMember Σ I 0..* Reference ( QuestionnaireResponse | MolecularSequence | Vital Signs Profile ) Used when reporting vital signs panel components
. . . derivedFrom Σ I 0..* Reference ( DocumentReference | ImagingStudy | Media | QuestionnaireResponse | MolecularSequence | Vital Signs Profile ) Related measurements the observation is made from
. . . component S Σ I 0..* BackboneElement Used when reporting systolic and diastolic blood pressure.
vs-3: If there is no a value a data absent reason must be present
. . . . id 0..1 string id Unique id for inter-element referencing
. . . . extension I 0..* Extension Additional content defined by implementations
. . . . modifierExtension ?! Σ I 0..* Extension Extensions that cannot be ignored even if unrecognized
. . . . code S Σ I 1..1 CodeableConcept Type of component observation (code / type)
Binding: Vital Signs ( extensible )
. . . . value[x] S Σ I 0..1 Vital Sign Value recorded with UCUM
Binding: Vital Signs Units ( required )
. . . . . valueQuantity Quantity
..... valueCodeableConcept Quantity CodeableConcept
. . . . valueCodeableConcept . valueString CodeableConcept string
. . . . . valueString valueBoolean string boolean
. . . . . valueBoolean valueInteger boolean integer
. . . . valueInteger . valueRange integer Range
. . . . . valueRange valueRatio Range Ratio
. . . . . valueRatio valueSampledData Ratio SampledData
. . . . valueSampledData . valueTime SampledData time
. . . . . valueTime valueDateTime time dateTime
. . . . valueDateTime . valuePeriod dateTime Period
. . . . . valuePeriod valueAttachment Period Attachment
. . . . dataAbsentReason S I 0..1 CodeableConcept Why the component result is missing
Binding: DataAbsentReason ( extensible )
. . . . interpretation I 0..* CodeableConcept High, low, normal, etc.
Binding: Observation Interpretation Codes ( extensible )
. . . . referenceRange I 0..* See referenceRange Unknown reference to #Observation.referenceRange Provides guide for interpretation of component result

doco Documentation for this format

XML Template

<!-- observation-vitalsigns -->doco
<Observation xmlns="http://hl7.org/fhir"
>
  <!-- from Element: extension -->
 <</id>

 <id value="[id]"/><!-- 0..1 Logical id of this artifact -->

 <meta><!-- ?? 0..1 Meta Metadata about the resource --></meta>
 <implicitRules value="[uri]"/><!-- ?? 0..1 A set of rules under which this content was created -->
 <language value="[code]"/><!-- ?? 0..1 Language of the resource content   -->
 <text><!-- ?? 0..1 Narrative 
     Text summary of the resource, for human interpretation --></text>
 <</contained>

 <contained><!-- 0..* Resource Contained, inline Resources --></contained>

 <modifierExtension><!-- ?? 0..* Extension  Extensions that cannot be ignored  --></modifierExtension>
 <identifier><!-- ?? 0..* Identifier 
     Business Identifier for observation --></identifier>
 <basedOn><!-- ?? 0..* Reference(CarePlan) Fulfills plan, proposal or order --></basedOn>
 <partOf><!-- ?? 0..* Reference(MedicationAdministration) Part of referenced event --></partOf>
 <status value="[code]"/><!-- ?? 1..1 registered | preliminary | final | amended +   -->
 <-- category sliced by value:coding.code, value:coding.system  in the specified orderOpen-->
 <category> ?? 1..1 CodeableConcept  <!-- ?? 1..1 Classification of  type of observation -->
  <coding> ?? 1..* Coding  <!-- ?? 1..* Code defined by a terminology system -->
   <system value="[uri]"/><!-- ?? 1..1 Identity of the terminology system -->
   <version value="[string]"/><!-- ?? 0..1 Version of the system - if relevant -->
   <code value="[code]"/><!-- ?? 1..1 Symbol in syntax defined by the system -->
   <display value="[string]"/><!-- ?? 0..1 Representation defined by the system -->
   <userSelected value="[boolean]"/><!-- ?? 0..1 If this coding was chosen directly by the user -->
  </coding>
  <text value="[string]"/><!-- ?? 0..1 Plain text representation of the concept -->
 </category>
 <code><!-- ?? 1..1 CodeableConcept Coded Responses from C-CDA Vital Sign Results   --></code>
 <subject><!-- ?? 1..1 Reference(Patient) 
     Who and/or what the observation is about --></subject>
 <focus><!-- ?? 0..* Reference(Resource) 
     What the observation is about, when it is not about the subject of record --></focus>
 <encounter><!-- ?? 0..1 Reference(Encounter) 
     Healthcare event during which this observation is made --></encounter>
 <effective[x]><!-- ?? 1..1 dateTime|Period 
     Often just a dateTime for Vital Signs --></effective[x]>
 <issued value="[instant]"/><!-- ?? 0..1 Date/Time this version was made available -->
 <performer><!-- ?? 0..* Reference(Practitioner) 
     Who is responsible for the observation --></performer>
 <value[x]><!-- ?? 0..1 Quantity|CodeableConcept|string|boolean|integer|
   

   Range|Ratio|SampledData|time|dateTime|Period|Attachment 
     Vital Signs value are recorded using the Quantity data type. For supporting observations such as Cuff size could use other datatypes such as CodeableConcept. --></value[x]>
 <dataAbsentReason><!-- ?? 0..1 CodeableConcept Why the result is missing   --></dataAbsentReason>
 <interpretation><!-- ?? 0..* CodeableConcept High, low, normal, etc.   --></interpretation>
 <note><!-- ?? 0..* Annotation Comments about the observation --></note>
 <bodySite><!-- ?? 0..1 CodeableConcept Observed body part   --></bodySite>
 <method><!-- ?? 0..1 CodeableConcept How it was done   --></method>
 <specimen><!-- ?? 0..1 Reference(Specimen) Specimen used for this observation --></specimen>
 <device><!-- ?? 0..1 Reference(Device) (Measurement) Device --></device>
 <

 <referenceRange> ?? 0..* BackboneElement  <!-- ?? 0..* Provides guide for interpretation -->

  <modifierExtension><!-- ?? 0..* Extension  Extensions that cannot be ignored even if unrecognized  --></modifierExtension>
  <low><!-- ?? 0..1 Quantity 
      Low Range, if relevant --></low>
  <high><!-- ?? 0..1 Quantity 
      High Range, if relevant --></high>
  <type><!-- ?? 0..1 CodeableConcept Reference range qualifier   --></type>
  <appliesTo><!-- ?? 0..* CodeableConcept Reference range population   --></appliesTo>
  <age><!-- ?? 0..1 Range 
      Applicable age range, if relevant --></age>
  <text value="[string]"/><!-- ?? 0..1 Text based reference range in an observation -->
 </referenceRange>
 <hasMember><!-- ?? 0..* Reference(QuestionnaireResponse) 
     Used when reporting vital signs panel components --></hasMember>
 <derivedFrom><!-- ?? 0..* Reference(DocumentReference) 
     Related measurements the observation is made from --></derivedFrom>
 <

 <component> ?? 0..* BackboneElement  <!-- ?? 0..* Used when reporting systolic and diastolic blood pressure. -->

  <modifierExtension><!-- ?? 0..* Extension  Extensions that cannot be ignored even if unrecognized  --></modifierExtension>
  <code><!-- ?? 1..1 CodeableConcept Type of component observation (code / type)   --></code>
  <value[x]><!-- ?? 0..1 Quantity|CodeableConcept|string|
    </value[x]>

    boolean|integer|Range|Ratio|SampledData|time|dateTime|Period|Attachment Vital Sign Value recorded with UCUM   --></value[x]>
  <dataAbsentReason><!-- ?? 0..1 CodeableConcept Why the component result is missing   --></dataAbsentReason>
  <interpretation><!-- ?? 0..* CodeableConcept High, low, normal, etc.   --></interpretation>
  <referenceRange><!-- See #Observation.referenceRange  Provides guide for interpretation of component result --></referenceRange>
 </component>
</Observation>

JSON Template

{ // observation-vitalsigns
  // from Element: extension
    "meta" : { Meta }, // C?Metadata about the resource
    "implicitRules" : "<uri>", // C?A set of rules under which this content was created
    "language" : "<code>", // C?Language of the resource content
    "text" : { Narrative }, // C?Text summary of the resource, for human interpretation
    "

    "contained" : [{ Resource }], //Contained, inline Resources

    "modifierExtension" : [{ Extension }], // C?Extensions that cannot be ignored
    "identifier" : [{ Identifier }], // C?Business Identifier for observation
    "basedOn" : [{ Reference(CarePlan) }], // C?Fulfills plan, proposal or order
    "partOf" : [{ Reference(MedicationAdministration) }], // C?Part of referenced event
    "status" : "<code>", // C? R! registered | preliminary | final | amended +
    "category" : [ //  sliced by value:coding.code, value:coding.system  in the specified order, Open 
      { // Classification of  type of observation // C? R! 
        // from Element: extension
        "extension" : [ //  sliced by value:url  in the specified order, Open ]
        "coding" : [{ Coding }], // C? R! Code defined by a terminology system
        "text" : "<string>" // C?Plain text representation of the concept
      }
    ],
    "code" : { CodeableConcept }, // C? R! Coded Responses from C-CDA Vital Sign Results
    "subject" : { Reference(Patient) }, // C? R! Who and/or what the observation is about
    "focus" : [{ Reference(Resource) }], // C?What the observation is about, when it is not about the subject of record
    "encounter" : { Reference(Encounter) }, // C?Healthcare event during which this observation is made
// value[x]: Often just a dateTime for Vital Signs. One of these 2:
    "effectiveDateTime" : "<dateTime>", // C? R! Often just a dateTime for Vital Signs
    "effectivePeriod" : { Period }, // C? R! Often just a dateTime for Vital Signs
    "issued" : "<instant>", // C?Date/Time this version was made available
    "performer" : [{ Reference(Practitioner) }], // C?Who is responsible for the observation
// value[x]: Vital Signs value are recorded using the Quantity data type. For supporting observations such as Cuff size could use other datatypes such as CodeableConcept.. One of these 12:
    "valueQuantity" : { Quantity }, // C?Vital Signs value are recorded using the Quantity data type. For supporting observations such as Cuff size could use other datatypes such as CodeableConcept.
    "valueCodeableConcept" : { CodeableConcept }, // C?Vital Signs value are recorded using the Quantity data type. For supporting observations such as Cuff size could use other datatypes such as CodeableConcept.
    "valueString" : "<string>", // C?Vital Signs value are recorded using the Quantity data type. For supporting observations such as Cuff size could use other datatypes such as CodeableConcept.
    "valueBoolean" : <boolean>, // C?Vital Signs value are recorded using the Quantity data type. For supporting observations such as Cuff size could use other datatypes such as CodeableConcept.
    "valueInteger" : <integer>, // C?Vital Signs value are recorded using the Quantity data type. For supporting observations such as Cuff size could use other datatypes such as CodeableConcept.
    "valueRange" : { Range }, // C?Vital Signs value are recorded using the Quantity data type. For supporting observations such as Cuff size could use other datatypes such as CodeableConcept.
    "valueRatio" : { Ratio }, // C?Vital Signs value are recorded using the Quantity data type. For supporting observations such as Cuff size could use other datatypes such as CodeableConcept.
    "valueSampledData" : { SampledData }, // C?Vital Signs value are recorded using the Quantity data type. For supporting observations such as Cuff size could use other datatypes such as CodeableConcept.
    "valueTime" : "<time>", // C?Vital Signs value are recorded using the Quantity data type. For supporting observations such as Cuff size could use other datatypes such as CodeableConcept.
    "valueDateTime" : "<dateTime>", // C?Vital Signs value are recorded using the Quantity data type. For supporting observations such as Cuff size could use other datatypes such as CodeableConcept.
    "valuePeriod" : { Period }, // C?Vital Signs value are recorded using the Quantity data type. For supporting observations such as Cuff size could use other datatypes such as CodeableConcept.
    "

    "valueAttachment" : { Attachment } // C?Vital Signs value are recorded using the Quantity data type. For supporting observations such as Cuff size could use other datatypes such as CodeableConcept.
    "dataAbsentReason" : { CodeableConcept }, // C?Why the result is missing

    "interpretation" : [{ CodeableConcept }], // C?High, low, normal, etc.
    "note" : [{ Annotation }], // C?Comments about the observation
    "bodySite" : { CodeableConcept }, // C?Observed body part
    "method" : { CodeableConcept }, // C?How it was done
    "specimen" : { Reference(Specimen) }, // C?Specimen used for this observation
    "device" : { Reference(Device) }, // C?(Measurement) Device
    "

    "referenceRange" : [{ BackboneElement }], // C?Provides guide for interpretation

    "hasMember" : [{ Reference(QuestionnaireResponse) }], // C?Used when reporting vital signs panel components
    "derivedFrom" : [{ Reference(DocumentReference) }], // C?Related measurements the observation is made from
    "

    "component" : [{ BackboneElement }], // C?Used when reporting systolic and diastolic blood pressure.

  }

 

Alternate definitions: Master Definition ( XML , JSON ), Schematron

Path Name Conformance ValueSet
Observation.language Common Languages preferred Common Languages
Observation.status ObservationStatus required ObservationStatus
Observation.category Observation Category Codes preferred Observation Category Codes
Observation.category Observation Category Codes preferred Observation Category Codes
Observation.code Vital Signs extensible Vital Signs
Observation.dataAbsentReason DataAbsentReason extensible DataAbsentReason
Observation.interpretation Observation Interpretation Codes extensible Observation Interpretation Codes
Observation.bodySite SNOMED CT Body Structures example SNOMED CT Body Structures
Observation.method Observation Methods example Observation Methods
Observation.referenceRange.type Observation Reference Range Meaning Codes preferred Observation Reference Range Meaning Codes
Observation.referenceRange.appliesTo Observation Reference Range Applies To Codes example Observation Reference Range Applies To Codes
Observation.component.code Vital Signs extensible Vital Signs
Observation.component.value[x] Vital Signs Units required Vital Signs Units
Observation.component.dataAbsentReason DataAbsentReason extensible DataAbsentReason
Observation.component.interpretation Observation Interpretation Codes extensible Observation Interpretation Codes
Rule Rule Rule Rule
Id Path Details Requirements
vs-2 Observation If there is no component or hasMember element then either a value[x] or a data absent reason must be present.
Expression : (component.empty() and hasMember.empty()) implies (dataAbsentReason.exists() or value.exists())
vs-1 Observation.effective[x] if Observation.effective[x] is dateTime and has a value then that value shall be precise to the day
Expression : ($this as dateTime).toString().length() >= 8
obs-3 Observation.referenceRange Must have at least a low or a high or text Expression : low.exists() or high.exists() or text.exists() vs-3 Observation.component If there is no a value a data absent reason must be present
Expression : value.exists() or dataAbsentReason.exists()
.