Diastolic blood pressure


PARAMETER CASE REPORT FORM RESPONSE OPTIONS
Diastolic blood pressure ☐ mm[Hg]

This profile of a FHIR Observation is derived from the Blood pressure-profile of the FHIR R4 core specification.

In addition to LOINC, Observation.code contains an exemplary SNOMED-CT coding.

Observation.value[x] shall not be used in this observation. Instead, Observation.component has two separate components for systolic and diastolic values, each includes a code/value pattern with a LOINC/SNOMED-CT code and a quantity with a fixed UCUM-unit of mm[Hg].


Profile - Blood Pressure

Canonical: https://www.netzwerk-universitaetsmedizin.de/fhir/StructureDefinition/blood-pressure

Snapshot

identifierΣ0..*Identifier
basedOnΣ I0..*Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest)
partOfΣ I0..*Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy)
statusS Σ ?!1..1codeBinding
vs-cat1..1CodeableConceptBinding
systemΣ1..1uri
versionΣ0..1string
codeΣ1..1code
displayΣ0..1string
userSelectedΣ0..1boolean
systemΣ1..1uri
versionΣ0..1string
codeΣ1..1code
displayΣ0..1string
userSelectedΣ0..1boolean
textΣ0..1string
subjectS Σ I1..1Reference(Patient)
focusΣ I0..*Reference(Resource)
encounterΣ I0..1Reference(Encounter)
effectiveDateTimedateTime
effectivePeriodPeriod
issuedΣ0..1instant
performerΣ I0..*Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson)
dataAbsentReasonI0..1CodeableConceptBinding
interpretation0..*CodeableConceptBinding
note0..*Annotation
bodySite0..1CodeableConcept
method0..1CodeableConcept
specimenI0..1Reference(Specimen)
deviceI0..1Reference(Device | DeviceMetric)
lowI0..1SimpleQuantity
highI0..1SimpleQuantity
type0..1CodeableConceptBinding
appliesTo0..*CodeableConcept
ageI0..1Range
text0..1string
hasMemberΣ I0..*Reference(Observation | QuestionnaireResponse | MolecularSequence)
derivedFromΣ I0..*Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | Observation | MolecularSequence)
codeΣ1..1CodeableConcept
valueQuantityQuantity
valueCodeableConceptCodeableConcept
valueStringstring
valueBooleanboolean
valueIntegerinteger
valueRangeRange
valueRatioRatio
valueSampledDataSampledData
valueTimetime
valueDateTimedateTime
valuePeriodPeriod
dataAbsentReasonI0..1CodeableConceptBinding
interpretation0..*CodeableConceptBinding
referenceRange0..*see (referenceRange)
systemΣ1..1uri
versionΣ0..1string
codeΣ1..1code
displayΣ0..1string
userSelectedΣ0..1boolean
systemΣ1..1uri
versionΣ0..1string
codeΣ1..1code
displayΣ0..1string
userSelectedΣ0..1boolean
textΣ0..1string
valueΣ1..1decimal
comparatorΣ ?!0..1codeBinding
unitΣ1..1string
systemΣ I1..1uri
codeΣ1..1code
dataAbsentReasonI0..1CodeableConceptBinding
interpretation0..*CodeableConceptBinding
referenceRange0..*see (referenceRange)
systemΣ1..1uri
versionΣ0..1string
codeΣ1..1code
displayΣ0..1string
userSelectedΣ0..1boolean
systemΣ1..1uri
versionΣ0..1string
codeΣ1..1code
displayΣ0..1string
userSelectedΣ0..1boolean
textΣ0..1string
valueΣ1..1decimal
comparatorΣ ?!0..1codeBinding
unitΣ1..1string
systemΣ I1..1uri
codeΣ1..1code
dataAbsentReasonI0..1CodeableConceptBinding
interpretation0..*CodeableConceptBinding
referenceRange0..*see (referenceRange)


Examples

Blood Pressure

{
    "resourceType": "Observation",
    "id": "blood-pressure",
    "meta": {
        "profile":  [
            "https://www.netzwerk-universitaetsmedizin.de/fhir/StructureDefinition/blood-pressure"
        ]
    },
    "category":  [
        {
            "coding":  [
                {
                    "code": "vital-signs",
                    "system": "http://terminology.hl7.org/CodeSystem/observation-category"
                }
            ]
        }
    ],
    "code": {
        "coding":  [
            {
                "code": "85354-9",
                "system": "http://loinc.org",
                "display": "Blood pressure panel with all children optional"
            },
            {
                "code": "75367002",
                "system": "http://snomed.info/sct",
                "display": "Blood pressure (observable entity)"
            }
        ],
        "text": "Blood pressure"
    },
    "component":  [
        {
            "code": {
                "coding":  [
                    {
                        "code": "8480-6",
                        "system": "http://loinc.org",
                        "display": "Systolic blood pressure"
                    },
                    {
                        "code": "271649006",
                        "system": "http://snomed.info/sct",
                        "display": "Systolic blood pressure"
                    }
                ],
                "text": "Systolic blood pressure"
            },
            "valueQuantity": {
                "system": "http://unitsofmeasure.org",
                "code": "mm[Hg]",
                "value": 120,
                "unit": "mmHg"
            }
        },
        {
            "code": {
                "coding":  [
                    {
                        "code": "8462-4",
                        "system": "http://loinc.org",
                        "display": "Diastolic blood pressure"
                    },
                    {
                        "code": "271650006",
                        "system": "http://snomed.info/sct",
                        "display": "Diastolic blood pressure (observable entity)"
                    }
                ],
                "text": "Diastolic blood pressure"
            },
            "valueQuantity": {
                "system": "http://unitsofmeasure.org",
                "code": "mm[Hg]",
                "value": 80,
                "unit": "mmHg"
            }
        }
    ],
    "identifier":  [
        {
            "type": {
                "coding":  [
                    {
                        "code": "OBI",
                        "system": "http://terminology.hl7.org/CodeSystem/v2-0203"
                    }
                ]
            },
            "system": "https://www.charite.de/fhir/CodeSystem/observation-identifiers",
            "value": "85354-9_BloodPressure",
            "assigner": {
                "reference": "Organization/Charité"
            }
        }
    ],
    "status": "final",
    "subject": {
        "reference": "Patient/gecco-patient"
    },
    "effectiveDateTime": "2020-09-25"
}


Blood Pressure Invasive
Note the additional codings on Observation.component.code

{
    "resourceType": "Observation",
    "id": "blood-pressure-invasive",
    "meta": {
        "profile":  [
            "https://www.netzwerk-universitaetsmedizin.de/fhir/StructureDefinition/blood-pressure"
        ]
    },
    "category":  [
        {
            "coding":  [
                {
                    "code": "vital-signs",
                    "system": "http://terminology.hl7.org/CodeSystem/observation-category"
                }
            ]
        }
    ],
    "code": {
        "coding":  [
            {
                "code": "85354-9",
                "system": "http://loinc.org",
                "display": "Blood pressure panel with all children optional"
            },
            {
                "code": "75367002",
                "system": "http://snomed.info/sct",
                "display": "Blood pressure (observable entity)"
            }
        ],
        "text": "Blood pressure invasive"
    },
    "component":  [
        {
            "code": {
                "coding":  [
                    {
                        "code": "8480-6",
                        "system": "http://loinc.org",
                        "display": "Systolic blood pressure"
                    },
                    {
                        "code": "76215-3",
                        "system": "http://loinc.org",
                        "display": "Invasive Systolic blood pressure"
                    },
                    {
                        "code": "271649006",
                        "system": "http://snomed.info/sct",
                        "display": "Systolic blood pressure"
                    },
                    {
                        "code": "251071003",
                        "system": "http://snomed.info/sct",
                        "display": "Invasive systolic arterial pressure (observable entity)"
                    }
                ],
                "text": "Invasive systolic blood pressure"
            },
            "valueQuantity": {
                "system": "http://unitsofmeasure.org",
                "code": "mm[Hg]",
                "value": 136,
                "unit": "mmHg"
            }
        },
        {
            "code": {
                "coding":  [
                    {
                        "code": "8462-4",
                        "system": "http://loinc.org",
                        "display": "Diastolic blood pressure"
                    },
                    {
                        "code": "76213-8",
                        "system": "http://loinc.org",
                        "display": "Invasive Diastolic blood pressure"
                    },
                    {
                        "code": "271650006",
                        "system": "http://snomed.info/sct",
                        "display": "Diastolic blood pressure (observable entity)"
                    },
                    {
                        "code": "251073000",
                        "system": "http://snomed.info/sct",
                        "display": "Invasive diastolic arterial pressure (observable entity)"
                    }
                ],
                "text": "Invasive diastolic blood pressure"
            },
            "valueQuantity": {
                "system": "http://unitsofmeasure.org",
                "code": "mm[Hg]",
                "value": 87,
                "unit": "mmHg"
            }
        }
    ],
    "identifier":  [
        {
            "type": {
                "coding":  [
                    {
                        "code": "OBI",
                        "system": "http://terminology.hl7.org/CodeSystem/v2-0203"
                    }
                ]
            },
            "system": "https://www.charite.de/fhir/CodeSystem/observation-identifiers",
            "value": "85354-9_BloodPressure",
            "assigner": {
                "reference": "Organization/Charité"
            }
        }
    ],
    "status": "final",
    "subject": {
        "reference": "Patient/gecco-patient"
    },
    "effectiveDateTime": "2021-04-14",
    "method": {
        "coding":  [
            {
                "code": "10179008",
                "system": "http://snomed.info/sct",
                "display": "Invasive (qualifier value)"
            }
        ]
    }
}