{
"resourceType": "StructureDefinition",
"id": "vitalsigns",
"text": {
"status": "generated",
"div": "to do
"
},
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-summary",
"valueMarkdown": "### Complete Summary of the Mandatory Requirements\n\n1. One status in `Observation.status`which has a [required](http://build.fhir.org/terminologies.html#extensible) binding to:\n - [ObservationStatus] value set.\n1. A category in `Observation.category` which must have:\n - a fixed `Observation.category.coding.system`=\"http://hl7.org/fhir/observation-category\"\n - a fixed `Observation.category.coding.code`= \"vital-signs\"\n\n1. A code in `Observation.code`\n - a fixed `Observation.code.coding.system`= \"http://loinc.org\"\n - a LOINC code in `Observation.code.coding.code` which has an [extensible](http://build.fhir.org/terminologies.html#extensible) binding to:\n - [Vital Signs] value set.\n \n1. One patient in `Observation.subject`\n1. A date and time in `effectiveDateTime` or `effectivePeriod`\n1. Either one `Observation.valueQuantity` or, if there is no value, one code in `Observation.DataAbsentReason`\n - Each Observation.valueQuantity must have:\n - One numeric value in `Observation.valueQuantity.value`\n - a fixed `Observation.valueQuantity.system`=\"http://unitsofmeasure\"\n - a UCUM unit code in `Observation.valueQuantity.code` which has an [required] binding to:\n - [Vital Signs Units] value set.\n - Observation.DataAbsentReason is bound to [Observation Value\n Absent Reason] value set.\n\n1. When using a panel code to group component observations (Note: See\n the comments regarding blood pressure in the table above), one or\n more `Observation.component.code` each of which must have:\n - a fixed\n `Observation.component.code.coding.system` =\"\"\n - a LOINC code in `Observation.code.coding.code` which has an [extensible] binding to:\n - [Vital Signs Units] value set.\n\n1. Either one `Observation.component.valueQuantity` or, if there is\n no value, one code in `Observation.component.DataAbsentReason`\n - Each Observation.component.valueQuantity must have:\n - One numeric value in\n `Observation.component.valueQuantity.value`\n - a fixed `Observation.component.valueQuantity.system`= \"\"\n - a UCUM unit code in\n `Observation.component.valueQuantity.code` which has an [required] binding to:\n - [Vital Signs Units] value set.\n - Observation.component.DataAbsentReason is bound to [Observation\n Value Absent Reason] value set.\n\n1. When using a panel code to group observations, one or more reference\n to Vitals Signs Observations in `Observation.related.target`\n - a fixed `Observation.related.type`= \"has-member\"\n\n [Vital Signs]: valueset-observation-vitalsignresult.html\n [Vital Signs Units]: valueset-ucum-vitals-common.html\n [extensible]: terminologies.html#extensible\n [ObservationStatus]: valueset-observation-status.html\n [Observation Value Absent Reason]: valueset-observation-valueabsentreason.html\n[required]: terminologies.html#required"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/vitalsigns",
"name": "Vital Signs Profile",
"title": "VitalSigns",
"status": "draft",
"experimental": false,
"date": "2016-03-25",
"publisher": "Health Level Seven International (Orders and Observations Workgroup)",
"contact": [
{
"telecom": [
{
"system": "url",
"value": "http://www.hl7.org/Special/committees/orders/index.cfm Orders and Observations"
}
]
}
],
"description": "FHIR Vital Signs Profile",
"fhirVersion": "3.0.1",
"mapping": [
{
"identity": "workflow",
"uri": "http://hl7.org/fhir/workflow",
"name": "Workflow Mapping"
},
{
"identity": "sct-concept",
"uri": "http://snomed.info/conceptdomain",
"name": "SNOMED CT Concept Domain Binding"
},
{
"identity": "v2",
"uri": "http://hl7.org/v2",
"name": "HL7 v2 Mapping"
},
{
"identity": "rim",
"uri": "http://hl7.org/v3",
"name": "RIM Mapping"
},
{
"identity": "w5",
"uri": "http://hl7.org/fhir/w5",
"name": "W5 Mapping"
},
{
"identity": "sct-attr",
"uri": "http://snomed.info/sct",
"name": "SNOMED CT Attribute Binding"
}
],
"kind": "resource",
"abstract": false,
"type": "Observation",
"baseDefinition": "http://hl7.org/fhir/StructureDefinition/Observation",
"derivation": "constraint",
"differential": {
"element": [
{
"id": "Observation",
"path": "Observation",
"short": "FHIR Vital Signs Profile",
"definition": "The FHIR Vitals Signs profile sets a minimum expectations for the Observation Resource to record, search and fetch the vital signs associated with a patient.",
"alias": [
"Vital Signs",
"Measurement",
"Results",
"Tests"
],
"min": 0,
"max": "*",
"constraint": [
{
"key": "vs-2",
"severity": "error",
"human": "If there is no component or related element then either a value[x] or a data absent reason must be present",
"expression": "(component.empty() and related.empty()) implies (dataAbsentReason or value)",
"xpath": "exists(f:component) or exists(f:related) or exists(f:*[starts-with(local-name(.), 'value')]) or exists(f:dataAbsentReason)"
}
]
},
{
"id": "Observation.status",
"path": "Observation.status",
"min": 1,
"max": "1",
"type": [
{
"code": "code"
}
],
"mustSupport": true,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "Status"
}
],
"strength": "required",
"valueSetReference": {
"reference": "http://hl7.org/fhir/ValueSet/observation-status"
}
}
},
{
"id": "Observation.category",
"path": "Observation.category",
"min": 1,
"max": "*",
"type": [
{
"code": "CodeableConcept"
}
],
"condition": [
"vs-4"
],
"constraint": [
{
"key": "vs-4",
"severity": "error",
"human": "Must have a category of 'vital-signs' and a code system 'http://hl7.org/fhir/observation-category'",
"expression": "where(coding.system='http://hl7.org/fhir/observation-category' and coding.code='vital-signs').exists()",
"xpath": "exists(f:coding/code[@value='vital-signs']) and exists(f:coding/system[@value='http://hl7.org/fhir/observation-category'])"
}
],
"mustSupport": true
},
{
"id": "Observation.code",
"path": "Observation.code",
"short": "Coded Responses from C-CDA Vital Sign Results",
"definition": "Coded Responses from C-CDA Vital Sign Results.",
"requirements": "5. SHALL contain exactly one [1..1] code, where the @code SHOULD be selected from ValueSet HITSP Vital Sign Result Type 2.16.840.1.113883.3.88.12.80.62 DYNAMIC (CONF:7301).",
"min": 1,
"max": "1",
"type": [
{
"code": "CodeableConcept"
}
],
"mustSupport": true,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "VitalSigns"
}
],
"strength": "extensible",
"description": "This identifies the vital sign result type.",
"valueSetReference": {
"reference": "http://hl7.org/fhir/ValueSet/observation-vitalsignresult"
}
}
},
{
"id": "Observation.subject",
"path": "Observation.subject",
"min": 1,
"max": "1",
"type": [
{
"code": "Reference",
"targetProfile": "http://hl7.org/fhir/StructureDefinition/Patient"
}
],
"mustSupport": true
},
{
"id": "Observation.effective[x]",
"path": "Observation.effective[x]",
"short": "Often just a dateTime for Vital Signs",
"definition": "Often just a dateTime for Vital Signs.",
"min": 1,
"max": "1",
"type": [
{
"code": "dateTime"
},
{
"code": "Period"
}
],
"condition": [
"vs-1"
],
"constraint": [
{
"key": "vs-1",
"severity": "error",
"human": "Datetime must be at least to day.",
"expression": "($this as dateTime).toString().length() >= 8",
"xpath": "f:matches(effectiveDateTime,/\\d{4}-[01]\\d-[0-3]\\dT[0-2]\\d:[0-5]\\d([+-][0-2]\\d:[0-5]\\d|Z)/)"
}
],
"mustSupport": true
},
{
"id": "Observation.valueQuantity",
"path": "Observation.valueQuantity",
"short": "Vital Sign Value recorded with UCUM",
"definition": "Vital Sign Value recorded with UCUM.",
"requirements": "9. SHALL contain exactly one [1..1] value with @xsi:type=\"PQ\" (CONF:7305).",
"min": 0,
"max": "1",
"type": [
{
"code": "Quantity"
}
],
"condition": [
"vs-2"
],
"mustSupport": true,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "VitalSignsUnits"
}
],
"strength": "required",
"description": "Common UCUM units for recording Vital Signs",
"valueSetReference": {
"reference": "http://hl7.org/fhir/ValueSet/ucum-vitals-common"
}
}
},
{
"id": "Observation.valueQuantity.value",
"path": "Observation.valueQuantity.value",
"min": 1,
"max": "1",
"type": [
{
"code": "decimal"
}
],
"mustSupport": true
},
{
"id": "Observation.valueQuantity.unit",
"path": "Observation.valueQuantity.unit",
"min": 1,
"max": "1",
"type": [
{
"code": "string"
}
],
"mustSupport": true
},
{
"id": "Observation.valueQuantity.system",
"path": "Observation.valueQuantity.system",
"min": 1,
"max": "1",
"type": [
{
"code": "uri"
}
],
"fixedUri": "http://unitsofmeasure.org",
"mustSupport": true
},
{
"id": "Observation.valueQuantity.code",
"path": "Observation.valueQuantity.code",
"short": "Coded responses from the common UCUM units for vital signs value set.",
"definition": "Coded responses from the common UCUM units for vital signs value set.",
"min": 1,
"max": "1",
"type": [
{
"code": "code"
}
],
"mustSupport": true
},
{
"id": "Observation.dataAbsentReason",
"path": "Observation.dataAbsentReason",
"min": 0,
"max": "1",
"type": [
{
"code": "CodeableConcept"
}
],
"condition": [
"vs-2"
],
"mustSupport": true,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "DAR"
}
],
"strength": "extensible",
"valueSetReference": {
"reference": "http://hl7.org/fhir/ValueSet/observation-valueabsentreason"
}
}
},
{
"id": "Observation.related",
"path": "Observation.related",
"short": "Used when reporting vital signs panel components",
"definition": "Used when reporting vital signs panel components.",
"mustSupport": true
},
{
"id": "Observation.related.type",
"path": "Observation.related.type",
"min": 1,
"max": "1",
"type": [
{
"code": "code"
}
],
"fixedCode": "has-member",
"mustSupport": true
},
{
"id": "Observation.related.target",
"path": "Observation.related.target",
"min": 1,
"max": "1",
"type": [
{
"code": "Reference",
"targetProfile": "http://hl7.org/fhir/StructureDefinition/vitalsigns"
}
],
"mustSupport": true
},
{
"id": "Observation.component",
"path": "Observation.component",
"short": "Used when reporting systolic and diastolic blood pressure.",
"definition": "Used when reporting systolic and diastolic blood pressure.",
"constraint": [
{
"key": "vs-3",
"severity": "error",
"human": "If there is no a value a data absent reason must be present",
"expression": "value.exists() or dataAbsentReason.exists()",
"xpath": "exists(f:*[starts-with(local-name(.), 'value')]) or exists(f:dataAbsentReason)"
}
],
"mustSupport": true
},
{
"id": "Observation.component.code",
"path": "Observation.component.code",
"min": 1,
"max": "1",
"type": [
{
"code": "CodeableConcept"
}
],
"mustSupport": true,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "VitalSigns"
}
],
"strength": "extensible",
"description": "This identifies the vital sign result type.",
"valueSetReference": {
"reference": "http://hl7.org/fhir/ValueSet/observation-vitalsignresult"
}
}
},
{
"id": "Observation.component.valueQuantity",
"path": "Observation.component.valueQuantity",
"short": "Vital Sign Value recorded with UCUM",
"definition": "Vital Sign Value recorded with UCUM.",
"requirements": "9. SHALL contain exactly one [1..1] value with @xsi:type=\"PQ\" (CONF:7305).",
"min": 0,
"max": "1",
"type": [
{
"code": "Quantity"
}
],
"condition": [
"vs-3"
],
"mustSupport": true,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "VitalSignsUnits"
}
],
"strength": "required",
"description": "Common UCUM units for recording Vital Signs",
"valueSetReference": {
"reference": "http://hl7.org/fhir/ValueSet/ucum-vitals-common"
}
}
},
{
"id": "Observation.component.valueQuantity.value",
"path": "Observation.component.valueQuantity.value",
"min": 1,
"max": "1",
"type": [
{
"code": "decimal"
}
],
"mustSupport": true
},
{
"id": "Observation.component.valueQuantity.unit",
"path": "Observation.component.valueQuantity.unit",
"min": 1,
"max": "1",
"type": [
{
"code": "string"
}
],
"mustSupport": true
},
{
"id": "Observation.component.valueQuantity.system",
"path": "Observation.component.valueQuantity.system",
"min": 1,
"max": "1",
"type": [
{
"code": "uri"
}
],
"fixedUri": "http://unitsofmeasure.org",
"mustSupport": true
},
{
"id": "Observation.component.valueQuantity.code",
"path": "Observation.component.valueQuantity.code",
"short": "Coded responses from the common UCUM units for vital signs value set.",
"definition": "Coded responses from the common UCUM units for vital signs value set.",
"min": 1,
"max": "1",
"type": [
{
"code": "code"
}
],
"mustSupport": true
},
{
"id": "Observation.component.dataAbsentReason",
"path": "Observation.component.dataAbsentReason",
"min": 0,
"max": "1",
"type": [
{
"code": "CodeableConcept"
}
],
"condition": [
"vs-3"
],
"mustSupport": true,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "DAR"
}
],
"strength": "extensible",
"valueSetReference": {
"reference": "http://hl7.org/fhir/ValueSet/observation-valueabsentreason"
}
}
}
]
}
}