Interweave Implementation Guide
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Interweave Implementation Guide - Local Development build (v0.1.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the STU3 profiles here.

Resource Profile: InterweaveObservationVitalSignsBloodPressure

Official URL: https://fhir.interweavedigital.nhs.uk/R4/StructureDefinition/Interweave-Observation-VitalSigns-BloodPressure Version: 0.0.1
Draft as of 2024-07-15 Computable Name: InterweaveObservationVitalSignsBloodPressure

Interweave Observation Vital Signs Blood Pressure resource profile - DRAFT.

Status: DRAFT: For Review

Introduction

This profile sets out the expectations for the interweave blood pressure observation resource. The base for this profile is the UK Core Observation Vital Signs Blood Pressure and we have made little adjustment to this base profile. We have enforced the use of SNOMED codes where possible.

Mandatory fields

The following mandatory fields are defined:

  1. status – Fixed value of ‘final’. Only finalised observations should be shared.

  2. category – Fixed value of ‘vital-signs’.

  3. code – Fixed value of a LOINC "magic code" describing the type of observation SHALL be present. (LOINC: 85354-9(Blood pressure panel with all children optional)). There is also a mandated set of SNOMED CT codes defined in UK Core Blood Pressure with preferred binding.

  4. subject – Reference to the patient who is the subject of this measurement.

  5. effective – An important field to provide details of the time/time period during which the observation was taken.

  6. component – The component field contains two (SystolicBP and DiastolicBP) slices, one which represents the systolic measurement (mandatory) and the other the diastolic. Both components must be populated. Each slice within the component field has a number of important child fields that should/must be provided as below:

    • SystolicBP

      • code – Fixed value of a LOINC "magic code" describing the type of observation SHALL be present. (LOINC: 8480-6(Systolic blood pressure)). There is also a mandated set of SNOMED CT codes defined in UK Core Blood Pressure Systolic with preferred binding.

      • code.text – Fixed value of 'Systolic blood pressure'.

      • valueQuantity – The actual result recorded.

      • interpretation – This is also known as the ‘abnormal flag’ and is regularly recorded alongside the actual result. It is used to signal the meaning of the result.

      • referenceRange - To aid the interpretation of a result, it is important to include the reference range.

    • DiastolicBP

      • code – Fixed value of a LOINC "magic code" describing the type of observation SHALL be present. (LOINC: 8462-4(Diastolic blood pressure)). There is also a mandated set of SNOMED CT codes defined in UK Core Blood Pressure Diastolic with preferred binding.

      • code.text - Fixed value of 'Diastolic blood pressure'.

      • valueQuantity – The actual result recorded.

      • interpretation – This is also known as the ‘abnormal flag’ and is regularly recorded alongside the actual result. It is used to signal the meaning of the result.

      • referenceRange - To aid the interpretation of a result, it is important to include the reference range.

      • dataAbsentReason - The reason why the result is missing, this is valuable if a value has not been obtained for some reason e.g. a patient refused. This field must be provided when there is no value present.

Must Support fields

In addition the following fields are "Must Support" - ie they must be populated if relevant and known.

  1. identifier – A Local Id should be provided, such that could be quoted if manually getting in touch to find out more.

  2. encounter – his will typically be the encounter the event occurred within, but some events may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter (e.g. pre-admission laboratory tests). For some observations it may be important to know the link between an observation and a particular encounter.

  3. performer – We limit this field to reference practitioner / practitionerRole/ CareTeam resources only. The organization responsible for the observation can be obtained via the provenance tag.

  4. note – Comments in addition to the result are often recorded for observations, it is therefore important to provide this field when available to give the consumer the full result information.

  5. bodySite – A long list of SNOMED codes which represent the observed parts of the body.

Optional fields

Other fields are optional and may be populated if known - on the understanding that not all data consumers will necessarily make use of them. Points of note include:

  • method – Option to provide the mechanism used to perform the observation

  • device – Opportunity to provide a link to a device resource from which was used to obtain the observation.

Discouraged or Removed fields

  • basedOn – This field is discouraged as it does not appear to provide information which would be beneficial in a shared care record. It also allows references to a raft of request/order resources which introduces a lot of complexity for a data consumer.

  • partOf – This field is discouraged as it does not appear to provide information which would be beneficial in a shared care record. It also allows references to a raft of request/order resources which introduces a lot of complexity for a data consumer.

  • issued – This field has been removed as this information can be taken from the mandatory meta.lastUpdated field, and to also avoid any confusion with the other date fields.

  • hasMember - Removed.

  • dataAbsentReason - Removed. This element would be covered as part of individual component for Systolic / Diastolic Blood pressure.

  • derivedFrom – This field is discouraged as it does not appear to provide information which would be beneficial in a shared care record. It also allows references to a raft of request/order resources which introduces a lot of complexity for a data consumer.

  • referenceRange - Removed. This element would be covered as part of individual component for Systolic / Diastolic Blood pressure.

  • specimen – Removed.

  • interpretation - Removed. This element would be covered as part of individual component for Systolic / Diastolic Blood pressure.

  • focus - Removed.

Usage:

  • This Resource Profile is not used by any profiles in this Implementation Guide

Formal Views of Profile Content

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

This structure is derived from UKCoreObservationVitalSignsBloodPressure

NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation 0..* UKCoreObservationVitalSignsBloodPressure Measurements and simple assertions
... id S 0..1 id Logical id of this artifact
... meta
.... id 0..0
.... versionId S 0..1 id Version specific identifier
.... lastUpdated S 0..1 instant MANDATORY except in Contained Resources. When the resource version last changed.
.... profile S 0..* canonical(StructureDefinition) Profiles this resource claims to conform to. Should list (i) this profile (ii) base profile for this resource.
.... security 0..* Coding DISCOURAGED - may not be honoured by Data Consumers
.... Slices for tag 0..* Coding Tags applied to this resource
Slice: Unordered, Open by value:system
..... tag:Source S 0..1 Coding MANDATORY except in Contained Resources. The Data Provider Id (and display text) of the system supplying the data
...... id 0..0
...... system 1..1 uri Identity of the terminology system
Fixed Value: https://fhir.interweavedigital.nhs.uk/Source
...... version 0..0
...... code S 1..1 code The Data Provider Id of the system supplying the data
...... display S 1..1 string Name of the system supplying the data
..... tag:Provenance S 0..1 Coding MANDATORY except in Contained Resources. The ODS Code (and display text) of the organisation responsible for the data
...... id 0..0
...... system 1..1 uri Identity of the terminology system
Fixed Value: https://fhir.interweavedigital.nhs.uk/Provenance
...... version 0..0
...... code S 1..1 code The ODS Code of the organisation responsible for the data
...... display S 1..1 string Name of the organisation supplying the data
... implicitRules 0..1 uri DISCOURAGED - may not be honoured by Data Consumers
... language 0..1 code English is assumed (not currently a multi-lingual implementation)
... text 0..1 Narrative DISCOURAGED - the preferred approach is to offer structured data fields which a Data Consumer can then render and present in a manner most suited to its users
... Slices for extension Content/Rules for all slices
.... extension:triggeredByR5 0..0
... identifier S 0..* Identifier Business Identifier for observation
... basedOn 0..* Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest) DISCOURAGED - This field does not appear to provide information which would be beneficial in a shared care record. It also allows references to a raft of request/order resources which introduces a lot of complexity for a data consumer.
... partOf 0..* Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy) DISCOURAGED - This field does not appear to provide information which would be beneficial in a shared care record. It also allows references to a raft of request/order resources which introduces a lot of complexity for a data consumer.
... category 1..1 CodeableConcept A category of `vital-signs` SHALL be present.
Binding: ObservationCategoryCodes (required): Codes for high level observation categories.

.... id 0..0
.... coding
..... id 0..0
..... system 1..1 uri Identity of the terminology system
..... code 1..1 code Symbol in syntax defined by the system
..... display 1..1 string Representation defined by the system
Fixed Value: Vital Signs
... code
.... id 0..0
.... coding 2..* Coding Code defined by a terminology system
..... id 0..0
.... Slices for coding Content/Rules for all slices
..... coding:loinc 1..1 Coding A LOINC "magic code" describing the type of observation SHALL be present.
...... id 0..0
...... version 0..0
...... code 1..1 code Symbol in syntax defined by the system
...... display 1..1 string Representation defined by the system
Fixed Value: Blood pressure panel with all children optional
.... Slices for coding Content/Rules for all slices
..... coding:snomedCT 1..* Coding A SNOMED CT concept describing the type of observation SHALL be present.
...... id 0..0
...... version 0..0
...... code 1..1 code Symbol in syntax defined by the system
...... display 1..1 string Representation defined by the system
... subject 1..1 Reference(InterweavePatient) Who or what the observation relates to SHALL be present.
.... id 0..0
.... reference 1..1 string Reference to a resource (could be Contained)
.... identifier 0..1 Identifier If relevant could include an id
.... display 1..1 string Description of the referenced resource
... focus 0..0
... encounter S 0..1 Reference(InterweaveEncounter) Healthcare event during which this observation is made
... effective[x] 1..1 This is the time/time period during which the observation was taken.
.... effectiveDateTime dateTime
.... effectiveInstant instant
... issued 0..0
... performer 0..* Reference(Practitioner | PractitionerRole | CareTeam) Who is responsible for the observation.
.... reference 1..1 string Reference to a resource (could be Contained)
.... identifier 0..1 Identifier If relevant could include an id
.... display 1..1 string Description of the referenced resource
... dataAbsentReason 0..0
... interpretation 0..0
... note S 0..1 Annotation Comments about the observation
... bodySite S 0..1 CodeableConcept Observed body part
Binding: SNOMEDCTBodyStructures (required)
.... id 0..0
.... coding
..... id 0..0
..... system 1..1 uri Identity of the terminology system
..... code 1..1 code Symbol in syntax defined by the system
..... display 1..1 string Representation defined by the system
... method
.... id 0..0
.... coding
..... id 0..0
..... system 1..1 uri Identity of the terminology system
..... code 1..1 code Symbol in syntax defined by the system
..... display 1..1 string Representation defined by the system
... referenceRange 0..0
... hasMember 0..0
... derivedFrom 0..* Reference(InterweaveObservation | InterweaveQuestionnaireResponse) Related measurements the observation is made from
... component 1..2 BackboneElement Component / sub results.
.... code
..... coding
...... system 1..1 uri Identity of the terminology system
...... code 1..1 code Symbol in syntax defined by the system
...... display 1..1 string Representation defined by the system
... Slices for component Content/Rules for all slices
.... component:SystolicBP 1..1 BackboneElement Component / sub results.
..... id 0..0
..... code S 1..1 CodeableConcept Type of component observation (code / type)
...... id 0..0
...... Slices for coding Content/Rules for all slices
....... coding:loinc 1..1 Coding Code defined by a terminology system
........ id 0..0
........ system 1..1 uri Identity of the terminology system
Fixed Value: http://loinc.org
........ version 0..0
........ code 1..1 code Symbol in syntax defined by the system
........ display 1..1 string Representation defined by the system
...... Slices for coding Content/Rules for all slices
....... coding:snomedCT 1..* Coding Code defined by a terminology system
........ id 0..0
........ system 1..1 uri Identity of the terminology system
Fixed Value: http://snomed.info/sct
........ version 0..0
........ code 1..1 code Symbol in syntax defined by the system
........ display 1..1 string Representation defined by the system
..... value[x] S 1..1 Quantity Actual component result
...... unit 1..1 string Unit representation
...... system 1..1 uri System that defines coded unit form
...... code 1..1 code Coded form of the unit
..... dataAbsentReason 0..0
..... interpretation S 0..* CodeableConcept High, low, normal, etc.
Binding: ObservationInterpretationCodes (required)
...... coding
....... system 1..1 uri Identity of the terminology system
....... code 1..1 code Symbol in syntax defined by the system
....... display 1..1 string Representation defined by the system
... Slices for component Content/Rules for all slices
.... component:DiastolicBP 0..1 BackboneElement Component / sub results.
..... id 0..0
..... code S 1..1 CodeableConcept Type of component observation (code / type)
...... id 0..0
...... Slices for coding Content/Rules for all slices
....... coding:loinc 1..1 Coding Code defined by a terminology system
........ id 0..0
........ system 1..1 uri Identity of the terminology system
Fixed Value: http://loinc.org
........ version 0..0
........ code 1..1 code Symbol in syntax defined by the system
........ display 1..1 string Representation defined by the system
...... Slices for coding Content/Rules for all slices
....... coding:snomedCT 1..* Coding Code defined by a terminology system
........ id 0..0
........ system 1..1 uri Identity of the terminology system
Fixed Value: http://snomed.info/sct
........ version 0..0
........ code 1..1 code Symbol in syntax defined by the system
........ display 1..1 string Representation defined by the system
..... value[x] S 1..1 Quantity Actual component result
...... unit 1..1 string Unit representation
...... system 1..1 uri System that defines coded unit form
...... code 1..1 code Coded form of the unit
..... dataAbsentReason S 0..1 CodeableConcept Why the component result is missing
Binding: DataAbsentReason (required)
...... coding
....... system 1..1 uri Identity of the terminology system
....... code 1..1 code Symbol in syntax defined by the system
....... display 1..1 string Representation defined by the system
..... interpretation S 0..* CodeableConcept High, low, normal, etc.
Binding: ObservationInterpretationCodes (required)
...... coding
....... system 1..1 uri Identity of the terminology system
....... code 1..1 code Symbol in syntax defined by the system
....... display 1..1 string Representation defined by the system

doco Documentation for this format

Terminology Bindings (Differential)

PathConformanceValueSetURI
Observation.categoryrequiredObservationCategoryCodes
http://hl7.org/fhir/ValueSet/observation-category
from the FHIR Standard
Observation.bodySiterequiredSNOMEDCTBodyStructures
http://hl7.org/fhir/ValueSet/body-site
from the FHIR Standard
Observation.component:SystolicBP.interpretationrequiredObservationInterpretationCodes
http://hl7.org/fhir/ValueSet/observation-interpretation
from the FHIR Standard
Observation.component:DiastolicBP.dataAbsentReasonrequiredDataAbsentReason
http://hl7.org/fhir/ValueSet/data-absent-reason
from the FHIR Standard
Observation.component:DiastolicBP.interpretationrequiredObservationInterpretationCodes
http://hl7.org/fhir/ValueSet/observation-interpretation
from the FHIR Standard
NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation C 0..* UKCoreObservationVitalSignsBloodPressure Measurements and simple assertions
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
ukcore-obs-vs-001: `code.coding` SHALL include a LOINC "magic code"
... id SΣ 0..1 id Logical id of this artifact
... meta Σ 0..1 Meta Metadata about the resource
.... versionId SΣ 0..1 id Version specific identifier
.... lastUpdated SΣ 0..1 instant MANDATORY except in Contained Resources. When the resource version last changed.
.... profile SΣ 0..* canonical(StructureDefinition) Profiles this resource claims to conform to. Should list (i) this profile (ii) base profile for this resource.
.... security Σ 0..* Coding DISCOURAGED - may not be honoured by Data Consumers
Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.


.... Slices for tag Σ 0..* Coding Tags applied to this resource
Slice: Unordered, Open by value:system
Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".


..... tag:Source SΣ 0..1 Coding MANDATORY except in Contained Resources. The Data Provider Id (and display text) of the system supplying the data
Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".


...... system Σ 1..1 uri Identity of the terminology system
Fixed Value: https://fhir.interweavedigital.nhs.uk/Source
...... code SΣ 1..1 code The Data Provider Id of the system supplying the data
...... display SΣ 1..1 string Name of the system supplying the data
..... tag:Provenance SΣ 0..1 Coding MANDATORY except in Contained Resources. The ODS Code (and display text) of the organisation responsible for the data
Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".


...... system Σ 1..1 uri Identity of the terminology system
Fixed Value: https://fhir.interweavedigital.nhs.uk/Provenance
...... code SΣ 1..1 code The ODS Code of the organisation responsible for the data
...... display SΣ 1..1 string Name of the organisation supplying the data
... implicitRules ?!Σ 0..1 uri DISCOURAGED - may not be honoured by Data Consumers
... text 0..1 Narrative DISCOURAGED - the preferred approach is to offer structured data fields which a Data Consumer can then render and present in a manner most suited to its users
... Slices for extension Content/Rules for all slices
.... bodyStructureR5 0..1 Reference(BodyStructure) Observed body structure. This is a R5 backport.
URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.bodyStructure
.... bodyPosition 0..1 (Complex) The patients body position when the vital signs observation was recorded.
URL: http://hl7.org/fhir/StructureDefinition/observation-bodyPosition
..... extension 0..0
..... url 1..1 uri "http://hl7.org/fhir/StructureDefinition/observation-bodyPosition"
..... value[x] 1..1 CodeableConcept Value of extension
Binding: UK Core Body Position (preferred)
.... recordingSetting 0..* CodeableConcept Records whether the vital signs observation was performed in a clinical or non clinical setting.
URL: https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-RecordingSetting
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... identifier SΣ 0..* Identifier Business Identifier for observation
... basedOn Σ 0..* Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest) DISCOURAGED - This field does not appear to provide information which would be beneficial in a shared care record. It also allows references to a raft of request/order resources which introduces a lot of complexity for a data consumer.
... partOf Σ 0..* Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy) DISCOURAGED - This field does not appear to provide information which would be beneficial in a shared care record. It also allows references to a raft of request/order resources which introduces a lot of complexity for a data consumer.
... status ?!SΣ 1..1 code A status of `final` SHALL be present.
Binding: ObservationStatus (required): Codes providing the status of an observation.


Fixed Value: final
... category S 1..1 CodeableConcept A category of `vital-signs` SHALL be present.
Binding: ObservationCategoryCodes (required): Codes for high level observation categories.


... code SΣ 1..1 CodeableConcept The type of vital signs observation (code / type).
Binding: UK Core Observation Type (preferred): A code from the SNOMED Clinical Terminology UK coding system describing a type of observation

.... Slices for coding Σ 2..* Coding Code defined by a terminology system
Slice: Unordered, Open by value:system
..... coding:All Slices Content/Rules for all slices
..... coding:loinc Σ 1..1 Coding A LOINC "magic code" describing the type of observation SHALL be present.
Binding: VitalSigns (extensible)
...... system Σ 1..1 uri Identity of the terminology system
Fixed Value: http://loinc.org
...... code Σ 1..1 code Symbol in syntax defined by the system
Fixed Value: 85354-9
...... display Σ 1..1 string Representation defined by the system
Fixed Value: Blood pressure panel with all children optional
..... coding:snomedCT Σ 1..* Coding A SNOMED CT concept describing the type of observation SHALL be present.
Binding: UK Core Blood Pressure (preferred)
...... system Σ 1..1 uri Identity of the terminology system
Fixed Value: http://snomed.info/sct
...... code Σ 1..1 code Symbol in syntax defined by the system
...... display Σ 1..1 string Representation defined by the system
... subject SΣ 1..1 Reference(InterweavePatient) Who or what the observation relates to SHALL be present.
.... reference ΣC 1..1 string Reference to a resource (could be Contained)
.... identifier Σ 0..1 Identifier If relevant could include an id
.... display Σ 1..1 string Description of the referenced resource
... encounter SΣ 0..1 Reference(InterweaveEncounter) Healthcare event during which this observation is made
... effective[x] SΣ 1..1 This is the time/time period during which the observation was taken.
.... effectiveDateTime dateTime
.... effectiveInstant instant
... performer SΣ 0..* Reference(Practitioner | PractitionerRole | CareTeam) Who is responsible for the observation.
.... reference ΣC 1..1 string Reference to a resource (could be Contained)
.... identifier Σ 0..1 Identifier If relevant could include an id
.... display Σ 1..1 string Description of the referenced resource
... note S 0..1 Annotation Comments about the observation
... bodySite S 0..1 CodeableConcept Observed body part
Binding: SNOMEDCTBodyStructures (required)
... derivedFrom Σ 0..* Reference(InterweaveObservation | InterweaveQuestionnaireResponse) Related measurements the observation is made from
... Slices for component SΣ 1..2 BackboneElement Component / sub results.
Slice: Unordered, Closed by value:code.text
.... component:All Slices Content/Rules for all slices
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... code Σ 1..1 CodeableConcept Type of component observation (code / type)
Binding: UK Core Observation Vital Signs Type (preferred): A code from the SNOMED Clinical Terminology UK coding system describing a type of vital sign.

.... component:SystolicBP SΣ 1..1 BackboneElement Component / sub results.
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... code SΣ 1..1 CodeableConcept Type of component observation (code / type)
Binding: UK Core Observation Type (preferred): A code from the SNOMED Clinical Terminology UK coding system describing a type of observation

...... Slices for coding Σ 2..* Coding Code defined by a terminology system
Slice: Unordered, Open by value:system
....... coding:loinc Σ 1..1 Coding Code defined by a terminology system
........ system Σ 1..1 uri Identity of the terminology system
Fixed Value: http://loinc.org
........ code Σ 1..1 code Symbol in syntax defined by the system
Fixed Value: 8480-6
........ display Σ 1..1 string Representation defined by the system
Fixed Value: Systolic blood pressure
....... coding:snomedCT Σ 1..* Coding Code defined by a terminology system
Binding: UK Core Blood Pressure Systolic (preferred)
........ system Σ 1..1 uri Identity of the terminology system
Fixed Value: http://snomed.info/sct
........ code Σ 1..1 code Symbol in syntax defined by the system
........ display Σ 1..1 string Representation defined by the system
...... text Σ 1..1 string Plain text representation of the concept
Fixed Value: Systolic blood pressure
..... value[x] SΣ 1..1 Quantity Actual component result
...... comparator ?!Σ 0..1 code < | <= | >= | > - how to understand the value
Binding: QuantityComparator (required): How the Quantity should be understood and represented.

...... unit Σ 1..1 string Unit representation
Fixed Value: millimeter of mercury
...... system ΣC 1..1 uri System that defines coded unit form
Fixed Value: http://unitsofmeasure.org
...... code Σ 1..1 code Coded form of the unit
Fixed Value: mm[Hg]
..... interpretation S 0..* CodeableConcept High, low, normal, etc.
Binding: ObservationInterpretationCodes (required)
.... component:DiastolicBP SΣ 0..1 BackboneElement Component / sub results.
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... code SΣ 1..1 CodeableConcept Type of component observation (code / type)
Binding: UK Core Observation Type (preferred): A code from the SNOMED Clinical Terminology UK coding system describing a type of observation

...... Slices for coding Σ 2..* Coding Code defined by a terminology system
Slice: Unordered, Open by value:system
...... Slices for coding Content/Rules for all slices
....... coding:loinc Σ 1..1 Coding Code defined by a terminology system
........ system Σ 1..1 uri Identity of the terminology system
Fixed Value: http://loinc.org
........ code Σ 1..1 code Symbol in syntax defined by the system
Fixed Value: 8462-4
........ display Σ 1..1 string Representation defined by the system
Fixed Value: Diastolic blood pressure
...... Slices for coding Content/Rules for all slices
....... coding:snomedCT Σ 1..* Coding Code defined by a terminology system
Binding: UK Core Blood Pressure Diastolic (preferred)
........ system Σ 1..1 uri Identity of the terminology system
Fixed Value: http://snomed.info/sct
........ code Σ 1..1 code Symbol in syntax defined by the system
........ display Σ 1..1 string Representation defined by the system
...... text Σ 1..1 string Plain text representation of the concept
Fixed Value: Diastolic blood pressure
..... value[x] SΣ 1..1 Quantity Actual component result
...... comparator ?!Σ 0..1 code < | <= | >= | > - how to understand the value
Binding: QuantityComparator (required): How the Quantity should be understood and represented.

...... unit Σ 1..1 string Unit representation
Fixed Value: millimeter of mercury
...... system ΣC 1..1 uri System that defines coded unit form
Fixed Value: http://unitsofmeasure.org
...... code Σ 1..1 code Coded form of the unit
Fixed Value: mm[Hg]
..... dataAbsentReason SC 0..1 CodeableConcept Why the component result is missing
Binding: DataAbsentReason (required)
..... interpretation S 0..* CodeableConcept High, low, normal, etc.
Binding: ObservationInterpretationCodes (required)

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / CodeURI
Observation.meta.securityextensibleAll Security Labels
http://hl7.org/fhir/ValueSet/security-labels
from the FHIR Standard
Observation.meta.tagexampleCommonTags
http://hl7.org/fhir/ValueSet/common-tags
from the FHIR Standard
Observation.meta.tag:SourceexampleCommonTags
http://hl7.org/fhir/ValueSet/common-tags
from the FHIR Standard
Observation.meta.tag:ProvenanceexampleCommonTags
http://hl7.org/fhir/ValueSet/common-tags
from the FHIR Standard
Observation.languagepreferredCommonLanguages
Additional Bindings Purpose
AllLanguages Max Binding
http://hl7.org/fhir/ValueSet/languages
from the FHIR Standard
Observation.extension:triggeredByR5.extension:type.value[x]requiredhttp://hl7.org/fhir/ValueSet/observation-triggeredbytype
http://hl7.org/fhir/ValueSet/observation-triggeredbytype
Observation.extension:bodyPosition.value[x]preferredUKCoreBodyPosition
https://fhir.hl7.org.uk/ValueSet/UKCore-BodyPosition
from this IG
Observation.statusrequiredFixed Value: final
http://hl7.org/fhir/ValueSet/observation-status|4.0.1
from the FHIR Standard
Observation.categoryrequiredObservationCategoryCodes
http://hl7.org/fhir/ValueSet/observation-category
from the FHIR Standard
Observation.codepreferredUKCoreObservationType
https://fhir.hl7.org.uk/ValueSet/UKCore-ObservationType
from this IG
Observation.code.coding:loincextensibleFixed Value: LOINC Code 85354-9
http://hl7.org/fhir/ValueSet/observation-vitalsignresult
from the FHIR Standard
Observation.code.coding:snomedCTpreferredUKCoreBloodPressure
https://fhir.hl7.org.uk/ValueSet/UKCore-BloodPressure
from this IG
Observation.bodySiterequiredSNOMEDCTBodyStructures
http://hl7.org/fhir/ValueSet/body-site
from the FHIR Standard
Observation.component.codepreferredUKCoreObservationVitalSignsType
https://fhir.hl7.org.uk/ValueSet/UKCore-ObservationVitalSignsType
from this IG
Observation.component:SystolicBP.codepreferredUKCoreObservationType
https://fhir.hl7.org.uk/ValueSet/UKCore-ObservationType
from this IG
Observation.component:SystolicBP.code.coding:snomedCTpreferredUKCoreBloodPressureSystolic
https://fhir.hl7.org.uk/ValueSet/UKCore-BloodPressure-Systolic
from this IG
Observation.component:SystolicBP.value[x].comparatorrequiredQuantityComparator
http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1
from the FHIR Standard
Observation.component:SystolicBP.interpretationrequiredObservationInterpretationCodes
http://hl7.org/fhir/ValueSet/observation-interpretation
from the FHIR Standard
Observation.component:DiastolicBP.codepreferredUKCoreObservationType
https://fhir.hl7.org.uk/ValueSet/UKCore-ObservationType
from this IG
Observation.component:DiastolicBP.code.coding:snomedCTpreferredUKCoreBloodPressureDiastolic
https://fhir.hl7.org.uk/ValueSet/UKCore-BloodPressure-Diastolic
from this IG
Observation.component:DiastolicBP.value[x].comparatorrequiredQuantityComparator
http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1
from the FHIR Standard
Observation.component:DiastolicBP.dataAbsentReasonrequiredDataAbsentReason
http://hl7.org/fhir/ValueSet/data-absent-reason
from the FHIR Standard
Observation.component:DiastolicBP.interpretationrequiredObservationInterpretationCodes
http://hl7.org/fhir/ValueSet/observation-interpretation
from the FHIR Standard

Constraints

IdGradePath(s)DetailsRequirements
dom-2errorObservationIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorObservationIf 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-4errorObservationIf 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-5errorObservationIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practiceObservationA resource should have narrative for robust management
: text.`div`.exists()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()
obs-6errorObservationdataAbsentReason SHALL only be present if Observation.value[x] is not present
: dataAbsentReason.empty() or value.empty()
obs-7errorObservationIf 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()
ukcore-obs-vs-001errorObservation`code.coding` SHALL include a LOINC "magic code"
: code.coding.where(system='http://loinc.org').exists()
NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation C 0..* UKCoreObservationVitalSignsBloodPressure Measurements and simple assertions
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
ukcore-obs-vs-001: `code.coding` SHALL include a LOINC "magic code"
... id SΣ 0..1 id Logical id of this artifact
... meta Σ 0..1 Meta Metadata about the resource
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... versionId SΣ 0..1 id Version specific identifier
.... lastUpdated SΣ 0..1 instant MANDATORY except in Contained Resources. When the resource version last changed.
.... source Σ 0..1 uri Identifies where the resource comes from
.... profile SΣ 0..* canonical(StructureDefinition) Profiles this resource claims to conform to. Should list (i) this profile (ii) base profile for this resource.
.... security Σ 0..* Coding DISCOURAGED - may not be honoured by Data Consumers
Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.


.... Slices for tag Σ 0..* Coding Tags applied to this resource
Slice: Unordered, Open by value:system
Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".


..... tag:Source SΣ 0..1 Coding MANDATORY except in Contained Resources. The Data Provider Id (and display text) of the system supplying the data
Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".


...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... system Σ 1..1 uri Identity of the terminology system
Fixed Value: https://fhir.interweavedigital.nhs.uk/Source
...... code SΣ 1..1 code The Data Provider Id of the system supplying the data
...... display SΣ 1..1 string Name of the system supplying the data
...... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
..... tag:Provenance SΣ 0..1 Coding MANDATORY except in Contained Resources. The ODS Code (and display text) of the organisation responsible for the data
Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".


...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... system Σ 1..1 uri Identity of the terminology system
Fixed Value: https://fhir.interweavedigital.nhs.uk/Provenance
...... code SΣ 1..1 code The ODS Code of the organisation responsible for the data
...... display SΣ 1..1 string Name of the organisation supplying the data
...... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
... implicitRules ?!Σ 0..1 uri DISCOURAGED - may not be honoured by Data Consumers
... text 0..1 Narrative DISCOURAGED - the preferred approach is to offer structured data fields which a Data Consumer can then render and present in a manner most suited to its users
... contained 0..* Resource Contained, inline Resources
... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
.... bodyStructureR5 0..1 Reference(BodyStructure) Observed body structure. This is a R5 backport.
URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.bodyStructure
.... bodyPosition 0..1 (Complex) The patients body position when the vital signs observation was recorded.
URL: http://hl7.org/fhir/StructureDefinition/observation-bodyPosition
..... id 0..1 id Unique id for inter-element referencing
..... extension 0..0
..... url 1..1 uri "http://hl7.org/fhir/StructureDefinition/observation-bodyPosition"
..... value[x] 1..1 CodeableConcept Value of extension
Binding: UK Core Body Position (preferred)
.... recordingSetting 0..* CodeableConcept Records whether the vital signs observation was performed in a clinical or non clinical setting.
URL: https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-RecordingSetting
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... identifier SΣ 0..* Identifier Business Identifier for observation
... basedOn Σ 0..* Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest) DISCOURAGED - This field does not appear to provide information which would be beneficial in a shared care record. It also allows references to a raft of request/order resources which introduces a lot of complexity for a data consumer.
... partOf Σ 0..* Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy) DISCOURAGED - This field does not appear to provide information which would be beneficial in a shared care record. It also allows references to a raft of request/order resources which introduces a lot of complexity for a data consumer.
... status ?!SΣ 1..1 code A status of `final` SHALL be present.
Binding: ObservationStatus (required): Codes providing the status of an observation.


Fixed Value: final
... category S 1..1 CodeableConcept A category of `vital-signs` SHALL be present.
Binding: ObservationCategoryCodes (required): Codes for high level observation categories.


.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... coding Σ 0..* Coding Code defined by a terminology system
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... system Σ 1..1 uri Identity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category
..... version Σ 0..1 string Version of the system - if relevant
..... code Σ 1..1 code Symbol in syntax defined by the system
Fixed Value: vital-signs
..... display Σ 1..1 string Representation defined by the system
Fixed Value: Vital Signs
..... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
.... text Σ 0..1 string Plain text representation of the concept
... code SΣ 1..1 CodeableConcept The type of vital signs observation (code / type).
Binding: UK Core Observation Type (preferred): A code from the SNOMED Clinical Terminology UK coding system describing a type of observation

.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... Slices for coding Σ 2..* Coding Code defined by a terminology system
Slice: Unordered, Open by value:system
..... coding:All Slices Content/Rules for all slices
...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... system Σ 0..1 uri Identity of the terminology system
...... version Σ 0..1 string Version of the system - if relevant
...... code Σ 0..1 code Symbol in syntax defined by the system
...... display Σ 0..1 string Representation defined by the system
...... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
..... coding:loinc Σ 1..1 Coding A LOINC "magic code" describing the type of observation SHALL be present.
Binding: VitalSigns (extensible)
...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... system Σ 1..1 uri Identity of the terminology system
Fixed Value: http://loinc.org
...... code Σ 1..1 code Symbol in syntax defined by the system
Fixed Value: 85354-9
...... display Σ 1..1 string Representation defined by the system
Fixed Value: Blood pressure panel with all children optional
...... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
..... coding:snomedCT Σ 1..* Coding A SNOMED CT concept describing the type of observation SHALL be present.
Binding: UK Core Blood Pressure (preferred)
...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... system Σ 1..1 uri Identity of the terminology system
Fixed Value: http://snomed.info/sct
...... code Σ 1..1 code Symbol in syntax defined by the system
...... display Σ 1..1 string Representation defined by the system
...... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
.... text Σ 0..1 string Plain text representation of the concept
... subject SΣ 1..1 Reference(InterweavePatient) Who or what the observation relates to SHALL be present.
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... reference ΣC 1..1 string Reference to a resource (could be Contained)
.... type Σ 0..1 uri Type the reference refers to (e.g. "Patient")
Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).

.... identifier Σ 0..1 Identifier If relevant could include an id
.... display Σ 1..1 string Description of the referenced resource
... encounter SΣ 0..1 Reference(InterweaveEncounter) Healthcare event during which this observation is made
... effective[x] SΣ 1..1 This is the time/time period during which the observation was taken.
.... effectiveDateTime dateTime
.... effectiveInstant instant
... performer SΣ 0..* Reference(Practitioner | PractitionerRole | CareTeam) Who is responsible for the observation.
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... reference ΣC 1..1 string Reference to a resource (could be Contained)
.... type Σ 0..1 uri Type the reference refers to (e.g. "Patient")
Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).

.... identifier Σ 0..1 Identifier If relevant could include an id
.... display Σ 1..1 string Description of the referenced resource
... note S 0..1 Annotation Comments about the observation
... bodySite S 0..1 CodeableConcept Observed body part
Binding: SNOMEDCTBodyStructures (required)
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... coding Σ 0..* Coding Code defined by a terminology system
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... system Σ 1..1 uri Identity of the terminology system
..... version Σ 0..1 string Version of the system - if relevant
..... code Σ 1..1 code Symbol in syntax defined by the system
..... display Σ 1..1 string Representation defined by the system
..... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
.... text Σ 0..1 string Plain text representation of the concept
... method 0..1 CodeableConcept How it was done
Binding: UK Core Blood Pressure Measurement Method (preferred)
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... coding Σ 0..* Coding Code defined by a terminology system
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... system Σ 1..1 uri Identity of the terminology system
..... version Σ 0..1 string Version of the system - if relevant
..... code Σ 1..1 code Symbol in syntax defined by the system
..... display Σ 1..1 string Representation defined by the system
..... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
.... text Σ 0..1 string Plain text representation of the concept
... device 0..1 Reference(DeviceMetric | UK Core Device Blood Pressure) (Measurement) Device
... derivedFrom Σ 0..* Reference(InterweaveObservation | InterweaveQuestionnaireResponse) Related measurements the observation is made from
... Slices for component SΣ 1..2 BackboneElement Component / sub results.
Slice: Unordered, Closed by value:code.text
.... component:All Slices Content/Rules for all slices
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... code Σ 1..1 CodeableConcept Type of component observation (code / type)
Binding: UK Core Observation Vital Signs Type (preferred): A code from the SNOMED Clinical Terminology UK coding system describing a type of vital sign.

...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... coding Σ 0..* Coding Code defined by a terminology system
....... id 0..1 string Unique id for inter-element referencing
....... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
....... system Σ 1..1 uri Identity of the terminology system
....... version Σ 0..1 string Version of the system - if relevant
....... code Σ 1..1 code Symbol in syntax defined by the system
....... display Σ 1..1 string Representation defined by the system
....... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
...... text Σ 0..1 string Plain text representation of the concept
..... value[x] Σ 0..1 Actual component result
...... valueQuantity Quantity
...... valueCodeableConcept CodeableConcept
...... valueString string
...... valueBoolean boolean
...... valueInteger integer
...... valueRange Range
...... valueRatio Ratio
...... valueSampledData SampledData
...... valueTime time
...... valueDateTime dateTime
...... valuePeriod Period
..... dataAbsentReason C 0..1 CodeableConcept Why the component result is missing
Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.

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


..... referenceRange 0..* See referenceRange (Observation) Provides guide for interpretation of component result
.... component:SystolicBP SΣ 1..1 BackboneElement Component / sub results.
..... extension 0..* Extension Additional content defined by implementations
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... code SΣ 1..1 CodeableConcept Type of component observation (code / type)
Binding: UK Core Observation Type (preferred): A code from the SNOMED Clinical Terminology UK coding system describing a type of observation

...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... Slices for coding Σ 2..* Coding Code defined by a terminology system
Slice: Unordered, Open by value:system
...... Slices for coding Content/Rules for all slices
....... coding:loinc Σ 1..1 Coding Code defined by a terminology system
........ extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
........ system Σ 1..1 uri Identity of the terminology system
Fixed Value: http://loinc.org
........ code Σ 1..1 code Symbol in syntax defined by the system
Fixed Value: 8480-6
........ display Σ 1..1 string Representation defined by the system
Fixed Value: Systolic blood pressure
........ userSelected Σ 0..1 boolean If this coding was chosen directly by the user
...... Slices for coding Content/Rules for all slices
....... coding:snomedCT Σ 1..* Coding Code defined by a terminology system
Binding: UK Core Blood Pressure Systolic (preferred)
........ extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
........ system Σ 1..1 uri Identity of the terminology system
Fixed Value: http://snomed.info/sct
........ code Σ 1..1 code Symbol in syntax defined by the system
........ display Σ 1..1 string Representation defined by the system
........ userSelected Σ 0..1 boolean If this coding was chosen directly by the user
...... text Σ 1..1 string Plain text representation of the concept
Fixed Value: Systolic blood pressure
..... value[x] SΣ 1..1 Quantity Actual component result
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... value Σ 0..1 decimal Numerical value (with implicit precision)
...... comparator ?!Σ 0..1 code < | <= | >= | > - how to understand the value
Binding: QuantityComparator (required): How the Quantity should be understood and represented.

...... unit Σ 1..1 string Unit representation
Fixed Value: millimeter of mercury
...... system ΣC 1..1 uri System that defines coded unit form
Fixed Value: http://unitsofmeasure.org
...... code Σ 1..1 code Coded form of the unit
Fixed Value: mm[Hg]
..... interpretation S 0..* CodeableConcept High, low, normal, etc.
Binding: ObservationInterpretationCodes (required)
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... coding Σ 0..* Coding Code defined by a terminology system
....... id 0..1 string Unique id for inter-element referencing
....... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
....... system Σ 1..1 uri Identity of the terminology system
....... version Σ 0..1 string Version of the system - if relevant
....... code Σ 1..1 code Symbol in syntax defined by the system
....... display Σ 1..1 string Representation defined by the system
....... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
...... text Σ 0..1 string Plain text representation of the concept
..... referenceRange 0..* See referenceRange (Observation) Provides guide for interpretation of component result
.... component:DiastolicBP SΣ 0..1 BackboneElement Component / sub results.
..... extension 0..* Extension Additional content defined by implementations
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... code SΣ 1..1 CodeableConcept Type of component observation (code / type)
Binding: UK Core Observation Type (preferred): A code from the SNOMED Clinical Terminology UK coding system describing a type of observation

...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... Slices for coding Σ 2..* Coding Code defined by a terminology system
Slice: Unordered, Open by value:system
...... Slices for coding Content/Rules for all slices
....... coding:loinc Σ 1..1 Coding Code defined by a terminology system
........ extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
........ system Σ 1..1 uri Identity of the terminology system
Fixed Value: http://loinc.org
........ code Σ 1..1 code Symbol in syntax defined by the system
Fixed Value: 8462-4
........ display Σ 1..1 string Representation defined by the system
Fixed Value: Diastolic blood pressure
........ userSelected Σ 0..1 boolean If this coding was chosen directly by the user
...... Slices for coding Content/Rules for all slices
....... coding:snomedCT Σ 1..* Coding Code defined by a terminology system
Binding: UK Core Blood Pressure Diastolic (preferred)
........ extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
........ system Σ 1..1 uri Identity of the terminology system
Fixed Value: http://snomed.info/sct
........ code Σ 1..1 code Symbol in syntax defined by the system
........ display Σ 1..1 string Representation defined by the system
........ userSelected Σ 0..1 boolean If this coding was chosen directly by the user
...... text Σ 1..1 string Plain text representation of the concept
Fixed Value: Diastolic blood pressure
..... value[x] SΣ 1..1 Quantity Actual component result
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... value Σ 0..1 decimal Numerical value (with implicit precision)
...... comparator ?!Σ 0..1 code < | <= | >= | > - how to understand the value
Binding: QuantityComparator (required): How the Quantity should be understood and represented.

...... unit Σ 1..1 string Unit representation
Fixed Value: millimeter of mercury
...... system ΣC 1..1 uri System that defines coded unit form
Fixed Value: http://unitsofmeasure.org
...... code Σ 1..1 code Coded form of the unit
Fixed Value: mm[Hg]
..... dataAbsentReason SC 0..1 CodeableConcept Why the component result is missing
Binding: DataAbsentReason (required)
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... coding Σ 0..* Coding Code defined by a terminology system
....... id 0..1 string Unique id for inter-element referencing
....... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
....... system Σ 1..1 uri Identity of the terminology system
....... version Σ 0..1 string Version of the system - if relevant
....... code Σ 1..1 code Symbol in syntax defined by the system
....... display Σ 1..1 string Representation defined by the system
....... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
...... text Σ 0..1 string Plain text representation of the concept
..... interpretation S 0..* CodeableConcept High, low, normal, etc.
Binding: ObservationInterpretationCodes (required)
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... coding Σ 0..* Coding Code defined by a terminology system
....... id 0..1 string Unique id for inter-element referencing
....... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
....... system Σ 1..1 uri Identity of the terminology system
....... version Σ 0..1 string Version of the system - if relevant
....... code Σ 1..1 code Symbol in syntax defined by the system
....... display Σ 1..1 string Representation defined by the system
....... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
...... text Σ 0..1 string Plain text representation of the concept
..... referenceRange 0..* See referenceRange (Observation) Provides guide for interpretation of component result

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / CodeURI
Observation.meta.securityextensibleAll Security Labels
http://hl7.org/fhir/ValueSet/security-labels
from the FHIR Standard
Observation.meta.tagexampleCommonTags
http://hl7.org/fhir/ValueSet/common-tags
from the FHIR Standard
Observation.meta.tag:SourceexampleCommonTags
http://hl7.org/fhir/ValueSet/common-tags
from the FHIR Standard
Observation.meta.tag:ProvenanceexampleCommonTags
http://hl7.org/fhir/ValueSet/common-tags
from the FHIR Standard
Observation.languagepreferredCommonLanguages
Additional Bindings Purpose
AllLanguages Max Binding
http://hl7.org/fhir/ValueSet/languages
from the FHIR Standard
Observation.extension:triggeredByR5.extension:type.value[x]requiredhttp://hl7.org/fhir/ValueSet/observation-triggeredbytype
http://hl7.org/fhir/ValueSet/observation-triggeredbytype
Observation.extension:bodyPosition.value[x]preferredUKCoreBodyPosition
https://fhir.hl7.org.uk/ValueSet/UKCore-BodyPosition
from this IG
Observation.statusrequiredFixed Value: final
http://hl7.org/fhir/ValueSet/observation-status|4.0.1
from the FHIR Standard
Observation.categoryrequiredObservationCategoryCodes
http://hl7.org/fhir/ValueSet/observation-category
from the FHIR Standard
Observation.codepreferredUKCoreObservationType
https://fhir.hl7.org.uk/ValueSet/UKCore-ObservationType
from this IG
Observation.code.coding:loincextensibleFixed Value: LOINC Code 85354-9
http://hl7.org/fhir/ValueSet/observation-vitalsignresult
from the FHIR Standard
Observation.code.coding:snomedCTpreferredUKCoreBloodPressure
https://fhir.hl7.org.uk/ValueSet/UKCore-BloodPressure
from this IG
Observation.subject.typeextensibleResourceType
http://hl7.org/fhir/ValueSet/resource-types
from the FHIR Standard
Observation.performer.typeextensibleResourceType
http://hl7.org/fhir/ValueSet/resource-types
from the FHIR Standard
Observation.bodySiterequiredSNOMEDCTBodyStructures
http://hl7.org/fhir/ValueSet/body-site
from the FHIR Standard
Observation.methodpreferredUKCoreBloodPressureMeasurementMethod
https://fhir.hl7.org.uk/ValueSet/UKCore-BloodPressure-MeasurementMethod
from this IG
Observation.referenceRange.typepreferredObservationReferenceRangeMeaningCodes
http://hl7.org/fhir/ValueSet/referencerange-meaning
from the FHIR Standard
Observation.referenceRange.appliesToexampleObservationReferenceRangeAppliesToCodes
http://hl7.org/fhir/ValueSet/referencerange-appliesto
from the FHIR Standard
Observation.component.codepreferredUKCoreObservationVitalSignsType
https://fhir.hl7.org.uk/ValueSet/UKCore-ObservationVitalSignsType
from this IG
Observation.component.dataAbsentReasonextensibleDataAbsentReason
http://hl7.org/fhir/ValueSet/data-absent-reason
from the FHIR Standard
Observation.component.interpretationextensibleObservationInterpretationCodes
http://hl7.org/fhir/ValueSet/observation-interpretation
from the FHIR Standard
Observation.component:SystolicBP.codepreferredUKCoreObservationType
https://fhir.hl7.org.uk/ValueSet/UKCore-ObservationType
from this IG
Observation.component:SystolicBP.code.coding:snomedCTpreferredUKCoreBloodPressureSystolic
https://fhir.hl7.org.uk/ValueSet/UKCore-BloodPressure-Systolic
from this IG
Observation.component:SystolicBP.value[x].comparatorrequiredQuantityComparator
http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1
from the FHIR Standard
Observation.component:SystolicBP.interpretationrequiredObservationInterpretationCodes
http://hl7.org/fhir/ValueSet/observation-interpretation
from the FHIR Standard
Observation.component:DiastolicBP.codepreferredUKCoreObservationType
https://fhir.hl7.org.uk/ValueSet/UKCore-ObservationType
from this IG
Observation.component:DiastolicBP.code.coding:snomedCTpreferredUKCoreBloodPressureDiastolic
https://fhir.hl7.org.uk/ValueSet/UKCore-BloodPressure-Diastolic
from this IG
Observation.component:DiastolicBP.value[x].comparatorrequiredQuantityComparator
http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1
from the FHIR Standard
Observation.component:DiastolicBP.dataAbsentReasonrequiredDataAbsentReason
http://hl7.org/fhir/ValueSet/data-absent-reason
from the FHIR Standard
Observation.component:DiastolicBP.interpretationrequiredObservationInterpretationCodes
http://hl7.org/fhir/ValueSet/observation-interpretation
from the FHIR Standard

Constraints

IdGradePath(s)DetailsRequirements
dom-2errorObservationIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorObservationIf 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-4errorObservationIf 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-5errorObservationIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practiceObservationA resource should have narrative for robust management
: text.`div`.exists()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()
obs-6errorObservationdataAbsentReason SHALL only be present if Observation.value[x] is not present
: dataAbsentReason.empty() or value.empty()
obs-7errorObservationIf 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()
ukcore-obs-vs-001errorObservation`code.coding` SHALL include a LOINC "magic code"
: code.coding.where(system='http://loinc.org').exists()

This structure is derived from UKCoreObservationVitalSignsBloodPressure

Summary

Mandatory: 15 elements(38 nested mandatory elements)
Must-Support: 21 elements
Fixed: 8 elements
Prohibited: 41 elements

Structures

This structure refers to these other structures:

Slices

This structure defines the following Slices:

  • The element 1 is sliced based on the value of Observation.meta.tag

Differential View

This structure is derived from UKCoreObservationVitalSignsBloodPressure

NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation 0..* UKCoreObservationVitalSignsBloodPressure Measurements and simple assertions
... id S 0..1 id Logical id of this artifact
... meta
.... id 0..0
.... versionId S 0..1 id Version specific identifier
.... lastUpdated S 0..1 instant MANDATORY except in Contained Resources. When the resource version last changed.
.... profile S 0..* canonical(StructureDefinition) Profiles this resource claims to conform to. Should list (i) this profile (ii) base profile for this resource.
.... security 0..* Coding DISCOURAGED - may not be honoured by Data Consumers
.... Slices for tag 0..* Coding Tags applied to this resource
Slice: Unordered, Open by value:system
..... tag:Source S 0..1 Coding MANDATORY except in Contained Resources. The Data Provider Id (and display text) of the system supplying the data
...... id 0..0
...... system 1..1 uri Identity of the terminology system
Fixed Value: https://fhir.interweavedigital.nhs.uk/Source
...... version 0..0
...... code S 1..1 code The Data Provider Id of the system supplying the data
...... display S 1..1 string Name of the system supplying the data
..... tag:Provenance S 0..1 Coding MANDATORY except in Contained Resources. The ODS Code (and display text) of the organisation responsible for the data
...... id 0..0
...... system 1..1 uri Identity of the terminology system
Fixed Value: https://fhir.interweavedigital.nhs.uk/Provenance
...... version 0..0
...... code S 1..1 code The ODS Code of the organisation responsible for the data
...... display S 1..1 string Name of the organisation supplying the data
... implicitRules 0..1 uri DISCOURAGED - may not be honoured by Data Consumers
... language 0..1 code English is assumed (not currently a multi-lingual implementation)
... text 0..1 Narrative DISCOURAGED - the preferred approach is to offer structured data fields which a Data Consumer can then render and present in a manner most suited to its users
... Slices for extension Content/Rules for all slices
.... extension:triggeredByR5 0..0
... identifier S 0..* Identifier Business Identifier for observation
... basedOn 0..* Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest) DISCOURAGED - This field does not appear to provide information which would be beneficial in a shared care record. It also allows references to a raft of request/order resources which introduces a lot of complexity for a data consumer.
... partOf 0..* Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy) DISCOURAGED - This field does not appear to provide information which would be beneficial in a shared care record. It also allows references to a raft of request/order resources which introduces a lot of complexity for a data consumer.
... category 1..1 CodeableConcept A category of `vital-signs` SHALL be present.
Binding: ObservationCategoryCodes (required): Codes for high level observation categories.

.... id 0..0
.... coding
..... id 0..0
..... system 1..1 uri Identity of the terminology system
..... code 1..1 code Symbol in syntax defined by the system
..... display 1..1 string Representation defined by the system
Fixed Value: Vital Signs
... code
.... id 0..0
.... coding 2..* Coding Code defined by a terminology system
..... id 0..0
.... Slices for coding Content/Rules for all slices
..... coding:loinc 1..1 Coding A LOINC "magic code" describing the type of observation SHALL be present.
...... id 0..0
...... version 0..0
...... code 1..1 code Symbol in syntax defined by the system
...... display 1..1 string Representation defined by the system
Fixed Value: Blood pressure panel with all children optional
.... Slices for coding Content/Rules for all slices
..... coding:snomedCT 1..* Coding A SNOMED CT concept describing the type of observation SHALL be present.
...... id 0..0
...... version 0..0
...... code 1..1 code Symbol in syntax defined by the system
...... display 1..1 string Representation defined by the system
... subject 1..1 Reference(InterweavePatient) Who or what the observation relates to SHALL be present.
.... id 0..0
.... reference 1..1 string Reference to a resource (could be Contained)
.... identifier 0..1 Identifier If relevant could include an id
.... display 1..1 string Description of the referenced resource
... focus 0..0
... encounter S 0..1 Reference(InterweaveEncounter) Healthcare event during which this observation is made
... effective[x] 1..1 This is the time/time period during which the observation was taken.
.... effectiveDateTime dateTime
.... effectiveInstant instant
... issued 0..0
... performer 0..* Reference(Practitioner | PractitionerRole | CareTeam) Who is responsible for the observation.
.... reference 1..1 string Reference to a resource (could be Contained)
.... identifier 0..1 Identifier If relevant could include an id
.... display 1..1 string Description of the referenced resource
... dataAbsentReason 0..0
... interpretation 0..0
... note S 0..1 Annotation Comments about the observation
... bodySite S 0..1 CodeableConcept Observed body part
Binding: SNOMEDCTBodyStructures (required)
.... id 0..0
.... coding
..... id 0..0
..... system 1..1 uri Identity of the terminology system
..... code 1..1 code Symbol in syntax defined by the system
..... display 1..1 string Representation defined by the system
... method
.... id 0..0
.... coding
..... id 0..0
..... system 1..1 uri Identity of the terminology system
..... code 1..1 code Symbol in syntax defined by the system
..... display 1..1 string Representation defined by the system
... referenceRange 0..0
... hasMember 0..0
... derivedFrom 0..* Reference(InterweaveObservation | InterweaveQuestionnaireResponse) Related measurements the observation is made from
... component 1..2 BackboneElement Component / sub results.
.... code
..... coding
...... system 1..1 uri Identity of the terminology system
...... code 1..1 code Symbol in syntax defined by the system
...... display 1..1 string Representation defined by the system
... Slices for component Content/Rules for all slices
.... component:SystolicBP 1..1 BackboneElement Component / sub results.
..... id 0..0
..... code S 1..1 CodeableConcept Type of component observation (code / type)
...... id 0..0
...... Slices for coding Content/Rules for all slices
....... coding:loinc 1..1 Coding Code defined by a terminology system
........ id 0..0
........ system 1..1 uri Identity of the terminology system
Fixed Value: http://loinc.org
........ version 0..0
........ code 1..1 code Symbol in syntax defined by the system
........ display 1..1 string Representation defined by the system
...... Slices for coding Content/Rules for all slices
....... coding:snomedCT 1..* Coding Code defined by a terminology system
........ id 0..0
........ system 1..1 uri Identity of the terminology system
Fixed Value: http://snomed.info/sct
........ version 0..0
........ code 1..1 code Symbol in syntax defined by the system
........ display 1..1 string Representation defined by the system
..... value[x] S 1..1 Quantity Actual component result
...... unit 1..1 string Unit representation
...... system 1..1 uri System that defines coded unit form
...... code 1..1 code Coded form of the unit
..... dataAbsentReason 0..0
..... interpretation S 0..* CodeableConcept High, low, normal, etc.
Binding: ObservationInterpretationCodes (required)
...... coding
....... system 1..1 uri Identity of the terminology system
....... code 1..1 code Symbol in syntax defined by the system
....... display 1..1 string Representation defined by the system
... Slices for component Content/Rules for all slices
.... component:DiastolicBP 0..1 BackboneElement Component / sub results.
..... id 0..0
..... code S 1..1 CodeableConcept Type of component observation (code / type)
...... id 0..0
...... Slices for coding Content/Rules for all slices
....... coding:loinc 1..1 Coding Code defined by a terminology system
........ id 0..0
........ system 1..1 uri Identity of the terminology system
Fixed Value: http://loinc.org
........ version 0..0
........ code 1..1 code Symbol in syntax defined by the system
........ display 1..1 string Representation defined by the system
...... Slices for coding Content/Rules for all slices
....... coding:snomedCT 1..* Coding Code defined by a terminology system
........ id 0..0
........ system 1..1 uri Identity of the terminology system
Fixed Value: http://snomed.info/sct
........ version 0..0
........ code 1..1 code Symbol in syntax defined by the system
........ display 1..1 string Representation defined by the system
..... value[x] S 1..1 Quantity Actual component result
...... unit 1..1 string Unit representation
...... system 1..1 uri System that defines coded unit form
...... code 1..1 code Coded form of the unit
..... dataAbsentReason S 0..1 CodeableConcept Why the component result is missing
Binding: DataAbsentReason (required)
...... coding
....... system 1..1 uri Identity of the terminology system
....... code 1..1 code Symbol in syntax defined by the system
....... display 1..1 string Representation defined by the system
..... interpretation S 0..* CodeableConcept High, low, normal, etc.
Binding: ObservationInterpretationCodes (required)
...... coding
....... system 1..1 uri Identity of the terminology system
....... code 1..1 code Symbol in syntax defined by the system
....... display 1..1 string Representation defined by the system

doco Documentation for this format

Terminology Bindings (Differential)

PathConformanceValueSetURI
Observation.categoryrequiredObservationCategoryCodes
http://hl7.org/fhir/ValueSet/observation-category
from the FHIR Standard
Observation.bodySiterequiredSNOMEDCTBodyStructures
http://hl7.org/fhir/ValueSet/body-site
from the FHIR Standard
Observation.component:SystolicBP.interpretationrequiredObservationInterpretationCodes
http://hl7.org/fhir/ValueSet/observation-interpretation
from the FHIR Standard
Observation.component:DiastolicBP.dataAbsentReasonrequiredDataAbsentReason
http://hl7.org/fhir/ValueSet/data-absent-reason
from the FHIR Standard
Observation.component:DiastolicBP.interpretationrequiredObservationInterpretationCodes
http://hl7.org/fhir/ValueSet/observation-interpretation
from the FHIR Standard

Key Elements View

NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation C 0..* UKCoreObservationVitalSignsBloodPressure Measurements and simple assertions
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
ukcore-obs-vs-001: `code.coding` SHALL include a LOINC "magic code"
... id SΣ 0..1 id Logical id of this artifact
... meta Σ 0..1 Meta Metadata about the resource
.... versionId SΣ 0..1 id Version specific identifier
.... lastUpdated SΣ 0..1 instant MANDATORY except in Contained Resources. When the resource version last changed.
.... profile SΣ 0..* canonical(StructureDefinition) Profiles this resource claims to conform to. Should list (i) this profile (ii) base profile for this resource.
.... security Σ 0..* Coding DISCOURAGED - may not be honoured by Data Consumers
Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.


.... Slices for tag Σ 0..* Coding Tags applied to this resource
Slice: Unordered, Open by value:system
Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".


..... tag:Source SΣ 0..1 Coding MANDATORY except in Contained Resources. The Data Provider Id (and display text) of the system supplying the data
Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".


...... system Σ 1..1 uri Identity of the terminology system
Fixed Value: https://fhir.interweavedigital.nhs.uk/Source
...... code SΣ 1..1 code The Data Provider Id of the system supplying the data
...... display SΣ 1..1 string Name of the system supplying the data
..... tag:Provenance SΣ 0..1 Coding MANDATORY except in Contained Resources. The ODS Code (and display text) of the organisation responsible for the data
Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".


...... system Σ 1..1 uri Identity of the terminology system
Fixed Value: https://fhir.interweavedigital.nhs.uk/Provenance
...... code SΣ 1..1 code The ODS Code of the organisation responsible for the data
...... display SΣ 1..1 string Name of the organisation supplying the data
... implicitRules ?!Σ 0..1 uri DISCOURAGED - may not be honoured by Data Consumers
... text 0..1 Narrative DISCOURAGED - the preferred approach is to offer structured data fields which a Data Consumer can then render and present in a manner most suited to its users
... Slices for extension Content/Rules for all slices
.... bodyStructureR5 0..1 Reference(BodyStructure) Observed body structure. This is a R5 backport.
URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.bodyStructure
.... bodyPosition 0..1 (Complex) The patients body position when the vital signs observation was recorded.
URL: http://hl7.org/fhir/StructureDefinition/observation-bodyPosition
..... extension 0..0
..... url 1..1 uri "http://hl7.org/fhir/StructureDefinition/observation-bodyPosition"
..... value[x] 1..1 CodeableConcept Value of extension
Binding: UK Core Body Position (preferred)
.... recordingSetting 0..* CodeableConcept Records whether the vital signs observation was performed in a clinical or non clinical setting.
URL: https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-RecordingSetting
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... identifier SΣ 0..* Identifier Business Identifier for observation
... basedOn Σ 0..* Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest) DISCOURAGED - This field does not appear to provide information which would be beneficial in a shared care record. It also allows references to a raft of request/order resources which introduces a lot of complexity for a data consumer.
... partOf Σ 0..* Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy) DISCOURAGED - This field does not appear to provide information which would be beneficial in a shared care record. It also allows references to a raft of request/order resources which introduces a lot of complexity for a data consumer.
... status ?!SΣ 1..1 code A status of `final` SHALL be present.
Binding: ObservationStatus (required): Codes providing the status of an observation.


Fixed Value: final
... category S 1..1 CodeableConcept A category of `vital-signs` SHALL be present.
Binding: ObservationCategoryCodes (required): Codes for high level observation categories.


... code SΣ 1..1 CodeableConcept The type of vital signs observation (code / type).
Binding: UK Core Observation Type (preferred): A code from the SNOMED Clinical Terminology UK coding system describing a type of observation

.... Slices for coding Σ 2..* Coding Code defined by a terminology system
Slice: Unordered, Open by value:system
..... coding:All Slices Content/Rules for all slices
..... coding:loinc Σ 1..1 Coding A LOINC "magic code" describing the type of observation SHALL be present.
Binding: VitalSigns (extensible)
...... system Σ 1..1 uri Identity of the terminology system
Fixed Value: http://loinc.org
...... code Σ 1..1 code Symbol in syntax defined by the system
Fixed Value: 85354-9
...... display Σ 1..1 string Representation defined by the system
Fixed Value: Blood pressure panel with all children optional
..... coding:snomedCT Σ 1..* Coding A SNOMED CT concept describing the type of observation SHALL be present.
Binding: UK Core Blood Pressure (preferred)
...... system Σ 1..1 uri Identity of the terminology system
Fixed Value: http://snomed.info/sct
...... code Σ 1..1 code Symbol in syntax defined by the system
...... display Σ 1..1 string Representation defined by the system
... subject SΣ 1..1 Reference(InterweavePatient) Who or what the observation relates to SHALL be present.
.... reference ΣC 1..1 string Reference to a resource (could be Contained)
.... identifier Σ 0..1 Identifier If relevant could include an id
.... display Σ 1..1 string Description of the referenced resource
... encounter SΣ 0..1 Reference(InterweaveEncounter) Healthcare event during which this observation is made
... effective[x] SΣ 1..1 This is the time/time period during which the observation was taken.
.... effectiveDateTime dateTime
.... effectiveInstant instant
... performer SΣ 0..* Reference(Practitioner | PractitionerRole | CareTeam) Who is responsible for the observation.
.... reference ΣC 1..1 string Reference to a resource (could be Contained)
.... identifier Σ 0..1 Identifier If relevant could include an id
.... display Σ 1..1 string Description of the referenced resource
... note S 0..1 Annotation Comments about the observation
... bodySite S 0..1 CodeableConcept Observed body part
Binding: SNOMEDCTBodyStructures (required)
... derivedFrom Σ 0..* Reference(InterweaveObservation | InterweaveQuestionnaireResponse) Related measurements the observation is made from
... Slices for component SΣ 1..2 BackboneElement Component / sub results.
Slice: Unordered, Closed by value:code.text
.... component:All Slices Content/Rules for all slices
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... code Σ 1..1 CodeableConcept Type of component observation (code / type)
Binding: UK Core Observation Vital Signs Type (preferred): A code from the SNOMED Clinical Terminology UK coding system describing a type of vital sign.

.... component:SystolicBP SΣ 1..1 BackboneElement Component / sub results.
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... code SΣ 1..1 CodeableConcept Type of component observation (code / type)
Binding: UK Core Observation Type (preferred): A code from the SNOMED Clinical Terminology UK coding system describing a type of observation

...... Slices for coding Σ 2..* Coding Code defined by a terminology system
Slice: Unordered, Open by value:system
....... coding:loinc Σ 1..1 Coding Code defined by a terminology system
........ system Σ 1..1 uri Identity of the terminology system
Fixed Value: http://loinc.org
........ code Σ 1..1 code Symbol in syntax defined by the system
Fixed Value: 8480-6
........ display Σ 1..1 string Representation defined by the system
Fixed Value: Systolic blood pressure
....... coding:snomedCT Σ 1..* Coding Code defined by a terminology system
Binding: UK Core Blood Pressure Systolic (preferred)
........ system Σ 1..1 uri Identity of the terminology system
Fixed Value: http://snomed.info/sct
........ code Σ 1..1 code Symbol in syntax defined by the system
........ display Σ 1..1 string Representation defined by the system
...... text Σ 1..1 string Plain text representation of the concept
Fixed Value: Systolic blood pressure
..... value[x] SΣ 1..1 Quantity Actual component result
...... comparator ?!Σ 0..1 code < | <= | >= | > - how to understand the value
Binding: QuantityComparator (required): How the Quantity should be understood and represented.

...... unit Σ 1..1 string Unit representation
Fixed Value: millimeter of mercury
...... system ΣC 1..1 uri System that defines coded unit form
Fixed Value: http://unitsofmeasure.org
...... code Σ 1..1 code Coded form of the unit
Fixed Value: mm[Hg]
..... interpretation S 0..* CodeableConcept High, low, normal, etc.
Binding: ObservationInterpretationCodes (required)
.... component:DiastolicBP SΣ 0..1 BackboneElement Component / sub results.
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... code SΣ 1..1 CodeableConcept Type of component observation (code / type)
Binding: UK Core Observation Type (preferred): A code from the SNOMED Clinical Terminology UK coding system describing a type of observation

...... Slices for coding Σ 2..* Coding Code defined by a terminology system
Slice: Unordered, Open by value:system
...... Slices for coding Content/Rules for all slices
....... coding:loinc Σ 1..1 Coding Code defined by a terminology system
........ system Σ 1..1 uri Identity of the terminology system
Fixed Value: http://loinc.org
........ code Σ 1..1 code Symbol in syntax defined by the system
Fixed Value: 8462-4
........ display Σ 1..1 string Representation defined by the system
Fixed Value: Diastolic blood pressure
...... Slices for coding Content/Rules for all slices
....... coding:snomedCT Σ 1..* Coding Code defined by a terminology system
Binding: UK Core Blood Pressure Diastolic (preferred)
........ system Σ 1..1 uri Identity of the terminology system
Fixed Value: http://snomed.info/sct
........ code Σ 1..1 code Symbol in syntax defined by the system
........ display Σ 1..1 string Representation defined by the system
...... text Σ 1..1 string Plain text representation of the concept
Fixed Value: Diastolic blood pressure
..... value[x] SΣ 1..1 Quantity Actual component result
...... comparator ?!Σ 0..1 code < | <= | >= | > - how to understand the value
Binding: QuantityComparator (required): How the Quantity should be understood and represented.

...... unit Σ 1..1 string Unit representation
Fixed Value: millimeter of mercury
...... system ΣC 1..1 uri System that defines coded unit form
Fixed Value: http://unitsofmeasure.org
...... code Σ 1..1 code Coded form of the unit
Fixed Value: mm[Hg]
..... dataAbsentReason SC 0..1 CodeableConcept Why the component result is missing
Binding: DataAbsentReason (required)
..... interpretation S 0..* CodeableConcept High, low, normal, etc.
Binding: ObservationInterpretationCodes (required)

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / CodeURI
Observation.meta.securityextensibleAll Security Labels
http://hl7.org/fhir/ValueSet/security-labels
from the FHIR Standard
Observation.meta.tagexampleCommonTags
http://hl7.org/fhir/ValueSet/common-tags
from the FHIR Standard
Observation.meta.tag:SourceexampleCommonTags
http://hl7.org/fhir/ValueSet/common-tags
from the FHIR Standard
Observation.meta.tag:ProvenanceexampleCommonTags
http://hl7.org/fhir/ValueSet/common-tags
from the FHIR Standard
Observation.languagepreferredCommonLanguages
Additional Bindings Purpose
AllLanguages Max Binding
http://hl7.org/fhir/ValueSet/languages
from the FHIR Standard
Observation.extension:triggeredByR5.extension:type.value[x]requiredhttp://hl7.org/fhir/ValueSet/observation-triggeredbytype
http://hl7.org/fhir/ValueSet/observation-triggeredbytype
Observation.extension:bodyPosition.value[x]preferredUKCoreBodyPosition
https://fhir.hl7.org.uk/ValueSet/UKCore-BodyPosition
from this IG
Observation.statusrequiredFixed Value: final
http://hl7.org/fhir/ValueSet/observation-status|4.0.1
from the FHIR Standard
Observation.categoryrequiredObservationCategoryCodes
http://hl7.org/fhir/ValueSet/observation-category
from the FHIR Standard
Observation.codepreferredUKCoreObservationType
https://fhir.hl7.org.uk/ValueSet/UKCore-ObservationType
from this IG
Observation.code.coding:loincextensibleFixed Value: LOINC Code 85354-9
http://hl7.org/fhir/ValueSet/observation-vitalsignresult
from the FHIR Standard
Observation.code.coding:snomedCTpreferredUKCoreBloodPressure
https://fhir.hl7.org.uk/ValueSet/UKCore-BloodPressure
from this IG
Observation.bodySiterequiredSNOMEDCTBodyStructures
http://hl7.org/fhir/ValueSet/body-site
from the FHIR Standard
Observation.component.codepreferredUKCoreObservationVitalSignsType
https://fhir.hl7.org.uk/ValueSet/UKCore-ObservationVitalSignsType
from this IG
Observation.component:SystolicBP.codepreferredUKCoreObservationType
https://fhir.hl7.org.uk/ValueSet/UKCore-ObservationType
from this IG
Observation.component:SystolicBP.code.coding:snomedCTpreferredUKCoreBloodPressureSystolic
https://fhir.hl7.org.uk/ValueSet/UKCore-BloodPressure-Systolic
from this IG
Observation.component:SystolicBP.value[x].comparatorrequiredQuantityComparator
http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1
from the FHIR Standard
Observation.component:SystolicBP.interpretationrequiredObservationInterpretationCodes
http://hl7.org/fhir/ValueSet/observation-interpretation
from the FHIR Standard
Observation.component:DiastolicBP.codepreferredUKCoreObservationType
https://fhir.hl7.org.uk/ValueSet/UKCore-ObservationType
from this IG
Observation.component:DiastolicBP.code.coding:snomedCTpreferredUKCoreBloodPressureDiastolic
https://fhir.hl7.org.uk/ValueSet/UKCore-BloodPressure-Diastolic
from this IG
Observation.component:DiastolicBP.value[x].comparatorrequiredQuantityComparator
http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1
from the FHIR Standard
Observation.component:DiastolicBP.dataAbsentReasonrequiredDataAbsentReason
http://hl7.org/fhir/ValueSet/data-absent-reason
from the FHIR Standard
Observation.component:DiastolicBP.interpretationrequiredObservationInterpretationCodes
http://hl7.org/fhir/ValueSet/observation-interpretation
from the FHIR Standard

Constraints

IdGradePath(s)DetailsRequirements
dom-2errorObservationIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorObservationIf 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-4errorObservationIf 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-5errorObservationIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practiceObservationA resource should have narrative for robust management
: text.`div`.exists()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()
obs-6errorObservationdataAbsentReason SHALL only be present if Observation.value[x] is not present
: dataAbsentReason.empty() or value.empty()
obs-7errorObservationIf 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()
ukcore-obs-vs-001errorObservation`code.coding` SHALL include a LOINC "magic code"
: code.coding.where(system='http://loinc.org').exists()

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation C 0..* UKCoreObservationVitalSignsBloodPressure Measurements and simple assertions
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
ukcore-obs-vs-001: `code.coding` SHALL include a LOINC "magic code"
... id SΣ 0..1 id Logical id of this artifact
... meta Σ 0..1 Meta Metadata about the resource
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... versionId SΣ 0..1 id Version specific identifier
.... lastUpdated SΣ 0..1 instant MANDATORY except in Contained Resources. When the resource version last changed.
.... source Σ 0..1 uri Identifies where the resource comes from
.... profile SΣ 0..* canonical(StructureDefinition) Profiles this resource claims to conform to. Should list (i) this profile (ii) base profile for this resource.
.... security Σ 0..* Coding DISCOURAGED - may not be honoured by Data Consumers
Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.


.... Slices for tag Σ 0..* Coding Tags applied to this resource
Slice: Unordered, Open by value:system
Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".


..... tag:Source SΣ 0..1 Coding MANDATORY except in Contained Resources. The Data Provider Id (and display text) of the system supplying the data
Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".


...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... system Σ 1..1 uri Identity of the terminology system
Fixed Value: https://fhir.interweavedigital.nhs.uk/Source
...... code SΣ 1..1 code The Data Provider Id of the system supplying the data
...... display SΣ 1..1 string Name of the system supplying the data
...... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
..... tag:Provenance SΣ 0..1 Coding MANDATORY except in Contained Resources. The ODS Code (and display text) of the organisation responsible for the data
Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".


...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... system Σ 1..1 uri Identity of the terminology system
Fixed Value: https://fhir.interweavedigital.nhs.uk/Provenance
...... code SΣ 1..1 code The ODS Code of the organisation responsible for the data
...... display SΣ 1..1 string Name of the organisation supplying the data
...... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
... implicitRules ?!Σ 0..1 uri DISCOURAGED - may not be honoured by Data Consumers
... text 0..1 Narrative DISCOURAGED - the preferred approach is to offer structured data fields which a Data Consumer can then render and present in a manner most suited to its users
... contained 0..* Resource Contained, inline Resources
... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
.... bodyStructureR5 0..1 Reference(BodyStructure) Observed body structure. This is a R5 backport.
URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.bodyStructure
.... bodyPosition 0..1 (Complex) The patients body position when the vital signs observation was recorded.
URL: http://hl7.org/fhir/StructureDefinition/observation-bodyPosition
..... id 0..1 id Unique id for inter-element referencing
..... extension 0..0
..... url 1..1 uri "http://hl7.org/fhir/StructureDefinition/observation-bodyPosition"
..... value[x] 1..1 CodeableConcept Value of extension
Binding: UK Core Body Position (preferred)
.... recordingSetting 0..* CodeableConcept Records whether the vital signs observation was performed in a clinical or non clinical setting.
URL: https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-RecordingSetting
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... identifier SΣ 0..* Identifier Business Identifier for observation
... basedOn Σ 0..* Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest) DISCOURAGED - This field does not appear to provide information which would be beneficial in a shared care record. It also allows references to a raft of request/order resources which introduces a lot of complexity for a data consumer.
... partOf Σ 0..* Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy) DISCOURAGED - This field does not appear to provide information which would be beneficial in a shared care record. It also allows references to a raft of request/order resources which introduces a lot of complexity for a data consumer.
... status ?!SΣ 1..1 code A status of `final` SHALL be present.
Binding: ObservationStatus (required): Codes providing the status of an observation.


Fixed Value: final
... category S 1..1 CodeableConcept A category of `vital-signs` SHALL be present.
Binding: ObservationCategoryCodes (required): Codes for high level observation categories.


.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... coding Σ 0..* Coding Code defined by a terminology system
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... system Σ 1..1 uri Identity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category
..... version Σ 0..1 string Version of the system - if relevant
..... code Σ 1..1 code Symbol in syntax defined by the system
Fixed Value: vital-signs
..... display Σ 1..1 string Representation defined by the system
Fixed Value: Vital Signs
..... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
.... text Σ 0..1 string Plain text representation of the concept
... code SΣ 1..1 CodeableConcept The type of vital signs observation (code / type).
Binding: UK Core Observation Type (preferred): A code from the SNOMED Clinical Terminology UK coding system describing a type of observation

.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... Slices for coding Σ 2..* Coding Code defined by a terminology system
Slice: Unordered, Open by value:system
..... coding:All Slices Content/Rules for all slices
...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... system Σ 0..1 uri Identity of the terminology system
...... version Σ 0..1 string Version of the system - if relevant
...... code Σ 0..1 code Symbol in syntax defined by the system
...... display Σ 0..1 string Representation defined by the system
...... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
..... coding:loinc Σ 1..1 Coding A LOINC "magic code" describing the type of observation SHALL be present.
Binding: VitalSigns (extensible)
...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... system Σ 1..1 uri Identity of the terminology system
Fixed Value: http://loinc.org
...... code Σ 1..1 code Symbol in syntax defined by the system
Fixed Value: 85354-9
...... display Σ 1..1 string Representation defined by the system
Fixed Value: Blood pressure panel with all children optional
...... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
..... coding:snomedCT Σ 1..* Coding A SNOMED CT concept describing the type of observation SHALL be present.
Binding: UK Core Blood Pressure (preferred)
...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... system Σ 1..1 uri Identity of the terminology system
Fixed Value: http://snomed.info/sct
...... code Σ 1..1 code Symbol in syntax defined by the system
...... display Σ 1..1 string Representation defined by the system
...... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
.... text Σ 0..1 string Plain text representation of the concept
... subject SΣ 1..1 Reference(InterweavePatient) Who or what the observation relates to SHALL be present.
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... reference ΣC 1..1 string Reference to a resource (could be Contained)
.... type Σ 0..1 uri Type the reference refers to (e.g. "Patient")
Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).

.... identifier Σ 0..1 Identifier If relevant could include an id
.... display Σ 1..1 string Description of the referenced resource
... encounter SΣ 0..1 Reference(InterweaveEncounter) Healthcare event during which this observation is made
... effective[x] SΣ 1..1 This is the time/time period during which the observation was taken.
.... effectiveDateTime dateTime
.... effectiveInstant instant
... performer SΣ 0..* Reference(Practitioner | PractitionerRole | CareTeam) Who is responsible for the observation.
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... reference ΣC 1..1 string Reference to a resource (could be Contained)
.... type Σ 0..1 uri Type the reference refers to (e.g. "Patient")
Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).

.... identifier Σ 0..1 Identifier If relevant could include an id
.... display Σ 1..1 string Description of the referenced resource
... note S 0..1 Annotation Comments about the observation
... bodySite S 0..1 CodeableConcept Observed body part
Binding: SNOMEDCTBodyStructures (required)
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... coding Σ 0..* Coding Code defined by a terminology system
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... system Σ 1..1 uri Identity of the terminology system
..... version Σ 0..1 string Version of the system - if relevant
..... code Σ 1..1 code Symbol in syntax defined by the system
..... display Σ 1..1 string Representation defined by the system
..... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
.... text Σ 0..1 string Plain text representation of the concept
... method 0..1 CodeableConcept How it was done
Binding: UK Core Blood Pressure Measurement Method (preferred)
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... coding Σ 0..* Coding Code defined by a terminology system
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... system Σ 1..1 uri Identity of the terminology system
..... version Σ 0..1 string Version of the system - if relevant
..... code Σ 1..1 code Symbol in syntax defined by the system
..... display Σ 1..1 string Representation defined by the system
..... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
.... text Σ 0..1 string Plain text representation of the concept
... device 0..1 Reference(DeviceMetric | UK Core Device Blood Pressure) (Measurement) Device
... derivedFrom Σ 0..* Reference(InterweaveObservation | InterweaveQuestionnaireResponse) Related measurements the observation is made from
... Slices for component SΣ 1..2 BackboneElement Component / sub results.
Slice: Unordered, Closed by value:code.text
.... component:All Slices Content/Rules for all slices
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... code Σ 1..1 CodeableConcept Type of component observation (code / type)
Binding: UK Core Observation Vital Signs Type (preferred): A code from the SNOMED Clinical Terminology UK coding system describing a type of vital sign.

...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... coding Σ 0..* Coding Code defined by a terminology system
....... id 0..1 string Unique id for inter-element referencing
....... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
....... system Σ 1..1 uri Identity of the terminology system
....... version Σ 0..1 string Version of the system - if relevant
....... code Σ 1..1 code Symbol in syntax defined by the system
....... display Σ 1..1 string Representation defined by the system
....... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
...... text Σ 0..1 string Plain text representation of the concept
..... value[x] Σ 0..1 Actual component result
...... valueQuantity Quantity
...... valueCodeableConcept CodeableConcept
...... valueString string
...... valueBoolean boolean
...... valueInteger integer
...... valueRange Range
...... valueRatio Ratio
...... valueSampledData SampledData
...... valueTime time
...... valueDateTime dateTime
...... valuePeriod Period
..... dataAbsentReason C 0..1 CodeableConcept Why the component result is missing
Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.

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


..... referenceRange 0..* See referenceRange (Observation) Provides guide for interpretation of component result
.... component:SystolicBP SΣ 1..1 BackboneElement Component / sub results.
..... extension 0..* Extension Additional content defined by implementations
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... code SΣ 1..1 CodeableConcept Type of component observation (code / type)
Binding: UK Core Observation Type (preferred): A code from the SNOMED Clinical Terminology UK coding system describing a type of observation

...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... Slices for coding Σ 2..* Coding Code defined by a terminology system
Slice: Unordered, Open by value:system
...... Slices for coding Content/Rules for all slices
....... coding:loinc Σ 1..1 Coding Code defined by a terminology system
........ extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
........ system Σ 1..1 uri Identity of the terminology system
Fixed Value: http://loinc.org
........ code Σ 1..1 code Symbol in syntax defined by the system
Fixed Value: 8480-6
........ display Σ 1..1 string Representation defined by the system
Fixed Value: Systolic blood pressure
........ userSelected Σ 0..1 boolean If this coding was chosen directly by the user
...... Slices for coding Content/Rules for all slices
....... coding:snomedCT Σ 1..* Coding Code defined by a terminology system
Binding: UK Core Blood Pressure Systolic (preferred)
........ extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
........ system Σ 1..1 uri Identity of the terminology system
Fixed Value: http://snomed.info/sct
........ code Σ 1..1 code Symbol in syntax defined by the system
........ display Σ 1..1 string Representation defined by the system
........ userSelected Σ 0..1 boolean If this coding was chosen directly by the user
...... text Σ 1..1 string Plain text representation of the concept
Fixed Value: Systolic blood pressure
..... value[x] SΣ 1..1 Quantity Actual component result
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... value Σ 0..1 decimal Numerical value (with implicit precision)
...... comparator ?!Σ 0..1 code < | <= | >= | > - how to understand the value
Binding: QuantityComparator (required): How the Quantity should be understood and represented.

...... unit Σ 1..1 string Unit representation
Fixed Value: millimeter of mercury
...... system ΣC 1..1 uri System that defines coded unit form
Fixed Value: http://unitsofmeasure.org
...... code Σ 1..1 code Coded form of the unit
Fixed Value: mm[Hg]
..... interpretation S 0..* CodeableConcept High, low, normal, etc.
Binding: ObservationInterpretationCodes (required)
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... coding Σ 0..* Coding Code defined by a terminology system
....... id 0..1 string Unique id for inter-element referencing
....... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
....... system Σ 1..1 uri Identity of the terminology system
....... version Σ 0..1 string Version of the system - if relevant
....... code Σ 1..1 code Symbol in syntax defined by the system
....... display Σ 1..1 string Representation defined by the system
....... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
...... text Σ 0..1 string Plain text representation of the concept
..... referenceRange 0..* See referenceRange (Observation) Provides guide for interpretation of component result
.... component:DiastolicBP SΣ 0..1 BackboneElement Component / sub results.
..... extension 0..* Extension Additional content defined by implementations
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... code SΣ 1..1 CodeableConcept Type of component observation (code / type)
Binding: UK Core Observation Type (preferred): A code from the SNOMED Clinical Terminology UK coding system describing a type of observation

...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... Slices for coding Σ 2..* Coding Code defined by a terminology system
Slice: Unordered, Open by value:system
...... Slices for coding Content/Rules for all slices
....... coding:loinc Σ 1..1 Coding Code defined by a terminology system
........ extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
........ system Σ 1..1 uri Identity of the terminology system
Fixed Value: http://loinc.org
........ code Σ 1..1 code Symbol in syntax defined by the system
Fixed Value: 8462-4
........ display Σ 1..1 string Representation defined by the system
Fixed Value: Diastolic blood pressure
........ userSelected Σ 0..1 boolean If this coding was chosen directly by the user
...... Slices for coding Content/Rules for all slices
....... coding:snomedCT Σ 1..* Coding Code defined by a terminology system
Binding: UK Core Blood Pressure Diastolic (preferred)
........ extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
........ system Σ 1..1 uri Identity of the terminology system
Fixed Value: http://snomed.info/sct
........ code Σ 1..1 code Symbol in syntax defined by the system
........ display Σ 1..1 string Representation defined by the system
........ userSelected Σ 0..1 boolean If this coding was chosen directly by the user
...... text Σ 1..1 string Plain text representation of the concept
Fixed Value: Diastolic blood pressure
..... value[x] SΣ 1..1 Quantity Actual component result
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... value Σ 0..1 decimal Numerical value (with implicit precision)
...... comparator ?!Σ 0..1 code < | <= | >= | > - how to understand the value
Binding: QuantityComparator (required): How the Quantity should be understood and represented.

...... unit Σ 1..1 string Unit representation
Fixed Value: millimeter of mercury
...... system ΣC 1..1 uri System that defines coded unit form
Fixed Value: http://unitsofmeasure.org
...... code Σ 1..1 code Coded form of the unit
Fixed Value: mm[Hg]
..... dataAbsentReason SC 0..1 CodeableConcept Why the component result is missing
Binding: DataAbsentReason (required)
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... coding Σ 0..* Coding Code defined by a terminology system
....... id 0..1 string Unique id for inter-element referencing
....... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
....... system Σ 1..1 uri Identity of the terminology system
....... version Σ 0..1 string Version of the system - if relevant
....... code Σ 1..1 code Symbol in syntax defined by the system
....... display Σ 1..1 string Representation defined by the system
....... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
...... text Σ 0..1 string Plain text representation of the concept
..... interpretation S 0..* CodeableConcept High, low, normal, etc.
Binding: ObservationInterpretationCodes (required)
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... coding Σ 0..* Coding Code defined by a terminology system
....... id 0..1 string Unique id for inter-element referencing
....... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
....... system Σ 1..1 uri Identity of the terminology system
....... version Σ 0..1 string Version of the system - if relevant
....... code Σ 1..1 code Symbol in syntax defined by the system
....... display Σ 1..1 string Representation defined by the system
....... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
...... text Σ 0..1 string Plain text representation of the concept
..... referenceRange 0..* See referenceRange (Observation) Provides guide for interpretation of component result

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / CodeURI
Observation.meta.securityextensibleAll Security Labels
http://hl7.org/fhir/ValueSet/security-labels
from the FHIR Standard
Observation.meta.tagexampleCommonTags
http://hl7.org/fhir/ValueSet/common-tags
from the FHIR Standard
Observation.meta.tag:SourceexampleCommonTags
http://hl7.org/fhir/ValueSet/common-tags
from the FHIR Standard
Observation.meta.tag:ProvenanceexampleCommonTags
http://hl7.org/fhir/ValueSet/common-tags
from the FHIR Standard
Observation.languagepreferredCommonLanguages
Additional Bindings Purpose
AllLanguages Max Binding
http://hl7.org/fhir/ValueSet/languages
from the FHIR Standard
Observation.extension:triggeredByR5.extension:type.value[x]requiredhttp://hl7.org/fhir/ValueSet/observation-triggeredbytype
http://hl7.org/fhir/ValueSet/observation-triggeredbytype
Observation.extension:bodyPosition.value[x]preferredUKCoreBodyPosition
https://fhir.hl7.org.uk/ValueSet/UKCore-BodyPosition
from this IG
Observation.statusrequiredFixed Value: final
http://hl7.org/fhir/ValueSet/observation-status|4.0.1
from the FHIR Standard
Observation.categoryrequiredObservationCategoryCodes
http://hl7.org/fhir/ValueSet/observation-category
from the FHIR Standard
Observation.codepreferredUKCoreObservationType
https://fhir.hl7.org.uk/ValueSet/UKCore-ObservationType
from this IG
Observation.code.coding:loincextensibleFixed Value: LOINC Code 85354-9
http://hl7.org/fhir/ValueSet/observation-vitalsignresult
from the FHIR Standard
Observation.code.coding:snomedCTpreferredUKCoreBloodPressure
https://fhir.hl7.org.uk/ValueSet/UKCore-BloodPressure
from this IG
Observation.subject.typeextensibleResourceType
http://hl7.org/fhir/ValueSet/resource-types
from the FHIR Standard
Observation.performer.typeextensibleResourceType
http://hl7.org/fhir/ValueSet/resource-types
from the FHIR Standard
Observation.bodySiterequiredSNOMEDCTBodyStructures
http://hl7.org/fhir/ValueSet/body-site
from the FHIR Standard
Observation.methodpreferredUKCoreBloodPressureMeasurementMethod
https://fhir.hl7.org.uk/ValueSet/UKCore-BloodPressure-MeasurementMethod
from this IG
Observation.referenceRange.typepreferredObservationReferenceRangeMeaningCodes
http://hl7.org/fhir/ValueSet/referencerange-meaning
from the FHIR Standard
Observation.referenceRange.appliesToexampleObservationReferenceRangeAppliesToCodes
http://hl7.org/fhir/ValueSet/referencerange-appliesto
from the FHIR Standard
Observation.component.codepreferredUKCoreObservationVitalSignsType
https://fhir.hl7.org.uk/ValueSet/UKCore-ObservationVitalSignsType
from this IG
Observation.component.dataAbsentReasonextensibleDataAbsentReason
http://hl7.org/fhir/ValueSet/data-absent-reason
from the FHIR Standard
Observation.component.interpretationextensibleObservationInterpretationCodes
http://hl7.org/fhir/ValueSet/observation-interpretation
from the FHIR Standard
Observation.component:SystolicBP.codepreferredUKCoreObservationType
https://fhir.hl7.org.uk/ValueSet/UKCore-ObservationType
from this IG
Observation.component:SystolicBP.code.coding:snomedCTpreferredUKCoreBloodPressureSystolic
https://fhir.hl7.org.uk/ValueSet/UKCore-BloodPressure-Systolic
from this IG
Observation.component:SystolicBP.value[x].comparatorrequiredQuantityComparator
http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1
from the FHIR Standard
Observation.component:SystolicBP.interpretationrequiredObservationInterpretationCodes
http://hl7.org/fhir/ValueSet/observation-interpretation
from the FHIR Standard
Observation.component:DiastolicBP.codepreferredUKCoreObservationType
https://fhir.hl7.org.uk/ValueSet/UKCore-ObservationType
from this IG
Observation.component:DiastolicBP.code.coding:snomedCTpreferredUKCoreBloodPressureDiastolic
https://fhir.hl7.org.uk/ValueSet/UKCore-BloodPressure-Diastolic
from this IG
Observation.component:DiastolicBP.value[x].comparatorrequiredQuantityComparator
http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1
from the FHIR Standard
Observation.component:DiastolicBP.dataAbsentReasonrequiredDataAbsentReason
http://hl7.org/fhir/ValueSet/data-absent-reason
from the FHIR Standard
Observation.component:DiastolicBP.interpretationrequiredObservationInterpretationCodes
http://hl7.org/fhir/ValueSet/observation-interpretation
from the FHIR Standard

Constraints

IdGradePath(s)DetailsRequirements
dom-2errorObservationIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorObservationIf 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-4errorObservationIf 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-5errorObservationIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practiceObservationA resource should have narrative for robust management
: text.`div`.exists()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()
obs-6errorObservationdataAbsentReason SHALL only be present if Observation.value[x] is not present
: dataAbsentReason.empty() or value.empty()
obs-7errorObservationIf 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()
ukcore-obs-vs-001errorObservation`code.coding` SHALL include a LOINC "magic code"
: code.coding.where(system='http://loinc.org').exists()

This structure is derived from UKCoreObservationVitalSignsBloodPressure

Summary

Mandatory: 15 elements(38 nested mandatory elements)
Must-Support: 21 elements
Fixed: 8 elements
Prohibited: 41 elements

Structures

This structure refers to these other structures:

Slices

This structure defines the following Slices:

  • The element 1 is sliced based on the value of Observation.meta.tag

 

Other representations of profile: CSV, Excel, Schematron

Notes:

Differences between Interweave STU3 and R4 profiles

Element name Change details
extension:reason
  • Deleted
extension:bodyStructureR5
  • Added Element
extension:bodyPosition
  • Added Element
extension:recordingSetting
  • Added Element
extension:valuePrecision
  • Added Element
category.coding.system
  • Change of codeSystem from http://hl7.org/fhir/observation-category to http://terminology.hl7.org/CodeSystem/observation-category
code.coding:loinc.display
  • Added fixed value: Blood pressure panel with all children optional
code.coding:snomedCT
  • Added preferred binding to https://fhir.hl7.org.uk/ValueSet/UKCore-BloodPressure
code.coding:snomedCT.code
  • Fixed value removed
code.coding:snomedCT.display
  • Fixed value removed
encounter
  • Renamed from context to encounter
effective[x]
  • Removed Type period
  • Added Type instant
performer
  • Type Reference: Added Target Types PractitionerRole, CareTeam
dataAbsentReason
  • Deleted
interpretation
  • Deleted
note
  • Renamed from comment to note
  • Type changed from string to Annotation
specimen
  • Deleted
referenceRange
  • Deleted
derivedFrom
  • Renamed from related to derivedFrom
  • Type changed from BackboneElement to Reference
  • Type Reference: Added Target Type QuestionnaireResponse
component:SystolicBP.code.coding:snomedCT
  • Added preferred binding to https://fhir.hl7.org.uk/ValueSet/UKCore-BloodPressure-Systolic
component:SystolicBP.code.coding:snomedCT.code
  • Fixed value removed
component:SystolicBP.code.coding:snomedCT.display
  • Fixed value removed
component:SystolicBP.code.text
  • Added fixed value: Systolic blood pressure
component:SystolicBP.valueQuantity.unit
  • Added fixed value: millimeter of mercury
component:DiastolicBP.dataAbsentReason
  • Deleted
component:SystolicBP.interpretation
  • Change of codeSystem from http://hl7.org/fhir/v2/0078 to http://terminology.hl7.org/CodeSystem/v3-ObservationInterpretation
component:SystolicBP.referenceRange.type
  • Binding updated form extensible to preferred
  • Change of codeSystem from http://hl7.org/fhir/referencerange-meaning to http://terminology.hl7.org/CodeSystem/referencerange-meaning
component:DiastolicBP
  • min cardinality changed from 1 to 0
component:DiastolicBP.code.coding:snomedCT
  • Added preferred binding to https://fhir.hl7.org.uk/ValueSet/UKCore-BloodPressure-Diastolic
component:DiastolicBP.code.coding:snomedCT.code
  • Fixed value removed
component:DiastolicBP.code.coding:snomedCT.display
  • Fixed value removed
component:DiastolicBP.code.text
  • Added fixed value: Diastolic blood pressure
component:DiastolicBP.dataAbsentReason
  • Changed valueSet from http://hl7.org/fhir/ValueSet/observation-valueabsentreason to http://hl7.org/fhir/ValueSet/data-absent-reason
  • Change of codeSystem from http://hl7.org/fhir/data-absent-reason to http://terminology.hl7.org/CodeSystem/data-absent-reason
component:DiastolicBP.interpretation
  • Change of codeSystem from http://hl7.org/fhir/v2/0078 to http://terminology.hl7.org/CodeSystem/v3-ObservationInterpretation
component:DiastolicBP.referenceRange.type
  • Binding updated form extensible to preferred
  • Change of codeSystem from http://hl7.org/fhir/referencerange-meaning to http://terminology.hl7.org/CodeSystem/referencerange-meaning