US Core Implementation Guide
6.0.0-preview - CI Build United States of America flag

US Core Implementation Guide, published by HL7 International - Cross-Group Projects. This is not an authorized publication; it is the continuous build for version 6.0.0-preview). This version is based on the current content of https://github.com/HL7/US-Core/ and changes regularly. See the Directory of published versions

Resource Profile: US Core Pulse Oximetry Profile

Official URL: http://hl7.org/fhir/us/core/StructureDefinition/us-core-pulse-oximetry Version: 6.0.0-preview
Active as of 2022-04-20 Computable Name: USCorePulseOximetryProfile

Copyright/Legal: Used by permission of HL7 International, all rights reserved Creative Commons License

To promote interoperability and adoption through common implementation, this profile sets minimum expectations for the Observation resource to record, search, and fetch pulse oximetry and inspired oxygen observations with a standard LOINC codes and UCUM units of measure. It is based on the US Core Vital Signs Profile and identifies the additional mandatory core elements, extensions, vocabularies and value sets which SHALL be present in the Observation resource when using this profile. It provides the floor for standards development for specific use cases.

Example Usage Scenarios:

The following are example usage scenarios for this profile:

  • Query for pulse oximety observations for a patient
  • Record or update pulse oximety observations belonging to a patient

Mandatory and Must Support Data Elements

In addition to the mandatory and must support data elements in the US Core Vital Signs Profile, the following data-elements must always be present (Mandatory definition) or must be supported if the data is present in the sending system (Must Support definition). They are presented below in a simple human-readable explanation. Profile specific guidance and examples are provided as well. The Formal Views below provides the formal summary, definitions, and terminology requirements.

Each Observation must have:

  1. a fixed code for oxygen saturation in arterial blood as defined in the FHIR oxygen saturation profile
  2. a additional coding for oxygen saturation in arterial blood by pulse oximetry

Each Observation must support:

  1. a value for oxygen saturation
  2. a code for inspired oxygen concentration*
  3. a value for inspired oxygen concentration

*see guidance below

Profile specific implementation guidance:

  • The observations MAY have additional codes that translate or map to the Observation code or category codes. For example:
    • providing a local system specific code
    • providing 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.

    Note that the code system value SHOULD be supplied for each additional code.

  • The observations MAY have component observations. For example, to qualify the vital sign observation 8310-5 - Body temperature, 8327-9 - *Body temperature measurement site** (oral, forehead, rectal, etc.) may be used as a component observation. Several of these are provided in the FHIR core specification vital signs table.
  • *An Observation without a value, SHALL include a reason why the data is absent unless there are 1) component observations, or 2) reporting panel observations using Observation.hasMember.
    • For further guidance see the Observation Grouping section in FHIR Specification.
    • Systems that never provide an observation without a value are not required to support Observation.dataAbsentReason.
  • *An Observation.component without a value, SHALL include a reason why the data is absent.
    • Systems that never provide a component observation without a component value are not required to support Observation.component.dataAbsentReason.
  • Implementers may use this profile as a base for other vital signs in addition to those in this guide.

  • Inspired oxygen therapy may be represented with component observations when measured at the same time as the pulse oximetry measurements. They are expressed as inhaled oxygen flow rate (e.g., 6 liters/min) and as inhaled oxygen concentration (e.g., 40% oxygen).
    • This profile is technically non-conformant with the base FHIR ver 4.0.1 vitals profile which defines a required binding that excludes the concept for L/min for Observation.component.value(x). This is a known issue in and it means validation errors may occur when validating against this version of the US Core Pulse Oximetry Profile. A change request to correct this has been applied to the base FHIR ver 4.3.0 (“Release 4B”).
  • Many pulse oximetry readings are taken while the patient is breathing room air. The concept of “room air” (unmodified, ambient air) should be represented as an inhaled oxygen flow rate of 0 liters/min.
  • A pulse oximetry reading without component inspired oxygen observations may imply that the measurement was performed while the patient was breathing room air or that the inspired oxygen reading was omitted. To remove this uncertainty, the inspired oxygen component observations should be used.

Usage:

Formal Views of Profile Content

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

This structure is derived from USCoreVitalSignsProfile

NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation 0..*USCoreVitalSignsProfileUS Core Pulse Oximetry Profile
... code S1..1CodeableConceptOxygen Saturation by Pulse Oximetry
.... Slices for coding S0..*CodingCode defined by a terminology system
Slice: Unordered, Open by pattern:$this
..... coding:PulseOx S1..1CodingCode defined by a terminology system
Required Pattern: At least the following
...... system1..1uriIdentity of the terminology system
Fixed Value: http://loinc.org
...... code1..1codeSymbol in syntax defined by the system
Fixed Value: 59408-5
..... coding:O2Sat S1..1CodingCode defined by a terminology system
Required Pattern: At least the following
...... system1..1uriIdentity of the terminology system
Fixed Value: http://loinc.org
...... code1..1codeSymbol in syntax defined by the system
Fixed Value: 2708-6
... valueQuantity S0..1QuantityOxygen Saturation by Pulse Oximetry Value
.... value S1..1decimalNumerical value (with implicit precision)
.... unit S1..1stringUnit representation
.... system S1..1uriSystem that defines coded unit form
Fixed Value: http://unitsofmeasure.org
.... code S1..1codeCoded form of the unit
Fixed Value: %
... Slices for component S0..*BackboneElementUsed when reporting flow rates or oxygen concentration.
Slice: Unordered, Open by pattern:code
.... component:FlowRate S0..1BackboneElementInhaled oxygen flow rate
..... code S1..1CodeableConceptType of component observation (code / type)
Required Pattern: At least the following
...... coding1..*CodingCode defined by a terminology system
Fixed Value: (complex)
....... system1..1uriIdentity of the terminology system
Fixed Value: http://loinc.org
....... code1..1codeSymbol in syntax defined by the system
Fixed Value: 3151-8
..... valueQuantity S0..1Quantity SVital Sign Component Value
...... value S1..1decimalNumerical value (with implicit precision)
...... unit S1..1stringUnit representation
...... system S1..1uriSystem that defines coded unit form
Fixed Value: http://unitsofmeasure.org
...... code S1..1codeCoded form of the unit
Fixed Value: L/min
.... component:Concentration S0..1BackboneElementInhaled oxygen concentration
..... code S1..1CodeableConceptType of component observation (code / type)
Required Pattern: At least the following
...... coding1..*CodingCode defined by a terminology system
Fixed Value: (complex)
....... system1..1uriIdentity of the terminology system
Fixed Value: http://loinc.org
....... code1..1codeSymbol in syntax defined by the system
Fixed Value: 3150-0
..... valueQuantity S0..1Quantity SVital Sign Component Value
...... value S1..1decimalNumerical value (with implicit precision)
...... unit S1..1stringUnit representation
...... system S1..1uriSystem that defines coded unit form
Fixed Value: http://unitsofmeasure.org
...... code S1..1codeCoded form of the unit
Fixed Value: %

doco Documentation for this format
NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation C0..*USCoreVitalSignsProfileUS Core Pulse Oximetry Profile
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... status ?!SΣ1..1coderegistered | preliminary | final | amended +
Binding: ObservationStatus (required)
... Slices for category S1..*CodeableConceptClassification of type of observation
Slice: Unordered, Open by value:coding.code, value:coding.system
Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.


.... category:VSCat S1..1CodeableConceptClassification of type of observation
Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.


..... coding SΣ1..*CodingCode defined by a terminology system
...... system SΣ1..1uriIdentity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category
...... code SΣ1..1codeSymbol in syntax defined by the system
Fixed Value: vital-signs
... code SΣ1..1CodeableConceptOxygen Saturation by Pulse Oximetry
Binding: US Core Vital Signs ValueSet (extensible): The vital sign codes from the base FHIR and US Core Vital Signs.

.... Slices for coding SΣ0..*CodingCode defined by a terminology system
Slice: Unordered, Open by pattern:$this
..... coding:PulseOx SΣ1..1CodingCode defined by a terminology system

Required Pattern: At least the following
...... system1..1uriIdentity of the terminology system
Fixed Value: http://loinc.org
...... code1..1codeSymbol in syntax defined by the system
Fixed Value: 59408-5
..... coding:O2Sat SΣ1..1CodingCode defined by a terminology system

Required Pattern: At least the following
...... system1..1uriIdentity of the terminology system
Fixed Value: http://loinc.org
...... code1..1codeSymbol in syntax defined by the system
Fixed Value: 2708-6
... subject SΣ1..1Reference(US Core Patient Profile)Who and/or what the observation is about
... effective[x] SΣC1..1Often just a dateTime for Vital Signs
.... effectiveDateTimedateTime
... Slices for value[x] SΣC0..1Vital Signs Value
Slice: Unordered, Open by type:$this
Binding: VitalSignsUnits (extensible): Common UCUM units for recording Vital Signs.

.... valueQuantityQuantity
.... value[x]:valueQuantity SΣC0..1QuantityOxygen Saturation by Pulse Oximetry Value
Binding: VitalSignsUnits (extensible): Common UCUM units for recording Vital Signs.

..... value SΣ1..1decimalNumerical value (with implicit precision)
..... comparator ?!Σ0..1code< | <= | >= | > - how to understand the value
Binding: QuantityComparator (required): How the Quantity should be understood and represented.

..... unit SΣ1..1stringUnit representation
..... system SΣC1..1uriSystem that defines coded unit form
Fixed Value: http://unitsofmeasure.org
..... code SΣ1..1codeCoded form of the unit
Fixed Value: %
... dataAbsentReason SC0..1CodeableConceptWhy the result is missing
Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.

... Slices for component SΣC0..*BackboneElementUsed when reporting flow rates or oxygen concentration.
Slice: Unordered, Open by pattern:code
.... component:All Slices Content/Rules for all slices
..... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
..... code SΣ1..1CodeableConceptType of component observation (code / type)
Binding: US Core Vital Signs ValueSet (extensible): The vital sign codes from the base FHIR and US Core Vital Signs.

..... value[x] SΣC0..1Vital Sign Component Value
Binding: VitalSignsUnits (extensible): Common UCUM units for recording Vital Signs.

...... valueQuantityQuantity
..... dataAbsentReason SC0..1CodeableConceptWhy the component result is missing
Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.

.... component:FlowRate SΣC0..1BackboneElementInhaled oxygen flow rate
..... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
..... code SΣ1..1CodeableConceptType of component observation (code / type)
Binding: US Core Vital Signs ValueSet (extensible): The vital sign codes from the base FHIR and US Core Vital Signs.


Required Pattern: At least the following
...... coding1..*CodingCode defined by a terminology system
Fixed Value: (complex)
....... system1..1uriIdentity of the terminology system
Fixed Value: http://loinc.org
....... code1..1codeSymbol in syntax defined by the system
Fixed Value: 3151-8
..... value[x] SΣC0..1QuantityVital Sign Component Value
Binding: VitalSignsUnits (extensible): Common UCUM units for recording Vital Signs.

...... value SΣ1..1decimalNumerical value (with implicit precision)
...... comparator ?!Σ0..1code< | <= | >= | > - how to understand the value
Binding: QuantityComparator (required): How the Quantity should be understood and represented.

...... unit SΣ1..1stringUnit representation
...... system SΣC1..1uriSystem that defines coded unit form
Fixed Value: http://unitsofmeasure.org
...... code SΣ1..1codeCoded form of the unit
Fixed Value: L/min
..... dataAbsentReason SC0..1CodeableConceptWhy the component result is missing
Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.

.... component:Concentration SΣC0..1BackboneElementInhaled oxygen concentration
..... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
..... code SΣ1..1CodeableConceptType of component observation (code / type)
Binding: US Core Vital Signs ValueSet (extensible): The vital sign codes from the base FHIR and US Core Vital Signs.


Required Pattern: At least the following
...... coding1..*CodingCode defined by a terminology system
Fixed Value: (complex)
....... system1..1uriIdentity of the terminology system
Fixed Value: http://loinc.org
....... code1..1codeSymbol in syntax defined by the system
Fixed Value: 3150-0
..... value[x] SΣC0..1QuantityVital Sign Component Value
Binding: VitalSignsUnits (extensible): Common UCUM units for recording Vital Signs.

...... value SΣ1..1decimalNumerical value (with implicit precision)
...... comparator ?!Σ0..1code< | <= | >= | > - how to understand the value
Binding: QuantityComparator (required): How the Quantity should be understood and represented.

...... unit SΣ1..1stringUnit representation
...... system SΣC1..1uriSystem that defines coded unit form
Fixed Value: http://unitsofmeasure.org
...... code SΣ1..1codeCoded form of the unit
Fixed Value: %
..... dataAbsentReason SC0..1CodeableConceptWhy the component result is missing
Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.


doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / Code
Observation.statusrequiredObservationStatus
Observation.categorypreferredObservationCategoryCodes
Observation.category:VSCatpreferredObservationCategoryCodes
Observation.codeextensibleUsCoreVitalSigns
Observation.value[x]extensibleVitalSignsUnits
Observation.value[x]:valueQuantityextensibleVitalSignsUnits
Observation.value[x]:valueQuantity.comparatorrequiredQuantityComparator
Observation.dataAbsentReasonextensibleDataAbsentReason
Observation.component.codeextensibleUsCoreVitalSigns
Observation.component.value[x]extensibleVitalSignsUnits
Observation.component.dataAbsentReasonextensibleDataAbsentReason
Observation.component:FlowRate.codeextensiblePattern: LOINC code 3151-8
Observation.component:FlowRate.value[x]extensibleVitalSignsUnits
Observation.component:FlowRate.value[x].comparatorrequiredQuantityComparator
Observation.component:FlowRate.dataAbsentReasonextensibleDataAbsentReason
Observation.component:Concentration.codeextensiblePattern: LOINC code 3150-0
Observation.component:Concentration.value[x]extensibleVitalSignsUnits
Observation.component:Concentration.value[x].comparatorrequiredQuantityComparator
Observation.component:Concentration.dataAbsentReasonextensibleDataAbsentReason
NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation C0..*USCoreVitalSignsProfileUS Core Pulse Oximetry Profile
... id Σ0..1idLogical id of this artifact
... meta Σ0..1MetaMetadata about the resource
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... language 0..1codeLanguage of the resource content
Binding: CommonLanguages (preferred): A human language.

Additional BindingsPurpose
AllLanguagesMax Binding
... text 0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... extension 0..*ExtensionAdditional content defined by implementations
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... identifier Σ0..*IdentifierBusiness Identifier for observation
... basedOn Σ0..*Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest)Fulfills plan, proposal or order
... partOf Σ0..*Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy)Part of referenced event
... status ?!SΣ1..1coderegistered | preliminary | final | amended +
Binding: ObservationStatus (required)
... Slices for category S1..*CodeableConceptClassification of type of observation
Slice: Unordered, Open by value:coding.code, value:coding.system
Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.


.... category:VSCat S1..1CodeableConceptClassification of type of observation
Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.


..... id 0..1stringUnique id for inter-element referencing
..... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
..... coding SΣ1..*CodingCode defined by a terminology system
...... id 0..1stringUnique id for inter-element referencing
...... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
...... system SΣ1..1uriIdentity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category
...... version Σ0..1stringVersion of the system - if relevant
...... code SΣ1..1codeSymbol in syntax defined by the system
Fixed Value: vital-signs
...... display Σ0..1stringRepresentation defined by the system
...... userSelected Σ0..1booleanIf this coding was chosen directly by the user
..... text Σ0..1stringPlain text representation of the concept
... code SΣ1..1CodeableConceptOxygen Saturation by Pulse Oximetry
Binding: US Core Vital Signs ValueSet (extensible): The vital sign codes from the base FHIR and US Core Vital Signs.

.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
.... Slices for coding SΣ0..*CodingCode defined by a terminology system
Slice: Unordered, Open by pattern:$this
..... coding:PulseOx SΣ1..1CodingCode defined by a terminology system

Required Pattern: At least the following
...... id0..1idUnique id for inter-element referencing
...... extension0..*ExtensionAdditional content defined by implementations
...... system1..1uriIdentity of the terminology system
Fixed Value: http://loinc.org
...... version0..1stringVersion of the system - if relevant
...... code1..1codeSymbol in syntax defined by the system
Fixed Value: 59408-5
...... display0..1stringRepresentation defined by the system
...... userSelected0..1booleanIf this coding was chosen directly by the user
..... coding:O2Sat SΣ1..1CodingCode defined by a terminology system

Required Pattern: At least the following
...... id0..1idUnique id for inter-element referencing
...... extension0..*ExtensionAdditional content defined by implementations
...... system1..1uriIdentity of the terminology system
Fixed Value: http://loinc.org
...... version0..1stringVersion of the system - if relevant
...... code1..1codeSymbol in syntax defined by the system
Fixed Value: 2708-6
...... display0..1stringRepresentation defined by the system
...... userSelected0..1booleanIf this coding was chosen directly by the user
.... text Σ0..1stringPlain text representation of the concept
... subject SΣ1..1Reference(US Core Patient Profile)Who and/or what the observation is about
... focus ΣTU0..*Reference(Resource)What the observation is about, when it is not about the subject of record
... encounter Σ0..1Reference(Encounter)Healthcare event during which this observation is made
... effective[x] SΣC1..1Often just a dateTime for Vital Signs
.... effectiveDateTimedateTime S
.... effectivePeriodPeriod
... issued Σ0..1instantDate/Time this version was made available
... performer Σ0..*Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson)Who is responsible for the observation
... Slices for value[x] SΣC0..1Vital Signs Value
Slice: Unordered, Open by type:$this
Binding: VitalSignsUnits (extensible): Common UCUM units for recording Vital Signs.

.... valueQuantityQuantity S
.... valueCodeableConceptCodeableConcept
.... valueStringstring
.... valueBooleanboolean
.... valueIntegerinteger
.... valueRangeRange
.... valueRatioRatio
.... valueSampledDataSampledData
.... valueTimetime
.... valueDateTimedateTime
.... valuePeriodPeriod
.... value[x]:valueQuantity SΣC0..1QuantityOxygen Saturation by Pulse Oximetry Value
Binding: VitalSignsUnits (extensible): Common UCUM units for recording Vital Signs.

..... id 0..1stringUnique id for inter-element referencing
..... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
..... value SΣ1..1decimalNumerical value (with implicit precision)
..... comparator ?!Σ0..1code< | <= | >= | > - how to understand the value
Binding: QuantityComparator (required): How the Quantity should be understood and represented.

..... unit SΣ1..1stringUnit representation
..... system SΣC1..1uriSystem that defines coded unit form
Fixed Value: http://unitsofmeasure.org
..... code SΣ1..1codeCoded form of the unit
Fixed Value: %
... dataAbsentReason SC0..1CodeableConceptWhy the result is missing
Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.

... interpretation 0..*CodeableConceptHigh, low, normal, etc.
Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.


... note 0..*AnnotationComments about the observation
... bodySite 0..1CodeableConceptObserved body part
Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.

... method 0..1CodeableConceptHow it was done
Binding: ObservationMethods (example): Methods for simple observations.

... specimen 0..1Reference(Specimen)Specimen used for this observation
... device 0..1Reference(Device | DeviceMetric)(Measurement) Device
... referenceRange C0..*BackboneElementProvides guide for interpretation
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... low C0..1SimpleQuantityLow Range, if relevant
.... high C0..1SimpleQuantityHigh Range, if relevant
.... type 0..1CodeableConceptReference range qualifier
Binding: ObservationReferenceRangeMeaningCodes (preferred): Code for the meaning of a reference range.

.... appliesTo 0..*CodeableConceptReference range population
Binding: ObservationReferenceRangeAppliesToCodes (example): Codes identifying the population the reference range applies to.


.... age 0..1RangeApplicable age range, if relevant
.... text 0..1stringText based reference range in an observation
... hasMember Σ0..*Reference(QuestionnaireResponse | MolecularSequence | Vital Signs Profile)Used when reporting vital signs panel components
... derivedFrom Σ0..*Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | MolecularSequence | Vital Signs Profile)Related measurements the observation is made from
... Slices for component SΣC0..*BackboneElementUsed when reporting flow rates or oxygen concentration.
Slice: Unordered, Open by pattern:code
.... component:All Slices Content/Rules for all slices
..... id 0..1stringUnique id for inter-element referencing
..... extension 0..*ExtensionAdditional content defined by implementations
..... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
..... code SΣ1..1CodeableConceptType of component observation (code / type)
Binding: US Core Vital Signs ValueSet (extensible): The vital sign codes from the base FHIR and US Core Vital Signs.

..... value[x] SΣC0..1Vital Sign Component Value
Binding: VitalSignsUnits (extensible): Common UCUM units for recording Vital Signs.

...... valueQuantityQuantity S
...... valueCodeableConceptCodeableConcept
...... valueStringstring
...... valueBooleanboolean
...... valueIntegerinteger
...... valueRangeRange
...... valueRatioRatio
...... valueSampledDataSampledData
...... valueTimetime
...... valueDateTimedateTime
...... valuePeriodPeriod
..... dataAbsentReason SC0..1CodeableConceptWhy the component result is missing
Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.

..... interpretation 0..*CodeableConceptHigh, low, normal, etc.
Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.


..... referenceRange 0..*See referenceRange (Observation)Provides guide for interpretation of component result
.... component:FlowRate SΣC0..1BackboneElementInhaled oxygen flow rate
..... id 0..1stringUnique id for inter-element referencing
..... extension 0..*ExtensionAdditional content defined by implementations
..... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
..... code SΣ1..1CodeableConceptType of component observation (code / type)
Binding: US Core Vital Signs ValueSet (extensible): The vital sign codes from the base FHIR and US Core Vital Signs.


Required Pattern: At least the following
...... id0..1idUnique id for inter-element referencing
...... extension0..*ExtensionAdditional content defined by implementations
...... coding1..*CodingCode defined by a terminology system
Fixed Value: (complex)
....... id0..1idUnique id for inter-element referencing
....... extension0..*ExtensionAdditional content defined by implementations
....... system1..1uriIdentity of the terminology system
Fixed Value: http://loinc.org
....... version0..1stringVersion of the system - if relevant
....... code1..1codeSymbol in syntax defined by the system
Fixed Value: 3151-8
....... display0..1stringRepresentation defined by the system
....... userSelected0..1booleanIf this coding was chosen directly by the user
...... text0..1stringPlain text representation of the concept
..... value[x] SΣC0..1Quantity SVital Sign Component Value
Binding: VitalSignsUnits (extensible): Common UCUM units for recording Vital Signs.

...... id 0..1stringUnique id for inter-element referencing
...... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
...... value SΣ1..1decimalNumerical value (with implicit precision)
...... comparator ?!Σ0..1code< | <= | >= | > - how to understand the value
Binding: QuantityComparator (required): How the Quantity should be understood and represented.

...... unit SΣ1..1stringUnit representation
...... system SΣC1..1uriSystem that defines coded unit form
Fixed Value: http://unitsofmeasure.org
...... code SΣ1..1codeCoded form of the unit
Fixed Value: L/min
..... dataAbsentReason SC0..1CodeableConceptWhy the component result is missing
Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.

..... interpretation 0..*CodeableConceptHigh, low, normal, etc.
Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.


..... referenceRange 0..*See referenceRange (Observation)Provides guide for interpretation of component result
.... component:Concentration SΣC0..1BackboneElementInhaled oxygen concentration
..... id 0..1stringUnique id for inter-element referencing
..... extension 0..*ExtensionAdditional content defined by implementations
..... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
..... code SΣ1..1CodeableConceptType of component observation (code / type)
Binding: US Core Vital Signs ValueSet (extensible): The vital sign codes from the base FHIR and US Core Vital Signs.


Required Pattern: At least the following
...... id0..1idUnique id for inter-element referencing
...... extension0..*ExtensionAdditional content defined by implementations
...... coding1..*CodingCode defined by a terminology system
Fixed Value: (complex)
....... id0..1idUnique id for inter-element referencing
....... extension0..*ExtensionAdditional content defined by implementations
....... system1..1uriIdentity of the terminology system
Fixed Value: http://loinc.org
....... version0..1stringVersion of the system - if relevant
....... code1..1codeSymbol in syntax defined by the system
Fixed Value: 3150-0
....... display0..1stringRepresentation defined by the system
....... userSelected0..1booleanIf this coding was chosen directly by the user
...... text0..1stringPlain text representation of the concept
..... value[x] SΣC0..1Quantity SVital Sign Component Value
Binding: VitalSignsUnits (extensible): Common UCUM units for recording Vital Signs.

...... id 0..1stringUnique id for inter-element referencing
...... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
...... value SΣ1..1decimalNumerical value (with implicit precision)
...... comparator ?!Σ0..1code< | <= | >= | > - how to understand the value
Binding: QuantityComparator (required): How the Quantity should be understood and represented.

...... unit SΣ1..1stringUnit representation
...... system SΣC1..1uriSystem that defines coded unit form
Fixed Value: http://unitsofmeasure.org
...... code SΣ1..1codeCoded form of the unit
Fixed Value: %
..... dataAbsentReason SC0..1CodeableConceptWhy the component result is missing
Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.

..... interpretation 0..*CodeableConceptHigh, low, normal, etc.
Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.


..... referenceRange 0..*See referenceRange (Observation)Provides guide for interpretation of component result

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / Code
Observation.languagepreferredCommonLanguages
Additional Bindings Purpose
AllLanguages Max Binding
Observation.statusrequiredObservationStatus
Observation.categorypreferredObservationCategoryCodes
Observation.category:VSCatpreferredObservationCategoryCodes
Observation.codeextensibleUsCoreVitalSigns
Observation.value[x]extensibleVitalSignsUnits
Observation.value[x]:valueQuantityextensibleVitalSignsUnits
Observation.value[x]:valueQuantity.comparatorrequiredQuantityComparator
Observation.dataAbsentReasonextensibleDataAbsentReason
Observation.interpretationextensibleObservationInterpretationCodes
Observation.bodySiteexampleSNOMEDCTBodyStructures
Observation.methodexampleObservationMethods
Observation.referenceRange.typepreferredObservationReferenceRangeMeaningCodes
Observation.referenceRange.appliesToexampleObservationReferenceRangeAppliesToCodes
Observation.component.codeextensibleUsCoreVitalSigns
Observation.component.value[x]extensibleVitalSignsUnits
Observation.component.dataAbsentReasonextensibleDataAbsentReason
Observation.component.interpretationextensibleObservationInterpretationCodes
Observation.component:FlowRate.codeextensiblePattern: LOINC code 3151-8
Observation.component:FlowRate.value[x]extensibleVitalSignsUnits
Observation.component:FlowRate.value[x].comparatorrequiredQuantityComparator
Observation.component:FlowRate.dataAbsentReasonextensibleDataAbsentReason
Observation.component:FlowRate.interpretationextensibleObservationInterpretationCodes
Observation.component:Concentration.codeextensiblePattern: LOINC code 3150-0
Observation.component:Concentration.value[x]extensibleVitalSignsUnits
Observation.component:Concentration.value[x].comparatorrequiredQuantityComparator
Observation.component:Concentration.dataAbsentReasonextensibleDataAbsentReason
Observation.component:Concentration.interpretationextensibleObservationInterpretationCodes

This structure is derived from USCoreVitalSignsProfile

Summary

Mandatory: 2 elements (12 nested mandatory elements)
Must-Support: 24 elements
Fixed Value: 6 elements

Slices

This structure defines the following Slices:

  • The element Observation.code.coding is sliced based on the value of pattern:$this
  • The element Observation.component is sliced based on the value of pattern:code

Differential View

This structure is derived from USCoreVitalSignsProfile

NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation 0..*USCoreVitalSignsProfileUS Core Pulse Oximetry Profile
... code S1..1CodeableConceptOxygen Saturation by Pulse Oximetry
.... Slices for coding S0..*CodingCode defined by a terminology system
Slice: Unordered, Open by pattern:$this
..... coding:PulseOx S1..1CodingCode defined by a terminology system
Required Pattern: At least the following
...... system1..1uriIdentity of the terminology system
Fixed Value: http://loinc.org
...... code1..1codeSymbol in syntax defined by the system
Fixed Value: 59408-5
..... coding:O2Sat S1..1CodingCode defined by a terminology system
Required Pattern: At least the following
...... system1..1uriIdentity of the terminology system
Fixed Value: http://loinc.org
...... code1..1codeSymbol in syntax defined by the system
Fixed Value: 2708-6
... valueQuantity S0..1QuantityOxygen Saturation by Pulse Oximetry Value
.... value S1..1decimalNumerical value (with implicit precision)
.... unit S1..1stringUnit representation
.... system S1..1uriSystem that defines coded unit form
Fixed Value: http://unitsofmeasure.org
.... code S1..1codeCoded form of the unit
Fixed Value: %
... Slices for component S0..*BackboneElementUsed when reporting flow rates or oxygen concentration.
Slice: Unordered, Open by pattern:code
.... component:FlowRate S0..1BackboneElementInhaled oxygen flow rate
..... code S1..1CodeableConceptType of component observation (code / type)
Required Pattern: At least the following
...... coding1..*CodingCode defined by a terminology system
Fixed Value: (complex)
....... system1..1uriIdentity of the terminology system
Fixed Value: http://loinc.org
....... code1..1codeSymbol in syntax defined by the system
Fixed Value: 3151-8
..... valueQuantity S0..1Quantity SVital Sign Component Value
...... value S1..1decimalNumerical value (with implicit precision)
...... unit S1..1stringUnit representation
...... system S1..1uriSystem that defines coded unit form
Fixed Value: http://unitsofmeasure.org
...... code S1..1codeCoded form of the unit
Fixed Value: L/min
.... component:Concentration S0..1BackboneElementInhaled oxygen concentration
..... code S1..1CodeableConceptType of component observation (code / type)
Required Pattern: At least the following
...... coding1..*CodingCode defined by a terminology system
Fixed Value: (complex)
....... system1..1uriIdentity of the terminology system
Fixed Value: http://loinc.org
....... code1..1codeSymbol in syntax defined by the system
Fixed Value: 3150-0
..... valueQuantity S0..1Quantity SVital Sign Component Value
...... value S1..1decimalNumerical value (with implicit precision)
...... unit S1..1stringUnit representation
...... system S1..1uriSystem that defines coded unit form
Fixed Value: http://unitsofmeasure.org
...... code S1..1codeCoded form of the unit
Fixed Value: %

doco Documentation for this format

Key Elements View

NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation C0..*USCoreVitalSignsProfileUS Core Pulse Oximetry Profile
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... status ?!SΣ1..1coderegistered | preliminary | final | amended +
Binding: ObservationStatus (required)
... Slices for category S1..*CodeableConceptClassification of type of observation
Slice: Unordered, Open by value:coding.code, value:coding.system
Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.


.... category:VSCat S1..1CodeableConceptClassification of type of observation
Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.


..... coding SΣ1..*CodingCode defined by a terminology system
...... system SΣ1..1uriIdentity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category
...... code SΣ1..1codeSymbol in syntax defined by the system
Fixed Value: vital-signs
... code SΣ1..1CodeableConceptOxygen Saturation by Pulse Oximetry
Binding: US Core Vital Signs ValueSet (extensible): The vital sign codes from the base FHIR and US Core Vital Signs.

.... Slices for coding SΣ0..*CodingCode defined by a terminology system
Slice: Unordered, Open by pattern:$this
..... coding:PulseOx SΣ1..1CodingCode defined by a terminology system

Required Pattern: At least the following
...... system1..1uriIdentity of the terminology system
Fixed Value: http://loinc.org
...... code1..1codeSymbol in syntax defined by the system
Fixed Value: 59408-5
..... coding:O2Sat SΣ1..1CodingCode defined by a terminology system

Required Pattern: At least the following
...... system1..1uriIdentity of the terminology system
Fixed Value: http://loinc.org
...... code1..1codeSymbol in syntax defined by the system
Fixed Value: 2708-6
... subject SΣ1..1Reference(US Core Patient Profile)Who and/or what the observation is about
... effective[x] SΣC1..1Often just a dateTime for Vital Signs
.... effectiveDateTimedateTime
... Slices for value[x] SΣC0..1Vital Signs Value
Slice: Unordered, Open by type:$this
Binding: VitalSignsUnits (extensible): Common UCUM units for recording Vital Signs.

.... valueQuantityQuantity
.... value[x]:valueQuantity SΣC0..1QuantityOxygen Saturation by Pulse Oximetry Value
Binding: VitalSignsUnits (extensible): Common UCUM units for recording Vital Signs.

..... value SΣ1..1decimalNumerical value (with implicit precision)
..... comparator ?!Σ0..1code< | <= | >= | > - how to understand the value
Binding: QuantityComparator (required): How the Quantity should be understood and represented.

..... unit SΣ1..1stringUnit representation
..... system SΣC1..1uriSystem that defines coded unit form
Fixed Value: http://unitsofmeasure.org
..... code SΣ1..1codeCoded form of the unit
Fixed Value: %
... dataAbsentReason SC0..1CodeableConceptWhy the result is missing
Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.

... Slices for component SΣC0..*BackboneElementUsed when reporting flow rates or oxygen concentration.
Slice: Unordered, Open by pattern:code
.... component:All Slices Content/Rules for all slices
..... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
..... code SΣ1..1CodeableConceptType of component observation (code / type)
Binding: US Core Vital Signs ValueSet (extensible): The vital sign codes from the base FHIR and US Core Vital Signs.

..... value[x] SΣC0..1Vital Sign Component Value
Binding: VitalSignsUnits (extensible): Common UCUM units for recording Vital Signs.

...... valueQuantityQuantity
..... dataAbsentReason SC0..1CodeableConceptWhy the component result is missing
Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.

.... component:FlowRate SΣC0..1BackboneElementInhaled oxygen flow rate
..... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
..... code SΣ1..1CodeableConceptType of component observation (code / type)
Binding: US Core Vital Signs ValueSet (extensible): The vital sign codes from the base FHIR and US Core Vital Signs.


Required Pattern: At least the following
...... coding1..*CodingCode defined by a terminology system
Fixed Value: (complex)
....... system1..1uriIdentity of the terminology system
Fixed Value: http://loinc.org
....... code1..1codeSymbol in syntax defined by the system
Fixed Value: 3151-8
..... value[x] SΣC0..1QuantityVital Sign Component Value
Binding: VitalSignsUnits (extensible): Common UCUM units for recording Vital Signs.

...... value SΣ1..1decimalNumerical value (with implicit precision)
...... comparator ?!Σ0..1code< | <= | >= | > - how to understand the value
Binding: QuantityComparator (required): How the Quantity should be understood and represented.

...... unit SΣ1..1stringUnit representation
...... system SΣC1..1uriSystem that defines coded unit form
Fixed Value: http://unitsofmeasure.org
...... code SΣ1..1codeCoded form of the unit
Fixed Value: L/min
..... dataAbsentReason SC0..1CodeableConceptWhy the component result is missing
Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.

.... component:Concentration SΣC0..1BackboneElementInhaled oxygen concentration
..... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
..... code SΣ1..1CodeableConceptType of component observation (code / type)
Binding: US Core Vital Signs ValueSet (extensible): The vital sign codes from the base FHIR and US Core Vital Signs.


Required Pattern: At least the following
...... coding1..*CodingCode defined by a terminology system
Fixed Value: (complex)
....... system1..1uriIdentity of the terminology system
Fixed Value: http://loinc.org
....... code1..1codeSymbol in syntax defined by the system
Fixed Value: 3150-0
..... value[x] SΣC0..1QuantityVital Sign Component Value
Binding: VitalSignsUnits (extensible): Common UCUM units for recording Vital Signs.

...... value SΣ1..1decimalNumerical value (with implicit precision)
...... comparator ?!Σ0..1code< | <= | >= | > - how to understand the value
Binding: QuantityComparator (required): How the Quantity should be understood and represented.

...... unit SΣ1..1stringUnit representation
...... system SΣC1..1uriSystem that defines coded unit form
Fixed Value: http://unitsofmeasure.org
...... code SΣ1..1codeCoded form of the unit
Fixed Value: %
..... dataAbsentReason SC0..1CodeableConceptWhy the component result is missing
Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.


doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / Code
Observation.statusrequiredObservationStatus
Observation.categorypreferredObservationCategoryCodes
Observation.category:VSCatpreferredObservationCategoryCodes
Observation.codeextensibleUsCoreVitalSigns
Observation.value[x]extensibleVitalSignsUnits
Observation.value[x]:valueQuantityextensibleVitalSignsUnits
Observation.value[x]:valueQuantity.comparatorrequiredQuantityComparator
Observation.dataAbsentReasonextensibleDataAbsentReason
Observation.component.codeextensibleUsCoreVitalSigns
Observation.component.value[x]extensibleVitalSignsUnits
Observation.component.dataAbsentReasonextensibleDataAbsentReason
Observation.component:FlowRate.codeextensiblePattern: LOINC code 3151-8
Observation.component:FlowRate.value[x]extensibleVitalSignsUnits
Observation.component:FlowRate.value[x].comparatorrequiredQuantityComparator
Observation.component:FlowRate.dataAbsentReasonextensibleDataAbsentReason
Observation.component:Concentration.codeextensiblePattern: LOINC code 3150-0
Observation.component:Concentration.value[x]extensibleVitalSignsUnits
Observation.component:Concentration.value[x].comparatorrequiredQuantityComparator
Observation.component:Concentration.dataAbsentReasonextensibleDataAbsentReason

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation C0..*USCoreVitalSignsProfileUS Core Pulse Oximetry Profile
... id Σ0..1idLogical id of this artifact
... meta Σ0..1MetaMetadata about the resource
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... language 0..1codeLanguage of the resource content
Binding: CommonLanguages (preferred): A human language.

Additional BindingsPurpose
AllLanguagesMax Binding
... text 0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... extension 0..*ExtensionAdditional content defined by implementations
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... identifier Σ0..*IdentifierBusiness Identifier for observation
... basedOn Σ0..*Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest)Fulfills plan, proposal or order
... partOf Σ0..*Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy)Part of referenced event
... status ?!SΣ1..1coderegistered | preliminary | final | amended +
Binding: ObservationStatus (required)
... Slices for category S1..*CodeableConceptClassification of type of observation
Slice: Unordered, Open by value:coding.code, value:coding.system
Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.


.... category:VSCat S1..1CodeableConceptClassification of type of observation
Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.


..... id 0..1stringUnique id for inter-element referencing
..... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
..... coding SΣ1..*CodingCode defined by a terminology system
...... id 0..1stringUnique id for inter-element referencing
...... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
...... system SΣ1..1uriIdentity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category
...... version Σ0..1stringVersion of the system - if relevant
...... code SΣ1..1codeSymbol in syntax defined by the system
Fixed Value: vital-signs
...... display Σ0..1stringRepresentation defined by the system
...... userSelected Σ0..1booleanIf this coding was chosen directly by the user
..... text Σ0..1stringPlain text representation of the concept
... code SΣ1..1CodeableConceptOxygen Saturation by Pulse Oximetry
Binding: US Core Vital Signs ValueSet (extensible): The vital sign codes from the base FHIR and US Core Vital Signs.

.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
.... Slices for coding SΣ0..*CodingCode defined by a terminology system
Slice: Unordered, Open by pattern:$this
..... coding:PulseOx SΣ1..1CodingCode defined by a terminology system

Required Pattern: At least the following
...... id0..1idUnique id for inter-element referencing
...... extension0..*ExtensionAdditional content defined by implementations
...... system1..1uriIdentity of the terminology system
Fixed Value: http://loinc.org
...... version0..1stringVersion of the system - if relevant
...... code1..1codeSymbol in syntax defined by the system
Fixed Value: 59408-5
...... display0..1stringRepresentation defined by the system
...... userSelected0..1booleanIf this coding was chosen directly by the user
..... coding:O2Sat SΣ1..1CodingCode defined by a terminology system

Required Pattern: At least the following
...... id0..1idUnique id for inter-element referencing
...... extension0..*ExtensionAdditional content defined by implementations
...... system1..1uriIdentity of the terminology system
Fixed Value: http://loinc.org
...... version0..1stringVersion of the system - if relevant
...... code1..1codeSymbol in syntax defined by the system
Fixed Value: 2708-6
...... display0..1stringRepresentation defined by the system
...... userSelected0..1booleanIf this coding was chosen directly by the user
.... text Σ0..1stringPlain text representation of the concept
... subject SΣ1..1Reference(US Core Patient Profile)Who and/or what the observation is about
... focus ΣTU0..*Reference(Resource)What the observation is about, when it is not about the subject of record
... encounter Σ0..1Reference(Encounter)Healthcare event during which this observation is made
... effective[x] SΣC1..1Often just a dateTime for Vital Signs
.... effectiveDateTimedateTime S
.... effectivePeriodPeriod
... issued Σ0..1instantDate/Time this version was made available
... performer Σ0..*Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson)Who is responsible for the observation
... Slices for value[x] SΣC0..1Vital Signs Value
Slice: Unordered, Open by type:$this
Binding: VitalSignsUnits (extensible): Common UCUM units for recording Vital Signs.

.... valueQuantityQuantity S
.... valueCodeableConceptCodeableConcept
.... valueStringstring
.... valueBooleanboolean
.... valueIntegerinteger
.... valueRangeRange
.... valueRatioRatio
.... valueSampledDataSampledData
.... valueTimetime
.... valueDateTimedateTime
.... valuePeriodPeriod
.... value[x]:valueQuantity SΣC0..1QuantityOxygen Saturation by Pulse Oximetry Value
Binding: VitalSignsUnits (extensible): Common UCUM units for recording Vital Signs.

..... id 0..1stringUnique id for inter-element referencing
..... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
..... value SΣ1..1decimalNumerical value (with implicit precision)
..... comparator ?!Σ0..1code< | <= | >= | > - how to understand the value
Binding: QuantityComparator (required): How the Quantity should be understood and represented.

..... unit SΣ1..1stringUnit representation
..... system SΣC1..1uriSystem that defines coded unit form
Fixed Value: http://unitsofmeasure.org
..... code SΣ1..1codeCoded form of the unit
Fixed Value: %
... dataAbsentReason SC0..1CodeableConceptWhy the result is missing
Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.

... interpretation 0..*CodeableConceptHigh, low, normal, etc.
Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.


... note 0..*AnnotationComments about the observation
... bodySite 0..1CodeableConceptObserved body part
Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.

... method 0..1CodeableConceptHow it was done
Binding: ObservationMethods (example): Methods for simple observations.

... specimen 0..1Reference(Specimen)Specimen used for this observation
... device 0..1Reference(Device | DeviceMetric)(Measurement) Device
... referenceRange C0..*BackboneElementProvides guide for interpretation
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*