<status value="active" /> <date value="2023-10-04T15:33:14.3221484+00:00" /> <publisher value="NICE" /> <contact> <name value="NICE" /> <telecom> <system value="email" /> <value value="vragen@stichting-nice.nl" /> </telecom> </contact> <description value="The NICE submission requires the highest and lowest values within the first 24 hours of ICU admission for two blood pressure types: - The systolic blood pressure - Do not count short term blood pressure change due to exchange of pump, unless clinically relevant. - The average blood pressure - In case the average blood pressure is not recorded, it may be calculated using (2*diastolic+systolic)/3 NOTE: The values need to be inserted in a slice under the 'components' section of the profile" /> <purpose value="A profile derived from the HL7 Vital Signs profile for Blood Pressure in order to add mappings from the Dutch Health and Care Information models (HCIM; Dutch: Zorginformatiebouwsteen or ZIB) BloodPressure version 3.1, release 2017. Blood pressure is measured to gain an indication of the health condition of the patient’s cardiovascular system." /> <copyright value="CC0" /> <fhirVersion value="3.0.2" /> <mapping> <identity value="hcim-bloodpressure-v1.2-2015EN" /> <uri value="https://zibs.nl/wiki/BloodPressure-v1.2(2015EN)" /> <name value="HCIM BloodPressure-v1.2(2015EN)" /> </mapping> <mapping> <identity value="hcim-bloodpressure-v3.0-2016EN" /> <uri value="https://zibs.nl/wiki/BloodPressure-v3.0(2016EN)" /> <name value="HCIM BloodPressure-v3.0(2016EN)" /> </mapping> <mapping> <identity value="hcim-bloodpressure-v3.1-2017EN" /> <uri value="https://zibs.nl/wiki/BloodPressure-v3.1(2017EN)" /> <name value="HCIM BloodPressure-v3.1(2017EN)" /> </mapping> <mapping> <identity value="hcim-basicelements-v1.0-2017EN" /> <uri value="https://zibs.nl/wiki/BasicElements-v1.0(2017EN)" /> <name value="HCIM BasicElements-v1.0(2017EN)" /> </mapping> <mapping> <identity value="NICE-Datadictionary-MDS" /> <uri value="https://www.stichting-nice.nl/dd/#528" /> <name value="NICE-Datadictionary-MDS" /> <comment value="The Minimal Data Set (MDS) module" /> </mapping> <mapping> <identity value="NICE-Datadictionary-SOFA" /> <uri value="https://www.stichting-nice.nl/dd/#547" /> <name value="NICE-Datadictionary-SOFA" /> <comment value="The Sequential Organ Failure Assessment (SOFA) module" /> </mapping> <kind value="resource" /> <abstract value="false" /> <type value="Observation" /> <baseDefinition value="http://nictiz.nl/fhir/StructureDefinition/zib-VitalSigns" /> <derivation value="constraint" /> <differential> <element id="Observation"> <path value="Observation" /> <short value="BloodPressure" /> <definition value="The FHIR BloodPressure profile sets a minimum expectations for the Observation Resource to record, search and fetch the blood pressure associated with a patient." /> <alias value="Bloeddruk" /> <mapping> <identity value="hcim-bloodpressure-v1.2-2015EN" /> <map value="NL-CM:12.4.1" /> <comment value="BloodPressure" /> </mapping> <mapping> <identity value="hcim-bloodpressure-v3.0-2016EN" /> <map value="NL-CM:12.4.1" /> <comment value="BloodPressure" /> </mapping> <mapping> <identity value="hcim-bloodpressure-v3.1-2017EN" /> <map value="NL-CM:12.4.1" /> <comment value="BloodPressure" /> </mapping> </element> <element id="Observation.extension"> <path value="Observation.extension" /> <min value="2" /> </element> <element id="Observation.extension:ExtremeValueType"> <path value="Observation.extension" /> <sliceName value="ExtremeValueType" /> <type> <code value="Extension" /> <profile value="https://fhir.stichting-nice.nl/STU3/StructureDefinition/NICE-ExtremeValueType-2022Q1" /> </type> </element> <element id="Observation.extension:ScoreDay"> <path value="Observation.extension" /> <sliceName value="ScoreDay" /> <short value="Score day" /> <definition value="Extension that is used to indicate either the day of scoring. The first 24 hours after admission count as day 1. The next day starts from the first morning shift and lasts 24 hours, so until the start of the next morning shift. Note: Score day 1 can overlap with score day 2, and 'the first morning shift' is specified locally can differ between hospitals." /> <type> <code value="Extension" /> <profile value="https://fhir.stichting-nice.nl/STU3/StructureDefinition/NICE-ScoreDay-2022Q1" /> </type> </element> <element id="Observation.extension:Verified"> <path value="Observation.extension" /> <sliceName value="Verified" /> <short value="Is the instance validated by a medical professional?" /> <definition value="Extension that is used to indicate whether the entire instance has been validated. Every instance shall be validated by a hospital member / datamanager. However, this is not always feasible in case of automated submission of NICE data elements. This extensions shall be used to indicate the validation status of the instance." /> <min value="1" /> <max value="1" /> <type> <code value="Extension" /> <profile value="https://fhir.stichting-nice.nl/STU3/StructureDefinition/NICE-Verified-2022Q1" /> </type> </element> <element id="Observation.status"> <path value="Observation.status" /> <short value="Validated (final)" /> <definition value="Needs to have the "final" value, because everything needs to be validated." /> <fixedCode value="final" /> </element> <element id="Observation.code.coding"> <path value="Observation.code.coding" /> <slicing> <discriminator> <type value="value" /> <path value="system" /> </discriminator> <discriminator> <type value="value" /> <path value="code" /> </discriminator> <rules value="open" /> </slicing> <min value="1" /> </element> <element id="Observation.code.coding:bloodPressureCode"> <path value="Observation.code.coding" /> <sliceName value="bloodPressureCode" /> <min value="1" /> <max value="1" /> </element> <element id="Observation.code.coding:bloodPressureCode.system"> <path value="Observation.code.coding.system" /> <min value="1" /> <fixedUri value="http://loinc.org" /> </element> <element id="Observation.code.coding:bloodPressureCode.code"> <path value="Observation.code.coding.code" /> <comment value="Please note: the zib/HCIM uses the LOINC code 55284-4 rather than 85354-9. However, this latter code is used in the VitalSigns profile, and it has been chosen to align to this commonly used profile. Future versions of the zib/HCIM will use this code as well." /> <min value="1" /> <fixedCode value="85354-9" /> </element> <element id="Observation.code.coding:bloodPressureCode.display"> <path value="Observation.code.coding.display" /> <defaultValueString value="Blood pressure panel with all children optional" /> </element> <element id="Observation.subject"> <path value="Observation.subject" /> <type> <code value="Reference" /> <targetProfile value="https://fhir.stichting-nice.nl/STU3/StructureDefinition/NICE-Patient-2022Q1" /> </type> </element> <element id="Observation.context"> <path value="Observation.context" /> <type> <code value="Reference" /> <targetProfile value="https://fhir.stichting-nice.nl/STU3/StructureDefinition/NICE-Encounter-2022Q1" /> </type> <mustSupport value="true" /> </element> <element id="Observation.effective[x]:effectiveDateTime"> <path value="Observation.effectiveDateTime" /> <sliceName value="effectiveDateTime" /> <short value="BloodPressureDateTime" /> <alias value="BloeddrukDatumTijd" /> <type> <code value="dateTime" /> </type> <mapping> <identity value="hcim-bloodpressure-v1.2-2015EN" /> <map value="NL-CM:12.4.5" /> <comment value="BloodPressureDateTime" /> </mapping> <mapping> <identity value="hcim-bloodpressure-v3.0-2016EN" /> <map value="NL-CM:12.4.5" /> <comment value="BloodPressureDateTime" /> </mapping> <mapping> <identity value="hcim-bloodpressure-v3.1-2017EN" /> <map value="NL-CM:12.4.5" /> <comment value="BloodPressureDateTime" /> </mapping> </element> <element id="Observation.comment"> <path value="Observation.comment" /> <short value="Comment" /> <definition value="Comments on the measured blood pressure. Here, an explanation could be given, for example, of circumstances that may have influenced the patient’s blood pressure, such as pain, stress, exertion and sleep/wake cycles." /> <alias value="Toelichting" /> <mapping> <identity value="hcim-bloodpressure-v1.2-2015EN" /> <map value="NL-CM:12.4.6" /> <comment value="Explanation" /> </mapping> <mapping> <identity value="hcim-bloodpressure-v3.0-2016EN" /> <map value="NL-CM:12.4.6" /> <comment value="Explanation" /> </mapping> <mapping> <identity value="hcim-bloodpressure-v3.1-2017EN" /> <map value="NL-CM:12.4.6" /> <comment value="Comment" /> </mapping> </element> <element id="Observation.bodySite"> <path value="Observation.bodySite" /> <short value="MeasuringLocation" /> <definition value="Anatomical location where the blood pressure was measured." /> <alias value="MeetLocatie" /> <binding> <strength value="extensible" /> <description value="MeetLocatieCodelijst" /> <valueSetReference> <reference value="http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.12.4.4--20171231000000" /> <display value="MeetLocatieCodelijst" /> </valueSetReference> </binding> <mapping> <identity value="hcim-bloodpressure-v1.2-2015EN" /> <map value="NL-CM:12.4.10" /> <comment value="MeasuringLocation" /> </mapping> <mapping> <identity value="hcim-bloodpressure-v3.0-2016EN" /> <map value="NL-CM:12.4.10" /> <comment value="MeasuringLocation" /> </mapping> <mapping> <identity value="hcim-bloodpressure-v3.1-2017EN" /> <map value="NL-CM:12.4.10" /> <comment value="MeasuringLocation" /> </mapping> </element> <element id="Observation.method"> <path value="Observation.method" /> <short value="MeasuringMethod" /> <definition value="The type of method used to measure blood pressure." /> <alias value="Meetmethode" /> <binding> <strength value="extensible" /> <description value="MeetmethodeCodelijst" /> <valueSetReference> <reference value="http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.12.4.1--20171231000000" /> <display value="MeetmethodeCodelijst" /> </valueSetReference> </binding> <mapping> <identity value="hcim-bloodpressure-v1.2-2015EN" /> <map value="NL-CM:12.4.7" /> <comment value="MeasuringMethod" /> </mapping> <mapping> <identity value="hcim-bloodpressure-v3.0-2016EN" /> <map value="NL-CM:12.4.7" /> <comment value="MeasuringMethod" /> </mapping> <mapping> <identity value="hcim-bloodpressure-v3.1-2017EN" /> <map value="NL-CM:12.4.7" /> <comment value="MeasuringMethod" /> </mapping> </element> <element id="Observation.component"> <path value="Observation.component" /> <slicing> <discriminator> <type value="value" /> <path value="code.coding.code" /> </discriminator> <discriminator> <type value="value" /> <path value="code.coding.system" /> </discriminator> <ordered value="false" /> <rules value="open" /> </slicing> <min value="1" /> </element> <element id="Observation.component:SystolicBP"> <path value="Observation.component" /> <sliceName value="SystolicBP" /> <max value="1" /> <mapping> <identity value="NICE-Datadictionary-MDS" /> <map value="https://www.stichting-nice.nl/dd/#403" /> <comment value="Highest systolic blood pressure" /> </mapping> <mapping> <identity value="NICE-Datadictionary-MDS" /> <map value="https://www.stichting-nice.nl/dd/#404" /> <comment value="Lowest systolic blood pressure" /> </mapping> </element> <element id="Observation.component:SystolicBP.code"> <path value="Observation.component.code" /> <comment value="additional codes that translate or map to this code are allowed. For example a more granular LOINC code or code that is used locally in a system." /> </element> <element id="Observation.component:SystolicBP.code.coding"> <path value="Observation.component.code.coding" /> <min value="1" /> </element> <element id="Observation.component:SystolicBP.code.coding.system"> <path value="Observation.component.code.coding.system" /> <min value="1" /> <fixedUri value="http://loinc.org" /> </element> <element id="Observation.component:SystolicBP.code.coding.code"> <path value="Observation.component.code.coding.code" /> <min value="1" /> <fixedCode value="8480-6" /> </element> <element id="Observation.component:SystolicBP.code.coding.display"> <path value="Observation.component.code.coding.display" /> <defaultValueString value="Systolic blood pressure" /> </element> <element id="Observation.component:SystolicBP.value[x]:valueQuantity"> <path value="Observation.component.valueQuantity" /> <sliceName value="valueQuantity" /> <short value="SystolicBloodPressure recorded with UCUM" /> <definition value="The highest (peak) systematic arterial blood pressure - measured in the contraction stage or systole of the cardiac cycle." /> <alias value="SystolischeBloeddruk" /> <min value="1" /> <type> <code value="Quantity" /> </type> <mapping> <identity value="hcim-bloodpressure-v1.2-2015EN" /> <map value="NL-CM:12.4.2" /> <comment value="SystolicBloodPressure" /> </mapping> <mapping> <identity value="hcim-bloodpressure-v3.0-2016EN" /> <map value="NL-CM:12.4.2" /> <comment value="SystolicBloodPressure" /> </mapping> <mapping> <identity value="hcim-bloodpressure-v3.1-2017EN" /> <map value="NL-CM:12.4.2" /> <comment value="SystolicBloodPressure" /> </mapping> </element> <element id="Observation.component:SystolicBP.value[x]:valueQuantity.value"> <path value="Observation.component.valueQuantity.value" /> <minValueDecimal value="0.0" /> <maxValueDecimal value="300.0" /> <constraint> <key value="valueExtremes" /> <severity value="error" /> <human value="The value of Blood Pressure cannot be lower than 0.0 or higher than 300.0" /> <expression value="$this >= 0.0 and $this <= 300.0" /> </constraint> </element> <element id="Observation.component:SystolicBP.value[x]:valueQuantity.unit"> <path value="Observation.component.valueQuantity.unit" /> <fixedString value="mm[Hg]" /> </element> <element id="Observation.component:SystolicBP.value[x]:valueQuantity.code"> <path value="Observation.component.valueQuantity.code" /> <fixedCode value="mm[Hg]" /> </element> <element id="Observation.component:AverageBloodPressureLOINC"> <path value="Observation.component" /> <sliceName value="AverageBloodPressureLOINC" /> <max value="1" /> <mapping> <identity value="NICE-Datadictionary-MDS" /> <map value="https://www.stichting-nice.nl/dd/#179" /> <comment value="Highest average blood pressure" /> </mapping> <mapping> <identity value="NICE-Datadictionary-MDS" /> <map value="https://www.stichting-nice.nl/dd/#180" /> <comment value="Lowest average blood pressure" /> </mapping> <mapping> <identity value="NICE-Datadictionary-SOFA" /> <map value="https://www.stichting-nice.nl/dd/#389" /> <comment value="Lowest average arterial blood pressure" /> </mapping> </element> <element id="Observation.component:AverageBloodPressureLOINC.code"> <path value="Observation.component.code" /> <comment value="additional codes that translate or map to this code are allowed. For example a more granular LOINC code or code that is used locally in a system." /> </element> <element id="Observation.component:AverageBloodPressureLOINC.code.coding"> <path value="Observation.component.code.coding" /> <min value="1" /> </element> <element id="Observation.component:AverageBloodPressureLOINC.code.coding.system"> <path value="Observation.component.code.coding.system" /> <min value="1" /> <fixedUri value="http://loinc.org" /> </element> <element id="Observation.component:AverageBloodPressureLOINC.code.coding.code"> <path value="Observation.component.code.coding.code" /> <min value="1" /> <fixedCode value="8478-0" /> </element> <element id="Observation.component:AverageBloodPressureLOINC.code.coding.display"> <path value="Observation.component.code.coding.display" /> <defaultValueString value="Mean blood pressure" /> </element> <element id="Observation.component:AverageBloodPressureLOINC.value[x]:valueQuantity"> <path value="Observation.component.valueQuantity" /> <sliceName value="valueQuantity" /> <short value="AverageBloodPressure recorded with UCUM" /> <definition value="Average blood pressure during one cycle of the heart contracting and relaxing. Estimated based on systolic and diastolic blood pressure. This estimate is unreliable in cases of circulatory disorders. This value can only be reliably determined when invasive blood pressure is measured." /> <alias value="GemiddeldeBloeddruk" /> <type> <code value="Quantity" /> </type> <mapping> <identity value="hcim-bloodpressure-v1.2-2015EN" /> <map value="NL-CM:12.4.4" /> <comment value="AverageBloodPressure" /> </mapping> <mapping> <identity value="hcim-bloodpressure-v3.0-2016EN" /> <map value="NL-CM:12.4.4" /> <comment value="AverageBloodPressure" /> </mapping> <mapping> <identity value="hcim-bloodpressure-v3.1-2017EN" /> <map value="NL-CM:12.4.4" /> <comment value="AverageBloodPressure" /> </mapping> </element> <element id="Observation.component:AverageBloodPressureLOINC.value[x]:valueQuantity.value"> <path value="Observation.component.valueQuantity.value" /> <minValueDecimal value="0.0" /> <maxValueDecimal value="300.0" /> <constraint> <key value="valueExtremeLow" /> <severity value="error" /> <human value="The value of Blood Pressure cannot be lower than 0.0" /> <expression value="SystolicBP.valueQuantity.value >= 0.0" /> </constraint> <constraint> <key value="valueExtremeHigh" /> <severity value="error" /> <human value="The value of Blood Pressure cannot be higher than 300.0" /> <expression value="SystolicBP.valueQuantity.value <= 300.0" /> </constraint> </element> <element id="Observation.component:AverageBloodPressureLOINC.value[x]:valueQuantity.unit"> <path value="Observation.component.valueQuantity.unit" /> <fixedString value="mm[Hg]" /> </element> <element id="Observation.component:AverageBloodPressureLOINC.value[x]:valueQuantity.code"> <path value="Observation.component.valueQuantity.code" /> <fixedCode value="mm[Hg]" /> </element> <element id="Observation.component:AverageBloodPressureSNOMED"> <path value="Observation.component" /> <sliceName value="AverageBloodPressureSNOMED" /> <max value="1" /> </element> <element id="Observation.component:AverageBloodPressureSNOMED.code"> <path value="Observation.component.code" /> <comment value="additional codes that translate or map to this code are allowed. For example a more granular SNOMED code or code that is used locally in a system." /> </element> <element id="Observation.component:AverageBloodPressureSNOMED.code.coding.system"> <path value="Observation.component.code.coding.system" /> <min value="1" /> <fixedUri value="http://snomed.info/sct" /> </element> <element id="Observation.component:AverageBloodPressureSNOMED.code.coding.code"> <path value="Observation.component.code.coding.code" /> <min value="1" /> <fixedCode value="6797001" /> </element> <element id="Observation.component:AverageBloodPressureSNOMED.code.coding.display"> <path value="Observation.component.code.coding.display" /> <defaultValueString value="Mean blood pressure" /> </element> <element id="Observation.component:AverageBloodPressureSNOMED.value[x]:valueQuantity"> <path value="Observation.component.valueQuantity" /> <sliceName value="valueQuantity" /> <short value="AverageBloodPressure recorded with UCUM" /> <definition value="Average blood pressure during one cycle of the heart contracting and relaxing. Estimated based on systolic and diastolic blood pressure. This estimate is unreliable in cases of circulatory disorders. This value can only be reliably determined when invasive blood pressure is measured." /> <alias value="GemiddeldeBloeddruk" /> <type> <code value="Quantity" /> </type> <mapping> <identity value="hcim-bloodpressure-v1.2-2015EN" /> <map value="NL-CM:12.4.4" /> <comment value="AverageBloodPressure" /> </mapping> <mapping> <identity value="hcim-bloodpressure-v3.0-2016EN" /> <map value="NL-CM:12.4.4" /> <comment value="AverageBloodPressure" /> </mapping> <mapping> <identity value="hcim-bloodpressure-v3.1-2017EN" /> <map value="NL-CM:12.4.4" /> <comment value="AverageBloodPressure" /> </mapping> </element> <element id="Observation.component:AverageBloodPressureSNOMED.value[x]:valueQuantity.value"> <path value="Observation.component.valueQuantity.value" /> <minValueDecimal value="0.0" /> <maxValueDecimal value="300.0" /> <constraint> <key value="valueExtremes" /> <severity value="error" /> <human value="The value of Blood Pressure cannot be lower than 0.0 or higher than 300.0" /> <expression value="SystolicBP.valueQuantity.value >= 0.0 and SystolicBP.valueQuantity.value <= 300.0" /> </constraint> </element> <element id="Observation.component:AverageBloodPressureSNOMED.value[x]:valueQuantity.unit"> <path value="Observation.component.valueQuantity.unit" /> <fixedString value="mm[Hg]" /> </element> <element id="Observation.component:AverageBloodPressureSNOMED.value[x]:valueQuantity.code"> <path value="Observation.component.valueQuantity.code" /> <fixedCode value="mm[Hg]" /> </element> </differential> </StructureDefinition>