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Observation-example-glasgow.json

Example Observation/glasgow (JSON)

Maturity Level : N/A
Responsible Owner: Orders and Observations Work Group Ballot Standards Status : Informative Compartments : Device , Encounter , Group , Patient , Practitioner , RelatedPerson

Raw JSON ( canonical form + also see JSON Format Specification )

Clinical assessment tool example - GCS using related Observations with individual score as components 

{
  "resourceType": "Observation",
  "id": "glasgow",
  "text": {
    "status": "generated",
    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative with Details</b></p><p><b>id</b>: glasgow</p><p><b>contained</b>: , , </p><p><b>status</b>: final</p><p><b>code</b>: Glasgow Coma Scale , (GCS) <span>(Details : {LOINC code '9269-2' = 'Glasgow coma score total', given as 'Glasgow coma score total'})</span></p><p><b>subject</b>: <a>Peter James Chalmers</a></p><p><b>effective</b>: 11/12/2014 4:44:16 AM</p><p><b>value</b>: 13 {score}<span> (Details: UCUM code {score} = '{score}')</span></p><blockquote><p><b>referenceRange</b></p><p><b>high</b>: 8 {score}<span> (Details: UCUM code {score} = '{score}')</span></p><p><b>type</b>: Severe TBI <span>(Details )</span></p></blockquote><blockquote><p><b>referenceRange</b></p><p><b>low</b>: 9 {score}<span> (Details: UCUM code {score} = '{score}')</span></p><p><b>high</b>: 12 {score}<span> (Details: UCUM code {score} = '{score}')</span></p><p><b>type</b>: Moderate TBI <span>(Details )</span></p></blockquote><blockquote><p><b>referenceRange</b></p><p><b>low</b>: 13 {score}<span> (Details: UCUM code {score} = '{score}')</span></p><p><b>type</b>: Mild TBI <span>(Details )</span></p></blockquote><blockquote><p><b>related</b></p><p><b>type</b>: derived-from</p><p><b>target</b>: Motor score. Generated Summary: id: motor; status: final; GCS motor <span>(Details : {LOINC code '9268-4' = 'Glasgow coma score motor', given as 'Glasgow coma score motor'})</span>; ????; effective: 11/12/2014 4:44:16 AM; 5 (Localizes painful stimuli) <span>(Details : {http:/acme.ec/gcsmotor code '5' = '5', given as 'Localizes painful stimuli'}; {LOINC code 'LA6566-9' = 'Localizing pain', given as 'Localizing pain'})</span></p></blockquote><blockquote><p><b>related</b></p><p><b>type</b>: derived-from</p><p><b>target</b>: Verbal score. Generated Summary: id: verbal; status: final; Verbal <span>(Details : {LOINC code '9270-0' = 'Glasgow coma score verbal', given as 'Glasgow coma score verbal'})</span>; ????; effective: 11/12/2014 4:44:16 AM; 4 (Confused, disoriented) <span>(Details : {http:/acme.ec/gcsverbal code '4' = '4', given as 'Confused, disoriented'}; {LOINC code 'LA6560-2' = 'Confused', given as 'Confused'})</span></p></blockquote><blockquote><p><b>related</b></p><p><b>type</b>: derived-from</p><p><b>target</b>: Eyes score. Generated Summary: id: eyes; status: final; Eyes <span>(Details : {LOINC code '9267-6' = 'Glasgow coma score eye opening', given as 'Glasgow coma score eye opening'})</span>; ????; effective: 11/12/2014 4:44:16 AM; 4 (Opens eyes spontaneously) <span>(Details : {http:/acme.ec/gcseye code '4' = '4', given as 'Opens eyes spontaneously'}; {LOINC code 'LA6556-0' = 'Eyes open spontaneously', given as 'Eyes open spontaneously'})</span></p></blockquote></div>"

  "resourceType" : "Observation",
  "id" : "glasgow",
  "status" : "final",
  "code" : {
    "coding" : [{
      "system" : "http://loinc.org",
      "code" : "9269-2",
      "display" : "Glasgow coma score total"
    }],
    "text" : "Glasgow Coma Scale , (GCS)"

  },
  "contained": [
    {
      "resourceType": "Observation",
      "id": "motor",
      "status": "final",
      "code": {
        "coding": [
          {
            "system": "http://loinc.org",
            "code": "9268-4",
            "display": "Glasgow coma score motor"
          }
        ],
        "text": "GCS motor"
      },
      "subject": {
        "reference": "Patient/example"
      },
      "effectiveDateTime": "2014-12-11T04:44:16Z",
      "valueCodeableConcept": {
        "coding": [
          {
            "system": "http:/acme.ec/gcsmotor",
            "code": "5",
            "display": "Localizes painful stimuli"
          },
          {
            "extension": [
              {
                "url": "http://hl7.org/fhir/StructureDefinition/iso21090-CO-value",
                "valueDecimal": 5
              }
            ],
            "system": "http://loinc.org",
            "code": "LA6566-9",
            "display": "Localizing pain"
          }
        ],
        "text": "5 (Localizes painful stimuli)"
      }
    },
    {
      "resourceType": "Observation",
      "id": "verbal",
      "status": "final",
      "code": {
        "coding": [
          {
            "system": "http://loinc.org",
            "code": "9270-0",
            "display": "Glasgow coma score verbal"
          }
        ],
        "text": "Verbal"
      },
      "subject": {
        "reference": "Patient/example"
      },
      "effectiveDateTime": "2014-12-11T04:44:16Z",
      "valueCodeableConcept": {
        "coding": [
          {
            "system": "http:/acme.ec/gcsverbal",
            "code": "4",
            "display": "Confused, disoriented"
          },
          {
            "extension": [
              {
                "url": "http://hl7.org/fhir/StructureDefinition/iso21090-CO-value",
                "valueDecimal": 4
              }
            ],
            "system": "http://loinc.org",
            "code": "LA6560-2",
            "display": "Confused"
          }
        ],
        "text": "4 (Confused, disoriented)"
      }

  "subject" : {
    "reference" : "Patient/example",
    "display" : "Peter James Chalmers"
  },
  "effectiveDateTime" : "2014-12-11T04:44:16Z",
  "valueQuantity" : {
    "value" : 13,
    "system" : "http://unitsofmeasure.org",
    "code" : "{score}"
  },
  "referenceRange" : [{
    "high" : {
      "value" : 8,
      "system" : "http://unitsofmeasure.org",
      "code" : "{score}"

    },
    {
      "resourceType": "Observation",
      "id": "eyes",
      "status": "final",
      "code": {
        "coding": [
          {
            "system": "http://loinc.org",
            "code": "9267-6",
            "display": "Glasgow coma score eye opening"
          }
        ],
        "text": "Eyes"
      },
      "subject": {
        "reference": "Patient/example"
      },
      "effectiveDateTime": "2014-12-11T04:44:16Z",
      "valueCodeableConcept": {
        "coding": [
          {
            "system": "http:/acme.ec/gcseye",
            "code": "4",
            "display": "Opens eyes spontaneously"
          },
          {
            "extension": [
              {
                "url": "http://hl7.org/fhir/StructureDefinition/iso21090-CO-value",
                "valueDecimal": 4
              }
            ],
            "system": "http://loinc.org",
            "code": "LA6556-0",
            "display": "Eyes open spontaneously"
          }
        ],
        "text": "4 (Opens eyes spontaneously)"
      }

    "type" : {
      "text" : "Severe TBI"

    }
  ],
  "status": "final",
  "code": {
    "coding": [
      {
        "system": "http://loinc.org",
        "code": "9269-2",
        "display": "Glasgow coma score total"
      }
    ],
    "text": "Glasgow Coma Scale , (GCS)"
  },
  "subject": {
    "reference": "Patient/example",
    "display": "Peter James Chalmers"

  },
  "effectiveDateTime": "2014-12-11T04:44:16Z",
  "valueQuantity": {
    "value": 13,
    "system": "http://unitsofmeasure.org",
    "code": "{score}"

  {
    "low" : {
      "value" : 9,
      "system" : "http://unitsofmeasure.org",
      "code" : "{score}"
    },
    "high" : {
      "value" : 12,
      "system" : "http://unitsofmeasure.org",
      "code" : "{score}"
    },
    "type" : {
      "text" : "Moderate TBI"
    }

  },
  "referenceRange": [
    {
      "high": {
        "value": 8,
        "system": "http://unitsofmeasure.org",
        "code": "{score}"
      },
      "type": {
        "text": "Severe TBI"
      }

  {
    "low" : {
      "value" : 13,
      "system" : "http://unitsofmeasure.org",
      "code" : "{score}"

    },
    {
      "low": {
        "value": 9,
        "system": "http://unitsofmeasure.org",
        "code": "{score}"
      },
      "high": {
        "value": 12,
        "system": "http://unitsofmeasure.org",
        "code": "{score}"
      },
      "type": {
        "text": "Moderate TBI"
      }

    "type" : {
      "text" : "Mild TBI"
    }
  }],
  "component" : [{
    "code" : {
      "coding" : [{
        "system" : "http://loinc.org",
        "code" : "9268-4",
        "display" : "Glasgow coma score motor"
      }],
      "text" : "GCS Motor"

    },
    {
      "low": {
        "value": 13,
        "system": "http://unitsofmeasure.org",
        "code": "{score}"

    "valueCodeableConcept" : {
      "coding" : [{
        "system" : "http://example.org/codes",
        "code" : "5",
        "display" : "Localizes painful stimuli"

      },
      "type": {
        "text": "Mild TBI"
      }

      {
        "extension" : [{
          "url" : "http://hl7.org/fhir/StructureDefinition/itemWeight",
          "valueDecimal" : 5
        }],
        "system" : "http://loinc.org",
        "code" : "LA6566-9",
        "display" : "Localizing pain"
      }],
      "text" : "5 (Localizes painful stimuli)"

    }
  ],
  "related": [
    {
      "type": "derived-from",
      "target": {
        "reference": "#motor",
        "display": "Motor score"
      }

  },
  {
    "code" : {
      "coding" : [{
        "system" : "http://loinc.org",
        "code" : "9270-0",
        "display" : "Glasgow coma score verbal"
      }],
      "text" : "GSC Verbal"

    },
    {
      "type": "derived-from",
      "target": {
        "reference": "#verbal",
        "display": "Verbal score"
      }

    "valueCodeableConcept" : {
      "coding" : [{
        "system" : "http://example.org/codes",
        "code" : "4",
        "display" : "Confused, disoriented"
      },
      {
        "extension" : [{
          "url" : "http://hl7.org/fhir/StructureDefinition/itemWeight",
          "valueDecimal" : 4
        }],
        "system" : "http://loinc.org",
        "code" : "LA6560-2",
        "display" : "Confused"
      }],
      "text" : "4 (Confused, disoriented)"
    }
  },
  {
    "code" : {
      "coding" : [{
        "system" : "http://loinc.org",
        "code" : "9267-6",
        "display" : "Glasgow coma score eye opening"
      }],
      "text" : "Eyes"

    },
    {
      "type": "derived-from",
      "target": {
        "reference": "#eyes",
        "display": "Eyes score"
      }

    "valueCodeableConcept" : {
      "coding" : [{
        "system" : "http://example.org/codes",
        "code" : "4",
        "display" : "Opens eyes spontaneously"
      },
      {
        "extension" : [{
          "url" : "http://hl7.org/fhir/StructureDefinition/itemWeight",
          "valueDecimal" : 4
        }],
        "system" : "http://loinc.org",
        "code" : "LA6556-0",
        "display" : "Eyes open spontaneously"
      }],
      "text" : "4 (Opens eyes spontaneously)"

    }
  ]

  }]

}

Usage note: every effort has been made to ensure that the examples are correct and useful, but they are not a normative part of the specification.