Observation-example-bloodpressure.xml

Blood Pressure Measurement (id = "blood-pressure")

  
  
  
  
  
  <!--   first entry: the single resource with combined
     narrative, and links to the 2 component resources   -->
  
    
    
    
    
    
      
    
    
      
        
          
          
        
        
          
            
            
            
          
        
        
        <!--   an interpretation offered to the combination observation

<Observation xmlns="http://hl7.org/fhir">
  <id value="blood-pressure"/>
  <meta>
    <lastUpdated value="2014-01-30T22:35:23+11:00"/>
  </meta>
  <!--     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>
   -->
  <text><status value="generated"/><div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative with Details</b></p><p><b>id</b>: blood-pressure</p><p><b>meta</b>: </p><p><b>identifier</b>: urn:uuid:187e0c12-8dd2-67e2-99b2-bf273c878281</p><p><b>status</b>: final</p><p><b>code</b>: Blood pressure systolic &amp; diastolic <span>(Details : {LOINC code '55284-4' = 'Blood pressure systolic and diastolic', given as 'Blood

           pressure systolic &amp; diastolic'})</span></p><p><b>subject</b>: <a>Patient/example</a></p><p><b>effective</b>: 17/09/2012</p><p><b>performer</b>: <a>Practitioner/example</a></p><p><b>interpretation</b>: low <span>(Details : {http://hl7.org/fhir/v2/0078 code 'L' = 'Low', given as 'Below low normal'})</span></p><p><b>bodySite</b>: Right arm <span>(Details : {SNOMED CT code '368209003' = '368209003', given as 'Right arm'})</span></p><blockquote><p><b>component</b></p><p><b>code</b>: Systolic blood pressure <span>(Details : {LOINC code '8480-6' = 'Systolic blood pressure', given as 'Systolic blood
             pressure'}; {SNOMED CT code '271649006' = '271649006', given as 'Systolic blood pressure'};
             {http://acme.org/devices/clinical-codes code 'bp-s' = '??', given as 'Systolic Blood pressure'})</span></p><p><b>value</b>: 107 mm[Hg]</p></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: Diastolic blood pressure <span>(Details : {LOINC code '8462-4' = 'Diastolic blood pressure', given as 'Diastolic blood
             pressure'})</span></p><p><b>value</b>: 60 mm[Hg]</p></blockquote></div></text><identifier>
    <system value="urn:ietf:rfc:3986"/>
    <value value="urn:uuid:187e0c12-8dd2-67e2-99b2-bf273c878281"/>
  </identifier>
  <status value="final"/>
  <code>
    <coding>
      <system value="http://loinc.org"/>
      <code value="55284-4"/>
      <display value="Blood pressure systolic &amp; diastolic"/>
    </coding>
  </code>
  <subject>
    <reference value="Patient/example"/>
  </subject>
  <effectiveDateTime value="2012-09-17"/>
  <performer>
    <reference value="Practitioner/example"/>
  </performer>
  <!--    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 &quot;COMP&quot; (component)
        observations   -->        
        
          
            
            
            
          
          
        
        
      
        <!--   for an observation with components, these cannot disagree with the flags on the components
           -->
        
        
        
        
          
          
        
        
        
          
        
        
          
        
        
          
          
            
          
        
        
          
          
            
          
        
      
    
    
      
    
  

  
  
    

        of an observation that has no value if it has "COMP" (component)
        observations    -->
  <interpretation>
    <coding>
      <system value="http://hl7.org/fhir/v2/0078"/>
      <code value="L"/>
      <display value="Below low normal"/>
    </coding>
    <text value="low"/>
  </interpretation>
  <bodySite>
    <coding>
      <system value="http://snomed.info/sct"/>
      <code value="368209003"/>
      <display value="Right arm"/>
    </coding>
  </bodySite>
  <component>
    <!--   
      Most systems won't store systolic and diastolic observations separately.
      They'd usually be two fields in a database or something like that. The 
      FHIR interface treats these as separate observation for consistency 
      purposes (makes query easy). But that doesn't mean that the systems 
      have to really do that internally. This example implies a system that 
      appends -d or -s to the id of the base observation for the individual
      components. 

      This implies that you can operate on them separately, even though
      this would probably not be true. It would be up to the implementing 
      system to decide how to manage this (e.g. readonly, so there's no 
      update operations to worry about)
      -->
    
    
    
      
    
    
      
        
          
          
        
        <!--   
           Observations are often coded in multiple code systems. 
           - Loinc provides a very specific code (though not usefully more specific in
         this particular case)

           Observations are often coded in multiple code systems.
           - LOINC provides a very specific code (though not more specific in this particular
     case)

           - snomed provides a clinically relevant code that is usually less granular
         than LOINC
           - the source system provides it's own code, which may be less or more granular
         than LOINC
           -->
        
          
          
            
            
            
          
          
          
            
            
            
          
          
          
            
            
            
          
           
        
        
        
          
          
        
        
        
        
      
    
    
      
    
  
  
  
  
    
    
    
    
      
    
    
      
        
          
          
        
        
          
            
            
            
          
        
        
        
          
          
        
        
        
        
      
    
    
      
    
  

     than LOINC
           - the source system provides its own code, which may be less or more granular
     than LOINC
            -->
    <code>
      <!--    LOINC -code    -->
      <coding>
        <system value="http://loinc.org"/>
        <code value="8480-6"/>
        <display value="Systolic blood pressure"/>
      </coding>
      <!--    SNOMED CT Codes    -->
      <coding>
        <system value="http://snomed.info/sct"/>
        <code value="271649006"/>
        <display value="Systolic blood pressure"/>
      </coding>
      <!--    Also, a local code specific to the source system    -->
      <coding>
        <system value="http://acme.org/devices/clinical-codes"/>
        <code value="bp-s"/>
        <display value="Systolic Blood pressure"/>
      </coding>
      <!--    that shows the concept. The next two codes only have a LOINC code    -->
    </code>
    <!--    no standard units used in this example    -->
    <valueQuantity>
      <value value="107"/>
      <unit value="mm[Hg]"/>
    </valueQuantity>
  </component>
  <component>
    <code>
      <coding>
        <system value="http://loinc.org"/>
        <code value="8462-4"/>
        <display value="Diastolic blood pressure"/>
      </coding>
    </code>
    <!--    no formal units in this example    -->
    <valueQuantity>
      <value value="60"/>
      <unit value="mm[Hg]"/>
    </valueQuantity>
  </component>


</feed>

</

Observation

>