Diagnostics
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| Orders and Observations Work Group | Maturity Level : N/A | Standards Status : Informative | Compartments : Device , Encounter , Patient , Practitioner , RelatedPerson |
Raw Turtle (+ also see Turtle/RDF Format Specification )
Blood Pressure Measurement cancelled
@prefix fhir: <http://hl7.org/fhir/> .
@prefix loinc: <https://loinc.org/rdf/> .
@prefix owl: <http://www.w3.org/2002/07/owl#> .
@prefix rdfs: <http://www.w3.org/2000/01/rdf-schema#> .
@prefix sct: <http://snomed.info/id/> .
@prefix xsd: <http://www.w3.org/2001/XMLSchema#> .
# - resource -------------------------------------------------------------------
#
# This is an example of a cancelled standard blood pressure measurement. with an Observation/component/dataAbsentReason valued due to cancellation.
#
# Blood Pressure is a regarded as a single observation, and
# presented that way in plain text: 120/80. Also, it is usually
# interpreted as a single value, though intepretation can also
# be offered to the parts individually
#
# Technically, though, a blood pressure is a pair of component
# observations. LOINC code 85354-9 notes say:
# This term is intended as a section header for various
# blood pressure measurements (e.g. systolic, diastolic).
# LOINC discourages the reporting of two numbers, such as
# systolic and diastolic blood pressure (e.g. 120/80),
# in one observation. They should be reported as two
# separate variables, systolic (LOINC 8480-6) and
# diastolic (LOINC 8462-4)
#
# This example shows the standard way to represent a meaurement that cause the expected values to be empty
# single resource, with a narrative in the standard form, and two
# component observations for the actual values with Observation/component/dataAbsentReason valued due to cancellation
#
#
#
[a fhir:Observation ;
fhir:nodeRole fhir:treeRoot ;
fhir:id [ fhir:v "blood-pressure-cancel"] ; #
fhir:meta [
fhir:profile ( [
fhir:v "http://hl7.org/fhir/StructureDefinition/vitalsigns"^^xsd:anyURI ;
fhir:link <http://hl7.org/fhir/StructureDefinition/vitalsigns>
] )
] ; #
fhir:text [
fhir:status [ fhir:v "generated" ] ;
fhir:div "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Observation</b><a name=\"blood-pressure-cancel\"> </a></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Resource Observation "blood-pressure-cancel" </p><p style=\"margin-bottom: 0px\">Profile: <a href=\"vitalsigns.html\">Vital Signs Profile</a></p></div><p><b>identifier</b>: <span title=\" EH Narrative created by build\n <text>\n <status value="generated"/>\n <div xmlns="http://www.w3.org/1999/xhtml">Sept 17, 2012: Systolic Blood pressure 107/60 mmHg (low)</div>\n </text>\n \">id: urn:uuid:187e0c12-8dd2-67e2-99b2-bf273c878281</span></p><p><b>status</b>: cancelled</p><p><b>category</b>: Vital Signs <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.1.0/CodeSystem-observation-category.html\">Observation Category Codes</a>#vital-signs)</span></p><p><b>code</b>: Blood pressure systolic & diastolic <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://loinc.org/\">LOINC</a>#85354-9 "Blood pressure panel with all children optional")</span></p><p><b>subject</b>: <a href=\"patient-example.html\">Patient/example</a> "Peter CHALMERS"</p><p><b>effective</b>: 2012-09-17</p><p><b>performer</b>: <a href=\"practitioner-example.html\">Practitioner/example</a> "Adam CAREFUL"</p><p><b>interpretation</b>: <span title=\" an interpretation offered to the combination observation\n generally, it would only be appropriate to offer an interpretation\n of an observation that has no value if it has "COMP" (component)\n observations \">Below low normal <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.1.0/CodeSystem-v3-ObservationInterpretation.html\">ObservationInterpretation</a>#L "low")</span></span></p><p><b>note</b>: In this example, the blood pressure measurements are not available due to cancellation of the order. Data absent reason is present for each component</p><p><b>bodySite</b>: <span title=\" for an observation with components, these cannot disagree with the flags on the components \">Right arm <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#368209003)</span></span></p><blockquote><p><b>component</b></p><p><b>code</b>: <span title=\" \n Observations are often coded in multiple code systems.\n - LOINC provides a very specific code (though not usefully more specific in this particular case)\n - snomed provides a clinically relevant code that is usually less granular than LOINC\n - the source system provides its own code, which may be less or more granular than LOINC\n this instance shows the concept. The other codes only have a LOINC code \">Systolic blood pressure <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://loinc.org/\">LOINC</a>#8480-6; <a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#271649006; clinical-codes#bp-s "Systolic Blood pressure")</span></span></p><p><b>dataAbsentReason</b>: <span title=\" no value due to some error\n <valueQuantity>\n <value value="107"/>\n <unit value="mm[Hg]"/>\n </valueQuantity>\n \">Not Asked <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.1.0/CodeSystem-data-absent-reason.html\">DataAbsentReason</a>#not-asked)</span></span></p></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: Diastolic blood pressure <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://loinc.org/\">LOINC</a>#8462-4)</span></p><p><b>dataAbsentReason</b>: <span title=\" no value due to some error\n <valueQuantity>\n <value value="60"/>\n <unit value="mm[Hg]"/>\n </valueQuantity>\n \">Not Asked <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.1.0/CodeSystem-data-absent-reason.html\">DataAbsentReason</a>#not-asked)</span></span></p></blockquote></div>"
] ; # EH Narrative created by build
fhir:identifier ( [
fhir:system [ fhir:v "urn:ietf:rfc:3986"^^xsd:anyURI ] ;
fhir:value [ fhir:v "urn:uuid:187e0c12-8dd2-67e2-99b2-bf273c878281" ]
] ) ; # EH Narrative created by build
# <text>
# <status value="generated"/>
# <div xmlns="http://www.w3.org/1999/xhtml">Sept 17, 2012: Systolic Blood pressure 107/60 mmHg (low)</div>
# </text>
#
fhir:identifier ( [
fhir:system [ fhir:v "urn:ietf:rfc:3986"^^xsd:anyURI ] ;
fhir:value [ fhir:v "urn:uuid:187e0c12-8dd2-67e2-99b2-bf273c878281" ]
] ) ; #
#
fhir:status [ fhir:v "cancelled"] ; #
fhir:category ( [
fhir:coding ( [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/observation-category"^^xsd:anyURI ] ;
fhir:code [ fhir:v "vital-signs" ] ;
fhir:display [ fhir:v "Vital Signs" ]
] )
] [
fhir:coding ( [
a loinc:85354-9 ;
fhir:system [ fhir:v "http://loinc.org"^^xsd:anyURI ] ;
fhir:code [ fhir:v "85354-9" ] ;
fhir:display [ fhir:v "Blood pressure panel with all children optional" ]
] )
] ) ; #
fhir:code [
fhir:coding ( [
a loinc:85354-9 ;
fhir:system [ fhir:v "http://loinc.org"^^xsd:anyURI ] ;
fhir:code [ fhir:v "85354-9" ] ;
fhir:display [ fhir:v "Blood pressure panel with all children optional" ]
] ) ; # replaced by 85354-9\n <coding>\n <system value=\"http:\/\/loinc.org\"\/>\n <code value=\"85354-9\"\/>\n <display value=\"Blood pressure systolic & diastolic\"\/>\n <\/coding>\n
] ) ; # replaced by 85354-9\n <coding>\n <system value=\"http:\/\/loinc.org\"\/>\n <code value=\"85354-9\"\/>\n <display value=\"Blood pressure systolic & diastolic\"\/>\n <\/coding>\n
fhir:text [ fhir:v "Blood pressure systolic & diastolic" ]
] ; #
fhir:subject [
fhir:reference [ fhir:v "Patient/example" ]
] ; #
fhir:effective [ fhir:v "2012-09-17"^^xsd:date] ; #
fhir:performer ( [
fhir:reference [ fhir:v "Practitioner/example" ]
] ) ; #
fhir:interpretation ( [
fhir:coding ( [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/v3-ObservationInterpretation"^^xsd:anyURI ] ;
fhir:code [ fhir:v "L" ] ;
fhir:display [ fhir:v "low" ]
] ) ;
fhir:text [ fhir:v "Below low normal" ]
] ) ; # an interpretation offered to the combination observation
] ) ; # an interpretation offered to the combination observation
# generally, it would only be appropriate to offer an interpretation
# of an observation that has no value if it has "COMP" (component)
# observations
# observations
fhir:note ( [
fhir:text [ fhir:v "In this example, the blood pressure measurements are not available due to cancellation of the order. Data absent reason is present for each component" ]
] ) ; #
fhir:bodySite [
fhir:coding ( [
a sct:368209003 ;
fhir:system [ fhir:v "http://snomed.info/sct"^^xsd:anyURI ] ;
fhir:code [ fhir:v "368209003" ] ;
fhir:display [ fhir:v "Right arm" ]
] )
] ; # for an observation with components, these cannot disagree with the flags on the components
] ; # for an observation with components, these cannot disagree with the flags on the components
fhir:component ( [
fhir:extension ( [
fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/observation-componentCategory"^^xsd:anyURI ] ;
fhir:value [
a fhir:CodeableConcept ;
fhir:coding ( [
a loinc:8480-6 ;
fhir:system [ fhir:v "http://loinc.org"^^xsd:anyURI ] ;
fhir:code [ fhir:v "8480-6" ] ;
fhir:display [ fhir:v "Systolic blood pressure" ]
] )
]
] ) ;
fhir:code [
fhir:coding ( [
a loinc:8480-6 ;
fhir:system [ fhir:v "http://loinc.org"^^xsd:anyURI ] ;
fhir:code [ fhir:v "8480-6" ] ;
fhir:display [ fhir:v "Systolic blood pressure" ]
] [
a sct:271649006 ;
fhir:system [ fhir:v "http://snomed.info/sct"^^xsd:anyURI ] ;
fhir:code [ fhir:v "271649006" ] ;
fhir:display [ fhir:v "Systolic blood pressure" ]
] [
fhir:system [ fhir:v "http://acme.org/devices/clinical-codes"^^xsd:anyURI ] ;
fhir:code [ fhir:v "bp-s" ] ;
fhir:display [ fhir:v "Systolic Blood pressure" ]
] ) # LOINC - always recommended to have a LOINC code
] ; # \n Observations are often coded in multiple code systems.\n - LOINC provides a very specific code (though not usefully more specific in this particular case)\n - snomed provides a clinically relevant code that is usually less granular than LOINC\n - the source system provides its own code, which may be less or more granular than LOINC\n this instance shows the concept. The other codes only have a LOINC code , that shows the concept. The next two names only have a LOINC code
] ) # LOINC - always recommended to have a LOINC code
] ; # \n Observations are often coded in multiple code systems.\n - LOINC provides a very specific code (though not usefully more specific in this particular case)\n - snomed provides a clinically relevant code that is usually less granular than LOINC\n - the source system provides its own code, which may be less or more granular than LOINC\n this instance shows the concept. The other codes only have a LOINC code , that shows the concept. The next two names only have a LOINC code
fhir:dataAbsentReason [
fhir:coding ( [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/data-absent-reason"^^xsd:anyURI ] ;
fhir:code [ fhir:v "not-asked" ] ;
fhir:display [ fhir:v "Not Asked" ]
] )
] # no value due to some error\n <valueQuantity>\n <value value=\"107\"\/>\n <unit value=\"mm[Hg]\"\/>\n <\/valueQuantity>\n
] # no value due to some error\n <valueQuantity>\n <value value=\"107\"\/>\n <unit value=\"mm[Hg]\"\/>\n <\/valueQuantity>\n
] [
fhir:extension ( [
fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/observation-componentCategory"^^xsd:anyURI ] ;
fhir:value [
a fhir:CodeableConcept ;
fhir:coding ( [
a loinc:8462-4 ;
fhir:system [ fhir:v "http://loinc.org"^^xsd:anyURI ] ;
fhir:code [ fhir:v "8462-4" ] ;
fhir:display [ fhir:v "Diastolic blood pressure" ]
] )
]
] ) ;
fhir:code [
fhir:coding ( [
a loinc:8462-4 ;
fhir:system [ fhir:v "http://loinc.org"^^xsd:anyURI ] ;
fhir:code [ fhir:v "8462-4" ] ;
fhir:display [ fhir:v "Diastolic blood pressure" ]
] )
] ;
fhir:dataAbsentReason [
fhir:coding ( [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/data-absent-reason"^^xsd:anyURI ] ;
fhir:code [ fhir:v "not-asked" ] ;
fhir:display [ fhir:v "Not Asked" ]
] )
] # no value due to some error\n <valueQuantity>\n <value value=\"60\"\/>\n <unit value=\"mm[Hg]\"\/>\n <\/valueQuantity>\n
] # no value due to some error\n <valueQuantity>\n <value value=\"60\"\/>\n <unit value=\"mm[Hg]\"\/>\n <\/valueQuantity>\n
] )] . #
# -------------------------------------------------------------------------------------
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.
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