Release 4 5 Draft Ballot
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Orders and Observations Work Group   Maturity Level : 5 0 Trial Use Use Context : Any

The official URL for this profile is:

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

FHIR Blood Pressure Profile

This profile was published on Sat, Aug 11, 2018 00:00+1000 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-vitalsigns .

Summary

  1. One code in Observation.code which must have
    • a fixed Observation.code.coding.system = 'http ://loinc.org'
    • a fixed Observation.code.coding.code = 85354-9'
    • Other additional Codings are allowed in Observation.code - e.g. more specific LOINC Codes, SNOMED CT concepts, system specific codes. All codes SHALL have an system value
  2. One Observation.component.code which must have
    • a fixed Observation.component.code.coding.system = 'http://loinc.org'
    • fixed Observation.component.code.coding.code = '8480-6'
    • Other additional Codings are allowed in Observation.code - e.g. more specific LOINC Codes, SNOMED CT concepts, system specific codes. All codes SHALL have an system value
  3. One Observation.component.code which must have
    • a fixed Observation.component.code.coding.system = 'http://loinc.org'
    • fixed Observation.component.code.coding.code = '8462-4'
    • Other additional Codings are allowed in Observation.code - e.g. more specific LOINC Codes, SNOMED CT concepts, system specific codes. All codes SHALL have an system value
  4. Either one Observation.valueQuantity or, if there is no value, one code in Observation.DataAbsentReason
    • Each Observation.valueQuantity must have:
      • One numeric value in Observation.valueQuantity.value
      • a fixed Observation.valueQuantity.system="http://unitsofmeasure.org"
      • a UCUM unit code in Observation.valueQuantity.code = 'mm[Hg]'

Mandatory: 11 elements (+8 nested mandatory elements)
Must-Support: 8 elements
Fixed Value: 10 elements
Prohibited: 1 element

Slices

This structure defines the following Slices :

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

This structure is derived from observation-vitalsigns .

Name Flags Card. Type Description & Constraints doco
. . Observation 0..* observation-vitalsigns FHIR Blood Pressure Profile
. . . code 1 .. 1 CodeableConcept Blood Pressure
. . . . coding 0 .. * (Slice Definition) Code defined by a terminology system
Slice: Unordered, Open by value:code, value:system
. . . . . coding:BPCode 1..1 Coding Code defined by a terminology system
. . . . . . system 1..1 uri Identity of the terminology system
Fixed Value: http://loinc.org
. . . . . . code 1..1 code Symbol in syntax defined by the system
Fixed Value: 85354-9
. . . valueQuantity 0 .. 0
. . . component 2 .. * (Slice Definition) Used when reporting systolic and diastolic blood pressure.
Slice: Unordered, Open by value:code.coding.code, value:code.coding.system
. . . . component:SystolicBP 1..1 BackboneElement Used when reporting systolic and diastolic blood pressure.
. . . . . code 1 .. 1 CodeableConcept Type of component observation (code / type)
. . . . . . coding 0 .. * (Slice Definition) Systolic Blood Pressure
Slice: Unordered, Open by value:code, value:system
. . . . . . . coding:SBPCode 1..1 Coding Systolic Blood Pressure
. . . . . . . . system 1..1 uri Identity of the terminology system
Fixed Value: http://loinc.org
. . . . . . . . code 1..1 code Symbol in syntax defined by the system
Fixed Value: 8480-6
. . . . . valueQuantity 0 .. 1 Quantity Vital Sign Value recorded with UCUM
. . . . . . value S 1..1 decimal Numerical value (with implicit precision)
. . . . . . unit S 1..1 string Unit representation
. . . . . . system S 1..1 uri System that defines coded unit form
Fixed Value: http://unitsofmeasure.org
. . . . . . code S 1..1 code Coded responses from the common UCUM units for vital signs value set.
Fixed Value: mm[Hg]
. . . . component:DiastolicBP 1..1 BackboneElement Used when reporting systolic and diastolic blood pressure.
. . . . . code 1 .. 1 CodeableConcept Type of component observation (code / type)
. . . . . . coding 0 .. * (Slice Definition) Diastolic Blood Pressure
Slice: Unordered, Open by value:code, value:system
. . . . . . . coding:DBPCode 1..1 Coding Diastolic Blood Pressure
. . . . . . . . system 1..1 uri Identity of the terminology system
Fixed Value: http://loinc.org
. . . . . . . . code 1..1 code Symbol in syntax defined by the system
Fixed Value: 8462-4
. . . . . valueQuantity 0 .. 1 Quantity Vital Sign Value recorded with UCUM
. . . . . . value S 1..1 decimal Numerical value (with implicit precision)
. . . . . . unit S 1..1 string Unit representation
. . . . . . system S 1..1 uri System that defines coded unit form
Fixed Value: http://unitsofmeasure.org
. . . . . . code S 1..1 code Coded responses from the common UCUM units for vital signs value set.
Fixed Value: mm[Hg]

doco Documentation for this format
Name Flags Card. Type Description & Constraints doco
. . Observation I 0..* observation-vitalsigns FHIR Blood Pressure Profile
. . . 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 : IETF language tag

. . . 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 instantiates[x] Σ I 0..1 canonical ( ObservationDefinition ), Reference ( ObservationDefinition ) Instantiates FHIR ObservationDefinition
... basedOn Σ 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 ) : Codes for high level observation categories.


. . . . category:VSCat S I 1..1 CodeableConcept Classification of type of observation
Binding: Observation Category Codes ( preferred ) ): Codes for high level observation categories.


. . . . . 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 Blood Pressure
Binding: Vital Signs ( extensible ) ): This identifies the vital sign result type. Original source C-CDA R1.1 , HITSP Vital Sign Result Type.

. . . . 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 Σ I 0 .. * (Slice Definition) Code defined by a terminology system
Slice: Unordered, Open by value:code, value:system
. . . . . coding:BPCode Σ I 1..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 Σ I 1..1 uri Identity of the terminology system
Fixed Value: http://loinc.org
. . . . . . version Σ I 0..1 string Version of the system - if relevant
. . . . . . code Σ I 1..1 code Symbol in syntax defined by the system
Fixed Value: 85354-9
. . . . . . 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
. . . 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 (Slice Definition) Vital Signs value are recorded using the Quantity data type. For supporting observations such as Cuff size could use other datatypes such as CodeableConcept.
Slice: Unordered, Closed by type:$this
. . . dataAbsentReason S I 0..1 CodeableConcept Why the result is missing
Binding: DataAbsentReason ( extensible ): Codes specifying why the result ( Observation.value[x] ) is missing.

. . . interpretation I 0..* CodeableConcept High, low, normal, etc.
Binding: Observation Interpretation Codes ( extensible ) ): Codes identifying interpretations of observations.


. . . note I 0..* Annotation Comments about the observation
. . . bodySite I 0..1 CodeableConcept Observed body part
Binding: SNOMED CT Body Structures ( example ) ): SNOMED CT Body site concepts

. . . method I 0..1 CodeableConcept How it was done
Binding: Observation Methods ( example ) ): Methods for simple observations.

. . . 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 ) ): Code for the meaning of a reference range.

. . . . appliesTo I 0..* CodeableConcept Reference range population
Binding: Observation Reference Range Applies To Codes ( example ) ): Codes identifying the population the reference range applies to.


. . . . 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 2 .. * (Slice Definition) Used when reporting systolic and diastolic blood pressure.
Slice: Unordered, Open by value:code.coding.code, value:code.coding.system
. . . (All Slices) . component:All Slices Content/Rules for all slices
. . . . . 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 ) ): This identifies the vital sign result type. Original source C-CDA R1.1 , HITSP Vital Sign Result Type.

. . . . . value[x] S Σ I 0..1 Vital Sign Value recorded with UCUM
Binding: Vital Signs Units ( required ) ): Commonly encountered UCUM units for recording Vital Signs.

. . . . . . 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 ): Codes specifying why the result ( Observation.value[x] ) is missing.

. . . . . interpretation I 0..* CodeableConcept High, low, normal, etc.
Binding: Observation Interpretation Codes ( extensible ) ): Codes identifying interpretations of observations.


. . . . . referenceRange I 0..* See referenceRange (Observation) Unknown reference to #Observation.referenceRange Provides guide for interpretation of component result
. . . . component:SystolicBP S Σ I 1..1 BackboneElement Used when reporting systolic and diastolic blood pressure.
. . . . . 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 ) ): This identifies the vital sign result type. Original source C-CDA R1.1 , HITSP Vital Sign Result Type.

. . . . . . 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 Σ I 0 .. * (Slice Definition) Systolic Blood Pressure
Slice: Unordered, Open by value:code, value:system
. . . . . . . coding:SBPCode Σ I 1..1 Coding Systolic Blood Pressure
. . . . . . . . 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 Σ I 1..1 uri Identity of the terminology system
Fixed Value: http://loinc.org
. . . . . . . . version Σ I 0..1 string Version of the system - if relevant
. . . . . . . . code Σ I 1..1 code Symbol in syntax defined by the system
Fixed Value: 8480-6
. . . . . . . . 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
. . . . . value[x] S Σ I 0..1 Quantity Vital Sign Value recorded with UCUM
Binding: Vital Signs Units ( required ) ): Commonly encountered UCUM units for recording Vital Signs.

. . . . . . 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
. . . . . . value S Σ I 1..1 decimal Numerical value (with implicit precision)
. . . . . . comparator ?! Σ I 0..1 code < | <= | >= | > - how to understand the value < | <= | >= | > | ad - how to understand the value
Binding: QuantityComparator ( required )
. . . . . . unit S Σ I 1..1 string Unit representation
. . . . . . system S Σ I 1..1 uri System that defines coded unit form
Fixed Value: http://unitsofmeasure.org
. . . . . . code S Σ I 1..1 code Coded responses from the common UCUM units for vital signs value set.
Fixed Value: mm[Hg]
. . . . . dataAbsentReason S I 0..1 CodeableConcept Why the component result is missing
Binding: DataAbsentReason ( extensible ) ): Codes specifying why the result ( Observation.value[x] ) is missing.

. . . . . interpretation I 0..* CodeableConcept High, low, normal, etc.
Binding: Observation Interpretation Codes ( extensible ) ): Codes identifying interpretations of observations.


. . . . . referenceRange I 0..* See referenceRange (Observation) Unknown reference to #Observation.referenceRange Provides guide for interpretation of component result
. . . . component:DiastolicBP S Σ I 1..1 BackboneElement Used when reporting systolic and diastolic blood pressure.
. . . . . 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 ) ): This identifies the vital sign result type. Original source C-CDA R1.1 , HITSP Vital Sign Result Type.

. . . . . . 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 Σ I 0 .. * (Slice Definition) Diastolic Blood Pressure
Slice: Unordered, Open by value:code, value:system
. . . . . . . coding:DBPCode Σ I 1..1 Coding Diastolic Blood Pressure
. . . . . . . . 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 Σ I 1..1 uri Identity of the terminology system
Fixed Value: http://loinc.org
. . . . . . . . version Σ I 0..1 string Version of the system - if relevant
. . . . . . . . code Σ I 1..1 code Symbol in syntax defined by the system
Fixed Value: 8462-4
. . . . . . . . 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
. . . . . value[x] S Σ I 0..1 Quantity Vital Sign Value recorded with UCUM
Binding: Vital Signs Units ( required ) ): Commonly encountered UCUM units for recording Vital Signs.

. . . . . . 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
. . . . . . value S Σ I 1..1 decimal Numerical value (with implicit precision)
. . . . . . comparator ?! Σ I 0..1 code < | <= | >= | > - how to understand the value < | <= | >= | > | ad - how to understand the value
Binding: QuantityComparator ( required )
. . . . . . unit S Σ I 1..1 string Unit representation
. . . . . . system S Σ I 1..1 uri System that defines coded unit form
Fixed Value: http://unitsofmeasure.org
. . . . . . code S Σ I 1..1 code Coded responses from the common UCUM units for vital signs value set.
Fixed Value: mm[Hg]
. . . . . dataAbsentReason S I 0..1 CodeableConcept Why the component result is missing
Binding: DataAbsentReason ( extensible ) ): Codes specifying why the result ( Observation.value[x] ) is missing.

. . . . . interpretation I 0..* CodeableConcept High, low, normal, etc.
Binding: Observation Interpretation Codes ( extensible ) ): Codes identifying interpretations of observations.


. . . . . referenceRange I 0..* See referenceRange (Observation) Unknown reference to #Observation.referenceRange Provides guide for interpretation of component result

doco Documentation for this format
<!-- observation-bp -->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>
 <instantiates[x]><!-- ?? 0..1 canonical|Reference(ObservationDefinition) 
     Instantiates FHIR ObservationDefinition --></instantiates[x]>

 <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  <!-- ?? 1..1 Blood Pressure -->
  <-- coding sliced by value:code, value:system  in the specified orderOpen-->
  <coding> ?? 1..1 Coding  <!-- ?? 1..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 -->
 </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>
 <-- valueQuantity sliced by type:$this  in the specified orderClosed-->
 <valueQuantity><!-- ?? 0..0 Quantity 
     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>
 <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 sliced by value:code.coding.code, value:code.coding.system  in the specified orderOpen-->
 <

 <component> ?? 1..1 BackboneElement  <!-- ?? 1..1 Used when reporting systolic and diastolic blood pressure. -->

  <modifierExtension><!-- ?? 0..* Extension  Extensions that cannot be ignored even if unrecognized  --></modifierExtension>
  <code> ?? 1..1 CodeableConcept  <!-- ?? 1..1 Type of component observation (code / type) -->
   <-- coding sliced by value:code, value:system  in the specified orderOpen-->
   <coding> ?? 1..1 Coding  <!-- ?? 1..1 Systolic Blood Pressure -->
    <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 -->
  </code>
  <valueQuantity> ?? 0..1 Quantity  <!-- ?? 0..1 Vital Sign Value recorded with UCUM -->
   <value value="[decimal]"/><!-- ?? 1..1 Numerical value (with implicit precision) -->
   <

   <comparator value="[code]"/><!-- ?? 0..1 < | <= | >= | > | ad - how to understand the value   -->

   <unit value="[string]"/><!-- ?? 1..1 Unit representation -->
   <system value="[uri]"/><!-- ?? 1..1 System that defines coded unit form -->
   <code value="[code]"/><!-- ?? 1..1 
       Coded responses from the common UCUM units for vital signs value set. -->
  </valueQuantity>
  <dataAbsentReason><!-- ?? 0..1 CodeableConcept Why the component result is missing   --></dataAbsentReason>
  <interpretation><!-- ?? 0..* CodeableConcept High, low, normal, etc.   --></interpretation>
  <</referenceRange>

  <referenceRange><!-- See http://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange  Provides guide for interpretation of component result --></referenceRange>

 </component>
 <

 <component> ?? 1..1 BackboneElement  <!-- ?? 1..1 Used when reporting systolic and diastolic blood pressure. -->

  <modifierExtension><!-- ?? 0..* Extension  Extensions that cannot be ignored even if unrecognized  --></modifierExtension>
  <code> ?? 1..1 CodeableConcept  <!-- ?? 1..1 Type of component observation (code / type) -->
   <-- coding sliced by value:code, value:system  in the specified orderOpen-->
   <coding> ?? 1..1 Coding  <!-- ?? 1..1 Diastolic Blood Pressure -->
    <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 -->
  </code>
  <valueQuantity> ?? 0..1 Quantity  <!-- ?? 0..1 Vital Sign Value recorded with UCUM -->
   <value value="[decimal]"/><!-- ?? 1..1 Numerical value (with implicit precision) -->
   <

   <comparator value="[code]"/><!-- ?? 0..1 < | <= | >= | > | ad - how to understand the value   -->

   <unit value="[string]"/><!-- ?? 1..1 Unit representation -->
   <system value="[uri]"/><!-- ?? 1..1 System that defines coded unit form -->
   <code value="[code]"/><!-- ?? 1..1 
       Coded responses from the common UCUM units for vital signs value set. -->
  </valueQuantity>
  <dataAbsentReason><!-- ?? 0..1 CodeableConcept Why the component result is missing   --></dataAbsentReason>
  <interpretation><!-- ?? 0..* CodeableConcept High, low, normal, etc.   --></interpretation>
  <</referenceRange>

  <referenceRange><!-- See http://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange  Provides guide for interpretation of component result --></referenceRange>

 </component>
</Observation>
{ // observation-bp
  // 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
// value[x]: Instantiates FHIR ObservationDefinition. One of these 2:
    "instantiatesCanonical" : "<canonical>", // C?Instantiates FHIR ObservationDefinition
    "instantiatesReference" : { Reference(ObservationDefinition) }, // C?Instantiates FHIR ObservationDefinition

    "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! Blood Pressure
    "

    "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
    "valueQuantity" : [ //  sliced by type:$this  in the specified order, Closed 
      { // Vital Signs value are recorded using the Quantity data type. For supporting observations such as Cuff size could use other datatypes such as CodeableConcept. // C?
        // from Element: extension
      }
    ],
    "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" : [ //  sliced by value:code.coding.code, value:code.coding.system  in the specified order, Open 
      { // Used when reporting systolic and diastolic blood pressure. // C? R! 
        // from Element: extension
        "modifierExtension" : [{ Extension }], // C?Extensions that cannot be ignored even if unrecognized
        "code" : { CodeableConcept }, // C? R! Type of component observation (code / type)
        "valueQuantity" : { Quantity }, // C?Vital Sign Value recorded with UCUM
        "dataAbsentReason" : { CodeableConcept }, // C?Why the component result is missing
        "interpretation" : [{ CodeableConcept }], // C?High, low, normal, etc.
// value[x]: Provides guide for interpretation of component result. One of these 0:
      },
      { // Used when reporting systolic and diastolic blood pressure. // C? R! 
        // from Element: extension
        "modifierExtension" : [{ Extension }], // C?Extensions that cannot be ignored even if unrecognized
        "code" : { CodeableConcept }, // C? R! Type of component observation (code / type)
        "valueQuantity" : { Quantity }, // C?Vital Sign Value recorded with UCUM
        "dataAbsentReason" : { CodeableConcept }, // C?Why the component result is missing
        "interpretation" : [{ CodeableConcept }], // C?High, low, normal, etc.
// value[x]: Provides guide for interpretation of component result. One of these 0:
      }
    ],
  }

This structure is derived from observation-vitalsigns .

Summary

  1. One code in Observation.code which must have
    • a fixed Observation.code.coding.system = 'http ://loinc.org'
    • a fixed Observation.code.coding.code = 85354-9'
    • Other additional Codings are allowed in Observation.code - e.g. more specific LOINC Codes, SNOMED CT concepts, system specific codes. All codes SHALL have an system value
  2. One Observation.component.code which must have
    • a fixed Observation.component.code.coding.system = 'http://loinc.org'
    • fixed Observation.component.code.coding.code = '8480-6'
    • Other additional Codings are allowed in Observation.code - e.g. more specific LOINC Codes, SNOMED CT concepts, system specific codes. All codes SHALL have an system value
  3. One Observation.component.code which must have
    • a fixed Observation.component.code.coding.system = 'http://loinc.org'
    • fixed Observation.component.code.coding.code = '8462-4'
    • Other additional Codings are allowed in Observation.code - e.g. more specific LOINC Codes, SNOMED CT concepts, system specific codes. All codes SHALL have an system value
  4. Either one Observation.valueQuantity or, if there is no value, one code in Observation.DataAbsentReason
    • Each Observation.valueQuantity must have:
      • One numeric value in Observation.valueQuantity.value
      • a fixed Observation.valueQuantity.system="http://unitsofmeasure.org"
      • a UCUM unit code in Observation.valueQuantity.code = 'mm[Hg]'

Mandatory: 11 elements (+8 nested mandatory elements)
Must-Support: 8 elements
Fixed Value: 10 elements
Prohibited: 1 element

Slices

This structure defines the following Slices :

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

Differential View

This structure is derived from observation-vitalsigns .

Name Flags Card. Type Description & Constraints doco
. . Observation 0..* observation-vitalsigns FHIR Blood Pressure Profile
. . . code 1 .. 1 CodeableConcept Blood Pressure
. . . . coding 0 .. * (Slice Definition) Code defined by a terminology system
Slice: Unordered, Open by value:code, value:system
. . . . . coding:BPCode 1..1 Coding Code defined by a terminology system
. . . . . . system 1..1 uri Identity of the terminology system
Fixed Value: http://loinc.org
. . . . . . code 1..1 code Symbol in syntax defined by the system
Fixed Value: 85354-9
. . . valueQuantity 0 .. 0
. . . component 2 .. * (Slice Definition) Used when reporting systolic and diastolic blood pressure.
Slice: Unordered, Open by value:code.coding.code, value:code.coding.system
. . . . component:SystolicBP 1..1 BackboneElement Used when reporting systolic and diastolic blood pressure.
. . . . . code 1 .. 1 CodeableConcept Type of component observation (code / type)
. . . . . . coding 0 .. * (Slice Definition) Systolic Blood Pressure
Slice: Unordered, Open by value:code, value:system
. . . . . . . coding:SBPCode 1..1 Coding Systolic Blood Pressure
. . . . . . . . system 1..1 uri Identity of the terminology system
Fixed Value: http://loinc.org
. . . . . . . . code 1..1 code Symbol in syntax defined by the system
Fixed Value: 8480-6
. . . . . valueQuantity 0 .. 1 Quantity Vital Sign Value recorded with UCUM
. . . . . . value S 1..1 decimal Numerical value (with implicit precision)
. . . . . . unit S 1..1 string Unit representation
. . . . . . system S 1..1 uri System that defines coded unit form
Fixed Value: http://unitsofmeasure.org
. . . . . . code S 1..1 code Coded responses from the common UCUM units for vital signs value set.
Fixed Value: mm[Hg]
. . . . component:DiastolicBP 1..1 BackboneElement Used when reporting systolic and diastolic blood pressure.
. . . . . code 1 .. 1 CodeableConcept Type of component observation (code / type)
. . . . . . coding 0 .. * (Slice Definition) Diastolic Blood Pressure
Slice: Unordered, Open by value:code, value:system
. . . . . . . coding:DBPCode 1..1 Coding Diastolic Blood Pressure
. . . . . . . . system 1..1 uri Identity of the terminology system
Fixed Value: http://loinc.org
. . . . . . . . code 1..1 code Symbol in syntax defined by the system
Fixed Value: 8462-4
. . . . . valueQuantity 0 .. 1 Quantity Vital Sign Value recorded with UCUM
. . . . . . value S 1..1 decimal Numerical value (with implicit precision)
. . . . . . unit S 1..1 string Unit representation
. . . . . . system S 1..1 uri System that defines coded unit form
Fixed Value: http://unitsofmeasure.org
. . . . . . code S 1..1 code Coded responses from the common UCUM units for vital signs value set.
Fixed Value: mm[Hg]

doco Documentation for this format

Snapshot View

Name Flags Card. Type Description & Constraints doco
. . Observation I 0..* observation-vitalsigns FHIR Blood Pressure Profile
. . . 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 : IETF language tag

. . . 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 . instantiates[x] Σ I 0..1 canonical ( ObservationDefinition ), Reference ( ObservationDefinition ) Instantiates FHIR ObservationDefinition
... basedOn Σ 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 ) : Codes for high level observation categories.


. . . . category:VSCat S I 1..1 CodeableConcept Classification of type of observation
Binding: Observation Category Codes ( preferred ) ): Codes for high level observation categories.


. . . . . 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 Blood Pressure
Binding: Vital Signs ( extensible ) ): This identifies the vital sign result type. Original source C-CDA R1.1 , HITSP Vital Sign Result Type.

. . . . 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 Σ I 0 .. * (Slice Definition) Code defined by a terminology system
Slice: Unordered, Open by value:code, value:system
. . . . . coding:BPCode Σ I 1..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 Σ I 1..1 uri Identity of the terminology system
Fixed Value: http://loinc.org
. . . . . . version Σ I 0..1 string Version of the system - if relevant
. . . . . . code Σ I 1..1 code Symbol in syntax defined by the system
Fixed Value: 85354-9
. . . . . . 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
. . . 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 (Slice Definition) Vital Signs value are recorded using the Quantity data type. For supporting observations such as Cuff size could use other datatypes such as CodeableConcept.
Slice: Unordered, Closed by type:$this
. . . dataAbsentReason S I 0..1 CodeableConcept Why the result is missing
Binding: DataAbsentReason ( extensible ) ): Codes specifying why the result ( Observation.value[x] ) is missing.

. . . interpretation I 0..* CodeableConcept High, low, normal, etc.
Binding: Observation Interpretation Codes ( extensible ) ): Codes identifying interpretations of observations.


. . . note I 0..* Annotation Comments about the observation
. . . bodySite I 0..1 CodeableConcept Observed body part
Binding: SNOMED CT Body Structures ( example ) ): SNOMED CT Body site concepts

. . . method I 0..1 CodeableConcept How it was done
Binding: Observation Methods ( example ) ): Methods for simple observations.

. . . 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 ) ): Code for the meaning of a reference range.

. . . . appliesTo I 0..* CodeableConcept Reference range population
Binding: Observation Reference Range Applies To Codes ( example ) ): Codes identifying the population the reference range applies to.


. . . . 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 2 .. * (Slice Definition) Used when reporting systolic and diastolic blood pressure.
Slice: Unordered, Open by value:code.coding.code, value:code.coding.system
. . . (All Slices) . component:All Slices Content/Rules for all slices
. . . . . 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 ) ): This identifies the vital sign result type. Original source C-CDA R1.1 , HITSP Vital Sign Result Type.

. . . . . value[x] S Σ I 0..1 Vital Sign Value recorded with UCUM
Binding: Vital Signs Units ( required ) ): Commonly encountered UCUM units for recording Vital Signs.

. . . . . . 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 ) ): Codes specifying why the result ( Observation.value[x] ) is missing.

. . . . . interpretation I 0..* CodeableConcept High, low, normal, etc.
Binding: Observation Interpretation Codes ( extensible ) ): Codes identifying interpretations of observations.


. . . . . referenceRange I 0..* See referenceRange (Observation) Unknown reference to #Observation.referenceRange Provides guide for interpretation of component result
. . . . component:SystolicBP S Σ I 1..1 BackboneElement Used when reporting systolic and diastolic blood pressure.
. . . . . 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 ) ): This identifies the vital sign result type. Original source C-CDA R1.1 , HITSP Vital Sign Result Type.

. . . . . . 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 Σ I 0 .. * (Slice Definition) Systolic Blood Pressure
Slice: Unordered, Open by value:code, value:system
. . . . . . . coding:SBPCode Σ I 1..1 Coding Systolic Blood Pressure
. . . . . . . . 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 Σ I 1..1 uri Identity of the terminology system
Fixed Value: http://loinc.org
. . . . . . . . version Σ I 0..1 string Version of the system - if relevant
. . . . . . . . code Σ I 1..1 code Symbol in syntax defined by the system
Fixed Value: 8480-6
. . . . . . . . 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
. . . . . value[x] S Σ I 0..1 Quantity Vital Sign Value recorded with UCUM
Binding: Vital Signs Units ( required ) ): Commonly encountered UCUM units for recording Vital Signs.

. . . . . . 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
. . . . . . value S Σ I 1..1 decimal Numerical value (with implicit precision)
. . . . . . comparator ?! Σ I 0..1 code < | <= | >= | > - how to understand the value < | <= | >= | > | ad - how to understand the value
Binding: QuantityComparator ( required )
. . . . . . unit S Σ I 1..1 string Unit representation
. . . . . . system S Σ I 1..1 uri System that defines coded unit form
Fixed Value: http://unitsofmeasure.org
. . . . . . code S Σ I 1..1 code Coded responses from the common UCUM units for vital signs value set.
Fixed Value: mm[Hg]
. . . . . dataAbsentReason S I 0..1 CodeableConcept Why the component result is missing
Binding: DataAbsentReason ( extensible ) ): Codes specifying why the result ( Observation.value[x] ) is missing.

. . . . . interpretation I 0..* CodeableConcept High, low, normal, etc.
Binding: Observation Interpretation Codes ( extensible ) ): Codes identifying interpretations of observations.


. . . . . referenceRange I 0..* See referenceRange (Observation) Unknown reference to #Observation.referenceRange Provides guide for interpretation of component result
. . . . component:DiastolicBP S Σ I 1..1 BackboneElement Used when reporting systolic and diastolic blood pressure.
. . . . . 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 ) ): This identifies the vital sign result type. Original source C-CDA R1.1 , HITSP Vital Sign Result Type.

. . . . . . 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 Σ I 0 .. * (Slice Definition) Diastolic Blood Pressure
Slice: Unordered, Open by value:code, value:system
. . . . . . . coding:DBPCode Σ I 1..1 Coding Diastolic Blood Pressure
. . . . . . . . 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 Σ I 1..1 uri Identity of the terminology system
Fixed Value: http://loinc.org
. . . . . . . . version Σ I 0..1 string Version of the system - if relevant
. . . . . . . . code Σ I 1..1 code Symbol in syntax defined by the system
Fixed Value: 8462-4
. . . . . . . . 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
. . . . . value[x] S Σ I 0..1 Quantity Vital Sign Value recorded with UCUM
Binding: Vital Signs Units ( required ) ): Commonly encountered UCUM units for recording Vital Signs.

. . . . . . 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
. . . . . . value S Σ I 1..1 decimal Numerical value (with implicit precision)
. . . . . . comparator ?! Σ I 0..1 code < | <= | >= | > - how to understand the value < | <= | >= | > | ad - how to understand the value
Binding: QuantityComparator ( required )
. . . . . . unit S Σ I 1..1 string Unit representation
. . . . . . system S Σ I 1..1 uri System that defines coded unit form
Fixed Value: http://unitsofmeasure.org
. . . . . . code S Σ I 1..1 code Coded responses from the common UCUM units for vital signs value set.
Fixed Value: mm[Hg]
. . . . . dataAbsentReason S I 0..1 CodeableConcept Why the component result is missing
Binding: DataAbsentReason ( extensible ) ): Codes specifying why the result ( Observation.value[x] ) is missing.

. . . . . interpretation I 0..* CodeableConcept High, low, normal, etc.
Binding: Observation Interpretation Codes ( extensible ) ): Codes identifying interpretations of observations.


. . . . . referenceRange I 0..* See referenceRange (Observation) Unknown reference to #Observation.referenceRange Provides guide for interpretation of component result

doco Documentation for this format

XML Template

<!-- observation-bp -->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>
 <instantiates[x]><!-- ?? 0..1 canonical|Reference(ObservationDefinition) 
     Instantiates FHIR ObservationDefinition --></instantiates[x]>

 <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  <!-- ?? 1..1 Blood Pressure -->
  <-- coding sliced by value:code, value:system  in the specified orderOpen-->
  <coding> ?? 1..1 Coding  <!-- ?? 1..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 -->
 </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>
 <-- valueQuantity sliced by type:$this  in the specified orderClosed-->
 <valueQuantity><!-- ?? 0..0 Quantity 
     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>
 <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 sliced by value:code.coding.code, value:code.coding.system  in the specified orderOpen-->
 <

 <component> ?? 1..1 BackboneElement  <!-- ?? 1..1 Used when reporting systolic and diastolic blood pressure. -->

  <modifierExtension><!-- ?? 0..* Extension  Extensions that cannot be ignored even if unrecognized  --></modifierExtension>
  <code> ?? 1..1 CodeableConcept  <!-- ?? 1..1 Type of component observation (code / type) -->
   <-- coding sliced by value:code, value:system  in the specified orderOpen-->
   <coding> ?? 1..1 Coding  <!-- ?? 1..1 Systolic Blood Pressure -->
    <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 -->
  </code>
  <valueQuantity> ?? 0..1 Quantity  <!-- ?? 0..1 Vital Sign Value recorded with UCUM -->
   <value value="[decimal]"/><!-- ?? 1..1 Numerical value (with implicit precision) -->
   <

   <comparator value="[code]"/><!-- ?? 0..1 < | <= | >= | > | ad - how to understand the value   -->

   <unit value="[string]"/><!-- ?? 1..1 Unit representation -->
   <system value="[uri]"/><!-- ?? 1..1 System that defines coded unit form -->
   <code value="[code]"/><!-- ?? 1..1 
       Coded responses from the common UCUM units for vital signs value set. -->
  </valueQuantity>
  <dataAbsentReason><!-- ?? 0..1 CodeableConcept Why the component result is missing   --></dataAbsentReason>
  <interpretation><!-- ?? 0..* CodeableConcept High, low, normal, etc.   --></interpretation>
  <</referenceRange>

  <referenceRange><!-- See http://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange  Provides guide for interpretation of component result --></referenceRange>

 </component>
 <

 <component> ?? 1..1 BackboneElement  <!-- ?? 1..1 Used when reporting systolic and diastolic blood pressure. -->

  <modifierExtension><!-- ?? 0..* Extension  Extensions that cannot be ignored even if unrecognized  --></modifierExtension>
  <code> ?? 1..1 CodeableConcept  <!-- ?? 1..1 Type of component observation (code / type) -->
   <-- coding sliced by value:code, value:system  in the specified orderOpen-->
   <coding> ?? 1..1 Coding  <!-- ?? 1..1 Diastolic Blood Pressure -->
    <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 -->
  </code>
  <valueQuantity> ?? 0..1 Quantity  <!-- ?? 0..1 Vital Sign Value recorded with UCUM -->
   <value value="[decimal]"/><!-- ?? 1..1 Numerical value (with implicit precision) -->
   <

   <comparator value="[code]"/><!-- ?? 0..1 < | <= | >= | > | ad - how to understand the value   -->

   <unit value="[string]"/><!-- ?? 1..1 Unit representation -->
   <system value="[uri]"/><!-- ?? 1..1 System that defines coded unit form -->
   <code value="[code]"/><!-- ?? 1..1 
       Coded responses from the common UCUM units for vital signs value set. -->
  </valueQuantity>
  <dataAbsentReason><!-- ?? 0..1 CodeableConcept Why the component result is missing   --></dataAbsentReason>
  <interpretation><!-- ?? 0..* CodeableConcept High, low, normal, etc.   --></interpretation>
  <</referenceRange>

  <referenceRange><!-- See http://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange  Provides guide for interpretation of component result --></referenceRange>

 </component>
</Observation>

JSON Template

{ // observation-bp
  // 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
// value[x]: Instantiates FHIR ObservationDefinition. One of these 2:
    "instantiatesCanonical" : "<canonical>", // C?Instantiates FHIR ObservationDefinition
    "instantiatesReference" : { Reference(ObservationDefinition) }, // C?Instantiates FHIR ObservationDefinition

    "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! Blood Pressure
    "

    "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
    "valueQuantity" : [ //  sliced by type:$this  in the specified order, Closed 
      { // Vital Signs value are recorded using the Quantity data type. For supporting observations such as Cuff size could use other datatypes such as CodeableConcept. // C?
        // from Element: extension
      }
    ],
    "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" : [ //  sliced by value:code.coding.code, value:code.coding.system  in the specified order, Open 
      { // Used when reporting systolic and diastolic blood pressure. // C? R! 
        // from Element: extension
        "modifierExtension" : [{ Extension }], // C?Extensions that cannot be ignored even if unrecognized
        "code" : { CodeableConcept }, // C? R! Type of component observation (code / type)
        "valueQuantity" : { Quantity }, // C?Vital Sign Value recorded with UCUM
        "dataAbsentReason" : { CodeableConcept }, // C?Why the component result is missing
        "interpretation" : [{ CodeableConcept }], // C?High, low, normal, etc.
// value[x]: Provides guide for interpretation of component result. One of these 0:
      },
      { // Used when reporting systolic and diastolic blood pressure. // C? R! 
        // from Element: extension
        "modifierExtension" : [{ Extension }], // C?Extensions that cannot be ignored even if unrecognized
        "code" : { CodeableConcept }, // C? R! Type of component observation (code / type)
        "valueQuantity" : { Quantity }, // C?Vital Sign Value recorded with UCUM
        "dataAbsentReason" : { CodeableConcept }, // C?Why the component result is missing
        "interpretation" : [{ CodeableConcept }], // C?High, low, normal, etc.
// value[x]: Provides guide for interpretation of component result. One of these 0:
      }
    ],
  }

 

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
Observation.component.code Vital Signs extensible Vital Signs
Observation.component.value[x] Vital Signs Units required Vital Signs Units
Observation.component.value[x].comparator QuantityComparator required QuantityComparator
Observation.component.dataAbsentReason DataAbsentReason extensible DataAbsentReason
Observation.component.interpretation Observation Interpretation Codes extensible Observation Interpretation Codes
Observation.component.code Vital Signs extensible Vital Signs
Observation.component.value[x] Vital Signs Units required Vital Signs Units
Observation.component.value[x].comparator QuantityComparator required QuantityComparator
Observation.component.dataAbsentReason DataAbsentReason extensible DataAbsentReason
Observation.component.interpretation Observation Interpretation Codes extensible Observation Interpretation Codes 10.1.30.2.5 Rule Rule Id Path Details Requirements 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() QA Page Search
.