Da Vinci Payer Data Exchange
2.1.1 - STU 2.1

Da Vinci Payer Data Exchange, published by HL7 International / Financial Management. This guide is not an authorized publication; it is the continuous build for version 2.1.1 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/davinci-epdx/ and changes regularly. See the Directory of published versions

## VitalSigns

Page standards status: Informative

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This IG supports the full complement of US Core profiles. They are supported to enable a payer to produce FHIR resources from data provided in other formats.

For some resources, payers are unlikely to have the clinical information necessary to create a valid US Core resource. The Vital Signs are referenced in US Core 3.1.1 but uses the profile from the base FHIR specification and does not create a US Core specific profile. Payers may be unable to create a valid Vital Signs record from the source clinical data they have available. In US Core 6.1.0 a set of US Core specific Vital Signs profiles are defined:

- US Core Vital Signs Profile
  - US Core Pediatric Head Occipital Frontal Circumference Percentile Profile
  - US Core Pediatric BMI for Age Observation Profile
  - US Core Pediatric Weight for Height
  - US Core Blood Pressure Profile
  - US Core BMI Profile
  - US Core Body Height Profile
  - US Core Body Temperature Profile
  - US Core Body Weight Profile
  - US Core Head Circumference Profile
  - US Core Heart Rate Profile
  - US Core Pulse Oximetry Profile
  - US Core Respiratory Rate Profile

A Vital Signs resource requires a status, a magic value for what is being measured, the patient information and a time when the observation was taken. Payers may not have access to the detail measurement data needed to create a valid Vital Signs resource.

The essential fields (Must Support or Cardinality greater than 0..*) to be provided in the Base R4 Vital Signs or US Core 6.1.0 Vital Signs profiles are:

R4 Element | Name | Cardinality | Type
--- | --- | --- | ---
Observation.status | status | 1..1 | code
Observation.category | category |  | (Slice Definition)
Observation.category:VSCat | category:VSCat | 1..1 | CodeableConcept
Observation.category:VSCat.coding | coding | 1..* | Coding
Observation.category:VSCat.coding.system | system | 1..1 | uri
Observation.category:VSCat.coding.code | code | 1..1 | code
Observation.code | code | 1..1 | CodeableConcept
Observation.subject | subject | 1..1 | Reference(Patient)
Observation.effective[x] | effective[x] | 1..1 |
Observation.value[x] | value[x] | 0..1 |
Observation.dataAbsentReason | dataAbsentReason | 0..1 | CodeableConcept
Observation.component | component | 0..* | BackboneElement
Observation.component.code | code | 1..1 | CodeableConcept
Observation.component.value[x] | value[x] | 0..1 |
Observation.component.dataAbsentReason | dataAbsentReason | 0..1 | CodeableConcept

Table Definition

### Examples of Vital Signs Resources

- Vital Signs Panel: Vital signs, weight, height, head circumference, oxygen saturation and BMI panel
- Respiratory Rate
- Heart rate
- Oxygen Saturation
- Body Temperature
- Body Height
- Head Circumference
- Body Weight
- Body Mass Index
- Blood Pressure (systolic and diastolic)

See links to examples in the FHIR R4 specification here: https://hl7.org/fhir/R4/observation-vitalsigns.html

https://hl7.org/fhir/R4/observation-vitalsigns.html.

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