US Core Implementation Guide
8.0.0-ballot - Ballot United States of America flag

US Core Implementation Guide, published by HL7 International / Cross-Group Projects. This guide is not an authorized publication; it is the continuous build for version 8.0.0-ballot built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/US-Core/ and changes regularly. See the Directory of published versions

Resource Profile: US Core Average Blood Pressure Profile

Official URL: http://hl7.org/fhir/us/core/StructureDefinition/us-core-average-blood-pressure Version: 8.0.0-ballot
Standards status: Trial-use Maturity Level: 3 Computable Name: USCoreAverageBloodPressureProfile
Other Identifiers: OID:2.16.840.1.113883.4.642.40.2.42.7

Copyright/Legal: Used by permission of HL7 International, all rights reserved Creative Commons License

The US Core Average Blood Pressure Profile inherits from the Observation resource; refer to it for scope and usage definitions. This profile sets minimum expectations for recording, searching, and fetching average diastolic and systolic blood pressure observations with standard LOINC codes and UCUM units of measure. It specifies which core elements, extensions, vocabularies, and value sets SHALL be present in the resource and constrains how the elements are used. Providing the floor for standards development for specific use cases promotes interoperability and adoption.

This page has new content for US Core Version 8.0.0

Example Usage Scenarios:

The following are example usage scenarios for this profile:

  • Query for average blood pressure observations belonging to a patient
  • Record or update average blood pressure observations belonging to a patient

Mandatory and Must Support Data Elements

The following data elements must always be present (Mandatory definition) or must be supported if the data is present in the sending system (Must Support definition). They are presented below in a simple human-readable explanation. Profile specific guidance and examples are provided as well. The Formal Views below provides the formal summary, definitions, and terminology requirements.

Each Observation Must Have:

  1. a status
  2. a category code of "vital-signs"
  3. a fixed code for average systolic and diastolic blood pressure panel
  4. a fixed component code for average systolic blood pressure
  5. a fixed component code for average diastolic blood pressure
  6. a patient
  7. clinically relevant time-period for the average of blood pressure readings

Each Observation Must Support:

  1. a performer*
  2. a result value for the average systolic blood pressure
  3. a result value for the average diastolic blood pressure
  4. a reason if the value is absent*

*see guidance below

Profile Specific Implementation Guidance:

  • The category "vital-signs" aligns with the USCDI Data Class and Elements and provides a convenient and consistent grouping of the clinical concepts. Implementers can group them differently based on their clinical needs.
  • The observations MAY have additional codes that translate or map to the Observation code or category codes. For example:
    • providing a local system-specific code
    • providing more specific codes

    a code system value SHOULD be supplied for each additional code.

  • *The profile elements Observation.performer and Observation.device communicate the individual level provenance author data corresponding to the U.S. Core Data for Interoperability (USCDI) Provenance Author Data Elements.

  • *Because the blood pressure values are communicated in the mandatory systolic and diastolic components:
    • the Observation.value[x] element SHALL be omitted
    • An Observation without a systolic or diastolic result value SHALL include a reason why the data is absent in Observation.component.dataAbsentReason
    • All Server systems - including those that never provide a component observation without a value - SHALL support Observation.component.dataAbsentReason for the components.
  • This Profile is not dependent on any specific protocol. Information about the protocol used SHOULD be supplied in either:
  • Information about the number of measurements used to determine the average SHOULD be supplied as an Observation.component using the SNOMED CT code "246432004 Number of occurrences (qualifier value)". The example shows how this component can be used.
  • The observation MAY use an extension defined by other profiles such as Vital Signs with Qualifying Elements: Average Blood Pressure Profile.

Usage:

Changes since version 7.0.0:

  • The data elements list has changed

    • Formal Views of Profile Content

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

    This structure is derived from Observation

    NameFlagsCard.TypeDescription & Constraintsdoco
    .. Observation 0..* Observation US Core Average Blood Pressure Profile
    ... status S 1..1 code registered | preliminary | final | amended +
    ... Slices for category S 1..* CodeableConcept 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 1..1 uri Identity of the terminology system
    Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category
    ...... code 1..1 code Symbol in syntax defined by the system
    Fixed Value: vital-signs
    ... code S 1..1 CodeableConcept Blood Pressure
    Required Pattern: At least the following
    .... coding 1..* Coding Code defined by a terminology system
    Fixed Value: (complex)
    ..... 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: 96607-7
    ... subject S 1..1 Reference(US Core Patient Profile) Who and/or what the observation is about
    ... effective[x] S 1..1 clinically relevant time-period for the average of blood pressure (BP) readings
    .... effectiveDateTime dateTime
    .... effectivePeriod Period S
    ... performer S 0..* Reference(US Core Practitioner Profile | US Core Organization Profile | US Core Patient Profile | PractitionerRole | US Core CareTeam Profile | US Core RelatedPerson Profile) Who is responsible for the observation
    ... value[x] 0..0
    ... Slices for component SC 2..* BackboneElement Average systolic and diastolic blood pressure and other qualifiers.
    Slice: Unordered, Open by value:code
    us-core-26: If there is no value a data absent reason must be present
    .... component:All Slices Content/Rules for all slices
    ..... value[x] S 0..1 Vital Sign Component Value
    ...... valueQuantity Quantity S
    ...... valueCodeableConcept CodeableConcept
    ...... valueString string
    ...... valueBoolean boolean
    ...... valueInteger integer
    ...... valueRange Range
    ...... valueRatio Ratio
    ...... valueSampledData SampledData
    ...... valueTime time
    ...... valueDateTime dateTime
    ...... valuePeriod Period
    ..... dataAbsentReason SC 0..1 CodeableConcept Why the component result is missing
    .... component:systolic S 1..1 BackboneElement Systolic Average Blood Pressure
    ..... code S 1..1 CodeableConcept Systolic Average Blood Pressure Code
    Required Pattern: At least the following
    ...... coding 1..* Coding Code defined by a terminology system
    Fixed Value: (complex)
    ....... 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: 96608-5
    ..... valueQuantity SC 0..1 Quantity Systolic Average Blood Pressure Value
    ...... value 1..1 decimal Numerical value (with implicit precision)
    ...... unit 1..1 string Unit representation
    ...... system 1..1 uri System that defines coded unit form
    Fixed Value: http://unitsofmeasure.org
    ...... code 1..1 code Coded form of the unit
    Fixed Value: mm[Hg]
    .... component:diastolic S 1..1 BackboneElement Diastolic Average Blood Pressure
    ..... code S 1..1 CodeableConcept Diastolic Average Blood Pressure Code
    Required Pattern: At least the following
    ...... coding 1..* Coding Code defined by a terminology system
    Fixed Value: (complex)
    ....... 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: 96609-3
    ..... valueQuantity SC 0..1 Quantity Diastolic Average Blood Pressure Value
    ...... value 1..1 decimal Numerical value (with implicit precision)
    ...... unit 1..1 string Unit representation
    ...... system 1..1 uri System that defines coded unit form
    Fixed Value: http://unitsofmeasure.org
    ...... code 1..1 code Coded form of the unit
    Fixed Value: mm[Hg]

    doco Documentation for this format

    Constraints

    IdGradePath(s)DetailsRequirements
    us-core-26errorObservation.componentIf there is no value a data absent reason must be present
    : value.exists() or dataAbsentReason.exists()
    NameFlagsCard.TypeDescription & Constraintsdoco
    .. Observation C 0..* Observation US Core Average Blood Pressure Profile
    obs-6: dataAbsentReason SHALL only be present if Observation.value[x] is not present
    obs-7: If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present
    ... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
    ... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
    ... status ?!SΣ 1..1 code registered | preliminary | final | amended +
    Binding: ObservationStatus (required): Codes providing the status of an observation.

    ... Slices for category S 1..* CodeableConcept Classification of type of observation
    Slice: Unordered, Open by value:coding.code, value:coding.system
    Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.


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


    ..... coding SΣ 1..* Coding Code defined by a terminology system
    ...... system Σ 1..1 uri Identity of the terminology system
    Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category
    ...... code Σ 1..1 code Symbol in syntax defined by the system
    Fixed Value: vital-signs
    ... code SΣ 1..1 CodeableConcept Blood Pressure
    Binding: LOINCCodes (example): Codes identifying names of simple observations.


    Required Pattern: At least the following
    .... coding 1..* Coding Code defined by a terminology system
    Fixed Value: (complex)
    ..... 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: 96607-7
    ... subject SΣ 1..1 Reference(US Core Patient Profile) Who and/or what the observation is about
    ... effective[x] SΣ 1..1 clinically relevant time-period for the average of blood pressure (BP) readings
    .... effectivePeriod Period
    ... performer SΣ 0..* Reference(US Core Practitioner Profile | US Core Organization Profile | US Core Patient Profile | PractitionerRole | US Core CareTeam Profile | US Core RelatedPerson Profile) Who is responsible for the observation
    ... Slices for component SΣC 2..* BackboneElement Average systolic and diastolic blood pressure and other qualifiers.
    Slice: Unordered, Open by value:code
    us-core-26: If there is no value a data absent reason must be present
    .... component:All Slices Content/Rules for all slices
    ..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
    ..... code Σ 1..1 CodeableConcept Type of component observation (code / type)
    Binding: LOINCCodes (example): Codes identifying names of simple observations.

    ..... value[x] SΣ 0..1 Vital Sign Component Value
    ...... valueQuantity Quantity
    ..... dataAbsentReason SC 0..1 CodeableConcept Why the component result is missing
    Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.

    .... component:systolic SΣ 1..1 BackboneElement Systolic Average Blood Pressure
    ..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
    ..... code SΣ 1..1 CodeableConcept Systolic Average Blood Pressure Code
    Binding: LOINCCodes (example): Codes identifying names of simple observations.


    Required Pattern: At least the following
    ...... coding 1..* Coding Code defined by a terminology system
    Fixed Value: (complex)
    ....... 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: 96608-5
    ..... value[x] SΣC 0..1 Quantity Systolic Average Blood Pressure Value
    ...... value Σ 1..1 decimal Numerical value (with implicit precision)
    ...... comparator ?!Σ 0..1 code < | <= | >= | > - how to understand the value
    Binding: QuantityComparator (required): How the Quantity should be understood and represented.

    ...... unit Σ 1..1 string Unit representation
    ...... system ΣC 1..1 uri System that defines coded unit form
    Fixed Value: http://unitsofmeasure.org
    ...... code Σ 1..1 code Coded form of the unit
    Fixed Value: mm[Hg]
    .... component:diastolic SΣ 1..1 BackboneElement Diastolic Average Blood Pressure
    ..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
    ..... code SΣ 1..1 CodeableConcept Diastolic Average Blood Pressure Code
    Binding: LOINCCodes (example): Codes identifying names of simple observations.


    Required Pattern: At least the following
    ...... coding 1..* Coding Code defined by a terminology system
    Fixed Value: (complex)
    ....... 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: 96609-3
    ..... value[x] SΣC 0..1 Quantity Diastolic Average Blood Pressure Value
    ...... value Σ 1..1 decimal Numerical value (with implicit precision)
    ...... comparator ?!Σ 0..1 code < | <= | >= | > - how to understand the value
    Binding: QuantityComparator (required): How the Quantity should be understood and represented.

    ...... unit Σ 1..1 string Unit representation
    ...... system ΣC 1..1 uri System that defines coded unit form
    Fixed Value: http://unitsofmeasure.org
    ...... code Σ 1..1 code Coded form of the unit
    Fixed Value: mm[Hg]

    doco Documentation for this format

    Terminology Bindings

    PathConformanceValueSet / CodeURI
    Observation.statusrequiredObservationStatus
    http://hl7.org/fhir/ValueSet/observation-status|4.0.1
    from the FHIR Standard
    Observation.categorypreferredObservationCategoryCodes
    http://hl7.org/fhir/ValueSet/observation-category
    from the FHIR Standard
    Observation.category:VSCatpreferredObservationCategoryCodes
    http://hl7.org/fhir/ValueSet/observation-category
    from the FHIR Standard
    Observation.codeexamplePattern: LOINC Code 96607-7
    http://hl7.org/fhir/ValueSet/observation-codes
    from the FHIR Standard
    Observation.component.codeexampleLOINCCodes (a valid code from LOINC)
    http://hl7.org/fhir/ValueSet/observation-codes
    from the FHIR Standard
    Observation.component.dataAbsentReasonextensibleDataAbsentReason
    http://hl7.org/fhir/ValueSet/data-absent-reason
    from the FHIR Standard
    Observation.component:systolic.codeexamplePattern: LOINC Code 96608-5
    http://hl7.org/fhir/ValueSet/observation-codes
    from the FHIR Standard
    Observation.component:systolic.value[x].comparatorrequiredQuantityComparator
    http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1
    from the FHIR Standard
    Observation.component:diastolic.codeexamplePattern: LOINC Code 96609-3
    http://hl7.org/fhir/ValueSet/observation-codes
    from the FHIR Standard
    Observation.component:diastolic.value[x].comparatorrequiredQuantityComparator
    http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1
    from the FHIR Standard

    Constraints

    IdGradePath(s)DetailsRequirements
    us-core-26errorObservation.componentIf there is no value a data absent reason must be present
    : value.exists() or dataAbsentReason.exists()
    NameFlagsCard.TypeDescription & Constraintsdoco
    .. Observation C 0..* Observation US Core Average Blood Pressure Profile
    obs-6: dataAbsentReason SHALL only be present if Observation.value[x] is not present
    obs-7: If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present
    ... id Σ 0..1 id Logical id of this artifact
    ... meta Σ 0..1 Meta Metadata about the resource
    ... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
    ... language 0..1 code Language of the resource content
    Binding: CommonLanguages (preferred): A human language.

    Additional BindingsPurpose
    AllLanguages Max Binding
    ... text 0..1 Narrative Text summary of the resource, for human interpretation
    ... contained 0..* Resource Contained, inline Resources
    ... extension 0..* Extension Additional content defined by implementations
    ... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
    ... identifier Σ 0..* Identifier Business Identifier for observation
    ... basedOn Σ 0..* Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest) Fulfills plan, proposal or order
    ... partOf Σ 0..* Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy) Part of referenced event
    ... status ?!SΣ 1..1 code registered | preliminary | final | amended +
    Binding: ObservationStatus (required): Codes providing the status of an observation.

    ... Slices for category S 1..* CodeableConcept Classification of type of observation
    Slice: Unordered, Open by value:coding.code, value:coding.system
    Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.


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


    ..... id 0..1 string Unique id for inter-element referencing
    ..... extension 0..* Extension Additional content defined by implementations
    Slice: Unordered, Open by value:url
    ..... coding SΣ 1..* Coding Code defined by a terminology system
    ...... id 0..1 string Unique id for inter-element referencing
    ...... extension 0..* Extension Additional content defined by implementations
    Slice: Unordered, Open by value:url
    ...... system Σ 1..1 uri Identity of the terminology system
    Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category
    ...... version Σ 0..1 string Version of the system - if relevant
    ...... code Σ 1..1 code Symbol in syntax defined by the system
    Fixed Value: vital-signs
    ...... display Σ 0..1 string Representation defined by the system
    ...... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
    ..... text Σ 0..1 string Plain text representation of the concept
    ... code SΣ 1..1 CodeableConcept Blood Pressure
    Binding: LOINCCodes (example): Codes identifying names of simple observations.


    Required Pattern: At least the following
    .... id 0..1 string Unique id for inter-element referencing
    .... extension 0..* Extension Additional content defined by implementations
    .... coding 1..* Coding Code defined by a terminology system
    Fixed Value: (complex)
    ..... id 0..1 string Unique id for inter-element referencing
    ..... extension 0..* Extension Additional content defined by implementations
    ..... system 1..1 uri Identity of the terminology system
    Fixed Value: http://loinc.org
    ..... version 0..1 string Version of the system - if relevant
    ..... code 1..1 code Symbol in syntax defined by the system
    Fixed Value: 96607-7
    ..... display 0..1 string Representation defined by the system
    ..... userSelected 0..1 boolean If this coding was chosen directly by the user
    .... text 0..1 string Plain text representation of the concept
    ... subject SΣ 1..1 Reference(US Core Patient Profile) Who and/or what the observation is about
    ... focus Σ 0..* Reference(Resource) What the observation is about, when it is not about the subject of record
    ... encounter Σ 0..1 Reference(Encounter) Healthcare event during which this observation is made
    ... effective[x] SΣ 1..1 clinically relevant time-period for the average of blood pressure (BP) readings
    .... effectiveDateTime dateTime
    .... effectivePeriod Period S
    ... issued Σ 0..1 instant Date/Time this version was made available
    ... performer SΣ 0..* Reference(US Core Practitioner Profile | US Core Organization Profile | US Core Patient Profile | PractitionerRole | US Core CareTeam Profile | US Core RelatedPerson Profile) Who is responsible for the observation
    ... dataAbsentReason C 0..1 CodeableConcept Why the result is missing
    Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.

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


    ... note 0..* Annotation Comments about the observation
    ... bodySite 0..1 CodeableConcept Observed body part
    Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.

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

    ... specimen 0..1 Reference(Specimen) Specimen used for this observation
    ... device 0..1 Reference(Device | DeviceMetric) (Measurement) Device
    ... referenceRange C 0..* BackboneElement Provides guide for interpretation
    obs-3: Must have at least a low or a high or text
    .... id 0..1 string Unique id for inter-element referencing
    .... extension 0..* Extension Additional content defined by implementations
    .... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
    .... low C 0..1 SimpleQuantity Low Range, if relevant
    .... high C 0..1 SimpleQuantity High Range, if relevant
    .... type 0..1 CodeableConcept Reference range qualifier
    Binding: ObservationReferenceRangeMeaningCodes (preferred): Code for the meaning of a reference range.

    .... appliesTo 0..* CodeableConcept Reference range population
    Binding: ObservationReferenceRangeAppliesToCodes (example): Codes identifying the population the reference range applies to.


    .... age 0..1 Range Applicable age range, if relevant
    .... text 0..1 string Text based reference range in an observation
    ... hasMember Σ 0..* Reference(Observation | QuestionnaireResponse | MolecularSequence) Related resource that belongs to the Observation group
    ... derivedFrom Σ 0..* Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | Observation | MolecularSequence) Related measurements the observation is made from
    ... Slices for component SΣC 2..* BackboneElement Average systolic and diastolic blood pressure and other qualifiers.
    Slice: Unordered, Open by value:code
    us-core-26: If there is no value a data absent reason must be present
    .... component:All Slices Content/Rules for all slices
    ..... id 0..1 string Unique id for inter-element referencing
    ..... extension 0..* Extension Additional content defined by implementations
    ..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
    ..... code Σ 1..1 CodeableConcept Type of component observation (code / type)
    Binding: LOINCCodes (example): Codes identifying names of simple observations.

    ..... value[x] SΣ 0..1 Vital Sign Component Value
    ...... valueQuantity Quantity S
    ...... valueCodeableConcept CodeableConcept
    ...... valueString string
    ...... valueBoolean boolean
    ...... valueInteger integer
    ...... valueRange Range
    ...... valueRatio Ratio
    ...... valueSampledData SampledData
    ...... valueTime time
    ...... valueDateTime dateTime
    ...... valuePeriod Period
    ..... dataAbsentReason SC 0..1 CodeableConcept Why the component result is missing
    Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.

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


    ..... referenceRange 0..* See referenceRange (Observation) Provides guide for interpretation of component result
    .... component:systolic SΣ 1..1 BackboneElement Systolic Average Blood Pressure
    ..... id 0..1 string Unique id for inter-element referencing
    ..... extension 0..* Extension Additional content defined by implementations
    ..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
    ..... code SΣ 1..1 CodeableConcept Systolic Average Blood Pressure Code
    Binding: LOINCCodes (example): Codes identifying names of simple observations.


    Required Pattern: At least the following
    ...... id 0..1 string Unique id for inter-element referencing
    ...... extension 0..* Extension Additional content defined by implementations
    ...... coding 1..* Coding Code defined by a terminology system
    Fixed Value: (complex)
    ....... id 0..1 string Unique id for inter-element referencing
    ....... extension 0..* Extension Additional content defined by implementations
    ....... system 1..1 uri Identity of the terminology system
    Fixed Value: http://loinc.org
    ....... version 0..1 string Version of the system - if relevant
    ....... code 1..1 code Symbol in syntax defined by the system
    Fixed Value: 96608-5
    ....... display 0..1 string Representation defined by the system
    ....... userSelected 0..1 boolean If this coding was chosen directly by the user
    ...... text 0..1 string Plain text representation of the concept
    ..... value[x] SΣC 0..1 Quantity Systolic Average Blood Pressure Value
    ...... id 0..1 string Unique id for inter-element referencing
    ...... extension 0..* Extension Additional content defined by implementations
    Slice: Unordered, Open by value:url
    ...... value Σ 1..1 decimal Numerical value (with implicit precision)
    ...... comparator ?!Σ 0..1 code < | <= | >= | > - how to understand the value
    Binding: QuantityComparator (required): How the Quantity should be understood and represented.

    ...... unit Σ 1..1 string Unit representation
    ...... system ΣC 1..1 uri System that defines coded unit form
    Fixed Value: http://unitsofmeasure.org
    ...... code Σ 1..1 code Coded form of the unit
    Fixed Value: mm[Hg]
    ..... dataAbsentReason C 0..1 CodeableConcept Why the component result is missing
    Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.

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


    ..... referenceRange 0..* See referenceRange (Observation) Provides guide for interpretation of component result
    .... component:diastolic SΣ 1..1 BackboneElement Diastolic Average Blood Pressure
    ..... id 0..1 string Unique id for inter-element referencing
    ..... extension 0..* Extension Additional content defined by implementations
    ..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
    ..... code SΣ 1..1 CodeableConcept Diastolic Average Blood Pressure Code
    Binding: LOINCCodes (example): Codes identifying names of simple observations.


    Required Pattern: At least the following
    ...... id 0..1 string Unique id for inter-element referencing
    ...... extension 0..* Extension Additional content defined by implementations
    ...... coding 1..* Coding Code defined by a terminology system
    Fixed Value: (complex)
    ....... id 0..1 string Unique id for inter-element referencing
    ....... extension 0..* Extension Additional content defined by implementations
    ....... system 1..1 uri Identity of the terminology system
    Fixed Value: http://loinc.org
    ....... version 0..1 string Version of the system - if relevant
    ....... code 1..1 code Symbol in syntax defined by the system
    Fixed Value: 96609-3
    ....... display 0..1 string Representation defined by the system
    ....... userSelected 0..1 boolean If this coding was chosen directly by the user
    ...... text 0..1 string Plain text representation of the concept
    ..... value[x] SΣC 0..1 Quantity Diastolic Average Blood Pressure Value
    ...... id 0..1 string Unique id for inter-element referencing
    ...... extension 0..* Extension Additional content defined by implementations
    Slice: Unordered, Open by value:url
    ...... value Σ 1..1 decimal Numerical value (with implicit precision)
    ...... comparator ?!Σ 0..1 code < | <= | >= | > - how to understand the value
    Binding: QuantityComparator (required): How the Quantity should be understood and represented.

    ...... unit Σ 1..1 string Unit representation
    ...... system ΣC 1..1 uri System that defines coded unit form
    Fixed Value: http://unitsofmeasure.org
    ...... code Σ 1..1 code Coded form of the unit
    Fixed Value: mm[Hg]
    ..... dataAbsentReason C 0..1 CodeableConcept Why the component result is missing
    Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.

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


    ..... referenceRange 0..* See referenceRange (Observation) Provides guide for interpretation of component result

    doco Documentation for this format

    Terminology Bindings

    PathConformanceValueSet / CodeURI
    Observation.languagepreferredCommonLanguages
    Additional Bindings Purpose
    AllLanguages Max Binding
    http://hl7.org/fhir/ValueSet/languages
    from the FHIR Standard
    Observation.statusrequiredObservationStatus
    http://hl7.org/fhir/ValueSet/observation-status|4.0.1
    from the FHIR Standard
    Observation.categorypreferredObservationCategoryCodes
    http://hl7.org/fhir/ValueSet/observation-category
    from the FHIR Standard
    Observation.category:VSCatpreferredObservationCategoryCodes
    http://hl7.org/fhir/ValueSet/observation-category
    from the FHIR Standard
    Observation.codeexamplePattern: LOINC Code 96607-7
    http://hl7.org/fhir/ValueSet/observation-codes
    from the FHIR Standard
    Observation.dataAbsentReasonextensibleDataAbsentReason
    http://hl7.org/fhir/ValueSet/data-absent-reason
    from the FHIR Standard
    Observation.interpretationextensibleObservationInterpretationCodes
    http://hl7.org/fhir/ValueSet/observation-interpretation
    from the FHIR Standard
    Observation.bodySiteexampleSNOMEDCTBodyStructures
    http://hl7.org/fhir/ValueSet/body-site
    from the FHIR Standard
    Observation.methodexampleObservationMethods
    http://hl7.org/fhir/ValueSet/observation-methods
    from the FHIR Standard
    Observation.referenceRange.typepreferredObservationReferenceRangeMeaningCodes
    http://hl7.org/fhir/ValueSet/referencerange-meaning
    from the FHIR Standard
    Observation.referenceRange.appliesToexampleObservationReferenceRangeAppliesToCodes
    http://hl7.org/fhir/ValueSet/referencerange-appliesto
    from the FHIR Standard
    Observation.component.codeexampleLOINCCodes (a valid code from LOINC)
    http://hl7.org/fhir/ValueSet/observation-codes
    from the FHIR Standard
    Observation.component.dataAbsentReasonextensibleDataAbsentReason
    http://hl7.org/fhir/ValueSet/data-absent-reason
    from the FHIR Standard
    Observation.component.interpretationextensibleObservationInterpretationCodes
    http://hl7.org/fhir/ValueSet/observation-interpretation
    from the FHIR Standard
    Observation.component:systolic.codeexamplePattern: LOINC Code 96608-5
    http://hl7.org/fhir/ValueSet/observation-codes
    from the FHIR Standard
    Observation.component:systolic.value[x].comparatorrequiredQuantityComparator
    http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1
    from the FHIR Standard
    Observation.component:systolic.dataAbsentReasonextensibleDataAbsentReason
    http://hl7.org/fhir/ValueSet/data-absent-reason
    from the FHIR Standard
    Observation.component:systolic.interpretationextensibleObservationInterpretationCodes
    http://hl7.org/fhir/ValueSet/observation-interpretation
    from the FHIR Standard
    Observation.component:diastolic.codeexamplePattern: LOINC Code 96609-3
    http://hl7.org/fhir/ValueSet/observation-codes
    from the FHIR Standard
    Observation.component:diastolic.value[x].comparatorrequiredQuantityComparator
    http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1
    from the FHIR Standard
    Observation.component:diastolic.dataAbsentReasonextensibleDataAbsentReason
    http://hl7.org/fhir/ValueSet/data-absent-reason
    from the FHIR Standard
    Observation.component:diastolic.interpretationextensibleObservationInterpretationCodes
    http://hl7.org/fhir/ValueSet/observation-interpretation
    from the FHIR Standard

    Constraints

    IdGradePath(s)DetailsRequirements
    us-core-26errorObservation.componentIf there is no value a data absent reason must be present
    : value.exists() or dataAbsentReason.exists()

    This structure is derived from Observation

    Summary

    Mandatory: 11 elements(8 nested mandatory elements)
    Must-Support: 17 elements
    Fixed: 6 elements
    Prohibited: 1 element

    Structures

    This structure refers to these other structures:

    Slices

    This structure defines the following Slices:

    • The element 2 is sliced based on the values of Observation.category
    • The element 1 is sliced based on the value of Observation.component

    Maturity: 3

    Differential View

    This structure is derived from Observation

    NameFlagsCard.TypeDescription & Constraintsdoco
    .. Observation 0..* Observation US Core Average Blood Pressure Profile
    ... status S 1..1 code registered | preliminary | final | amended +
    ... Slices for category S 1..* CodeableConcept 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 1..1 uri Identity of the terminology system
    Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category
    ...... code 1..1 code Symbol in syntax defined by the system
    Fixed Value: vital-signs
    ... code S 1..1 CodeableConcept Blood Pressure
    Required Pattern: At least the following
    .... coding 1..* Coding Code defined by a terminology system
    Fixed Value: (complex)
    ..... 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: 96607-7
    ... subject S 1..1 Reference(US Core Patient Profile) Who and/or what the observation is about
    ... effective[x] S 1..1 clinically relevant time-period for the average of blood pressure (BP) readings
    .... effectiveDateTime dateTime
    .... effectivePeriod Period S
    ... performer S 0..* Reference(US Core Practitioner Profile | US Core Organization Profile | US Core Patient Profile | PractitionerRole | US Core CareTeam Profile | US Core RelatedPerson Profile) Who is responsible for the observation
    ... value[x] 0..0
    ... Slices for component SC 2..* BackboneElement Average systolic and diastolic blood pressure and other qualifiers.
    Slice: Unordered, Open by value:code
    us-core-26: If there is no value a data absent reason must be present
    .... component:All Slices Content/Rules for all slices
    ..... value[x] S 0..1 Vital Sign Component Value
    ...... valueQuantity Quantity S
    ...... valueCodeableConcept CodeableConcept
    ...... valueString string
    ...... valueBoolean boolean
    ...... valueInteger integer
    ...... valueRange Range
    ...... valueRatio Ratio
    ...... valueSampledData SampledData
    ...... valueTime time
    ...... valueDateTime dateTime
    ...... valuePeriod Period
    ..... dataAbsentReason SC 0..1 CodeableConcept Why the component result is missing
    .... component:systolic S 1..1 BackboneElement Systolic Average Blood Pressure
    ..... code S 1..1 CodeableConcept Systolic Average Blood Pressure Code
    Required Pattern: At least the following
    ...... coding 1..* Coding Code defined by a terminology system
    Fixed Value: (complex)
    ....... 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: 96608-5
    ..... valueQuantity SC 0..1 Quantity Systolic Average Blood Pressure Value
    ...... value 1..1 decimal Numerical value (with implicit precision)
    ...... unit 1..1 string Unit representation
    ...... system 1..1 uri System that defines coded unit form
    Fixed Value: http://unitsofmeasure.org
    ...... code 1..1 code Coded form of the unit
    Fixed Value: mm[Hg]
    .... component:diastolic S 1..1 BackboneElement Diastolic Average Blood Pressure
    ..... code S 1..1 CodeableConcept Diastolic Average Blood Pressure Code
    Required Pattern: At least the following
    ...... coding 1..* Coding Code defined by a terminology system
    Fixed Value: (complex)
    ....... 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: 96609-3
    ..... valueQuantity SC 0..1 Quantity Diastolic Average Blood Pressure Value
    ...... value 1..1 decimal Numerical value (with implicit precision)
    ...... unit 1..1 string Unit representation
    ...... system 1..1 uri System that defines coded unit form
    Fixed Value: http://unitsofmeasure.org
    ...... code 1..1 code Coded form of the unit
    Fixed Value: mm[Hg]

    doco Documentation for this format

    Constraints

    IdGradePath(s)DetailsRequirements
    us-core-26errorObservation.componentIf there is no value a data absent reason must be present
    : value.exists() or dataAbsentReason.exists()

    Key Elements View

    NameFlagsCard.TypeDescription & Constraintsdoco
    .. Observation C 0..* Observation US Core Average Blood Pressure Profile
    obs-6: dataAbsentReason SHALL only be present if Observation.value[x] is not present
    obs-7: If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present
    ... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
    ... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
    ... status ?!SΣ 1..1 code registered | preliminary | final | amended +
    Binding: ObservationStatus (required): Codes providing the status of an observation.

    ... Slices for category S 1..* CodeableConcept Classification of type of observation
    Slice: Unordered, Open by value:coding.code, value:coding.system
    Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.


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


    ..... coding SΣ 1..* Coding Code defined by a terminology system
    ...... system Σ 1..1 uri Identity of the terminology system
    Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category
    ...... code Σ 1..1 code Symbol in syntax defined by the system
    Fixed Value: vital-signs
    ... code SΣ 1..1 CodeableConcept Blood Pressure
    Binding: LOINCCodes (example): Codes identifying names of simple observations.


    Required Pattern: At least the following
    .... coding 1..* Coding Code defined by a terminology system
    Fixed Value: (complex)
    ..... 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: 96607-7
    ... subject SΣ 1..1 Reference(US Core Patient Profile) Who and/or what the observation is about
    ... effective[x] SΣ 1..1 clinically relevant time-period for the average of blood pressure (BP) readings
    .... effectivePeriod Period
    ... performer SΣ 0..* Reference(US Core Practitioner Profile | US Core Organization Profile | US Core Patient Profile | PractitionerRole | US Core CareTeam Profile | US Core RelatedPerson Profile) Who is responsible for the observation
    ... Slices for component SΣC 2..* BackboneElement Average systolic and diastolic blood pressure and other qualifiers.
    Slice: Unordered, Open by value:code
    us-core-26: If there is no value a data absent reason must be present
    .... component:All Slices Content/Rules for all slices
    ..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
    ..... code Σ 1..1 CodeableConcept Type of component observation (code / type)
    Binding: LOINCCodes (example): Codes identifying names of simple observations.

    ..... value[x] SΣ 0..1 Vital Sign Component Value
    ...... valueQuantity Quantity
    ..... dataAbsentReason SC 0..1 CodeableConcept Why the component result is missing
    Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.

    .... component:systolic SΣ 1..1 BackboneElement Systolic Average Blood Pressure
    ..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
    ..... code SΣ 1..1 CodeableConcept Systolic Average Blood Pressure Code
    Binding: LOINCCodes (example): Codes identifying names of simple observations.


    Required Pattern: At least the following
    ...... coding 1..* Coding Code defined by a terminology system
    Fixed Value: (complex)
    ....... 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: 96608-5
    ..... value[x] SΣC 0..1 Quantity Systolic Average Blood Pressure Value
    ...... value Σ 1..1 decimal Numerical value (with implicit precision)
    ...... comparator ?!Σ 0..1 code < | <= | >= | > - how to understand the value
    Binding: QuantityComparator (required): How the Quantity should be understood and represented.

    ...... unit Σ 1..1 string Unit representation
    ...... system ΣC 1..1 uri System that defines coded unit form
    Fixed Value: http://unitsofmeasure.org
    ...... code Σ 1..1 code Coded form of the unit
    Fixed Value: mm[Hg]
    .... component:diastolic SΣ 1..1 BackboneElement Diastolic Average Blood Pressure
    ..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
    ..... code SΣ 1..1 CodeableConcept Diastolic Average Blood Pressure Code
    Binding: LOINCCodes (example): Codes identifying names of simple observations.


    Required Pattern: At least the following
    ...... coding 1..* Coding Code defined by a terminology system
    Fixed Value: (complex)
    ....... 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: 96609-3
    ..... value[x] SΣC 0..1 Quantity Diastolic Average Blood Pressure Value
    ...... value Σ 1..1 decimal Numerical value (with implicit precision)
    ...... comparator ?!Σ 0..1 code < | <= | >= | > - how to understand the value
    Binding: QuantityComparator (required): How the Quantity should be understood and represented.

    ...... unit Σ 1..1 string Unit representation
    ...... system ΣC 1..1 uri System that defines coded unit form
    Fixed Value: http://unitsofmeasure.org
    ...... code Σ 1..1 code Coded form of the unit
    Fixed Value: mm[Hg]

    doco Documentation for this format

    Terminology Bindings

    PathConformanceValueSet / CodeURI
    Observation.statusrequiredObservationStatus
    http://hl7.org/fhir/ValueSet/observation-status|4.0.1
    from the FHIR Standard
    Observation.categorypreferredObservationCategoryCodes
    http://hl7.org/fhir/ValueSet/observation-category
    from the FHIR Standard
    Observation.category:VSCatpreferredObservationCategoryCodes
    http://hl7.org/fhir/ValueSet/observation-category
    from the FHIR Standard
    Observation.codeexamplePattern: LOINC Code 96607-7
    http://hl7.org/fhir/ValueSet/observation-codes
    from the FHIR Standard
    Observation.component.codeexampleLOINCCodes (a valid code from LOINC)
    http://hl7.org/fhir/ValueSet/observation-codes
    from the FHIR Standard
    Observation.component.dataAbsentReasonextensibleDataAbsentReason
    http://hl7.org/fhir/ValueSet/data-absent-reason
    from the FHIR Standard
    Observation.component:systolic.codeexamplePattern: LOINC Code 96608-5
    http://hl7.org/fhir/ValueSet/observation-codes
    from the FHIR Standard
    Observation.component:systolic.value[x].comparatorrequiredQuantityComparator
    http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1
    from the FHIR Standard
    Observation.component:diastolic.codeexamplePattern: LOINC Code 96609-3
    http://hl7.org/fhir/ValueSet/observation-codes
    from the FHIR Standard
    Observation.component:diastolic.value[x].comparatorrequiredQuantityComparator
    http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1
    from the FHIR Standard

    Constraints

    IdGradePath(s)DetailsRequirements
    us-core-26errorObservation.componentIf there is no value a data absent reason must be present
    : value.exists() or dataAbsentReason.exists()

    Snapshot View

    NameFlagsCard.TypeDescription & Constraintsdoco
    .. Observation C 0..* Observation US Core Average Blood Pressure Profile
    obs-6: dataAbsentReason SHALL only be present if Observation.value[x] is not present
    obs-7: If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present
    ... id Σ 0..1 id Logical id of this artifact
    ... meta Σ 0..1 Meta Metadata about the resource
    ... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
    ... language 0..1 code Language of the resource content
    Binding: CommonLanguages (preferred): A human language.

    Additional BindingsPurpose
    AllLanguages Max Binding
    ... text 0..1 Narrative Text summary of the resource, for human interpretation
    ... contained 0..* Resource Contained, inline Resources
    ... extension 0..* Extension Additional content defined by implementations
    ... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
    ... identifier Σ 0..* Identifier Business Identifier for observation
    ... basedOn Σ 0..* Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest) Fulfills plan, proposal or order
    ... partOf Σ 0..* Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy) Part of referenced event
    ... status ?!SΣ 1..1 code registered | preliminary | final | amended +
    Binding: ObservationStatus (required): Codes providing the status of an observation.

    ... Slices for category S 1..* CodeableConcept Classification of type of observation
    Slice: Unordered, Open by value:coding.code, value:coding.system
    Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.


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


    ..... id 0..1 string Unique id for inter-element referencing
    ..... extension 0..* Extension Additional content defined by implementations
    Slice: Unordered, Open by value:url
    ..... coding SΣ 1..* Coding Code defined by a terminology system
    ...... id 0..1 string Unique id for inter-element referencing
    ...... extension 0..* Extension Additional content defined by implementations
    Slice: Unordered, Open by value:url
    ...... system Σ 1..1 uri Identity of the terminology system
    Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category
    ...... version Σ 0..1 string Version of the system - if relevant
    ...... code Σ 1..1 code Symbol in syntax defined by the system
    Fixed Value: vital-signs
    ...... display Σ 0..1 string Representation defined by the system
    ...... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
    ..... text Σ 0..1 string Plain text representation of the concept
    ... code SΣ 1..1 CodeableConcept Blood Pressure
    Binding: LOINCCodes (example): Codes identifying names of simple observations.


    Required Pattern: At least the following
    .... id 0..1 string Unique id for inter-element referencing
    .... extension 0..* Extension Additional content defined by implementations
    .... coding 1..* Coding Code defined by a terminology system
    Fixed Value: (complex)
    ..... id 0..1 string Unique id for inter-element referencing
    ..... extension 0..* Extension Additional content defined by implementations
    ..... system 1..1 uri Identity of the terminology system
    Fixed Value: http://loinc.org
    ..... version 0..1 string Version of the system - if relevant
    ..... code 1..1 code Symbol in syntax defined by the system
    Fixed Value: 96607-7
    ..... display 0..1 string Representation defined by the system
    ..... userSelected 0..1 boolean If this coding was chosen directly by the user
    .... text 0..1 string Plain text representation of the concept
    ... subject SΣ 1..1 Reference(US Core Patient Profile) Who and/or what the observation is about
    ... focus Σ 0..* Reference(Resource) What the observation is about, when it is not about the subject of record
    ... encounter Σ 0..1 Reference(Encounter) Healthcare event during which this observation is made
    ... effective[x] SΣ 1..1 clinically relevant time-period for the average of blood pressure (BP) readings
    .... effectiveDateTime dateTime
    .... effectivePeriod Period S
    ... issued Σ 0..1 instant Date/Time this version was made available
    ... performer SΣ 0..* Reference(US Core Practitioner Profile | US Core Organization Profile | US Core Patient Profile | PractitionerRole | US Core CareTeam Profile | US Core RelatedPerson Profile) Who is responsible for the observation
    ... dataAbsentReason C 0..1 CodeableConcept Why the result is missing
    Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.

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


    ... note 0..* Annotation Comments about the observation
    ... bodySite 0..1 CodeableConcept Observed body part
    Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.

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

    ... specimen 0..1 Reference(Specimen) Specimen used for this observation
    ... device 0..1 Reference(Device | DeviceMetric) (Measurement) Device
    ... referenceRange C 0..* BackboneElement Provides guide for interpretation
    obs-3: Must have at least a low or a high or text
    .... id 0..1 string Unique id for inter-element referencing
    .... extension 0..* Extension Additional content defined by implementations
    .... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
    .... low C 0..1 SimpleQuantity Low Range, if relevant
    .... high C 0..1 SimpleQuantity High Range, if relevant
    .... type 0..1 CodeableConcept Reference range qualifier
    Binding: ObservationReferenceRangeMeaningCodes (preferred): Code for the meaning of a reference range.

    .... appliesTo 0..* CodeableConcept Reference range population
    Binding: ObservationReferenceRangeAppliesToCodes (example): Codes identifying the population the reference range applies to.


    .... age 0..1 Range Applicable age range, if relevant
    .... text 0..1 string Text based reference range in an observation
    ... hasMember Σ 0..* Reference(Observation | QuestionnaireResponse | MolecularSequence) Related resource that belongs to the Observation group
    ... derivedFrom Σ 0..* Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | Observation | MolecularSequence) Related measurements the observation is made from
    ... Slices for component SΣC 2..* BackboneElement Average systolic and diastolic blood pressure and other qualifiers.
    Slice: Unordered, Open by value:code
    us-core-26: If there is no value a data absent reason must be present
    .... component:All Slices Content/Rules for all slices
    ..... id 0..1 string Unique id for inter-element referencing
    ..... extension 0..* Extension Additional content defined by implementations
    ..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
    ..... code Σ 1..1 CodeableConcept Type of component observation (code / type)
    Binding: LOINCCodes (example): Codes identifying names of simple observations.

    ..... value[x] SΣ 0..1 Vital Sign Component Value
    ...... valueQuantity Quantity S
    ...... valueCodeableConcept CodeableConcept
    ...... valueString string
    ...... valueBoolean boolean
    ...... valueInteger integer
    ...... valueRange Range
    ...... valueRatio Ratio
    ...... valueSampledData SampledData
    ...... valueTime time
    ...... valueDateTime dateTime
    ...... valuePeriod Period
    ..... dataAbsentReason SC 0..1 CodeableConcept Why the component result is missing
    Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.

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


    ..... referenceRange 0..* See referenceRange (Observation) Provides guide for interpretation of component result
    .... component:systolic SΣ 1..1 BackboneElement Systolic Average Blood Pressure
    ..... id 0..1 string Unique id for inter-element referencing
    ..... extension 0..* Extension Additional content defined by implementations
    ..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
    ..... code SΣ 1..1 CodeableConcept Systolic Average Blood Pressure Code
    Binding: LOINCCodes (example): Codes identifying names of simple observations.


    Required Pattern: At least the following
    ...... id 0..1 string Unique id for inter-element referencing
    ...... extension 0..* Extension Additional content defined by implementations
    ...... coding 1..* Coding Code defined by a terminology system
    Fixed Value: (complex)
    ....... id 0..1 string Unique id for inter-element referencing
    ....... extension 0..* Extension Additional content defined by implementations
    ....... system 1..1 uri Identity of the terminology system
    Fixed Value: http://loinc.org
    ....... version 0..1 string Version of the system - if relevant
    ....... code 1..1 code Symbol in syntax defined by the system
    Fixed Value: 96608-5
    ....... display 0..1 string Representation defined by the system
    ....... userSelected 0..1 boolean If this coding was chosen directly by the user
    ...... text 0..1 string Plain text representation of the concept
    ..... value[x] SΣC 0..1 Quantity Systolic Average Blood Pressure Value
    ...... id 0..1 string Unique id for inter-element referencing
    ...... extension 0..* Extension Additional content defined by implementations
    Slice: Unordered, Open by value:url
    ...... value Σ 1..1 decimal Numerical value (with implicit precision)
    ...... comparator ?!Σ 0..1 code < | <= | >= | > - how to understand the value
    Binding: QuantityComparator (required): How the Quantity should be understood and represented.

    ...... unit Σ 1..1 string Unit representation
    ...... system ΣC 1..1 uri System that defines coded unit form
    Fixed Value: http://unitsofmeasure.org
    ...... code Σ 1..1 code Coded form of the unit
    Fixed Value: mm[Hg]
    ..... dataAbsentReason C 0..1 CodeableConcept Why the component result is missing
    Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.

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


    ..... referenceRange 0..* See referenceRange (Observation) Provides guide for interpretation of component result
    .... component:diastolic SΣ 1..1 BackboneElement Diastolic Average Blood Pressure
    ..... id 0..1 string Unique id for inter-element referencing
    ..... extension 0..* Extension Additional content defined by implementations
    ..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
    ..... code SΣ 1..1 CodeableConcept Diastolic Average Blood Pressure Code
    Binding: LOINCCodes (example): Codes identifying names of simple observations.


    Required Pattern: At least the following
    ...... id 0..1 string Unique id for inter-element referencing
    ...... extension 0..* Extension Additional content defined by implementations
    ...... coding 1..* Coding Code defined by a terminology system
    Fixed Value: (complex)
    ....... id 0..1 string Unique id for inter-element referencing
    ....... extension 0..* Extension Additional content defined by implementations
    ....... system 1..1 uri Identity of the terminology system
    Fixed Value: http://loinc.org
    ....... version 0..1 string Version of the system - if relevant
    ....... code 1..1 code Symbol in syntax defined by the system
    Fixed Value: 96609-3
    ....... display 0..1 string Representation defined by the system
    ....... userSelected 0..1 boolean If this coding was chosen directly by the user
    ...... text 0..1 string Plain text representation of the concept
    ..... value[x] SΣC 0..1 Quantity Diastolic Average Blood Pressure Value
    ...... id 0..1 string Unique id for inter-element referencing
    ...... extension 0..* Extension Additional content defined by implementations
    Slice: Unordered, Open by value:url
    ...... value Σ 1..1 decimal Numerical value (with implicit precision)
    ...... comparator ?!Σ 0..1 code < | <= | >= | > - how to understand the value
    Binding: QuantityComparator (required): How the Quantity should be understood and represented.

    ...... unit Σ 1..1 string Unit representation
    ...... system ΣC 1..1 uri System that defines coded unit form
    Fixed Value: http://unitsofmeasure.org
    ...... code Σ 1..1 code Coded form of the unit
    Fixed Value: mm[Hg]
    ..... dataAbsentReason C 0..1 CodeableConcept Why the component result is missing
    Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.

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


    ..... referenceRange 0..* See referenceRange (Observation) Provides guide for interpretation of component result

    doco Documentation for this format

    Terminology Bindings

    PathConformanceValueSet / CodeURI
    Observation.languagepreferredCommonLanguages
    Additional Bindings Purpose
    AllLanguages Max Binding
    http://hl7.org/fhir/ValueSet/languages
    from the FHIR Standard
    Observation.statusrequiredObservationStatus
    http://hl7.org/fhir/ValueSet/observation-status|4.0.1
    from the FHIR Standard
    Observation.categorypreferredObservationCategoryCodes
    http://hl7.org/fhir/ValueSet/observation-category
    from the FHIR Standard
    Observation.category:VSCatpreferredObservationCategoryCodes
    http://hl7.org/fhir/ValueSet/observation-category
    from the FHIR Standard
    Observation.codeexamplePattern: LOINC Code 96607-7
    http://hl7.org/fhir/ValueSet/observation-codes
    from the FHIR Standard
    Observation.dataAbsentReasonextensibleDataAbsentReason
    http://hl7.org/fhir/ValueSet/data-absent-reason
    from the FHIR Standard
    Observation.interpretationextensibleObservationInterpretationCodes
    http://hl7.org/fhir/ValueSet/observation-interpretation
    from the FHIR Standard
    Observation.bodySiteexampleSNOMEDCTBodyStructures
    http://hl7.org/fhir/ValueSet/body-site
    from the FHIR Standard
    Observation.methodexampleObservationMethods
    http://hl7.org/fhir/ValueSet/observation-methods
    from the FHIR Standard
    Observation.referenceRange.typepreferredObservationReferenceRangeMeaningCodes
    http://hl7.org/fhir/ValueSet/referencerange-meaning
    from the FHIR Standard
    Observation.referenceRange.appliesToexampleObservationReferenceRangeAppliesToCodes
    http://hl7.org/fhir/ValueSet/referencerange-appliesto
    from the FHIR Standard
    Observation.component.codeexampleLOINCCodes (a valid code from LOINC)
    http://hl7.org/fhir/ValueSet/observation-codes
    from the FHIR Standard
    Observation.component.dataAbsentReasonextensibleDataAbsentReason
    http://hl7.org/fhir/ValueSet/data-absent-reason
    from the FHIR Standard
    Observation.component.interpretationextensibleObservationInterpretationCodes
    http://hl7.org/fhir/ValueSet/observation-interpretation
    from the FHIR Standard
    Observation.component:systolic.codeexamplePattern: LOINC Code 96608-5
    http://hl7.org/fhir/ValueSet/observation-codes
    from the FHIR Standard
    Observation.component:systolic.value[x].comparatorrequiredQuantityComparator
    http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1
    from the FHIR Standard
    Observation.component:systolic.dataAbsentReasonextensibleDataAbsentReason
    http://hl7.org/fhir/ValueSet/data-absent-reason
    from the FHIR Standard
    Observation.component:systolic.interpretationextensibleObservationInterpretationCodes
    http://hl7.org/fhir/ValueSet/observation-interpretation
    from the FHIR Standard
    Observation.component:diastolic.codeexamplePattern: LOINC Code 96609-3
    http://hl7.org/fhir/ValueSet/observation-codes
    from the FHIR Standard
    Observation.component:diastolic.value[x].comparatorrequiredQuantityComparator
    http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1
    from the FHIR Standard
    Observation.component:diastolic.dataAbsentReasonextensibleDataAbsentReason
    http://hl7.org/fhir/ValueSet/data-absent-reason
    from the FHIR Standard
    Observation.component:diastolic.interpretationextensibleObservationInterpretationCodes
    http://hl7.org/fhir/ValueSet/observation-interpretation
    from the FHIR Standard

    Constraints

    IdGradePath(s)DetailsRequirements
    us-core-26errorObservation.componentIf there is no value a data absent reason must be present
    : value.exists() or dataAbsentReason.exists()

    This structure is derived from Observation

    Summary

    Mandatory: 11 elements(8 nested mandatory elements)
    Must-Support: 17 elements
    Fixed: 6 elements
    Prohibited: 1 element

    Structures

    This structure refers to these other structures:

    Slices

    This structure defines the following Slices:

    • The element 2 is sliced based on the values of Observation.category
    • The element 1 is sliced based on the value of Observation.component

    Maturity: 3

     

    Other representations of profile: CSV, Excel, Schematron

    Notes:

    Quick Start

    ​Below is an overview of the required Server RESTful FHIR interactions for this profile - for example, search and read operations - when supporting the US Core interactions to access this profile's information (Profile Support + Interaction Support). Note that systems that support only US Core Profiles (Profile Only Support) are not required to support these interactions. See the US Core Server CapabilityStatement for a complete list of supported RESTful interactions for this IG.

    • See the Scopes Format section for a description of the SMART scopes syntax.
    • See the Search Syntax section for a description of the US Core search syntax.
    • See the General Requirements section for additional rules and expectations when a Server requires status parameters.
    • See the General Guidance section for additional guidance on searching for multiple patients.

    US Core Scopes

    Servers providing access to vital signs data SHALL support these US Core SMART Scopes:

    • resource level scopes: <patient|user|system>/Observation.rs

    • granular scopes: <patient|user|system>/Observation.rs?category=http://terminology.hl7.org/CodeSystem/observation-category|vital-signs

    Mandatory Search Parameters:

    The following search parameters and search parameter combinations SHALL be supported:

    1. SHALL support searching using the combination of the patient and category search parameters:

      GET [base]/Observation?patient={Type/}[id]&category=http://terminology.hl7.org/CodeSystem/observation-category|vital-signs

      Example:

      1. GET [base]/Observation?patient=1134281&category=http://terminology.hl7.org/CodeSystem/observation-category|vital-signs

      Implementation Notes: Fetches a bundle of all Observation resources for the specified patient and a category code = vital-signs (how to search by reference and how to search by token)

    2. SHALL support searching using the combination of the patient and code search parameters:
      • including optional support for OR search on code (e.g.code={system|}[code],{system|}[code],...)

      GET [base]/Observation?patient={Type/}[id]&code={system|}[code]{,{system|}[code],...}

      Example:

      1. GET [base]/Observation?patient=1186747&code=http://loinc.org|8867-4,http://loinc.org|85354-9,http://loinc.org|96607-7

      Implementation Notes: Fetches a bundle of all Observation resources for the specified patient and observation code(s). SHOULD support search by multiple codes. The Observation code parameter searches `Observation.code only. (how to search by reference and how to search by token)

    3. SHALL support searching using the combination of the patient and category and date search parameters:
      • including support for these date comparators: gt,lt,ge,le
      • including optional support for AND search on date (e.g.date=[date]&date=[date]]&...)

      GET [base]/Observation?patient={Type/}[id]&category=http://terminology.hl7.org/CodeSystem/observation-category|vital-signs&date={gt|lt|ge|le}[date]{&date={gt|lt|ge|le}[date]&...}

      Example:

      1. GET [base]/Observation?patient=1134281&category=http://terminology.hl7.org/CodeSystem/observation-category|vital-signs&date=ge2020-01-01T00:00:00Z

      Implementation Notes: Fetches a bundle of all Observation resources for the specified patient and date and a category code = vital-signs (how to search by reference and how to search by token and how to search by date)

    Optional Search Parameters:

    The following search parameter combinations SHOULD be supported:

    1. SHOULD support searching using the combination of the patient and category and status search parameters:
      • including support for OR search on status (e.g.status={system|}[code],{system|}[code],...)

      GET [base]/Observation?patient={Type/}[id]&category=http://terminology.hl7.org/CodeSystem/observation-category|vital-signs&status={system|}[code]{,{system|}[code],...}

      Example:

      1. GET [base]/Observation?patient=1134281&category=http://terminology.hl7.org/CodeSystem/observation-category|vital-signs&status=final

      Implementation Notes: Fetches a bundle of all Observation resources for the specified patient and category and status (how to search by reference and how to search by token)

    2. SHOULD support searching using the combination of the patient and category and _lastUpdated search parameters:
      • including support for these _lastUpdated comparators: gt,lt,ge,le
      • including optional support for AND search on _lastUpdated (e.g._lastUpdated=[date]&_lastUpdated=[date]]&...)

      GET [base]/Observation?patient={Type/}[id]&category={system|}[code]&_lastUpdated={gt|lt|ge|le}[date]{&_lastUpdated={gt|lt|ge|le}[date]&...}

      Example:

      1. GET [base]/Observation?patient=1134281&category=http://terminology.hl7.org/CodeSystem/observation-category|vital-signs&_lastUpdated=ge2024-01-01T00:00:00Z

      Implementation Notes: Fetches a bundle of all Observation resources for the specified patient and category and _lastUpdated. See the US Core General Guidance page for Searching Using lastUpdated. (how to search by reference and how to search by token and how to search by date)

    3. SHOULD support searching using the combination of the patient and code and date search parameters:
      • including optional support for OR search on code (e.g.code={system|}[code],{system|}[code],...)
      • including support for these date comparators: gt,lt,ge,le
      • including optional support for AND search on date (e.g.date=[date]&date=[date]]&...)

      GET [base]/Observation?patient={Type/}[id]&code={system|}[code]{,{system|}[code],...}&date={gt|lt|ge|le}[date]{&date={gt|lt|ge|le}[date]&...}

      Example:

      1. GET [base]/Observation?patient=1186747&code=http://loinc.org|8867-4,http://loinc.org|85354-9,http://loinc.org|96607-7&date=ge2020-01-01T00:00:00Z

      Implementation Notes: Fetches a bundle of all Observation resources for the specified patient and date and report code(s). SHOULD support search by multiple codes. (how to search by reference and how to search by token and how to search by date)