Birth And Fetal Death (BFDR) FHIR Implementation Guide
2.0.0 - STU2 flag

Birth And Fetal Death (BFDR) FHIR Implementation Guide, published by HL7 International / Public Health. 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/fhir-bfdr/ and changes regularly. See the Directory of published versions

Resource Profile: Observation - APGAR Score

Official URL: http://hl7.org/fhir/us/bfdr/StructureDefinition/Observation-apgar-score Version: 2.0.0
Active as of 2025-02-19 Computable Name: ObservationApgarScore
Other Identifiers: OID:2.16.840.1.113883.4.642.40.13.42.34

APGAR score post-birth.

Birth certificates only require 5 and 10 minute timings. Other use cases may require/accept other timings.

IJE Mapping

Natality
Use Case # Description IJE Name Field Type Value Set/Comments
Natality 205 Apgar Score at 5 Minutes APGAR5 value,
code = 9274-2 (5 minute Apgar Score)		 integer
Natality 206 Apgar Score at 10 Minutes APGAR10 value,
code = 9271-8 (10 minute Apgar Score)		 integer

Form Mapping

Form Mapping
Item # Form Field FHIR Profile Field Reference
51 Apgar Score value Certificate of Live Birth
32 Apgar score value Facility Worksheet for the Live Birth Certificate
32 Apgar score value Attachment to the Facility Worksheet for the Live Birth Certificate for Multiple Births

Usage:

Formal Views of Profile Content

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

NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation C 0..* USCoreObservationSurveyProfile Survey Observation
dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources
dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource
dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
dom-5: If a resource is contained in another resource, it SHALL NOT have a security label
dom-6: A resource should have narrative for robust management
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
us-core-2: If there is no component or hasMember element then either a value[x] or a data absent reason must be present
us-core-3: SHALL use UCUM for coded quantity units.
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
ele-1: All FHIR elements must have a @value or children
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
... status ?!SΣ 1..1 code registered | preliminary | final | amended +
Binding: ObservationStatus (required): Codes providing the status of an observation.


ele-1: All FHIR elements must have a @value or children
.... category:survey S 1..1 CodeableConcept Classification of type of observation
Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.


ele-1: All FHIR elements must have a @value or children

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://terminology.hl7.org/CodeSystem/observation-category
...... code 1..1 code Symbol in syntax defined by the system
Fixed Value: survey
... code SΣ 1..1 CodeableConcept Standard timings for APGAR assessments. Birth certificates only require 5 and 10 minute timings. Other use cases may require/accept other timings.
Binding: APGAR Score Timing (required): ApgarTiming


ele-1: All FHIR elements must have a @value or children
... subject SΣ 1..1 Reference(Patient - Child Vital Records) Who and/or what the observation is about
ele-1: All FHIR elements must have a @value or children
... effective[x] SΣC 0..1 Clinically relevant time/time-period for observation
ele-1: All FHIR elements must have a @value or children
us-core-1: Datetime must be at least to day.
.... effectiveDateTime dateTime
... performer SΣ 0..* Reference(US Core Practitioner Profile) Who is responsible for the observation
ele-1: All FHIR elements must have a @value or children
... value[x] SΣC 1..1 integer Actual result
ele-1: All FHIR elements must have a @value or children
... dataAbsentReason SC 0..1 CodeableConcept Why the result is missing
Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.


ele-1: All FHIR elements must have a @value or children
... hasMember SΣ 0..* Reference(US Core Observation Survey Profile) Reference to panel or multi-select responses
ele-1: All FHIR elements must have a @value or children
... derivedFrom SΣ 0..* Reference(US Core Observation Survey Profile | US Core QuestionnaireResponse Profile) Related Observations or QuestionnaireResponses that the observation is made from
ele-1: All FHIR elements must have a @value or children

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:surveypreferredPattern: survey
http://hl7.org/fhir/ValueSet/observation-category
from the FHIR Standard
Observation.coderequiredApgarTimingVS
http://hl7.org/fhir/us/bfdr/ValueSet/ValueSet-apgar-timing
from this IG
Observation.dataAbsentReasonextensibleDataAbsentReason
http://hl7.org/fhir/ValueSet/data-absent-reason
from the FHIR Standard

 

Other representations of profile: CSV, Excel, Schematron