Blood Pressure Cross-Country Cross-Language Cross-Paradigm (Demo) IG
0.5.1 - ci-build

Blood Pressure Cross-Country Cross-Language Cross-Paradigm (Demo) IG, published by FO. This guide is not an authorized publication; it is the continuous build for version 0.5.1 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/frankoemig/bloodpressure/ and changes regularly. See the Directory of published versions

Mindmap

MindMap as a starting point

The following mindmap collects and sorts all aspects around blood pressure that are necessary for a correct interpretation and clinical use. It has to be recognized that some artifacts (eg. reference range) are abbreviated, and the corresponding details must be duplicated. Unfortunately, PlantUML mindmaps do not allow for cross-links to denote that.

The following diagram aggregates all aspects that can be found somewhere, are provided as contributions, or are extracted from discussions. (At this point a small thank you to all participants.) The mindmap tries to arrange them in a way that helps to understand the semantics, and to sort them. For the moment, additional explanatory text has not been duplicated from other sources for copyright and IP reasons. It can be expected, that this will be done later on.

It is intended to add the documentation in the logical model associated with this mindmap. But please recognize that the LM is no replacement for an information model that will be derived from the mindmap.

Blood Pressure related Concepts to be consideredBlood Pressure related Concepts to be consideredBloodPressureadministrativeidentifierobservedDateTimeDT: instant | dateTime | periodrecordedDateTimeDT: dateTimeinvolved personsauthorperformerrecordercontext itemssubjectagegenderpositioning of bodyDT: codesittingstandingsupinereclininglyinglying on backlying with tilt to leftpositioning of armDT: codedownupcuff sizeDT: code/integermethodDT: codepulpationoscultationautomated cuffcatheterdevicetypemeasuringautomatedvalidated?...exertion(see lower left corner)protocol itemsduration of measurementrangestart: timestampend: timestampDT: codespot1h8h10h12h24hlocation at bodyDT: codeexternarmwristanklefingertoeinternleft heartright heartradialis arterycoronary arterylateralityrightleftmeasurement settingDT: codephysician officeclinic / hospitalemergency departmenthome / dwellingtilt (degree)DT: integerDT: codeaspirationexpirationinspirationassociated situationpre-surgeryintra-surgerypost-surgerypost-dose...eventnormalstressed by someone/thingphysicianbear/tiger/snakecuff typeDT: codeconsciousnessDT: codeawakeunconscioussleepingmeasurement setup(named context)AOBPSMBP..executable protocolorthostatic: supine -> sitting -> standingtilt: position + tiltABISPRINTNHANESstress testactivity level: increasemedicationhypertension management...commentDT: textmeasured valuesystolicDT: positiveIntrange: 0-400reference rangerange: 0-400age: integerdiastolicDT: positiveIntrange: 0-400age: integerreference rangerange: 0-400unitDT: codemmHgreference rangeage: integergender: codeinterpretationDT: codecritical lowlownormalhighcritical highcalculated valuenumber of measured valuesduration (start/end)meanArterialPressureDT: integerrange: 60-100durationDT: code1h8h10h12h24hcalculationDT: codeballancedalgorithmreference rangepulsePressureDT: integerrange: 0-1000reference rangecalculating functionminaveragemaxlong-termstart/endDT: timestampvaluedifference/deltaother relevant conceptsmedicationinfluences the resultsof the measurementbooleanMedicationAdministrationanaesthesiaDT: codebeforeduringafteranaestheticacurrent/former exercise assocationDT: codesleepingsittingwalkingslownormalfastjoggingslownormalfastrunningslownormalfastbikingDT: PQWattstimingpreduringpostbody weightrelevant for a correct interpretationpulsePQReferenceexertion/activitystatusin rest, sitting, sleepinglevel/type/intensityEnergy Consumption (Activity)Energy Consumption (Nutrition)external context informationmissing observationpatient refusedpatient undergoes procedureLegend:relevant context detailsaddt'l information

Further contributions or amendments are welcome.

Coloring Scheme

The mindmap uses colors to indicate the following:

  • red: measured details
  • light blue: data types
  • light green: artefacts that are better provided as separate models
  • dark blue: involved persons
  • yellow: details from context or protocols
  • light gray: specific protocols

Some Notes on the MindMap

  • value on the left
    • w/ red background: assembles all details dealing with the measured value itself
    • w/ green background: other "mini models" that may provide important details but are not directly specified here
  • context items: relevant details to correctly interpret the data
  • measurement setup / amed context: predefined specific settings for documenting the context, eg. sitting + in rest + in hospital, sitting + at home
  • protocol item: 'meta-data' about the measurements that are important to document or to alter for specific protocols
  • executable protocol: individual protocols that describe a set of specific bp measurements (with some known details)
  • sleep status: this has been replaced by consciousness to also allow for "unconscious" as a separate value.
  • activity, consciousness, exertion: these concepts overlap
  • event: Some people increase their blood pressure by just seeing a physician, or for other reasons. Not sure whether this is relevant information, but it should not be left out.
  • the device drives the method (unfortunately this cannot be expressed in the mindmap)

The mindmap logical model allows for more explanations on the details of the mindmap.

Other models

It is hard to draw a line where to stop. Some information is better provided as a separate information model so that we can link to that. Following some examples derived from the mindmap above:

  • Anaesthesia, Medication
  • Exertion/Activity: That could be managed as a separate observation. The same applies to other relevant details.
    • activity (status, level)
  • Body Weight (esp. overweight is important to know)
  • Pulse

Important next Steps: Information Model

The mindmap above has to be completed, enhanced, and conceptualized into information models. In addition, all elements must be described.