{ "resourceType": "StructureDefinition", "id": "vitalsigns", "meta": { "lastUpdated": "2021-06-08T06:14:12.09+00:00" }, "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://terminology.hl7.org/CodeSystem/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.value[x]` or, if there is no value, one code in `Observation.DataAbsentReason`\n - if a vital sign measure then:\n - One numeric value in Observation.valueQuantity.value\n - a fixed Observation.valueQuantity.system=\"http://unitsofmeasure.org\"\n - a UCUM unit code in Observation.valueQuantity.code which has an required binding to the [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` =\"\"http://loinc.org\"\"\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 - 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-data-absent-reason.html\n[required]: terminologies.html#required\"" }, { "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm", "valueInteger": 5 }, { "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg", "valueCode": "oo" }, { "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status", "valueCode": "trial-use" } ], "url": "https://fhir.mhn.asia/emr/StructureDefinition/vitalsigns", "version": "4.0.1", "name": "VitalSignObservation", "title": "Vital Signs Profile", "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": "4.0.1", "mapping": [ { "identity": "workflow", "uri": "http://hl7.org/fhir/workflow", "name": "Workflow Pattern" }, { "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/fivews", "name": "FiveWs Pattern Mapping" }, { "identity": "sct-attr", "uri": "http://snomed.org/attributebinding", "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 minimum expectations for the Observation Resource to record, search and fetch the vital signs associated with a patient.", "constraint": [ { "key": "vs-2", "severity": "error", "human": "If there is no component or hasMember element then either a value[x] or a data absent reason must be present.", "expression": "(component.empty() and hasMember.empty()) implies (dataAbsentReason.exists() or value.exists())", "xpath": "f:component or f:memberOF or f:*[starts-with(local-name(.), 'value')] or f:dataAbsentReason", "source": "http://hl7.org/fhir/StructureDefinition/vitalsigns" } ] }, { "id": "Observation.status", "path": "Observation.status", "mustSupport": true, "binding": { "strength": "required" } }, { "id": "Observation.category", "path": "Observation.category", "slicing": { "discriminator": [ { "type": "value", "path": "coding.code" }, { "type": "value", "path": "coding.system" } ], "ordered": false, "rules": "open" }, "min": 1, "mustSupport": true }, { "id": "Observation.category:VSCat", "path": "Observation.category", "sliceName": "VSCat", "min": 1, "max": "1", "mustSupport": true }, { "id": "Observation.category:VSCat.coding", "path": "Observation.category.coding", "min": 1, "mustSupport": true }, { "id": "Observation.category:VSCat.coding.system", "path": "Observation.category.coding.system", "min": 1, "fixedUri": "http://terminology.hl7.org/CodeSystem/observation-category", "mustSupport": true }, { "id": "Observation.category:VSCat.coding.code", "path": "Observation.category.coding.code", "min": 1, "fixedCode": "vital-signs", "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).", "mustSupport": true, "binding": { "strength": "extensible", "description": "This identifies the vital sign result type.", "valueSet": "http://hl7.org/fhir/ValueSet/observation-vitalsignresult" } }, { "id": "Observation.subject", "path": "Observation.subject", "min": 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, "type": [ { "code": "dateTime" }, { "code": "Period" } ], "condition": [ "vs-1" ], "constraint": [ { "key": "vs-1", "severity": "error", "human": "if Observation.effective[x] is dateTime and has a value then that value shall be precise to the day", "expression": "($this as dateTime).toString().length() >= 8", "xpath": "f:effectiveDateTime[matches(@value, '^\\d{4}-\\d{2}-\\d{2}')]", "source": "http://hl7.org/fhir/StructureDefinition/vitalsigns" } ], "mustSupport": true }, { "id": "Observation.value[x]", "path": "Observation.value[x]", "short": "Vital Signs value are recorded using the Quantity data type. For supporting observations such as Cuff size could use other datatypes such as CodeableConcept.", "definition": "Vital Signs value are recorded using the Quantity data type. For supporting observations such as Cuff size could use other datatypes such as CodeableConcept.", "requirements": "9. SHALL contain exactly one [1..1] value with @xsi:type=\"PQ\" (CONF:7305).", "condition": [ "vs-2" ], "mustSupport": true }, { "id": "Observation.dataAbsentReason", "path": "Observation.dataAbsentReason", "condition": [ "vs-2" ], "mustSupport": true }, { "id": "Observation.hasMember", "path": "Observation.hasMember", "short": "Used when reporting vital signs panel components", "definition": "Used when reporting vital signs panel components.", "type": [ { "code": "Reference", "targetProfile": [ "http://hl7.org/fhir/StructureDefinition/QuestionnaireResponse", "http://hl7.org/fhir/StructureDefinition/MolecularSequence", "http://hl7.org/fhir/StructureDefinition/vitalsigns" ] } ] }, { "id": "Observation.derivedFrom", "path": "Observation.derivedFrom", "type": [ { "code": "Reference", "targetProfile": [ "http://hl7.org/fhir/StructureDefinition/DocumentReference", "http://hl7.org/fhir/StructureDefinition/ImagingStudy", "http://hl7.org/fhir/StructureDefinition/Media", "http://hl7.org/fhir/StructureDefinition/QuestionnaireResponse", "http://hl7.org/fhir/StructureDefinition/MolecularSequence", "http://hl7.org/fhir/StructureDefinition/vitalsigns" ] } ] }, { "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": "f:*[starts-with(local-name(.), 'value')] or f:dataAbsentReason", "source": "http://hl7.org/fhir/StructureDefinition/vitalsigns" } ], "mustSupport": true }, { "id": "Observation.component.code", "path": "Observation.component.code", "mustSupport": true, "binding": { "strength": "extensible", "description": "This identifies the vital sign result type.", "valueSet": "http://hl7.org/fhir/ValueSet/observation-vitalsignresult" } }, { "id": "Observation.component.value[x]", "path": "Observation.component.value[x]", "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).", "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.", "valueSet": "http://hl7.org/fhir/ValueSet/ucum-vitals-common|4.0.1" } }, { "id": "Observation.component.dataAbsentReason", "path": "Observation.component.dataAbsentReason", "condition": [ "vs-3" ], "mustSupport": true } ] } }