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Orders and Observations Work Group Maturity Level: 5Trial Use Use Context: Any

The official URL for this profile is:

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

FHIR Vital Signs Profile

This profile was published on Fri, Mar 25, 2016 00:00+0000 as a draft by Health Level Seven International (Orders and Observations Workgroup).

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

This structure is derived from Observation.

Summary

"#### Complete Summary of the Mandatory Requirements

  1. One status in Observation.statuswhich has a required binding to:

  2. A category in Observation.category which must have:

    • a fixed Observation.category.coding.system="http://terminology.hl7.org/CodeSystem/observation-category"
    • a fixed Observation.category.coding.code= "vital-signs"
  3. A code in Observation.code

    • a fixed Observation.code.coding.system= "http://loinc.org""
    • a LOINC code in Observation.code.coding.code which has an extensible binding to:
  4. One patient in Observation.subject

  5. A date and time in effectiveDateTime or effectivePeriod

  6. Either one Observation.value[x] or, if there is no value, one code in Observation.DataAbsentReason

    • if a vital sign measure then:
      • One numeric value in Observation.valueQuantity.value
      • a fixed Observation.valueQuantity.system="http://unitsofmeasure.org"
      • a UCUM unit code in Observation.valueQuantity.code which has an required binding to the Vital Signs Units value set.
    • Observation.DataAbsentReason is bound to Observation Value Absent Reason value set.
  7. When using a panel code to group component observations (Note: See the comments regarding blood pressure in the table above), one or more Observation.component.code each of which must have:

    • a fixed Observation.component.code.coding.system =""http://loinc.org""
  8. Either one Observation.component.valueQuantity or, if there is no value, one code in Observation.component.DataAbsentReason

  9. When using a panel code to group observations, one or more reference to Vitals Signs Observations in Observation.related.target

    • a fixed Observation.related.type= "has-member""

Mandatory: 9 elements (+1 nested mandatory element)
Must-Support: 15 elements
Fixed Value: 2 elements

Slices

This structure defines the following Slices:

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

This structure is derived from Observation.

NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation I0..*FHIR Vital Signs Profile
vs-2: If there is no component or hasMember element then either a value[x] or a data absent reason must be present.
... status S1..1codeBinding: ObservationStatus (required)
... category S1..*(Slice Definition)Slice: Unordered, Open by value:coding.code, value:coding.system
.... category:VSCat S1..1CodeableConcept
..... coding S1..*Coding
...... system S1..1uriFixed Value: http://terminology.hl7.org/CodeSystem/observation-category
...... code S1..1codeFixed Value: vital-signs
... code S1..1CodeableConceptCoded Responses from C-CDA Vital Sign Results
Binding: Vital Signs (extensible)
... subject S1..1Reference(Patient)
... effective[x] SI1..1Often just a dateTime for Vital Signs
vs-1: if Observation.effective[x] is dateTime and has a value then that value shall be precise to the day
.... effectiveDateTimedateTime
.... effectivePeriodPeriod
... value[x] SI0..1Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period, AttachmentVital Signs value are recorded using the Quantity data type. For supporting observations such as Cuff size could use other datatypes such as CodeableConcept.
... dataAbsentReason SI0..1CodeableConcept
... hasMember 0..*Reference(QuestionnaireResponse | MolecularSequence | Vital Signs Profile)Used when reporting vital signs panel components
... derivedFrom 0..*Reference(DocumentReference | ImagingStudy | QuestionnaireResponse | MolecularSequence | Vital Signs Profile)
... component SI0..*BackboneElementUsed when reporting systolic and diastolic blood pressure.
vs-3: If there is no a value a data absent reason must be present
.... code S1..1CodeableConceptBinding: Vital Signs (extensible)
.... value[x] SI0..1Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period, AttachmentVital Sign Value recorded with UCUM
Binding: Vital Signs Units (required)
.... dataAbsentReason SI0..1CodeableConcept

doco Documentation for this format
NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation I0..*FHIR Vital Signs Profile
vs-2: If there is no component or hasMember element then either a value[x] or a data absent reason must be present.
... id Σ0..1stringLogical id of this artifact
... meta ΣI0..1MetaMetadata about the resource
... implicitRules ?!ΣI0..1uriA set of rules under which this content was created
... language I0..1codeLanguage of the resource content
Binding: Common Languages (preferred)
Max Binding: All Languages
... text I0..1NarrativeText summary of the resource, for human interpretation
... contained I0..*ResourceContained, inline Resources
... extension I0..*ExtensionAdditional content defined by implementations
... modifierExtension ?!I0..*ExtensionExtensions that cannot be ignored
... identifier ΣI0..*IdentifierBusiness Identifier for observation
... basedOn ΣI0..*Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest)Fulfills plan, proposal or order
... partOf ΣI0..*Reference(MedicationAdministration | MedicationDispense | MedicationUsage | Procedure | Immunization | ImagingStudy)Part of referenced event
... status ?!SΣI1..1coderegistered | preliminary | final | amended +
Binding: ObservationStatus (required)
... category SI1..*(Slice Definition)Classification of type of observation
Slice: Unordered, Open by value:coding.code, value:coding.system
Binding: Observation Category Codes (preferred)
.... category:VSCat SI1..1CodeableConceptClassification of type of observation
Binding: Observation Category Codes (preferred)
..... id 0..1stringUnique id for inter-element referencing
..... extension I0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
..... coding SΣI1..*CodingCode defined by a terminology system
...... id 0..1stringUnique id for inter-element referencing
...... extension I0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
...... system SΣI1..1uriIdentity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category
...... version ΣI0..1stringVersion of the system - if relevant
...... code SΣI1..1codeSymbol in syntax defined by the system
Fixed Value: vital-signs
...... display ΣI0..1stringRepresentation defined by the system
...... userSelected ΣI0..1booleanIf this coding was chosen directly by the user
..... text ΣI0..1stringPlain text representation of the concept
... code SΣI1..1CodeableConceptCoded Responses from C-CDA Vital Sign Results
Binding: Vital Signs (extensible)
... subject SΣI1..1Reference(Patient)Who and/or what the observation is about
... focus ΣI0..*Reference(Resource)What the observation is about, when it is not about the subject of record
... encounter ΣI0..1Reference(Encounter)Healthcare event during which this observation is made
... effective[x] SΣI1..1Often just a dateTime for Vital Signs
vs-1: if Observation.effective[x] is dateTime and has a value then that value shall be precise to the day
.... effectiveDateTimedateTime
.... effectivePeriodPeriod
... issued ΣI0..1instantDate/Time this version was made available
... performer ΣI0..*Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson)Who is responsible for the observation
... value[x] SΣI0..1Vital Signs value are recorded using the Quantity data type. For supporting observations such as Cuff size could use other datatypes such as CodeableConcept.
.... valueQuantityQuantity
.... valueCodeableConceptCodeableConcept
.... valueStringstring
.... valueBooleanboolean
.... valueIntegerinteger
.... valueRangeRange
.... valueRatioRatio
.... valueSampledDataSampledData
.... valueTimetime
.... valueDateTimedateTime
.... valuePeriodPeriod
.... valueAttachmentAttachment
... dataAbsentReason SI0..1CodeableConceptWhy the result is missing
Binding: DataAbsentReason (extensible)
... interpretation I0..*CodeableConceptHigh, low, normal, etc.
Binding: Observation Interpretation Codes (extensible)
... note I0..*AnnotationComments about the observation
... bodySite I0..1CodeableConceptObserved body part
Binding: SNOMED CT Body Structures (example)
... method I0..1CodeableConceptHow it was done
Binding: Observation Methods (example)
... specimen I0..1Reference(Specimen)Specimen used for this observation
... device I0..1Reference(Device | DeviceMetric)(Measurement) Device
... referenceRange I0..*BackboneElementProvides guide for interpretation
obs-3: Must have at least a low or a high or text
.... id 0..1stringUnique id for inter-element referencing
.... extension I0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!ΣI0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... low I0..1SimpleQuantityLow Range, if relevant
.... high I0..1SimpleQuantityHigh Range, if relevant
.... type I0..1CodeableConceptReference range qualifier
Binding: Observation Reference Range Meaning Codes (preferred)
.... appliesTo I0..*CodeableConceptReference range population
Binding: Observation Reference Range Applies To Codes (example)
.... age I0..1RangeApplicable age range, if relevant
.... text I0..1stringText based reference range in an observation
... hasMember ΣI0..*Reference(QuestionnaireResponse | MolecularSequence | Vital Signs Profile)Used when reporting vital signs panel components
... derivedFrom ΣI0..*Reference(DocumentReference | ImagingStudy | QuestionnaireResponse | MolecularSequence | Vital Signs Profile)Related measurements the observation is made from
... component SΣI0..*BackboneElementUsed when reporting systolic and diastolic blood pressure.
vs-3: If there is no a value a data absent reason must be present
.... id 0..1stringUnique id for inter-element referencing
.... extension I0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!ΣI0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... code SΣI1..1CodeableConceptType of component observation (code / type)
Binding: Vital Signs (extensible)
.... value[x] SΣI0..1Vital Sign Value recorded with UCUM
Binding: Vital Signs Units (required)
..... valueQuantityQuantity
..... valueCodeableConceptCodeableConcept
..... valueStringstring
..... valueBooleanboolean
..... valueIntegerinteger
..... valueRangeRange
..... valueRatioRatio
..... valueSampledDataSampledData
..... valueTimetime
..... valueDateTimedateTime
..... valuePeriodPeriod
..... valueAttachmentAttachment
.... dataAbsentReason SI0..1CodeableConceptWhy the component result is missing
Binding: DataAbsentReason (extensible)
.... interpretation I0..*CodeableConceptHigh, low, normal, etc.
Binding: Observation Interpretation Codes (extensible)
.... referenceRange I0..*Unknown reference to #Observation.referenceRange
Provides guide for interpretation of component result

doco Documentation for this format
<!-- observation-vitalsigns -->doco

<Observation xmlns="http://hl7.org/fhir"
>
  <!-- from Element: extension -->
 <id value="[string]"/><!-- 0..1 Logical id of this artifact -->
 <meta><!-- ?? 0..1 Meta Metadata about the resource --></meta>
 <implicitRules value="[uri]"/><!-- ?? 0..1 A set of rules under which this content was created -->
 <language value="[code]"/><!-- ?? 0..1 Language of the resource content   -->
 <text><!-- ?? 0..1 Narrative 
     Text summary of the resource, for human interpretation --></text>
 <contained><!-- ?? 0..* Resource Contained, inline Resources --></contained>
 <modifierExtension><!-- ?? 0..* Extension  Extensions that cannot be ignored  --></modifierExtension>
 <identifier><!-- ?? 0..* Identifier 
     Business Identifier for observation --></identifier>
 <basedOn><!-- ?? 0..* Reference(CarePlan) Fulfills plan, proposal or order --></basedOn>
 <partOf><!-- ?? 0..* Reference(MedicationAdministration) Part of referenced event --></partOf>
 <status value="[code]"/><!-- ?? 1..1 registered | preliminary | final | amended +   -->
 <-- category sliced by value:coding.code, value:coding.system  in the specified orderOpen-->
 <category> ?? 1..1 CodeableConcept  <!-- ?? 1..1 Classification of  type of observation -->
  <coding> ?? 1..* Coding  <!-- ?? 1..* Code defined by a terminology system -->
   <system value="[uri]"/><!-- ?? 1..1 Identity of the terminology system -->
   <version value="[string]"/><!-- ?? 0..1 Version of the system - if relevant -->
   <code value="[code]"/><!-- ?? 1..1 Symbol in syntax defined by the system -->
   <display value="[string]"/><!-- ?? 0..1 Representation defined by the system -->
   <userSelected value="[boolean]"/><!-- ?? 0..1 If this coding was chosen directly by the user -->
  </coding>
  <text value="[string]"/><!-- ?? 0..1 Plain text representation of the concept -->
 </category>
 <code><!-- ?? 1..1 CodeableConcept Coded Responses from C-CDA Vital Sign Results   --></code>
 <subject><!-- ?? 1..1 Reference(Patient) 
     Who and/or what the observation is about --></subject>
 <focus><!-- ?? 0..* Reference(Resource) 
     What the observation is about, when it is not about the subject of record --></focus>
 <encounter><!-- ?? 0..1 Reference(Encounter) 
     Healthcare event during which this observation is made --></encounter>
 <effective[x]><!-- ?? 1..1 dateTime|Period 
     Often just a dateTime for Vital Signs --></effective[x]>
 <issued value="[instant]"/><!-- ?? 0..1 Date/Time this version was made available -->
 <performer><!-- ?? 0..* Reference(Practitioner) 
     Who is responsible for the observation --></performer>
 <value[x]><!-- ?? 0..1 Quantity|CodeableConcept|string|boolean|integer|
   Range|Ratio|SampledData|time|dateTime|Period|Attachment 
     Vital Signs value are recorded using the Quantity data type. For supporting observations such as Cuff size could use other datatypes such as CodeableConcept. --></value[x]>
 <dataAbsentReason><!-- ?? 0..1 CodeableConcept Why the result is missing   --></dataAbsentReason>
 <interpretation><!-- ?? 0..* CodeableConcept High, low, normal, etc.   --></interpretation>
 <note><!-- ?? 0..* Annotation Comments about the observation --></note>
 <bodySite><!-- ?? 0..1 CodeableConcept Observed body part   --></bodySite>
 <method><!-- ?? 0..1 CodeableConcept How it was done   --></method>
 <specimen><!-- ?? 0..1 Reference(Specimen) Specimen used for this observation --></specimen>
 <device><!-- ?? 0..1 Reference(Device) (Measurement) Device --></device>
 <referenceRange> ?? 0..* BackboneElement  <!-- ?? 0..* Provides guide for interpretation -->
  <modifierExtension><!-- ?? 0..* Extension  Extensions that cannot be ignored even if unrecognized  --></modifierExtension>
  <low><!-- ?? 0..1 Quantity 
      Low Range, if relevant --></low>
  <high><!-- ?? 0..1 Quantity 
      High Range, if relevant --></high>
  <type><!-- ?? 0..1 CodeableConcept Reference range qualifier   --></type>
  <appliesTo><!-- ?? 0..* CodeableConcept Reference range population   --></appliesTo>
  <age><!-- ?? 0..1 Range 
      Applicable age range, if relevant --></age>
  <text value="[string]"/><!-- ?? 0..1 Text based reference range in an observation -->
 </referenceRange>
 <hasMember><!-- ?? 0..* Reference(QuestionnaireResponse) 
     Used when reporting vital signs panel components --></hasMember>
 <derivedFrom><!-- ?? 0..* Reference(DocumentReference) 
     Related measurements the observation is made from --></derivedFrom>
 <component> ?? 0..* BackboneElement  <!-- ?? 0..* Used when reporting systolic and diastolic blood pressure. -->
  <modifierExtension><!-- ?? 0..* Extension  Extensions that cannot be ignored even if unrecognized  --></modifierExtension>
  <code><!-- ?? 1..1 CodeableConcept Type of component observation (code / type)   --></code>
  <value[x]><!-- ?? 0..1 Quantity|CodeableConcept|string|
    boolean|integer|Range|Ratio|SampledData|time|dateTime|Period|Attachment Vital Sign Value recorded with UCUM   --></value[x]>
  <dataAbsentReason><!-- ?? 0..1 CodeableConcept Why the component result is missing   --></dataAbsentReason>
  <interpretation><!-- ?? 0..* CodeableConcept High, low, normal, etc.   --></interpretation>
  <referenceRange><!-- See #Observation.referenceRange  Provides guide for interpretation of component result --></referenceRange>
 </component>
</Observation>
{ // observation-vitalsigns
  // from Element: extension
    "meta" : { Meta }, // C?Metadata about the resource
    "implicitRules" : "<uri>", // C?A set of rules under which this content was created
    "language" : "<code>", // C?Language of the resource content
    "text" : { Narrative }, // C?Text summary of the resource, for human interpretation
    "contained" : [{ Resource }], // C?Contained, inline Resources
    "modifierExtension" : [{ Extension }], // C?Extensions that cannot be ignored
    "identifier" : [{ Identifier }], // C?Business Identifier for observation
    "basedOn" : [{ Reference(CarePlan) }], // C?Fulfills plan, proposal or order
    "partOf" : [{ Reference(MedicationAdministration) }], // C?Part of referenced event
    "status" : "<code>", // C? R! registered | preliminary | final | amended +
    "category" : [ //  sliced by value:coding.code, value:coding.system  in the specified order, Open 
      { // Classification of  type of observation // C? R! 
        // from Element: extension
        "extension" : [ //  sliced by value:url  in the specified order, Open ]
        "coding" : [{ Coding }], // C? R! Code defined by a terminology system
        "text" : "<string>" // C?Plain text representation of the concept
      }
    ],
    "code" : { CodeableConcept }, // C? R! Coded Responses from C-CDA Vital Sign Results
    "subject" : { Reference(Patient) }, // C? R! Who and/or what the observation is about
    "focus" : [{ Reference(Resource) }], // C?What the observation is about, when it is not about the subject of record
    "encounter" : { Reference(Encounter) }, // C?Healthcare event during which this observation is made
// value[x]: Often just a dateTime for Vital Signs. One of these 2:
    "effectiveDateTime" : "<dateTime>", // C? R! Often just a dateTime for Vital Signs
    "effectivePeriod" : { Period }, // C? R! Often just a dateTime for Vital Signs
    "issued" : "<instant>", // C?Date/Time this version was made available
    "performer" : [{ Reference(Practitioner) }], // C?Who is responsible for the observation
// value[x]: Vital Signs value are recorded using the Quantity data type. For supporting observations such as Cuff size could use other datatypes such as CodeableConcept.. One of these 12:
    "valueQuantity" : { Quantity }, // C?Vital Signs value are recorded using the Quantity data type. For supporting observations such as Cuff size could use other datatypes such as CodeableConcept.
    "valueCodeableConcept" : { CodeableConcept }, // C?Vital Signs value are recorded using the Quantity data type. For supporting observations such as Cuff size could use other datatypes such as CodeableConcept.
    "valueString" : "<string>", // C?Vital Signs value are recorded using the Quantity data type. For supporting observations such as Cuff size could use other datatypes such as CodeableConcept.
    "valueBoolean" : <boolean>, // C?Vital Signs value are recorded using the Quantity data type. For supporting observations such as Cuff size could use other datatypes such as CodeableConcept.
    "valueInteger" : <integer>, // C?Vital Signs value are recorded using the Quantity data type. For supporting observations such as Cuff size could use other datatypes such as CodeableConcept.
    "valueRange" : { Range }, // C?Vital Signs value are recorded using the Quantity data type. For supporting observations such as Cuff size could use other datatypes such as CodeableConcept.
    "valueRatio" : { Ratio }, // C?Vital Signs value are recorded using the Quantity data type. For supporting observations such as Cuff size could use other datatypes such as CodeableConcept.
    "valueSampledData" : { SampledData }, // C?Vital Signs value are recorded using the Quantity data type. For supporting observations such as Cuff size could use other datatypes such as CodeableConcept.
    "valueTime" : "<time>", // C?Vital Signs value are recorded using the Quantity data type. For supporting observations such as Cuff size could use other datatypes such as CodeableConcept.
    "valueDateTime" : "<dateTime>", // C?Vital Signs value are recorded using the Quantity data type. For supporting observations such as Cuff size could use other datatypes such as CodeableConcept.
    "valuePeriod" : { Period }, // C?Vital Signs value are recorded using the Quantity data type. For supporting observations such as Cuff size could use other datatypes such as CodeableConcept.
    "valueAttachment" : { Attachment } // C?Vital Signs value are recorded using the Quantity data type. For supporting observations such as Cuff size could use other datatypes such as CodeableConcept.
    "dataAbsentReason" : { CodeableConcept }, // C?Why the result is missing
    "interpretation" : [{ CodeableConcept }], // C?High, low, normal, etc.
    "note" : [{ Annotation }], // C?Comments about the observation
    "bodySite" : { CodeableConcept }, // C?Observed body part
    "method" : { CodeableConcept }, // C?How it was done
    "specimen" : { Reference(Specimen) }, // C?Specimen used for this observation
    "device" : { Reference(Device) }, // C?(Measurement) Device
    "referenceRange" : [{ BackboneElement }], // C?Provides guide for interpretation
    "hasMember" : [{ Reference(QuestionnaireResponse) }], // C?Used when reporting vital signs panel components
    "derivedFrom" : [{ Reference(DocumentReference) }], // C?Related measurements the observation is made from
    "component" : [{ BackboneElement }], // C?Used when reporting systolic and diastolic blood pressure.
  }

This structure is derived from Observation.

Summary

"#### Complete Summary of the Mandatory Requirements

  1. One status in Observation.statuswhich has a required binding to:

  2. A category in Observation.category which must have:

    • a fixed Observation.category.coding.system="http://terminology.hl7.org/CodeSystem/observation-category"
    • a fixed Observation.category.coding.code= "vital-signs"
  3. A code in Observation.code

    • a fixed Observation.code.coding.system= "http://loinc.org""
    • a LOINC code in Observation.code.coding.code which has an extensible binding to:
  4. One patient in Observation.subject

  5. A date and time in effectiveDateTime or effectivePeriod

  6. Either one Observation.value[x] or, if there is no value, one code in Observation.DataAbsentReason

    • if a vital sign measure then:
      • One numeric value in Observation.valueQuantity.value
      • a fixed Observation.valueQuantity.system="http://unitsofmeasure.org"
      • a UCUM unit code in Observation.valueQuantity.code which has an required binding to the Vital Signs Units value set.
    • Observation.DataAbsentReason is bound to Observation Value Absent Reason value set.
  7. When using a panel code to group component observations (Note: See the comments regarding blood pressure in the table above), one or more Observation.component.code each of which must have:

    • a fixed Observation.component.code.coding.system =""http://loinc.org""
  8. Either one Observation.component.valueQuantity or, if there is no value, one code in Observation.component.DataAbsentReason

  9. When using a panel code to group observations, one or more reference to Vitals Signs Observations in Observation.related.target

    • a fixed Observation.related.type= "has-member""

Mandatory: 9 elements (+1 nested mandatory element)
Must-Support: 15 elements
Fixed Value: 2 elements

Slices

This structure defines the following Slices:

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

Differential View

This structure is derived from Observation.

NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation I0..*FHIR Vital Signs Profile
vs-2: If there is no component or hasMember element then either a value[x] or a data absent reason must be present.
... status S1..1codeBinding: ObservationStatus (required)
... category S1..*(Slice Definition)Slice: Unordered, Open by value:coding.code, value:coding.system
.... category:VSCat S1..1CodeableConcept
..... coding S1..*Coding
...... system S1..1uriFixed Value: http://terminology.hl7.org/CodeSystem/observation-category
...... code S1..1codeFixed Value: vital-signs
... code S1..1CodeableConceptCoded Responses from C-CDA Vital Sign Results
Binding: Vital Signs (extensible)
... subject S1..1Reference(Patient)
... effective[x] SI1..1Often just a dateTime for Vital Signs
vs-1: if Observation.effective[x] is dateTime and has a value then that value shall be precise to the day
.... effectiveDateTimedateTime
.... effectivePeriodPeriod
... value[x] SI0..1Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period, AttachmentVital Signs value are recorded using the Quantity data type. For supporting observations such as Cuff size could use other datatypes such as CodeableConcept.
... dataAbsentReason SI0..1CodeableConcept
... hasMember 0..*Reference(QuestionnaireResponse | MolecularSequence | Vital Signs Profile)Used when reporting vital signs panel components
... derivedFrom 0..*Reference(DocumentReference | ImagingStudy | QuestionnaireResponse | MolecularSequence | Vital Signs Profile)
... component SI0..*BackboneElementUsed when reporting systolic and diastolic blood pressure.
vs-3: If there is no a value a data absent reason must be present
.... code S1..1CodeableConceptBinding: Vital Signs (extensible)
.... value[x] SI0..1Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period, AttachmentVital Sign Value recorded with UCUM
Binding: Vital Signs Units (required)
.... dataAbsentReason SI0..1CodeableConcept

doco Documentation for this format

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation I0..*FHIR Vital Signs Profile
vs-2: If there is no component or hasMember element then either a value[x] or a data absent reason must be present.
... id Σ0..1stringLogical id of this artifact
... meta ΣI0..1MetaMetadata about the resource
... implicitRules ?!ΣI0..1uriA set of rules under which this content was created
... language I0..1codeLanguage of the resource content
Binding: Common Languages (preferred)
Max Binding: All Languages
... text I0..1NarrativeText summary of the resource, for human interpretation
... contained I0..*ResourceContained, inline Resources
... extension I0..*ExtensionAdditional content defined by implementations
... modifierExtension ?!I0..*ExtensionExtensions that cannot be ignored
... identifier ΣI0..*IdentifierBusiness Identifier for observation
... basedOn ΣI0..*Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest)Fulfills plan, proposal or order
... partOf ΣI0..*Reference(MedicationAdministration | MedicationDispense | MedicationUsage | Procedure | Immunization | ImagingStudy)Part of referenced event
... status ?!SΣI1..1coderegistered | preliminary | final | amended +
Binding: ObservationStatus (required)
... category SI1..*(Slice Definition)Classification of type of observation
Slice: Unordered, Open by value:coding.code, value:coding.system
Binding: Observation Category Codes (preferred)
.... category:VSCat SI1..1CodeableConceptClassification of type of observation
Binding: Observation Category Codes (preferred)
..... id 0..1stringUnique id for inter-element referencing
..... extension I0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
..... coding SΣI1..*CodingCode defined by a terminology system
...... id 0..1stringUnique id for inter-element referencing
...... extension I0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
...... system SΣI1..1uriIdentity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category
...... version ΣI0..1stringVersion of the system - if relevant
...... code SΣI1..1codeSymbol in syntax defined by the system
Fixed Value: vital-signs
...... display ΣI0..1stringRepresentation defined by the system
...... userSelected ΣI0..1booleanIf this coding was chosen directly by the user
..... text ΣI0..1stringPlain text representation of the concept
... code SΣI1..1CodeableConceptCoded Responses from C-CDA Vital Sign Results
Binding: Vital Signs (extensible)
... subject SΣI1..1Reference(Patient)Who and/or what the observation is about
... focus ΣI0..*Reference(Resource)What the observation is about, when it is not about the subject of record
... encounter ΣI0..1Reference(Encounter)Healthcare event during which this observation is made
... effective[x] SΣI1..1Often just a dateTime for Vital Signs
vs-1: if Observation.effective[x] is dateTime and has a value then that value shall be precise to the day
.... effectiveDateTimedateTime
.... effectivePeriodPeriod
... issued ΣI0..1instantDate/Time this version was made available
... performer ΣI0..*Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson)Who is responsible for the observation
... value[x] SΣI0..1Vital Signs value are recorded using the Quantity data type. For supporting observations such as Cuff size could use other datatypes such as CodeableConcept.
.... valueQuantityQuantity
.... valueCodeableConceptCodeableConcept
.... valueStringstring
.... valueBooleanboolean
.... valueIntegerinteger
.... valueRangeRange
.... valueRatioRatio
.... valueSampledDataSampledData
.... valueTimetime
.... valueDateTimedateTime
.... valuePeriodPeriod
.... valueAttachmentAttachment
... dataAbsentReason SI0..1CodeableConceptWhy the result is missing
Binding: DataAbsentReason (extensible)
... interpretation I0..*CodeableConceptHigh, low, normal, etc.
Binding: Observation Interpretation Codes (extensible)
... note I0..*AnnotationComments about the observation
... bodySite I0..1CodeableConceptObserved body part
Binding: SNOMED CT Body Structures (example)
... method I0..1CodeableConceptHow it was done
Binding: Observation Methods (example)
... specimen I0..1Reference(Specimen)Specimen used for this observation
... device I0..1Reference(Device | DeviceMetric)(Measurement) Device
... referenceRange I0..*BackboneElementProvides guide for interpretation
obs-3: Must have at least a low or a high or text
.... id 0..1stringUnique id for inter-element referencing
.... extension I0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!ΣI0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... low I0..1SimpleQuantityLow Range, if relevant
.... high I0..1SimpleQuantityHigh Range, if relevant
.... type I0..1CodeableConceptReference range qualifier
Binding: Observation Reference Range Meaning Codes (preferred)
.... appliesTo I0..*CodeableConceptReference range population
Binding: Observation Reference Range Applies To Codes (example)
.... age I0..1RangeApplicable age range, if relevant
.... text I0..1stringText based reference range in an observation
... hasMember ΣI0..*Reference(QuestionnaireResponse | MolecularSequence | Vital Signs Profile)Used when reporting vital signs panel components
... derivedFrom ΣI0..*Reference(DocumentReference | ImagingStudy | QuestionnaireResponse | MolecularSequence | Vital Signs Profile)Related measurements the observation is made from
... component SΣI0..*BackboneElementUsed when reporting systolic and diastolic blood pressure.
vs-3: If there is no a value a data absent reason must be present
.... id 0..1stringUnique id for inter-element referencing
.... extension I0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!ΣI0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... code SΣI1..1CodeableConceptType of component observation (code / type)
Binding: Vital Signs (extensible)
.... value[x] SΣI0..1Vital Sign Value recorded with UCUM
Binding: Vital Signs Units (required)
..... valueQuantityQuantity
..... valueCodeableConceptCodeableConcept
..... valueStringstring
..... valueBooleanboolean
..... valueIntegerinteger
..... valueRangeRange
..... valueRatioRatio
..... valueSampledDataSampledData
..... valueTimetime
..... valueDateTimedateTime
..... valuePeriodPeriod
..... valueAttachmentAttachment
.... dataAbsentReason SI0..1CodeableConceptWhy the component result is missing
Binding: DataAbsentReason (extensible)
.... interpretation I0..*CodeableConceptHigh, low, normal, etc.
Binding: Observation Interpretation Codes (extensible)
.... referenceRange I0..*Unknown reference to #Observation.referenceRange
Provides guide for interpretation of component result

doco Documentation for this format

XML Template

<!-- observation-vitalsigns -->doco

<Observation xmlns="http://hl7.org/fhir"
>
  <!-- from Element: extension -->
 <id value="[string]"/><!-- 0..1 Logical id of this artifact -->
 <meta><!-- ?? 0..1 Meta Metadata about the resource --></meta>
 <implicitRules value="[uri]"/><!-- ?? 0..1 A set of rules under which this content was created -->
 <language value="[code]"/><!-- ?? 0..1 Language of the resource content   -->
 <text><!-- ?? 0..1 Narrative 
     Text summary of the resource, for human interpretation --></text>
 <contained><!-- ?? 0..* Resource Contained, inline Resources --></contained>
 <modifierExtension><!-- ?? 0..* Extension  Extensions that cannot be ignored  --></modifierExtension>
 <identifier><!-- ?? 0..* Identifier 
     Business Identifier for observation --></identifier>
 <basedOn><!-- ?? 0..* Reference(CarePlan) Fulfills plan, proposal or order --></basedOn>
 <partOf><!-- ?? 0..* Reference(MedicationAdministration) Part of referenced event --></partOf>
 <status value="[code]"/><!-- ?? 1..1 registered | preliminary | final | amended +   -->
 <-- category sliced by value:coding.code, value:coding.system  in the specified orderOpen-->
 <category> ?? 1..1 CodeableConcept  <!-- ?? 1..1 Classification of  type of observation -->
  <coding> ?? 1..* Coding  <!-- ?? 1..* Code defined by a terminology system -->
   <system value="[uri]"/><!-- ?? 1..1 Identity of the terminology system -->
   <version value="[string]"/><!-- ?? 0..1 Version of the system - if relevant -->
   <code value="[code]"/><!-- ?? 1..1 Symbol in syntax defined by the system -->
   <display value="[string]"/><!-- ?? 0..1 Representation defined by the system -->
   <userSelected value="[boolean]"/><!-- ?? 0..1 If this coding was chosen directly by the user -->
  </coding>
  <text value="[string]"/><!-- ?? 0..1 Plain text representation of the concept -->
 </category>
 <code><!-- ?? 1..1 CodeableConcept Coded Responses from C-CDA Vital Sign Results   --></code>
 <subject><!-- ?? 1..1 Reference(Patient) 
     Who and/or what the observation is about --></subject>
 <focus><!-- ?? 0..* Reference(Resource) 
     What the observation is about, when it is not about the subject of record --></focus>
 <encounter><!-- ?? 0..1 Reference(Encounter) 
     Healthcare event during which this observation is made --></encounter>
 <effective[x]><!-- ?? 1..1 dateTime|Period 
     Often just a dateTime for Vital Signs --></effective[x]>
 <issued value="[instant]"/><!-- ?? 0..1 Date/Time this version was made available -->
 <performer><!-- ?? 0..* Reference(Practitioner) 
     Who is responsible for the observation --></performer>
 <value[x]><!-- ?? 0..1 Quantity|CodeableConcept|string|boolean|integer|
   Range|Ratio|SampledData|time|dateTime|Period|Attachment 
     Vital Signs value are recorded using the Quantity data type. For supporting observations such as Cuff size could use other datatypes such as CodeableConcept. --></value[x]>
 <dataAbsentReason><!-- ?? 0..1 CodeableConcept Why the result is missing   --></dataAbsentReason>
 <interpretation><!-- ?? 0..* CodeableConcept High, low, normal, etc.   --></interpretation>
 <note><!-- ?? 0..* Annotation Comments about the observation --></note>
 <bodySite><!-- ?? 0..1 CodeableConcept Observed body part   --></bodySite>
 <method><!-- ?? 0..1 CodeableConcept How it was done   --></method>
 <specimen><!-- ?? 0..1 Reference(Specimen) Specimen used for this observation --></specimen>
 <device><!-- ?? 0..1 Reference(Device) (Measurement) Device --></device>
 <referenceRange> ?? 0..* BackboneElement  <!-- ?? 0..* Provides guide for interpretation -->
  <modifierExtension><!-- ?? 0..* Extension  Extensions that cannot be ignored even if unrecognized  --></modifierExtension>
  <low><!-- ?? 0..1 Quantity 
      Low Range, if relevant --></low>
  <high><!-- ?? 0..1 Quantity 
      High Range, if relevant --></high>
  <type><!-- ?? 0..1 CodeableConcept Reference range qualifier   --></type>
  <appliesTo><!-- ?? 0..* CodeableConcept Reference range population   --></appliesTo>
  <age><!-- ?? 0..1 Range 
      Applicable age range, if relevant --></age>
  <text value="[string]"/><!-- ?? 0..1 Text based reference range in an observation -->
 </referenceRange>
 <hasMember><!-- ?? 0..* Reference(QuestionnaireResponse) 
     Used when reporting vital signs panel components --></hasMember>
 <derivedFrom><!-- ?? 0..* Reference(DocumentReference) 
     Related measurements the observation is made from --></derivedFrom>
 <component> ?? 0..* BackboneElement  <!-- ?? 0..* Used when reporting systolic and diastolic blood pressure. -->
  <modifierExtension><!-- ?? 0..* Extension  Extensions that cannot be ignored even if unrecognized  --></modifierExtension>
  <code><!-- ?? 1..1 CodeableConcept Type of component observation (code / type)   --></code>
  <value[x]><!-- ?? 0..1 Quantity|CodeableConcept|string|
    boolean|integer|Range|Ratio|SampledData|time|dateTime|Period|Attachment Vital Sign Value recorded with UCUM   --></value[x]>
  <dataAbsentReason><!-- ?? 0..1 CodeableConcept Why the component result is missing   --></dataAbsentReason>
  <interpretation><!-- ?? 0..* CodeableConcept High, low, normal, etc.   --></interpretation>
  <referenceRange><!-- See #Observation.referenceRange  Provides guide for interpretation of component result --></referenceRange>
 </component>
</Observation>

JSON Template

{ // observation-vitalsigns
  // from Element: extension
    "meta" : { Meta }, // C?Metadata about the resource
    "implicitRules" : "<uri>", // C?A set of rules under which this content was created
    "language" : "<code>", // C?Language of the resource content
    "text" : { Narrative }, // C?Text summary of the resource, for human interpretation
    "contained" : [{ Resource }], // C?Contained, inline Resources
    "modifierExtension" : [{ Extension }], // C?Extensions that cannot be ignored
    "identifier" : [{ Identifier }], // C?Business Identifier for observation
    "basedOn" : [{ Reference(CarePlan) }], // C?Fulfills plan, proposal or order
    "partOf" : [{ Reference(MedicationAdministration) }], // C?Part of referenced event
    "status" : "<code>", // C? R! registered | preliminary | final | amended +
    "category" : [ //  sliced by value:coding.code, value:coding.system  in the specified order, Open 
      { // Classification of  type of observation // C? R! 
        // from Element: extension
        "extension" : [ //  sliced by value:url  in the specified order, Open ]
        "coding" : [{ Coding }], // C? R! Code defined by a terminology system
        "text" : "<string>" // C?Plain text representation of the concept
      }
    ],
    "code" : { CodeableConcept }, // C? R! Coded Responses from C-CDA Vital Sign Results
    "subject" : { Reference(Patient) }, // C? R! Who and/or what the observation is about
    "focus" : [{ Reference(Resource) }], // C?What the observation is about, when it is not about the subject of record
    "encounter" : { Reference(Encounter) }, // C?Healthcare event during which this observation is made
// value[x]: Often just a dateTime for Vital Signs. One of these 2:
    "effectiveDateTime" : "<dateTime>", // C? R! Often just a dateTime for Vital Signs
    "effectivePeriod" : { Period }, // C? R! Often just a dateTime for Vital Signs
    "issued" : "<instant>", // C?Date/Time this version was made available
    "performer" : [{ Reference(Practitioner) }], // C?Who is responsible for the observation
// value[x]: Vital Signs value are recorded using the Quantity data type. For supporting observations such as Cuff size could use other datatypes such as CodeableConcept.. One of these 12:
    "valueQuantity" : { Quantity }, // C?Vital Signs value are recorded using the Quantity data type. For supporting observations such as Cuff size could use other datatypes such as CodeableConcept.
    "valueCodeableConcept" : { CodeableConcept }, // C?Vital Signs value are recorded using the Quantity data type. For supporting observations such as Cuff size could use other datatypes such as CodeableConcept.
    "valueString" : "<string>", // C?Vital Signs value are recorded using the Quantity data type. For supporting observations such as Cuff size could use other datatypes such as CodeableConcept.
    "valueBoolean" : <boolean>, // C?Vital Signs value are recorded using the Quantity data type. For supporting observations such as Cuff size could use other datatypes such as CodeableConcept.
    "valueInteger" : <integer>, // C?Vital Signs value are recorded using the Quantity data type. For supporting observations such as Cuff size could use other datatypes such as CodeableConcept.
    "valueRange" : { Range }, // C?Vital Signs value are recorded using the Quantity data type. For supporting observations such as Cuff size could use other datatypes such as CodeableConcept.
    "valueRatio" : { Ratio }, // C?Vital Signs value are recorded using the Quantity data type. For supporting observations such as Cuff size could use other datatypes such as CodeableConcept.
    "valueSampledData" : { SampledData }, // C?Vital Signs value are recorded using the Quantity data type. For supporting observations such as Cuff size could use other datatypes such as CodeableConcept.
    "valueTime" : "<time>", // C?Vital Signs value are recorded using the Quantity data type. For supporting observations such as Cuff size could use other datatypes such as CodeableConcept.
    "valueDateTime" : "<dateTime>", // C?Vital Signs value are recorded using the Quantity data type. For supporting observations such as Cuff size could use other datatypes such as CodeableConcept.
    "valuePeriod" : { Period }, // C?Vital Signs value are recorded using the Quantity data type. For supporting observations such as Cuff size could use other datatypes such as CodeableConcept.
    "valueAttachment" : { Attachment } // C?Vital Signs value are recorded using the Quantity data type. For supporting observations such as Cuff size could use other datatypes such as CodeableConcept.
    "dataAbsentReason" : { CodeableConcept }, // C?Why the result is missing
    "interpretation" : [{ CodeableConcept }], // C?High, low, normal, etc.
    "note" : [{ Annotation }], // C?Comments about the observation
    "bodySite" : { CodeableConcept }, // C?Observed body part
    "method" : { CodeableConcept }, // C?How it was done
    "specimen" : { Reference(Specimen) }, // C?Specimen used for this observation
    "device" : { Reference(Device) }, // C?(Measurement) Device
    "referenceRange" : [{ BackboneElement }], // C?Provides guide for interpretation
    "hasMember" : [{ Reference(QuestionnaireResponse) }], // C?Used when reporting vital signs panel components
    "derivedFrom" : [{ Reference(DocumentReference) }], // C?Related measurements the observation is made from
    "component" : [{ BackboneElement }], // C?Used when reporting systolic and diastolic blood pressure.
  }

 

Alternate definitions: Master Definition (XML, JSON), Schematron

PathNameConformanceValueSet
Observation.languageCommon LanguagespreferredCommon Languages
Observation.statusObservationStatusrequiredObservationStatus
Observation.categoryObservation Category CodespreferredObservation Category Codes
Observation.categoryObservation Category CodespreferredObservation Category Codes
Observation.codeVital SignsextensibleVital Signs
Observation.dataAbsentReasonDataAbsentReasonextensibleDataAbsentReason
Observation.interpretationObservation Interpretation CodesextensibleObservation Interpretation Codes
Observation.bodySiteSNOMED CT Body StructuresexampleSNOMED CT Body Structures
Observation.methodObservation MethodsexampleObservation Methods
Observation.referenceRange.typeObservation Reference Range Meaning CodespreferredObservation Reference Range Meaning Codes
Observation.referenceRange.appliesToObservation Reference Range Applies To CodesexampleObservation Reference Range Applies To Codes
Observation.component.codeVital SignsextensibleVital Signs
Observation.component.value[x]Vital Signs UnitsrequiredVital Signs Units
Observation.component.dataAbsentReasonDataAbsentReasonextensibleDataAbsentReason
Observation.component.interpretationObservation Interpretation CodesextensibleObservation Interpretation Codes
RuleRuleRuleRule
IdPathDetailsRequirements
vs-2ObservationIf there is no component or hasMember element then either a value[x] or a data absent reason must be present.
Expression : (component.empty() and hasMember.empty()) implies (dataAbsentReason.exists() or value.exists())
vs-1Observation.effective[x]if Observation.effective[x] is dateTime and has a value then that value shall be precise to the day
Expression : ($this as dateTime).toString().length() >= 8
obs-3Observation.referenceRangeMust have at least a low or a high or text
Expression : low.exists() or high.exists() or text.exists()
vs-3Observation.componentIf there is no a value a data absent reason must be present
Expression : value.exists() or dataAbsentReason.exists()
.