SMIS Observation

Table of Contents

  1. SMIS Resources
  2. Profiles
  3. Interactions
  4. Observation Identifiers
  5. Observation Fields
  6. Related Vital Signs Observation Fields

SMIS Resources

Following SMIS resources are represented in FHIR as observations.

Name Category (system#code) Code (system#code)
Nursing report http://smis.ch/fhir/CodeSystem/smis-observation-category-code#open-type http://smis.ch/fhir/types/open#nursing-report
Unstructured vital signs http://smis.ch/fhir/CodeSystem/smis-observation-category-code#open-type http://smis.ch/fhir/types/open#vital-signs
Structured vital signs http://hl7.org/fhir/observation-category#vital-signs http://loinc.org#85353-1

Profiles

  • Default:
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  • Related:
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  • Vital signs:
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identifierΣ0..*Identifier
basedOnΣ I0..*Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ProcedureRequest | ReferralRequest)
statusΣ ?!1..1codeBindingFixed Value
category1..*CodeableConceptBinding
codeΣ1..1CodeableConcept
subjectΣ I0..1Reference(SMIS Patient Profile)
contextI0..1Reference(Encounter | EpisodeOfCare)
effectiveDateTimeΣ0..1dateTime
issuedΣ0..1instant
performerΣ I0..*Reference(Practitioner | Organization | Patient | RelatedPerson)
valueQuantityQuantity
valueStringstring
dataAbsentReasonI0..1CodeableConceptBinding
interpretation0..1CodeableConceptBinding
comment0..1string
bodySite0..1CodeableConcept
method0..1CodeableConcept
specimenI0..1Reference(Specimen)
deviceI0..1Reference(Device | DeviceMetric)
lowI0..1SimpleQuantity
highI0..1SimpleQuantity
type0..1CodeableConceptBinding
appliesTo0..*CodeableConcept
ageI0..1Range
text0..1string
type0..1codeBinding
targetI1..1Reference(SMIS Related Observation Profile)
codeΣ1..1CodeableConcept
valueQuantityQuantity
valueCodeableConceptCodeableConcept
valueStringstring
valueRangeRange
valueRatioRatio
valueSampledDataSampledData
valueAttachmentAttachment
valueTimetime
valueDateTimedateTime
valuePeriodPeriod
dataAbsentReasonI0..1CodeableConceptBinding
interpretation0..1CodeableConceptBinding
referenceRange0..*see (referenceRange)

The subject may be a reference to a patient by internal SMIS id

"subject": {
  "reference": "Patient/1489161154728048"
}

or an identifier identifying the patient with the external id.

"subject": {
  "identifier": {
    "system": "http://smis.ch/fhir/patient/external_id",
    "value": "FDDEC0EA-A0FA-448C-916E-51C777AD97E8"
  }
}

Interactions

  • update
  • create
  • search by patient and category
    • Search parameters:
      • patient (required)
      • category (required)
  • Search by patient and identifier
    • Search parameters:
      • patient (required)
      • identifier (required)

It's possible to search for a resource by internal or external patient id:

GET /fhir/MedicationStatement?patient=1489161154728048
GET /fhir/MedicationStatement?patient.identifier=FDDEC0EA-A0FA-448C-916E-51C777AD97E8

Observation Identifiers

Name System Sample Value
Internal Element Id http://smis.ch/fhir/element/internal_id 1297774007642120
External Element Id http://smis.ch/fhir/element/external_id 304C24D6-007B-465D-B608-26DCC3DA63AF

Observation Fields

The observation profile is open. Therefore, all attributes of the base observation are allowed. SMIS only needs the following attributes, all others are ignored.

Path Comment
id Numeric SMIS id
identifier[system=http://smis.ch/fhir/element/external_id] Required
category.coding[1].system ["http://smis.ch/fhir/CodeSystem/smis-observation-category-codes", "http://hl7.org/fhir/observation-category"]
category.coding[1].code ["open-type", "vital-signs"]
code.coding[1].system ["http://smis.ch/fhir/types/open", "http://loinc.org"]
code.coding[1].code ["vital-signs", "nursing-report", "85353-"]
subject.reference Required if subject.identifier is empty. Numeric ID
subject.identifier.system Required if subject.reference is empty. Fixed: http://smis.ch/fhir/patient/external_id
subject.identifier.value Required if subject.reference is empty. External patient id
effective Required
status final
value Required if category is 'open-type'
related Required if category is 'vital-signs'
Path Comment
category.coding[1].system http://hl7.org/fhir/observation-category
category.coding[1].code vital-signs
code.coding[1].system http://loinc.org
code.coding[1].code One of https://www.hl7.org/fhir/valueset-observation-vitalsignresult.html
status final
valueQuantity.value Required
valueQuantity.system http://unitsofmeasure.org
valueQuantity.code Required