Average Blood Pressure - Vital Signs with Qualifying Elements v2.0.0

Vital Signs with Qualifying Elements
2.0.0 - ci-build International flag

Vital Signs with Qualifying Elements, published by HL7 International - Clinical Information Modeling Initiative. This guide is not an authorized publication; it is the continuous build for version 2.0.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/cimi-vital-signs/ and changes regularly. See the Directory of published versions

Resource Profile: Average Blood Pressure

Official URL: http://hl7.org/fhir/us/vitals/StructureDefinition/average-blood-pressure				Version: 2.0.0
Draft as of 2024-10-09				Computable Name: AverageBloodPressure
Copyright/Legal: Logica Health, all rights reserved Creative Commons License

A calculated average of two or more blood pressure readings in a specified time period or according to a specified algorithm or protocol. The average blood pressure has a systolic and a diastolic component.

Scope

This blood pressure profile is used to capture the calculated average blood pressure from a set of individual measurements.

About the extensions

The expectation for the extensions in this profile is that if populated, they qualify each of the individual measurements used to calculate the average blood pressure. For example, if the body position give in an intance of the this profile is "sitting" then the body position for either the systolic or diastolic blood pressures is "sitting".

Body Position - This is used to capture an individual's body position while taking a blood pressure.

Exercise Association - This is used to capture an individual's excercise status while taking blood pressure.

Measurement Setting - This is used to capture the location (not body site) where the measurement(s) took place; At home, hospital, clinic, etc.

Measurement Protocol - This is used to capture a set of rules used for the calculation of the blood pressure average; the number of measurments to be obtained, the time interval between measurements, the overall period for the measurements, and any instructions such as "take while sitting, after five minutes", etc.. This can be institution specific, provider specific, clinical society specific (i.e. AMA), etc.

Example

AverageBloodPressure-example

Value Sets

Value Set	Purpose
Body Position value set	This value set contains concepts used to result the patient's body position, referencing the SNOMED Code 397155001 Body position (observable entity) and the LOINC term "Body position with respect to gravity" 8361-8.
Blood Pressure Device Type value set	This value set contains concepts used to result the type of device used to measure a body blood pressure, referencing the SNOMED Code 23591000205102 “Blood pressure device type (observable entity)" and the LOINC term “Type of Blood pressure device” 41901-0.
Blood Pressure Measurement Site value set	This value set contains a constrained list body location values used to result the body location where a blood pressure was measured, referencing the SNOMED Code 2281000205100 “Blood pressure measurement site (observable entity)” and the LOINC term "Blood pressure measurement site", 41904-4.
Blood Pressure Method value set	This value set contains concepts used to result the method used for a blood pressure measurement, referencing the SNOMED Code 2291000205103 “Blood pressure method (observable entity)” and the LOINC term "Blood pressure method" 8357-6.
Exertion Phase value set	The purpose of the value set is to document exercise associated with a measurement. Resulting LOINC code 74008-4 "Exercise intensity".
Sleep Status value set	This value set contains values used to indicate the state of wakefulness during measurement.
Measurement Setting value set	This value set is used to result the Measurement Setting extension.

Value Set

Purpose

Body Position value set

This value set contains concepts used to result the patient's body position, referencing the SNOMED Code 397155001 Body position (observable entity) and the LOINC term "Body position with respect to gravity" 8361-8.

Blood Pressure Device Type value set

This value set contains concepts used to result the type of device used to measure a body blood pressure, referencing the SNOMED Code 23591000205102 “Blood pressure device type (observable entity)" and the LOINC term “Type of Blood pressure device” 41901-0.

Blood Pressure Measurement Site value set

This value set contains a constrained list body location values used to result the body location where a blood pressure was measured, referencing the SNOMED Code 2281000205100 “Blood pressure measurement site (observable entity)” and the LOINC term "Blood pressure measurement site", 41904-4.

Blood Pressure Method value set

This value set contains concepts used to result the method used for a blood pressure measurement, referencing the SNOMED Code 2291000205103 “Blood pressure method (observable entity)” and the LOINC term "Blood pressure method" 8357-6.

Exertion Phase value set

The purpose of the value set is to document exercise associated with a measurement. Resulting LOINC code 74008-4 "Exercise intensity".

Sleep Status value set

This value set contains values used to indicate the state of wakefulness during measurement.

Measurement Setting value set

This value set is used to result the Measurement Setting extension.

Usage:

Examples for this Resource Profile: Observation/AverageBloodPressure-example

Formal Views of Profile Content

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

This structure is derived from Observation

Name	Flags	Card.	Type	Description & Constraints
Observation		0..*	Observation	Measurements and simple assertions
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
BodyPosition	S	0..1	CodeableConcept	Body Position URL: http://hl7.org/fhir/StructureDefinition/observation-bodyPosition
exerciseAssociation	S	0..1	CodeableConcept	Exercise Association URL: http://hl7.org/fhir/us/vitals/StructureDefinition/ExerciseAssociationExt Binding: Exertion Phase value set (extensible)
MeasurementSetting	S	0..1	CodeableConcept	Measurement setting URL: http://hl7.org/fhir/us/vitals/StructureDefinition/MeasurementSettingExt Binding: Measurement Setting value set (extensible)
MeasurementProtocol	S	0..1	CodeableConcept	Rules and algorithm for Average Blood Pressure calculation. URL: http://hl7.org/fhir/us/vitals/StructureDefinition/MeasurementProtocolExt Binding: Measurement Protocol value set (extensible)
status	S	1..1	code	registered \| preliminary \| final \| amended +
category
coding
system		0..1	uri	Identity of the terminology system Required Pattern: http://terminology.hl7.org/CodeSystem/observation-category
code		0..1	code	Symbol in syntax defined by the system Required Pattern: vital-signs
code		1..1	CodeableConcept	Blood pressure panel; mean systolic and mean diastolic pressures 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(Patient)	Who and/or what the observation is about
effective[x]	S	1..1	dateTime, Period, Timing, instant	Clinically relevant time/time-period for observation
value[x]		0..0
bodySite	S	0..1	CodeableConcept	Observed body part Binding: Blood Pressure Measurement Body Location Precoordinated value set (extensible): A set of codes that describe where on/in the body an observation or procedure took place
method	S	0..1	CodeableConcept	How it was done Binding: Blood Pressure Measurement Method value set (extensible): A set of codes that describe the method used to measure a blood pressure
specimen		0..0
device	S	0..1	Reference(Blood Pressure Device)	Blood Pressure Device
Slices for component	S	1..*	BackboneElement	Blood pressure components Slice: Unordered, Open by pattern:code
component:SystolicBP		1..1	BackboneElement	Systolic blood pressure mean
code	S	1..1	CodeableConcept	Systolic blood pressure mean 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]	S	0..1	Quantity	Actual component result
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 form of the unit Fixed Value: mm[Hg]
component:DiastolicBP		0..1	BackboneElement	Diastolic blood pressure mean
code	S	1..1	CodeableConcept	Diastolic blood pressure mean 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]	S	0..1	Quantity	Actual component result
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 form of the unit Fixed Value: mm[Hg]
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
Observation.bodySite	extensible	BloodPressureMeasurementBodyLocationPrecoodinated `http://hl7.org/fhir/us/vitals/ValueSet/bpmeasbodylocationprecoord` from this IG
Observation.method	extensible	BloodPressureMeasurementMethodvalueset `http://hl7.org/fhir/us/vitals/ValueSet/bpMeasMethodVS` from this IG

Name	Flags	Card.	Type	Description & Constraints
Observation	C	0..*	Observation	Measurements and simple assertions 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
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
BodyPosition	S	0..1	CodeableConcept	Body Position URL: http://hl7.org/fhir/StructureDefinition/observation-bodyPosition
exerciseAssociation	S	0..1	CodeableConcept	Exercise Association URL: http://hl7.org/fhir/us/vitals/StructureDefinition/ExerciseAssociationExt Binding: Exertion Phase value set (extensible)
MeasurementSetting	S	0..1	CodeableConcept	Measurement setting URL: http://hl7.org/fhir/us/vitals/StructureDefinition/MeasurementSettingExt Binding: Measurement Setting value set (extensible)
MeasurementProtocol	S	0..1	CodeableConcept	Rules and algorithm for Average Blood Pressure calculation. URL: http://hl7.org/fhir/us/vitals/StructureDefinition/MeasurementProtocolExt Binding: Measurement Protocol value set (extensible)
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.
code	Σ	1..1	CodeableConcept	Blood pressure panel; mean systolic and mean diastolic pressures 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(Patient)	Who and/or what the observation is about
effective[x]	SΣ	1..1		Clinically relevant time/time-period for observation
effectiveDateTime			dateTime
effectivePeriod			Period
effectiveTiming			Timing
effectiveInstant			instant
bodySite	S	0..1	CodeableConcept	Observed body part Binding: Blood Pressure Measurement Body Location Precoordinated value set (extensible): A set of codes that describe where on/in the body an observation or procedure took place
method	S	0..1	CodeableConcept	How it was done Binding: Blood Pressure Measurement Method value set (extensible): A set of codes that describe the method used to measure a blood pressure
device	S	0..1	Reference(Blood Pressure Device)	Blood Pressure Device
Slices for component	SΣ	1..*	BackboneElement	Blood pressure components Slice: Unordered, Open by pattern:code
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.
component:SystolicBP	Σ	1..1	BackboneElement	Systolic blood pressure mean
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	SΣ	1..1	CodeableConcept	Systolic blood pressure mean 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]	SΣ	0..1	Quantity	Actual component result
value	SΣ	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	SΣ	1..1	string	Unit representation
system	SΣC	1..1	uri	System that defines coded unit form Fixed Value: http://unitsofmeasure.org
code	SΣ	1..1	code	Coded form of the unit Fixed Value: mm[Hg]
component:DiastolicBP	Σ	0..1	BackboneElement	Diastolic blood pressure mean
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	SΣ	1..1	CodeableConcept	Diastolic blood pressure mean 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]	SΣ	0..1	Quantity	Actual component result
value	SΣ	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	SΣ	1..1	string	Unit representation
system	SΣC	1..1	uri	System that defines coded unit form Fixed Value: http://unitsofmeasure.org
code	SΣ	1..1	code	Coded form of the unit Fixed Value: mm[Hg]
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
Observation.status	required	ObservationStatus `http://hl7.org/fhir/ValueSet/observation-status\|4.0.1` from the FHIR Standard
Observation.code	example	Pattern: LOINC Code 96607-7 `http://hl7.org/fhir/ValueSet/observation-codes` from the FHIR Standard
Observation.bodySite	extensible	BloodPressureMeasurementBodyLocationPrecoodinated `http://hl7.org/fhir/us/vitals/ValueSet/bpmeasbodylocationprecoord` from this IG
Observation.method	extensible	BloodPressureMeasurementMethodvalueset `http://hl7.org/fhir/us/vitals/ValueSet/bpMeasMethodVS` from this IG
Observation.component.code	example	LOINCCodes (a valid code from LOINC) `http://hl7.org/fhir/ValueSet/observation-codes` from the FHIR Standard
Observation.component:SystolicBP.code	example	Pattern: LOINC Code 96608-5 `http://hl7.org/fhir/ValueSet/observation-codes` from the FHIR Standard
Observation.component:SystolicBP.value[x].comparator	required	QuantityComparator `http://hl7.org/fhir/ValueSet/quantity-comparator\|4.0.1` from the FHIR Standard
Observation.component:DiastolicBP.code	example	Pattern: LOINC Code 96609-3 `http://hl7.org/fhir/ValueSet/observation-codes` from the FHIR Standard
Observation.component:DiastolicBP.value[x].comparator	required	QuantityComparator `http://hl7.org/fhir/ValueSet/quantity-comparator\|4.0.1` from the FHIR Standard

Description & Constraints

Observation

C

0..*

Observation

Measurements and simple assertions
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