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Orders and Observations Work Group | Maturity Level: N/A | Standards Status: Informative | Compartments: Device, Encounter, Patient, Practitioner, RelatedPerson |
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Blood Pressure Measurement cancelled
@prefix fhir: <http://hl7.org/fhir/> . @prefix loinc: <https://loinc.org/rdf/> . @prefix owl: <http://www.w3.org/2002/07/owl#> . @prefix rdfs: <http://www.w3.org/2000/01/rdf-schema#> . @prefix sct: <http://snomed.info/id/> . @prefix xsd: <http://www.w3.org/2001/XMLSchema#> . # - resource ------------------------------------------------------------------- # # This is an example of a cancelled standard blood pressure measurement. with an Observation/component/dataAbsentReason valued due to cancellation. # # Blood Pressure is a regarded as a single observation, and # presented that way in plain text: 120/80. Also, it is usually # interpreted as a single value, though intepretation can also # be offered to the parts individually # # Technically, though, a blood pressure is a pair of component # observations. LOINC code 85354-9 notes say: # This term is intended as a section header for various # blood pressure measurements (e.g. systolic, diastolic). # LOINC discourages the reporting of two numbers, such as # systolic and diastolic blood pressure (e.g. 120/80), # in one observation. They should be reported as two # separate variables, systolic (LOINC 8480-6) and # diastolic (LOINC 8462-4) # # This example shows the standard way to represent a meaurement that cause the expected values to be empty # single resource, with a narrative in the standard form, and two # component observations for the actual values with Observation/component/dataAbsentReason valued due to cancellation # # # [a fhir:Observation ; fhir:nodeRole fhir:treeRoot ; fhir:id [ fhir:v "blood-pressure-cancel"] ; # fhir:meta [ fhir:profile ( [ fhir:v "http://hl7.org/fhir/StructureDefinition/vitalsigns"^^xsd:anyURI ; fhir:link <http://hl7.org/fhir/StructureDefinition/vitalsigns> ] ) ] ; # fhir:identifier ( [ fhir:system [ fhir:v "urn:ietf:rfc:3986"^^xsd:anyURI ] ; fhir:value [ fhir:v "urn:uuid:187e0c12-8dd2-67e2-99b2-bf273c878281" ] ] ) ; # EH Narrative created by build # <text> # <status value="generated"/> # <div xmlns="http://www.w3.org/1999/xhtml">Sept 17, 2012: Systolic Blood pressure 107/60 mmHg (low)</div> # </text> # fhir:status [ fhir:v "cancelled"] ; # fhir:category ( [ fhir:coding ( [ fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/observation-category"^^xsd:anyURI ] ; fhir:code [ fhir:v "vital-signs" ] ; fhir:display [ fhir:v "Vital Signs" ] ] ) ] [ fhir:coding ( [ a loinc:85354-9 ; fhir:system [ fhir:v "http://loinc.org"^^xsd:anyURI ] ; fhir:code [ fhir:v "85354-9" ] ; fhir:display [ fhir:v "Blood pressure panel with all children optional" ] ] ) ] ) ; # fhir:code [ fhir:coding ( [ a loinc:85354-9 ; fhir:system [ fhir:v "http://loinc.org"^^xsd:anyURI ] ; fhir:code [ fhir:v "85354-9" ] ; fhir:display [ fhir:v "Blood pressure panel with all children optional" ] ] ) ; # replaced by 85354-9\n <coding>\n <system value=\"http:\/\/loinc.org\"\/>\n <code value=\"85354-9\"\/>\n <display value=\"Blood pressure systolic & diastolic\"\/>\n <\/coding>\n fhir:text [ fhir:v "Blood pressure systolic & diastolic" ] ] ; # fhir:subject [ fhir:reference [ fhir:v "Patient/example" ] ] ; # fhir:effective [ fhir:v "2012-09-17"^^xsd:date] ; # fhir:performer ( [ fhir:reference [ fhir:v "Practitioner/example" ] ] ) ; # fhir:interpretation ( [ fhir:coding ( [ fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/v3-ObservationInterpretation"^^xsd:anyURI ] ; fhir:code [ fhir:v "L" ] ; fhir:display [ fhir:v "low" ] ] ) ; fhir:text [ fhir:v "Below low normal" ] ] ) ; # an interpretation offered to the combination observation # generally, it would only be appropriate to offer an interpretation # of an observation that has no value if it has "COMP" (component) # observations fhir:note ( [ fhir:text [ fhir:v "In this example, the blood pressure measurements are not available due to cancellation of the order. Data absent reason is present for each component" ] ] ) ; # fhir:bodySite [ fhir:coding ( [ a sct:368209003 ; fhir:system [ fhir:v "http://snomed.info/sct"^^xsd:anyURI ] ; fhir:code [ fhir:v "368209003" ] ; fhir:display [ fhir:v "Right arm" ] ] ) ] ; # for an observation with components, these cannot disagree with the flags on the components fhir:component ( [ fhir:extension ( [ fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/observation-componentCategory"^^xsd:anyURI ] ; fhir:value [ a fhir:CodeableConcept ; fhir:coding ( [ a loinc:8480-6 ; fhir:system [ fhir:v "http://loinc.org"^^xsd:anyURI ] ; fhir:code [ fhir:v "8480-6" ] ; fhir:display [ fhir:v "Systolic blood pressure" ] ] ) ] ] ) ; fhir:code [ fhir:coding ( [ a loinc:8480-6 ; fhir:system [ fhir:v "http://loinc.org"^^xsd:anyURI ] ; fhir:code [ fhir:v "8480-6" ] ; fhir:display [ fhir:v "Systolic blood pressure" ] ] [ a sct:271649006 ; fhir:system [ fhir:v "http://snomed.info/sct"^^xsd:anyURI ] ; fhir:code [ fhir:v "271649006" ] ; fhir:display [ fhir:v "Systolic blood pressure" ] ] [ fhir:system [ fhir:v "http://acme.org/devices/clinical-codes"^^xsd:anyURI ] ; fhir:code [ fhir:v "bp-s" ] ; fhir:display [ fhir:v "Systolic Blood pressure" ] ] ) # LOINC - always recommended to have a LOINC code ] ; # \n Observations are often coded in multiple code systems.\n - LOINC provides a very specific code (though not usefully more specific in this particular case)\n - snomed provides a clinically relevant code that is usually less granular than LOINC\n - the source system provides its own code, which may be less or more granular than LOINC\n this instance shows the concept. The other codes only have a LOINC code , that shows the concept. The next two names only have a LOINC code fhir:dataAbsentReason [ fhir:coding ( [ fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/data-absent-reason"^^xsd:anyURI ] ; fhir:code [ fhir:v "not-asked" ] ; fhir:display [ fhir:v "Not Asked" ] ] ) ] # no value due to some error\n <valueQuantity>\n <value value=\"107\"\/>\n <unit value=\"mm[Hg]\"\/>\n <\/valueQuantity>\n ] [ fhir:extension ( [ fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/observation-componentCategory"^^xsd:anyURI ] ; fhir:value [ a fhir:CodeableConcept ; fhir:coding ( [ a loinc:8462-4 ; fhir:system [ fhir:v "http://loinc.org"^^xsd:anyURI ] ; fhir:code [ fhir:v "8462-4" ] ; fhir:display [ fhir:v "Diastolic blood pressure" ] ] ) ] ] ) ; fhir:code [ fhir:coding ( [ a loinc:8462-4 ; fhir:system [ fhir:v "http://loinc.org"^^xsd:anyURI ] ; fhir:code [ fhir:v "8462-4" ] ; fhir:display [ fhir:v "Diastolic blood pressure" ] ] ) ] ; fhir:dataAbsentReason [ fhir:coding ( [ fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/data-absent-reason"^^xsd:anyURI ] ; fhir:code [ fhir:v "not-asked" ] ; fhir:display [ fhir:v "Not Asked" ] ] ) ] # no value due to some error\n <valueQuantity>\n <value value=\"60\"\/>\n <unit value=\"mm[Hg]\"\/>\n <\/valueQuantity>\n ] )] . # # -------------------------------------------------------------------------------------
Usage note: every effort has been made to ensure that the examples are correct and useful, but they are not a normative part of the specification.
FHIR ®© HL7.org 2011+. FHIR R6 hl7.fhir.core#6.0.0-ballot2 generated on Thu, Nov 7, 2024 08:44+0000.
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