AU Core Heart Rate - AU Core Implementation Guide v1.1.0-ci-build

AU Core Implementation Guide
1.1.0-ci-build - CI Build Australia flag

AU Core Implementation Guide, published by HL7 Australia. This guide is not an authorized publication; it is the continuous build for version 1.1.0-ci-build built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/AuDigitalHealth/au-fhir-core/ and changes regularly. See the Directory of published versions

Resource Profile: AU Core Heart Rate

Official URL: http://hl7.org.au/fhir/core/StructureDefinition/au-core-heartrate		Version: 1.1.0-ci-build
Standards status: Trial-use	Maturity Level: 2	Computable Name: AUCoreHeartRate
Copyright/Legal: Used by permission of HL7 International, all rights reserved Creative Commons License. HL7 Australia© 2022+; Licensed Under Creative Commons No Rights Reserved.

This profile sets minimum expectations for an Observation resource to record, search, and fetch heart rate observations with standard coding and units of measure. It is based on the FHIR Heart Rate Profile and identifies the additional mandatory core elements, extensions, vocabularies and value sets that SHALL be present in the Observation resource when conforming to this profile. It provides the floor for standards development for specific uses cases in an Australian context.

See Comparison with other national and international IGs for a comparison between AU Core profiles and profiles in other implementation guides.

Usage scenarios

The following are supported usage scenarios for this profile:

Query for observations of heart rate associated with a patient
Record or update an observation of heart rate associated with a patient

Profile specific implementation guidance

Observation.category provides an efficient way of supporting system interactions, e.g. restricting searches. Implementers need to understand that data categorisation is somewhat subjective. The categorisation applied by the source may not align with a receiver’s expectations.
Observations MAY have additional codes that translate or map to the Observation code or category codes. For example:
- providing a local code
- providing a more specific codes such as 8306-3 - Body height - lying in addition to 8302-2 - Body height. Several additional observation codes are provided in the FHIR core specification vital signs table.
Observations MAY have [component] observations to qualify the vital sign observation. For example, 8478-0 - Mean blood pressure, 8887-2 - Heart rate device type, 8326-1 - Type of body temperature device. Several of these are provided in the FHIR core specification vital signs table.
Pulse rate and heart rate are different concepts. In FHIR, both concepts are children of the parent Heart Rate concept and conform to the AU Core Heart Rate profile. When representing a pulse rate observation specifically, an additional SNOMED CT code 78564009 |Pulse rate| SHALL be added to Observation.code. This allows pulse rate observations to be identified and searched for directly. When populating pulse rate, the body site from which the pulse rate was observed is optional to include.

Usage:

Examples for this Resource Profile: Observation/heartrate-1 and Observation/pulserate-1
CapabilityStatements using this Resource Profile: AU Core Requester CapabilityStatement and AU Core Responder CapabilityStatement

Changes since version 1.0.0:

No changes

Formal Views of Profile Content

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

This structure is derived from observation-heartrate

Description & Constraints

Observation

0..*

observation-heartrate

Heart rate

status

O

1..1

code

registered | preliminary | final | amended +

Obligations

Actor

SHALL:populate-if-known

AU Core Responder

SHALL:no-error

AU Core Requester

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
Observation.bodySite	preferred	BodySite `https://healthterminologies.gov.au/fhir/ValueSet/body-site-1` from https://tx.ontoserver.csiro.au/fhir

Constraints

Id	Grade	Path(s)	Details	Requirements
au-core-obs-01	error	Observation.bodySite	If a coded body site is provided, at least one coding shall be from SNOMED CT : coding.exists() implies coding.where(system='http://snomed.info/sct').exists()

Description & Constraints

Observation

C

0..*

observation-heartrate

Heart rate
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
vs-2: If there is no component or hasMember element then either a value[x] or a data absent reason must be present.

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

?!SOΣ

1..1

code

registered | preliminary | final | amended +
Binding: ObservationStatus (required)
ele-1: All FHIR elements must have a @value or children

Obligations

Actor

SHALL:populate-if-known

AU Core Responder

SHALL:no-error

AU Core Requester

Slices for category

SO

1..*

CodeableConcept

Classification of type of observation
Slice: Unordered, Open by value:coding.code, value:coding.system
Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.

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

Obligations

Actor

SHALL:populate-if-known

AU Core Responder

SHALL:no-error

AU Core Requester

category:VSCat

SO

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

Obligations

Actor

SHALL:populate-if-known

AU Core Responder

SHALL:no-error

AU Core Requester

coding

SOΣ

1..*

Coding

Code defined by a terminology system
ele-1: All FHIR elements must have a @value or children

Obligations

Actor

SHALL:populate-if-known

AU Core Responder

SHALL:no-error

AU Core Requester

system

SOΣ

1..1

uri

Identity of the terminology system
ele-1: All FHIR elements must have a @value or children
Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category

Obligations

Actor

SHALL:populate-if-known

AU Core Responder

SHALL:no-error

AU Core Requester

code

SOΣ

1..1

code

Symbol in syntax defined by the system
ele-1: All FHIR elements must have a @value or children
Fixed Value: vital-signs

Obligations

Actor

SHALL:populate-if-known

AU Core Responder

SHALL:no-error

AU Core Requester

code

SOΣ

1..1

CodeableConcept

Heart Rate
Binding: VitalSigns (extensible): This identifies the vital sign result type.

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

Obligations

Actor

SHALL:populate-if-known

AU Core Responder

SHALL:no-error

AU Core Requester

Slices for coding

Σ

2..*

Coding

Code defined by a terminology system
Slice: Unordered, Open by value:code, value:system
ele-1: All FHIR elements must have a @value or children

coding:HeartRateCode

Σ

1..1

Coding

Code defined by a terminology system
ele-1: All FHIR elements must have a @value or children

system

Σ

1..1

uri

Identity of the terminology system
ele-1: All FHIR elements must have a @value or children
Fixed Value: http://loinc.org

code

Σ

1..1

code

Symbol in syntax defined by the system
ele-1: All FHIR elements must have a @value or children
Fixed Value: 8867-4

coding:snomedHeartRateCode

Σ

1..1

Coding

SNOMED CT Heart Rate
ele-1: All FHIR elements must have a @value or children

system

Σ

1..1

uri

Identity of the terminology system
ele-1: All FHIR elements must have a @value or children
Fixed Value: http://snomed.info/sct

code

Σ

1..1

code

Symbol in syntax defined by the system
ele-1: All FHIR elements must have a @value or children
Fixed Value: 364075005

subject

SOΣ

1..1

Reference(AU Core Patient)

Who and/or what the observation is about
ele-1: All FHIR elements must have a @value or children

Obligations

Actor

SHALL:populate-if-known

AU Core Responder

SHALL:no-error

AU Core Requester

effective[x]

SOΣC

1..1

dateTime

Date, and optionally time, the observation was performed
ele-1: All FHIR elements must have a @value or children
vs-1: if Observation.effective[x] is dateTime and has a value then that value shall be precise to the day

Obligations

Actor

SHALL:populate-if-known

AU Core Responder

SHALL:no-error

AU Core Requester

Slices for value[x]

SΣC

0..1

Quantity

Vital Signs value are recorded using the Quantity data type. For supporting observations such as Cuff size could use other datatypes such as CodeableConcept.
Slice: Unordered, Closed by type:$this
ele-1: All FHIR elements must have a @value or children

value[x]:valueQuantity

SOΣC

0..1

Quantity

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

Obligations

Actor

SHALL:populate-if-known

AU Core Responder

SHALL:no-error

AU Core Requester

value

SOΣ

1..1

decimal

Numerical value (with implicit precision)
ele-1: All FHIR elements must have a @value or children

Obligations

Actor

SHALL:populate-if-known

AU Core Responder

SHALL:no-error

AU Core Requester

comparator

?!Σ

0..1

code

< | <= | >= | > - how to understand the value
Binding: QuantityComparator (required): How the Quantity should be understood and represented.

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

unit

SOΣ

1..1

string

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

Obligations

Actor

SHALL:populate-if-known

AU Core Responder

SHALL:no-error

AU Core Requester

system

SOΣC

1..1

uri

System that defines coded unit form
ele-1: All FHIR elements must have a @value or children
Fixed Value: http://unitsofmeasure.org

Obligations

Actor

SHALL:populate-if-known

AU Core Responder

SHALL:no-error

AU Core Requester

code

SOΣ

1..1

code

Coded responses from the common UCUM units for vital signs value set.
ele-1: All FHIR elements must have a @value or children
Fixed Value: /min

Obligations

Actor

SHALL:populate-if-known

AU Core Responder

SHALL:no-error

AU Core Requester

dataAbsentReason

SOC

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

Obligations

Actor

SHALL:populate-if-known

SHALL:no-error

0..1

Observed body part
Binding: Body Site

(preferred)
ele-1: All FHIR elements must have a @value or children
au-core-obs-01: If a coded body site is provided, at least one coding shall be from SNOMED CT

component

SOΣC

0..*

BackboneElement

Used when reporting systolic and diastolic blood pressure.
ele-1: All FHIR elements must have a @value or children
vs-3: If there is no a value a data absent reason must be present

Obligations

Actor

SHALL:populate-if-known

AU Core Responder

SHALL:no-error

AU Core Requester

modifierExtension

?!Σ

0..*

Extension

Extensions that cannot be ignored even if unrecognized
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both

code

SOΣ

1..1

CodeableConcept

Type of component observation (code / type)
Binding: VitalSigns (extensible): This identifies the vital sign result type.

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

Obligations

Actor

SHALL:populate-if-known

AU Core Responder

SHALL:no-error

AU Core Requester

value[x]

SOΣC

0..1

Vital Sign Value recorded with UCUM
Binding: VitalSignsUnits (extensible): Common UCUM units for recording Vital Signs.

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

Obligations

Actor

SHALL:populate-if-known

SHALL:no-error

valueQuantity

valueCodeableConcept

valueString

valueBoolean

valueInteger

valueRange

valueRatio

valueSampledData

valueTime

valueDateTime

valuePeriod

SOC

0..1

CodeableConcept

Why the component 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

Obligations

Actor

SHALL:populate-if-known

AU Core Responder

SHALL:no-error

AU Core Requester

Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
Observation.status	required	ObservationStatus `http://hl7.org/fhir/ValueSet/observation-status\|4.0.1` from the FHIR Standard
Observation.category	preferred	ObservationCategoryCodes `http://hl7.org/fhir/ValueSet/observation-category` from the FHIR Standard
Observation.category:VSCat	preferred	ObservationCategoryCodes `http://hl7.org/fhir/ValueSet/observation-category` from the FHIR Standard
Observation.code	extensible	VitalSigns `http://hl7.org/fhir/ValueSet/observation-vitalsignresult` from the FHIR Standard
Observation.value[x]:valueQuantity.comparator	required	QuantityComparator `http://hl7.org/fhir/ValueSet/quantity-comparator\|4.0.1` from the FHIR Standard
Observation.dataAbsentReason	extensible	DataAbsentReason `http://hl7.org/fhir/ValueSet/data-absent-reason` from the FHIR Standard
Observation.bodySite	preferred	BodySite `https://healthterminologies.gov.au/fhir/ValueSet/body-site-1` from https://tx.ontoserver.csiro.au/fhir
Observation.component.code	extensible	VitalSigns `http://hl7.org/fhir/ValueSet/observation-vitalsignresult` from the FHIR Standard
Observation.component.value[x]	extensible	VitalSignsUnits `http://hl7.org/fhir/ValueSet/ucum-vitals-common\|4.0.1` from the FHIR Standard
Observation.component.dataAbsentReason	extensible	DataAbsentReason `http://hl7.org/fhir/ValueSet/data-absent-reason` from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
au-core-obs-01	error	Observation.bodySite	If a coded body site is provided, at least one coding shall be from SNOMED CT : coding.exists() implies coding.where(system='http://snomed.info/sct').exists()
dom-2	error	Observation	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Observation	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 : contained.where((('#'+id in (%resource.descendants().reference \| %resource.descendants().as(canonical) \| %resource.descendants().as(uri) \| %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Observation	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Observation	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Observation	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	ALL elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	ALL extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
obs-6	error	Observation	dataAbsentReason SHALL only be present if Observation.value[x] is not present : dataAbsentReason.empty() or value.empty()
obs-7	error	Observation	If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present : value.empty() or component.code.where(coding.intersect(%resource.code.coding).exists()).empty()
vs-1	error	Observation.effective[x]	if Observation.effective[x] is dateTime and has a value then that value shall be precise to the day : $this is dateTime implies $this.toString().length() >= 10
vs-2	error	Observation	If there is no component or hasMember element then either a value[x] or a data absent reason must be present. : (component.empty() and hasMember.empty()) implies (dataAbsentReason.exists() or value.exists())
vs-3	error	Observation.component	If there is no a value a data absent reason must be present : value.exists() or dataAbsentReason.exists()

Description & Constraints

Observation

C

0..*

observation-heartrate

Heart rate
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
vs-2: If there is no component or hasMember element then either a value[x] or a data absent reason must be present.

id

Σ

0..1

id

Logical id of this artifact

Terminology Bindings

Path Conformance ValueSet URI

Observation.language

preferred

CommonLanguages

http://hl7.org/fhir/ValueSet/languages

from the FHIR Standard

Additional Bindings

Purpose

AllLanguages

Max Binding

Observation.status

required

ObservationStatus

http://hl7.org/fhir/ValueSet/observation-status|4.0.1

from the FHIR Standard

Observation.category

preferred

ObservationCategoryCodes

http://hl7.org/fhir/ValueSet/observation-category

from the FHIR Standard

Observation.category:VSCat

preferred

ObservationCategoryCodes

http://hl7.org/fhir/ValueSet/observation-category

from the FHIR Standard

Observation.code

extensible

VitalSigns

http://hl7.org/fhir/ValueSet/observation-vitalsignresult

from the FHIR Standard

Observation.value[x]:valueQuantity.comparator

required

QuantityComparator

http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1

from the FHIR Standard

Observation.dataAbsentReason

extensible

DataAbsentReason

http://hl7.org/fhir/ValueSet/data-absent-reason

from the FHIR Standard

Observation.interpretation

extensible

ObservationInterpretationCodes

http://hl7.org/fhir/ValueSet/observation-interpretation

from the FHIR Standard

Observation.bodySite

preferred

BodySite

https://healthterminologies.gov.au/fhir/ValueSet/body-site-1

from https://tx.ontoserver.csiro.au/fhir

Observation.method

example

ObservationMethods

http://hl7.org/fhir/ValueSet/observation-methods

from the FHIR Standard

Observation.referenceRange.type

preferred

ObservationReferenceRangeMeaningCodes

http://hl7.org/fhir/ValueSet/referencerange-meaning

from the FHIR Standard

Observation.referenceRange.appliesTo

example

ObservationReferenceRangeAppliesToCodes

http://hl7.org/fhir/ValueSet/referencerange-appliesto

from the FHIR Standard

Observation.component.code

extensible

VitalSigns

http://hl7.org/fhir/ValueSet/observation-vitalsignresult

from the FHIR Standard

Observation.component.value[x]

extensible

VitalSignsUnits

http://hl7.org/fhir/ValueSet/ucum-vitals-common|4.0.1

from the FHIR Standard

Observation.component.dataAbsentReason

extensible

DataAbsentReason

http://hl7.org/fhir/ValueSet/data-absent-reason

from the FHIR Standard

Observation.component.interpretation

extensible

ObservationInterpretationCodes

http://hl7.org/fhir/ValueSet/observation-interpretation

from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
au-core-obs-01	error	Observation.bodySite	If a coded body site is provided, at least one coding shall be from SNOMED CT : coding.exists() implies coding.where(system='http://snomed.info/sct').exists()
dom-2	error	Observation	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Observation	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 : contained.where((('#'+id in (%resource.descendants().reference \| %resource.descendants().as(canonical) \| %resource.descendants().as(uri) \| %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Observation	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Observation	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Observation	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	ALL elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	ALL extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
obs-3	error	Observation.referenceRange	Must have at least a low or a high or text : low.exists() or high.exists() or text.exists()
obs-6	error	Observation	dataAbsentReason SHALL only be present if Observation.value[x] is not present : dataAbsentReason.empty() or value.empty()
obs-7	error	Observation	If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present : value.empty() or component.code.where(coding.intersect(%resource.code.coding).exists()).empty()
vs-1	error	Observation.effective[x]	if Observation.effective[x] is dateTime and has a value then that value shall be precise to the day : $this is dateTime implies $this.toString().length() >= 10
vs-2	error	Observation	If there is no component or hasMember element then either a value[x] or a data absent reason must be present. : (component.empty() and hasMember.empty()) implies (dataAbsentReason.exists() or value.exists())
vs-3	error	Observation.component	If there is no a value a data absent reason must be present : value.exists() or dataAbsentReason.exists()

Differential View

This structure is derived from observation-heartrate

Description & Constraints

Observation

0..*

observation-heartrate

Heart rate

status

O

1..1

code

registered | preliminary | final | amended +

Obligations

Actor

SHALL:populate-if-known

AU Core Responder

SHALL:no-error

AU Core Requester

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
Observation.bodySite	preferred	BodySite `https://healthterminologies.gov.au/fhir/ValueSet/body-site-1` from https://tx.ontoserver.csiro.au/fhir

Constraints

Id	Grade	Path(s)	Details	Requirements
au-core-obs-01	error	Observation.bodySite	If a coded body site is provided, at least one coding shall be from SNOMED CT : coding.exists() implies coding.where(system='http://snomed.info/sct').exists()

Key Elements View

Description & Constraints

Observation

C

0..*

observation-heartrate

Heart rate
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
vs-2: If there is no component or hasMember element then either a value[x] or a data absent reason must be present.

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

?!SOΣ

1..1

code

registered | preliminary | final | amended +
Binding: ObservationStatus (required)
ele-1: All FHIR elements must have a @value or children

Obligations

Actor

SHALL:populate-if-known

AU Core Responder

SHALL:no-error

AU Core Requester

Slices for category

SO

1..*

CodeableConcept

Classification of type of observation
Slice: Unordered, Open by value:coding.code, value:coding.system
Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.

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

Obligations

Actor

SHALL:populate-if-known

AU Core Responder

SHALL:no-error

AU Core Requester

category:VSCat

SO

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

Obligations

Actor

SHALL:populate-if-known

AU Core Responder

SHALL:no-error

AU Core Requester

coding

SOΣ

1..*

Coding

Code defined by a terminology system
ele-1: All FHIR elements must have a @value or children

Obligations

Actor

SHALL:populate-if-known

AU Core Responder

SHALL:no-error

AU Core Requester

system

SOΣ

1..1

uri

Identity of the terminology system
ele-1: All FHIR elements must have a @value or children
Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category

Obligations

Actor

SHALL:populate-if-known

AU Core Responder

SHALL:no-error

AU Core Requester

code

SOΣ

1..1

code

Symbol in syntax defined by the system
ele-1: All FHIR elements must have a @value or children
Fixed Value: vital-signs

Obligations

Actor

SHALL:populate-if-known

AU Core Responder

SHALL:no-error

AU Core Requester

code

SOΣ

1..1

CodeableConcept

Heart Rate
Binding: VitalSigns (extensible): This identifies the vital sign result type.

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

Obligations

Actor

SHALL:populate-if-known

AU Core Responder

SHALL:no-error

AU Core Requester

Slices for coding

Σ

2..*

Coding

Code defined by a terminology system
Slice: Unordered, Open by value:code, value:system
ele-1: All FHIR elements must have a @value or children

coding:HeartRateCode

Σ

1..1

Coding

Code defined by a terminology system
ele-1: All FHIR elements must have a @value or children

system

Σ

1..1

uri

Identity of the terminology system
ele-1: All FHIR elements must have a @value or children
Fixed Value: http://loinc.org

code

Σ

1..1

code

Symbol in syntax defined by the system
ele-1: All FHIR elements must have a @value or children
Fixed Value: 8867-4

coding:snomedHeartRateCode

Σ

1..1

Coding

SNOMED CT Heart Rate
ele-1: All FHIR elements must have a @value or children

system

Σ

1..1

uri

Identity of the terminology system
ele-1: All FHIR elements must have a @value or children
Fixed Value: http://snomed.info/sct

code

Σ

1..1

code

Symbol in syntax defined by the system
ele-1: All FHIR elements must have a @value or children
Fixed Value: 364075005

subject

SOΣ

1..1

Reference(AU Core Patient)

Who and/or what the observation is about
ele-1: All FHIR elements must have a @value or children

Obligations

Actor

SHALL:populate-if-known

AU Core Responder

SHALL:no-error

AU Core Requester

effective[x]

SOΣC

1..1

dateTime

Date, and optionally time, the observation was performed
ele-1: All FHIR elements must have a @value or children
vs-1: if Observation.effective[x] is dateTime and has a value then that value shall be precise to the day

Obligations

Actor

SHALL:populate-if-known

AU Core Responder

SHALL:no-error

AU Core Requester

Slices for value[x]

SΣC

0..1

Quantity

Vital Signs value are recorded using the Quantity data type. For supporting observations such as Cuff size could use other datatypes such as CodeableConcept.
Slice: Unordered, Closed by type:$this
ele-1: All FHIR elements must have a @value or children

value[x]:valueQuantity

SOΣC

0..1

Quantity

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

Obligations

Actor

SHALL:populate-if-known

AU Core Responder

SHALL:no-error

AU Core Requester

value

SOΣ

1..1

decimal

Numerical value (with implicit precision)
ele-1: All FHIR elements must have a @value or children

Obligations

Actor

SHALL:populate-if-known

AU Core Responder

SHALL:no-error

AU Core Requester

comparator

?!Σ

0..1

code

< | <= | >= | > - how to understand the value
Binding: QuantityComparator (required): How the Quantity should be understood and represented.

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

unit

SOΣ

1..1

string

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

Obligations

Actor

SHALL:populate-if-known

AU Core Responder

SHALL:no-error

AU Core Requester

system

SOΣC

1..1

uri

System that defines coded unit form
ele-1: All FHIR elements must have a @value or children
Fixed Value: http://unitsofmeasure.org

Obligations

Actor

SHALL:populate-if-known

AU Core Responder

SHALL:no-error

AU Core Requester

code

SOΣ

1..1

code

Coded responses from the common UCUM units for vital signs value set.
ele-1: All FHIR elements must have a @value or children
Fixed Value: /min

Obligations

Actor

SHALL:populate-if-known

AU Core Responder

SHALL:no-error

AU Core Requester

dataAbsentReason

SOC

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

Obligations

Actor

SHALL:populate-if-known

SHALL:no-error

0..1

Observed body part
Binding: Body Site

(preferred)
ele-1: All FHIR elements must have a @value or children
au-core-obs-01: If a coded body site is provided, at least one coding shall be from SNOMED CT

component

SOΣC

0..*

BackboneElement

Used when reporting systolic and diastolic blood pressure.
ele-1: All FHIR elements must have a @value or children
vs-3: If there is no a value a data absent reason must be present

Obligations

Actor

SHALL:populate-if-known

AU Core Responder

SHALL:no-error

AU Core Requester

modifierExtension

?!Σ

0..*

Extension

Extensions that cannot be ignored even if unrecognized
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both

code

SOΣ

1..1

CodeableConcept

Type of component observation (code / type)
Binding: VitalSigns (extensible): This identifies the vital sign result type.

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

Obligations

Actor

SHALL:populate-if-known

AU Core Responder

SHALL:no-error

AU Core Requester

value[x]

SOΣC

0..1

Vital Sign Value recorded with UCUM
Binding: VitalSignsUnits (extensible): Common UCUM units for recording Vital Signs.

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

Obligations

Actor

SHALL:populate-if-known

SHALL:no-error

valueQuantity

valueCodeableConcept

valueString

valueBoolean

valueInteger

valueRange

valueRatio

valueSampledData

valueTime

valueDateTime

valuePeriod

SOC

0..1

CodeableConcept

Why the component 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

Obligations

Actor

SHALL:populate-if-known

AU Core Responder

SHALL:no-error

AU Core Requester

Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
Observation.status	required	ObservationStatus `http://hl7.org/fhir/ValueSet/observation-status\|4.0.1` from the FHIR Standard
Observation.category	preferred	ObservationCategoryCodes `http://hl7.org/fhir/ValueSet/observation-category` from the FHIR Standard
Observation.category:VSCat	preferred	ObservationCategoryCodes `http://hl7.org/fhir/ValueSet/observation-category` from the FHIR Standard
Observation.code	extensible	VitalSigns `http://hl7.org/fhir/ValueSet/observation-vitalsignresult` from the FHIR Standard
Observation.value[x]:valueQuantity.comparator	required	QuantityComparator `http://hl7.org/fhir/ValueSet/quantity-comparator\|4.0.1` from the FHIR Standard
Observation.dataAbsentReason	extensible	DataAbsentReason `http://hl7.org/fhir/ValueSet/data-absent-reason` from the FHIR Standard
Observation.bodySite	preferred	BodySite `https://healthterminologies.gov.au/fhir/ValueSet/body-site-1` from https://tx.ontoserver.csiro.au/fhir
Observation.component.code	extensible	VitalSigns `http://hl7.org/fhir/ValueSet/observation-vitalsignresult` from the FHIR Standard
Observation.component.value[x]	extensible	VitalSignsUnits `http://hl7.org/fhir/ValueSet/ucum-vitals-common\|4.0.1` from the FHIR Standard
Observation.component.dataAbsentReason	extensible	DataAbsentReason `http://hl7.org/fhir/ValueSet/data-absent-reason` from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
au-core-obs-01	error	Observation.bodySite	If a coded body site is provided, at least one coding shall be from SNOMED CT : coding.exists() implies coding.where(system='http://snomed.info/sct').exists()
dom-2	error	Observation	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Observation	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 : contained.where((('#'+id in (%resource.descendants().reference \| %resource.descendants().as(canonical) \| %resource.descendants().as(uri) \| %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Observation	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Observation	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Observation	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	ALL elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	ALL extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
obs-6	error	Observation	dataAbsentReason SHALL only be present if Observation.value[x] is not present : dataAbsentReason.empty() or value.empty()
obs-7	error	Observation	If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present : value.empty() or component.code.where(coding.intersect(%resource.code.coding).exists()).empty()
vs-1	error	Observation.effective[x]	if Observation.effective[x] is dateTime and has a value then that value shall be precise to the day : $this is dateTime implies $this.toString().length() >= 10
vs-2	error	Observation	If there is no component or hasMember element then either a value[x] or a data absent reason must be present. : (component.empty() and hasMember.empty()) implies (dataAbsentReason.exists() or value.exists())
vs-3	error	Observation.component	If there is no a value a data absent reason must be present : value.exists() or dataAbsentReason.exists()

Snapshot View

Description & Constraints

Observation

C

0..*

observation-heartrate

Heart rate
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
vs-2: If there is no component or hasMember element then either a value[x] or a data absent reason must be present.

id

Σ

0..1

id

Logical id of this artifact

Terminology Bindings

Path Conformance ValueSet URI

Observation.language

preferred

CommonLanguages

http://hl7.org/fhir/ValueSet/languages

from the FHIR Standard

Additional Bindings

Purpose

AllLanguages

Max Binding

Observation.status

required

ObservationStatus

http://hl7.org/fhir/ValueSet/observation-status|4.0.1

from the FHIR Standard

Observation.category

preferred

ObservationCategoryCodes

http://hl7.org/fhir/ValueSet/observation-category

from the FHIR Standard

Observation.category:VSCat

preferred

ObservationCategoryCodes

http://hl7.org/fhir/ValueSet/observation-category

from the FHIR Standard

Observation.code

extensible

VitalSigns

http://hl7.org/fhir/ValueSet/observation-vitalsignresult

from the FHIR Standard

Observation.value[x]:valueQuantity.comparator

required

QuantityComparator

http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1

from the FHIR Standard

Observation.dataAbsentReason

extensible

DataAbsentReason

http://hl7.org/fhir/ValueSet/data-absent-reason

from the FHIR Standard

Observation.interpretation

extensible

ObservationInterpretationCodes

http://hl7.org/fhir/ValueSet/observation-interpretation

from the FHIR Standard

Observation.bodySite

preferred

BodySite

https://healthterminologies.gov.au/fhir/ValueSet/body-site-1

from https://tx.ontoserver.csiro.au/fhir

Observation.method

example

ObservationMethods

http://hl7.org/fhir/ValueSet/observation-methods

from the FHIR Standard

Observation.referenceRange.type

preferred

ObservationReferenceRangeMeaningCodes

http://hl7.org/fhir/ValueSet/referencerange-meaning

from the FHIR Standard

Observation.referenceRange.appliesTo

example

ObservationReferenceRangeAppliesToCodes

http://hl7.org/fhir/ValueSet/referencerange-appliesto

from the FHIR Standard

Observation.component.code

extensible

VitalSigns

http://hl7.org/fhir/ValueSet/observation-vitalsignresult

from the FHIR Standard

Observation.component.value[x]

extensible

VitalSignsUnits

http://hl7.org/fhir/ValueSet/ucum-vitals-common|4.0.1

from the FHIR Standard

Observation.component.dataAbsentReason

extensible

DataAbsentReason

http://hl7.org/fhir/ValueSet/data-absent-reason

from the FHIR Standard

Observation.component.interpretation

extensible

ObservationInterpretationCodes

http://hl7.org/fhir/ValueSet/observation-interpretation

from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
au-core-obs-01	error	Observation.bodySite	If a coded body site is provided, at least one coding shall be from SNOMED CT : coding.exists() implies coding.where(system='http://snomed.info/sct').exists()
dom-2	error	Observation	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Observation	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 : contained.where((('#'+id in (%resource.descendants().reference \| %resource.descendants().as(canonical) \| %resource.descendants().as(uri) \| %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Observation	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Observation	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Observation	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	ALL elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	ALL extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
obs-3	error	Observation.referenceRange	Must have at least a low or a high or text : low.exists() or high.exists() or text.exists()
obs-6	error	Observation	dataAbsentReason SHALL only be present if Observation.value[x] is not present : dataAbsentReason.empty() or value.empty()
obs-7	error	Observation	If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present : value.empty() or component.code.where(coding.intersect(%resource.code.coding).exists()).empty()
vs-1	error	Observation.effective[x]	if Observation.effective[x] is dateTime and has a value then that value shall be precise to the day : $this is dateTime implies $this.toString().length() >= 10
vs-2	error	Observation	If there is no component or hasMember element then either a value[x] or a data absent reason must be present. : (component.empty() and hasMember.empty()) implies (dataAbsentReason.exists() or value.exists())
vs-3	error	Observation.component	If there is no a value a data absent reason must be present : value.exists() or dataAbsentReason.exists()

This structure is derived from observation-heartrate

Summary

Mandatory: 3 elements
Fixed: 2 elements

Structures

This structure refers to these other structures:

AU Core Patient (http://hl7.org.au/fhir/core/StructureDefinition/au-core-patient)

Maturity: 2

Other representations of profile: CSV, Excel, Schematron

Notes:

Below is an overview of the mandatory and optional search parameters and combined search parameters. See the AU Core CapabilityStatements for a complete list of supported RESTful interactions for this IG.

FHIR search operations are described here and the syntax used to describe AU Core interactions is defined here.

Any search parameter defined in FHIR may be ‘allowed’ by the system unless explicitly marked as “SHALL NOT”. A few items are marked as MAY in this implementation guide to highlight their potential relevance.

Parameter(s)	Conformance	Type(s)	Requirements (when used alone or in combination)
patient+category	SHALL	`reference`+`token`
patient+category+date	SHALL	`reference`+`token`+`date`
patient+code	SHALL	`reference`+`token`
patient+category+status	SHOULD	`reference`+`token`+`token`
patient+code+date	SHOULD	`reference`+`token`+`date`
patient	MAY	`reference`	The requester SHALL provide at least an id value and MAY provide both the Type and id values. The responder SHALL support both. The requester SHOULD support chained search patient.identifier using IHI, Medicare Number, and DVA Number identifiers as defined in the AU Core Patient profile. The responder SHOULD support chained search patient.identifier using IHI, Medicare Number, and DVA Number identifiers as defined in the AU Core Patient profile.
category	MAY	`token`	The requester SHALL provide at least a code value and MAY provide both the system and code values. The responder SHALL support both. The requester SHALL support search using the 'vital-signs' category defined in this profile. The responder SHALL support search using the 'vital-signs' category defined in this profile.
code	MAY	`token`	The requester SHALL provide at least a code value and MAY provide both the system and code values. The responder SHALL support both. The requester SHALL support search using the LOINC codes defined in this profile. The responder SHALL support search using the LOINC codes defined in this profile.
date	MAY	`date`	A requester SHALL provide a value precise to the second + time offset. A responder SHALL support a value precise to the second + time offset. The requester SHALL support these search comparators `gt`, `lt`, `ge`, `le`. The responder SHALL support these search comparators `gt`, `lt`, `ge`, `le`. The requester SHOULD support `multipleAnd`, and if `multipleAnd` is supported, SHALL support the search comparators `gt`, `lt`, `ge`, `le`. The responder SHOULD support `multipleAnd`, and if `multipleAnd` is supported, SHALL support the search comparators `gt`, `lt`, `ge`, `le`.
status	MAY	`token`	The requester SHALL provide at least a code value and MAY provide both the system and code values. The responder SHALL support both. The requester SHALL support `multipleOr`.The responder SHALL support `multipleOr`.

Mandatory Search Parameters:

The following search parameters and search parameter combinations SHALL be supported:

SHALL support searching using the combination of the patient and category search parameters:
- SHOULD support chained searching of patient canonical identifier patient.identifier (e.g. patient.identifier=[system|][code])
GET [base]/Observation?patient={Type/}[id]&category=vital-signs

Example:
1. GET [base]/Observation?patient=5678&category=vital-signs
Implementation Notes: Fetches a bundle of all Observation resources for the specified patient and category (how to search by reference and how to search by token)
SHALL support searching using the combination of the patient and category and date search parameters:
- SHOULD support chained searching of patient canonical identifier patient.identifier (e.g. patient.identifier=[system|][code])
- SHALL support these date comparators: gt,lt,ge,le
- SHOULD support multipleAnd search on date (e.g.date=[date]&date=[date]]&...), and if multipleAnd is supported, SHALL support the search comparators gt,lt,ge,le
GET [base]/Observation?patient={Type/}[id]&category=vital-signs&date={gt|lt|ge|le}[date]{&date={gt|lt|ge|le}[date]&...}

Example:
1. GET [base]/Observation?patient=5678&category=vital-signs&date=ge2020-01-01T00:00:00Z
Implementation Notes: Fetches a bundle of all Observation resources for the specified patient and date and a category code = vital-signs (how to search by reference and how to search by token and how to search by date)
SHALL support searching using the combination of the patient and code search parameters:
- SHOULD support chained searching of patient canonical identifier patient.identifier (e.g. patient.identifier=[system|][code])
- SHOULD support multipleOr search on code (e.g.code={system|}[code],{system|}[code],...)
GET [base]/Observation?patient={Type/}[id]&code={system|}[code]{,{system|}[code],...}

Example:
1. GET [base]/Observation?patient=5678&code=http://snomed.info/sct|364075005,http://loinc.org|8867-4,http://loinc.org|85354-9
Implementation Notes: Fetches a bundle of all Observation resources for the specified patient and observation code(s). The Observation code parameter searches Observation.code only. (how to search by reference and how to search by token)

Optional Search Parameters:

The following search parameters and search parameter combinations SHOULD be supported:

SHOULD support chained searching of patient canonical identifier patient.identifier (e.g. patient.identifier=[system|][code])

GET [base]/Observation?patient.identifier=[system|][code]

Example:
1. GET [base]/Observation?patient.identifier=http://ns.electronichealth.net.au/id/medicare-number|32788511952
2. GET [base]/Observation?patient.identifier=http://ns.electronichealth.net.au/id/hi/ihi/1.0|8003608833357361
Implementation Notes: Fetches a bundle of all Observation resources for the specified patient (how to search by reference and how to search by token)
SHOULD support searching using the combination of the patient and category and status search parameters:
- SHOULD support chained searching of patient canonical identifier patient.identifier (e.g. patient.identifier=[system|][code])
- SHALL support multipleOr search on status (e.g.status={system|}[code],{system|}[code],...)
GET [base]/Observation?patient={Type/}[id]&category=vital-signs&status={system|}[code]{,{system|}[code],...}

Example:
1. GET [base]/Observation?patient=5678&category=vital-signs&status=final
2. GET [base]/Observation?patient=5678&category=vital-signs&status=final,preliminary
Implementation Notes: Fetches a bundle of all Observation resources for the specified patient and category and status (how to search by reference and how to search by token)
SHOULD support searching using the combination of the patient and code and date search parameters:
- SHOULD support chained searching of patient canonical identifier patient.identifier (e.g. patient.identifier=[system|][code]
- SHOULD support multipleOr search on code (e.g.code={system|}[code],{system|}[code],...)
- SHALL support these date comparators: gt,lt,ge,le
- SHOULD support multipleAnd search on date (e.g.date=[date]&date=[date]]&...), and if multipleAnd is supported, SHALL support the search comparators gt,lt,ge,le
GET [base]/Observation?patient={Type/}[id]&code={system|}[code]{,{system|}[code],...}&date={gt|lt|ge|le}[date]{&date={gt|lt|ge|le}[date]&...}

Example:
1. GET [base]/Observation?patient=5678&code=http://snomed.info/sct|364075005,http://loinc.org|8867-4,http://loinc.org|85354-9&date=ge2020-01-01T00:00:00Z
2. GET [base]/Observation?patient.identifier=http://example.org/fhir/mrn|12345&code=http://snomed.info/sct|364075005,http://loinc.org|8867-4,http://loinc.org|85354-9&date=ge2020-01-01T00:00:00Z
Implementation Notes: Fetches a bundle of all Observation resources for the specified patient and date and observation code(s) (how to search by reference and how to search by token and how to search by date)

IG © 2022+ HL7 Australia. Package hl7.fhir.au.core#1.1.0-ci-build based on FHIR 4.0.1. Generated 2025-03-11
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