Vital Signs with Qualifying Elements
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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: Twenty Four Hour Blood Pressure

Official URL: http://hl7.org/fhir/us/vitals/StructureDefinition/twenty-four-hour-blood-pressure Version: 2.0.0
Draft as of 2024-10-09 Computable Name: TwentyFourHourBloodPressure

Copyright/Legal: Logica Health, all rights reserved Creative Commons License

An average blood pressure (systolic and diastolic) over a twenty four hour period.

Scope

This blood pressure profile is used to capture an average blood pressure (systolic and diastolic) over a period of twenty four hours.

There are LOINC codes for the systolic and diastolic components.

About the extensions

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

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

observation-deviceCode - This is an intentional separation from the Observation.device backbone element. Used for when only a device type needs to be recorded without the use of another resource. Because the values of this extension span both device type and cuff size, the cardinality of this element has been set to 0..2.

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

Example

Twenty Four Hour Blood Pressure

Value Sets

Value Set Purpose
Body Position value set This value set is used to result the Body Position extension.
Exertion Phase value set This value set is used to result the Exercise Association extension.
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.
Measurement Setting value set This value set is used to result the Mesurement Setting extension.

Usage:

Formal Views of Profile Content

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

This structure is derived from observation-vitalsigns

NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation 0..* observation-vitalsigns FHIR Vital Signs Profile
... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
.... BodyPosition S 0..1 (Complex) Body Position
URL: http://hl7.org/fhir/StructureDefinition/observation-bodyPosition
..... value[x] 1..1 CodeableConcept Value of extension
Binding: Body Position 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)
... code 1..1 CodeableConcept Blood pressure panel 24 hour 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: 97844-5
... effective[x] 1..1 Period The dates and times over which the 24 hour period falls.
... 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 1..* BackboneElement Blood pressure components
Slice: Unordered, Open by pattern:code
.... component:SystolicBP24HMean 1..1 BackboneElement Systolic blood pressure 24 hour mean
..... code 1..1 CodeableConcept Systolic blood pressure 24 hour 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: 8490-5
..... value[x] 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 form of the unit
Fixed Value: mm[Hg]
.... component:DiastolicBP24HMean 0..1 BackboneElement Diastolic blood pressure 24 hour mean
..... code 1..1 CodeableConcept Diastolic blood pressure 24 hour 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: 8472-3
..... value[x] 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 form of the unit
Fixed Value: mm[Hg]

doco Documentation for this format

Terminology Bindings (Differential)

PathConformanceValueSetURI
Observation.extension:BodyPosition.value[x]extensibleBodyPositionvalueset
http://hl7.org/fhir/us/vitals/ValueSet/bodyPositionVS
from this IG
Observation.bodySiteextensibleBloodPressureMeasurementBodyLocationPrecoodinated
http://hl7.org/fhir/us/vitals/ValueSet/bpmeasbodylocationprecoord
from this IG
Observation.methodextensibleBloodPressureMeasurementMethodvalueset
http://hl7.org/fhir/us/vitals/ValueSet/bpMeasMethodVS
from this IG

 

Other representations of profile: CSV, Excel, Schematron