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| Orders and Observations Work Group | Maturity Level : N/A | Ballot Status : Informative | Compartments : Device , Encounter , Patient , Practitioner , RelatedPerson |
Blood Pressure Measurement (id = "blood-pressure")
<!-- 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> --> (Details : {LOINC code '55284-4' = 'Blood pressure systolic and diastolic', given as 'Blood pressure systolic & diastolic'})(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'})(Details : {LOINC code '8462-4' = 'Diastolic blood pressure', given as 'Diastolic blood pressure'}) <!-- an interpretation offered to the combination observation<Observation xmlns="http://hl7.org/fhir"> <id value="blood-pressure"/> <meta> <profile value="http://hl7.org/fhir/StructureDefinition/vitalsigns"/> </meta> <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> basedOn</b> : </p> <p> <b> status</b> : final</p> <p> <b> category</b> : Vital Signs <span> (Details : {http://hl7.org/fhir/observation-category code 'vital-signs' = 'Vital Signs', given as 'Vital Signs'})</span> </p> <p> <b> code</b> : Blood pressure systolic & diastolic <span> (Details : {LOINC code '85354-9' = 'lood pressure panel with all children optional', given as 'Bood pressure panel with all children optional'})</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> : Below low normal <span> (Details : {http://hl7.org/fhir/v2/0078 code 'L' = 'Low', given as 'low'})</span> </p> <p> <b> bodySite</b> : Right arm <span> (Details : {SNOMED CT code '368209003' = 'Right upper arm', 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' = 'Systolic blood pressure', given as 'Systolic blood pressure'}; {http://acme.org/devices/clinical-codes code 'bp-s' = 'bp-s', given as 'Systolic Blood pressure'})</span> </p> <p> <b> value</b> : 107 mmHg<span> (Details: UCUM code mm[Hg] = 'mmHg')</span> </p> <p> <b> interpretation</b> : Normal <span> (Details : {http://hl7.org/fhir/v2/0078 code 'N' = 'Normal', given as 'normal'})</span> </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 mmHg<span> (Details: UCUM code mm[Hg] = 'mmHg')</span> </p> <p> <b> interpretation</b> : Below low normal <span> (Details : {http://hl7.org/fhir/v2/0078 code 'L' = 'Low', given as 'low'})</span> </p> </blockquote> </div> </text> <identifier> <system value="urn:ietf:rfc:3986"/> <value value="urn:uuid:187e0c12-8dd2-67e2-99b2-bf273c878281"/> </identifier> <!-- demonstrating the use of the baseOn element with a fictive identifier --> <basedOn> <identifier> <system value="https://acme.org/identifiers"/> <value value="1234"/> </identifier> </basedOn> <status value="final"/> <category> <coding> <system value="http://hl7.org/fhir/observation-category"/> <code value="vital-signs"/> <display value="Vital Signs"/> </coding> </category> <code> <!-- replaced by 85354-9 <coding> <system value="http://loinc.org"/> <code value="55284-4"/> <display value="Blood pressure systolic & diastolic"/> </coding> --> <coding> <system value="http://loinc.org"/> <code value="85354-9"/> <display value="Bood pressure panel with all children optional"/> </coding> <text value="Blood pressure systolic & diastolic"/> </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 "COMP" (component)observations -->observations --> <interpretation> <coding> <system value="http://hl7.org/fhir/v2/0078"/> <code value="L"/> <display value="low"/> </coding> <text value="Below low normal"/> </interpretation> <!-- The BodySite can be captured in a LOINC code but am showing it here to demonstrate populating the element --> <bodySite> <coding> <system value="http://snomed.info/sct"/> <code value="368209003"/> <display value="Right arm"/> </coding> </bodySite> <component> <!-- 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 its own code, which may be less or more granular than LOINC-->this is shown here to demonstrate the concept of translations within the codeableConcept datatype. The diastolic code below only has a LOINC code --> <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> </code> <valueQuantity> <value value="107"/> <unit value="mmHg"/> <system value="http://unitsofmeasure.org"/> <code value="mm[Hg]"/> </valueQuantity> <!-- an interpretation for the individual composite observation --> <interpretation> <coding> <system value="http://hl7.org/fhir/v2/0078"/> <code value="N"/> <display value="normal"/> </coding> <text value="Normal"/> </interpretation> <!-- Should have a refrange as well --> </component> <component> <!-- this codes only has a LOINC code --> <code> <coding> <system value="http://loinc.org"/> <code value="8462-4"/> <display value="Diastolic blood pressure"/> </coding> </code> <valueQuantity> <value value="60"/> <unit value="mmHg"/> <system value="http://unitsofmeasure.org"/> <code value="mm[Hg]"/> </valueQuantity> <!-- an interpretation for the individual composite observation --> <interpretation> <coding> <system value="http://hl7.org/fhir/v2/0078"/> <code value="L"/> <display value="low"/> </coding> <text value="Below low normal"/> </interpretation> <!-- Should have a refrange as well --> </component> </ Observation >
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.