{
  "resourceType": "StructureDefinition",
  "id": "AMA-IHMI-observation-average-blood-pressure-1",
  "meta": {
    "versionId": "5",
    "lastUpdated": "2019-02-06T21:29:13.154+00:00"
  },
  "url": "http://www.ama-ihmi.org/fhir/StructureDefinition/AMA-IHMI-observation-average-blood-pressure-1",
  "name": "AMA-IHMI-observation-average-blood-pressure-1",
  "status": "draft",
  "publisher": "American Medical Association",
  "description": "This profile supports the use case of individuals who are self-measuring blood pressure at home via an automatic blood pressure monitor. The profile constrains paired calculated weekly averages of systolic and diastolic blood pressure where the measurements used to calculate the averages conform to clinical constraints that specify that the measurements are on the brachial artery (with laterality), in sitting position, at rest, using an automatic blood pressure monitor with cuff size specified (i.e., “clinically valid blood pressures” that conform to the AMA-IHMI-observation-blood-pressure-3 profile).  \r\nThe Observation.comment element of the profile references the AMA IHMI protocol used to calculate the weekly blood pressure averages.",
  "copyright": "Copyright 2016-2019 American Medical Association. All rights reserved.",
  "fhirVersion": "3.0.1",
  "kind": "resource",
  "abstract": false,
  "type": "Observation",
  "baseDefinition": "http://hl7.org/fhir/StructureDefinition/Observation",
  "derivation": "constraint",
  "differential": {
    "element": [
      {
        "id": "Observation.basedOn",
        "path": "Observation.basedOn",
        "max": "0"
      },
      {
        "id": "Observation.status",
        "extension": [
          {
            "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-display-hint",
            "valueString": "default: final"
          }
        ],
        "path": "Observation.status",
        "fixedCode": "final"
      },
      {
        "id": "Observation.category",
        "path": "Observation.category",
        "slicing": {
          "discriminator": [
            {
              "type": "value",
              "path": "coding.system"
            },
            {
              "type": "value",
              "path": "coding.code"
            }
          ],
          "rules": "open"
        },
        "min": 1,
        "max": "1"
      },
      {
        "id": "Observation.category:vitalSigns",
        "path": "Observation.category",
        "sliceName": "vitalSigns",
        "min": 1,
        "max": "1"
      },
      {
        "id": "Observation.category:vitalSigns.coding",
        "path": "Observation.category.coding",
        "min": 1
      },
      {
        "id": "Observation.category:vitalSigns.coding.system",
        "path": "Observation.category.coding.system",
        "min": 1,
        "fixedUri": "http://hl7.org/fhir/observation-category"
      },
      {
        "id": "Observation.category:vitalSigns.coding.code",
        "path": "Observation.category.coding.code",
        "min": 1,
        "fixedCode": "vital-signs"
      },
      {
        "id": "Observation.category:vitalSigns.coding.display",
        "extension": [
          {
            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
            "valueBoolean": true
          }
        ],
        "path": "Observation.category.coding.display",
        "min": 1,
        "fixedString": "Vital Signs"
      },
      {
        "id": "Observation.category:vitalSigns.coding.userSelected",
        "path": "Observation.category.coding.userSelected",
        "max": "0"
      },
      {
        "id": "Observation.category:vitalSigns.text",
        "extension": [
          {
            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
            "valueBoolean": true
          }
        ],
        "path": "Observation.category.text",
        "max": "0"
      },
      {
        "id": "Observation.code.coding",
        "path": "Observation.code.coding",
        "min": 1,
        "max": "1"
      },
      {
        "id": "Observation.code.coding.system",
        "path": "Observation.code.coding.system",
        "min": 1,
        "fixedUri": "http://ihmi.termspace.com/api/uri?uri=http://snomed.info/sct/3881000207102"
      },
      {
        "id": "Observation.code.coding.code",
        "path": "Observation.code.coding.code",
        "min": 1,
        "fixedCode": "5101000207103"
      },
      {
        "id": "Observation.code.coding.display",
        "extension": [
          {
            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
            "valueBoolean": true
          }
        ],
        "path": "Observation.code.coding.display",
        "min": 1,
        "fixedString": "Calculation of average blood pressure (procedure)"
      },
      {
        "id": "Observation.code.coding.userSelected",
        "path": "Observation.code.coding.userSelected",
        "max": "0"
      },
      {
        "id": "Observation.code.text",
        "extension": [
          {
            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
            "valueBoolean": true
          }
        ],
        "path": "Observation.code.text",
        "max": "0"
      },
      {
        "id": "Observation.subject",
        "path": "Observation.subject",
        "min": 1,
        "type": [
          {
            "code": "Reference",
            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Patient"
          }
        ]
      },
      {
        "id": "Observation.effective[x]",
        "path": "Observation.effective[x]",
        "min": 1
      },
      {
        "id": "Observation.issued",
        "path": "Observation.issued",
        "max": "0"
      },
      {
        "id": "Observation.performer",
        "path": "Observation.performer",
        "short": "Who/what is responsible for the observation",
        "definition": "Who or what was responsible for asserting the observed value as \"true\".",
        "type": [
          {
            "code": "Reference",
            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Practitioner"
          },
          {
            "code": "Reference",
            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Organization"
          }
        ]
      },
      {
        "id": "Observation.value[x]",
        "path": "Observation.value[x]",
        "max": "0"
      },
      {
        "id": "Observation.dataAbsentReason",
        "path": "Observation.dataAbsentReason",
        "max": "0"
      },
      {
        "id": "Observation.interpretation",
        "path": "Observation.interpretation",
        "max": "0"
      },
      {
        "id": "Observation.comment",
        "path": "Observation.comment",
        "min": 1,
        "fixedString": "org.ama.ihm.bp.model.BloodPressureAverage.IhmAverage"
      },
      {
        "id": "Observation.bodySite",
        "path": "Observation.bodySite",
        "max": "0"
      },
      {
        "id": "Observation.method",
        "path": "Observation.method",
        "max": "0"
      },
      {
        "id": "Observation.specimen",
        "path": "Observation.specimen",
        "max": "0"
      },
      {
        "id": "Observation.device",
        "path": "Observation.device",
        "max": "0",
        "type": [
          {
            "code": "Reference",
            "targetProfile": "http://ihmi.termspace.com/api/uri?uri=http://snomed.info/sct/3881000207102/IHMI_blood_pressure_device_1"
          }
        ]
      },
      {
        "id": "Observation.referenceRange",
        "path": "Observation.referenceRange",
        "max": "0"
      },
      {
        "id": "Observation.related.type",
        "path": "Observation.related.type",
        "min": 1,
        "fixedCode": "derived-from"
      },
      {
        "id": "Observation.related.target",
        "path": "Observation.related.target",
        "type": [
          {
            "code": "Reference",
            "targetProfile": "http://www.ama-ihmi.org/fhir/StructureDefinition/AMA-IHMI-observation-blood-pressure-3"
          }
        ]
      },
      {
        "id": "Observation.component",
        "path": "Observation.component",
        "slicing": {
          "discriminator": [
            {
              "type": "value",
              "path": "code.coding.system"
            },
            {
              "type": "value",
              "path": "code.coding.code"
            }
          ],
          "rules": "open"
        },
        "min": 2,
        "max": "2"
      },
      {
        "id": "Observation.component:average_SBP",
        "path": "Observation.component",
        "sliceName": "average_SBP",
        "min": 1,
        "max": "1"
      },
      {
        "id": "Observation.component:average_SBP.code.coding",
        "path": "Observation.component.code.coding",
        "min": 1,
        "max": "1"
      },
      {
        "id": "Observation.component:average_SBP.code.coding.system",
        "path": "Observation.component.code.coding.system",
        "min": 1,
        "fixedUri": "http://ihmi.termspace.com/api/uri?uri=http://snomed.info/sct/3881000207102"
      },
      {
        "id": "Observation.component:average_SBP.code.coding.code",
        "path": "Observation.component.code.coding.code",
        "min": 1,
        "fixedCode": "4711000207102"
      },
      {
        "id": "Observation.component:average_SBP.code.coding.display",
        "extension": [
          {
            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
            "valueBoolean": true
          }
        ],
        "path": "Observation.component.code.coding.display",
        "min": 1,
        "fixedString": "Calculation of average systolic blood pressure (procedure)"
      },
      {
        "id": "Observation.component:average_SBP.code.coding.userSelected",
        "path": "Observation.component.code.coding.userSelected",
        "max": "0"
      },
      {
        "id": "Observation.component:average_SBP.code.text",
        "extension": [
          {
            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
            "valueBoolean": true
          }
        ],
        "path": "Observation.component.code.text",
        "max": "0"
      },
      {
        "id": "Observation.component:average_SBP.value[x]:valueQuantity",
        "path": "Observation.component.valueQuantity",
        "sliceName": "valueQuantity",
        "min": 1,
        "type": [
          {
            "code": "Quantity"
          }
        ]
      },
      {
        "id": "Observation.component:average_SBP.value[x]:valueQuantity.value",
        "path": "Observation.component.valueQuantity.value",
        "min": 1
      },
      {
        "id": "Observation.component:average_SBP.value[x]:valueQuantity.comparator",
        "path": "Observation.component.valueQuantity.comparator",
        "max": "0"
      },
      {
        "id": "Observation.component:average_SBP.value[x]:valueQuantity.unit",
        "extension": [
          {
            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
            "valueBoolean": true
          }
        ],
        "path": "Observation.component.valueQuantity.unit",
        "min": 1
      },
      {
        "id": "Observation.component:average_SBP.value[x]:valueQuantity.system",
        "path": "Observation.component.valueQuantity.system",
        "min": 1,
        "fixedUri": "http://unitsofmeasure.org"
      },
      {
        "id": "Observation.component:average_SBP.value[x]:valueQuantity.code",
        "path": "Observation.component.valueQuantity.code",
        "min": 1,
        "fixedCode": "mm[Hg]"
      },
      {
        "id": "Observation.component:average_SBP.dataAbsentReason",
        "path": "Observation.component.dataAbsentReason",
        "max": "0"
      },
      {
        "id": "Observation.component:average_SBP.interpretation",
        "path": "Observation.component.interpretation",
        "max": "0"
      },
      {
        "id": "Observation.component:average_SBP.referenceRange",
        "path": "Observation.component.referenceRange",
        "max": "0"
      },
      {
        "id": "Observation.component:average_DBP",
        "path": "Observation.component",
        "sliceName": "average_DBP",
        "min": 1,
        "max": "1"
      },
      {
        "id": "Observation.component:average_DBP.code.coding",
        "path": "Observation.component.code.coding",
        "min": 1,
        "max": "1"
      },
      {
        "id": "Observation.component:average_DBP.code.coding.system",
        "path": "Observation.component.code.coding.system",
        "min": 1,
        "fixedUri": "http://ihmi.termspace.com/api/uri?uri=http://snomed.info/sct/3881000207102"
      },
      {
        "id": "Observation.component:average_DBP.code.coding.code",
        "path": "Observation.component.code.coding.code",
        "min": 1,
        "fixedCode": "4701000207100"
      },
      {
        "id": "Observation.component:average_DBP.code.coding.display",
        "extension": [
          {
            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
            "valueBoolean": true
          }
        ],
        "path": "Observation.component.code.coding.display",
        "min": 1,
        "fixedString": "Calculation of average diastolic blood pressure (procedure)"
      },
      {
        "id": "Observation.component:average_DBP.code.coding.userSelected",
        "path": "Observation.component.code.coding.userSelected",
        "max": "0"
      },
      {
        "id": "Observation.component:average_DBP.code.text",
        "extension": [
          {
            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
            "valueBoolean": true
          }
        ],
        "path": "Observation.component.code.text",
        "max": "0"
      },
      {
        "id": "Observation.component:average_DBP.value[x]:valueQuantity",
        "path": "Observation.component.valueQuantity",
        "sliceName": "valueQuantity",
        "min": 1,
        "type": [
          {
            "code": "Quantity"
          }
        ]
      },
      {
        "id": "Observation.component:average_DBP.value[x]:valueQuantity.value",
        "path": "Observation.component.valueQuantity.value",
        "min": 1
      },
      {
        "id": "Observation.component:average_DBP.value[x]:valueQuantity.comparator",
        "path": "Observation.component.valueQuantity.comparator",
        "max": "0"
      },
      {
        "id": "Observation.component:average_DBP.value[x]:valueQuantity.unit",
        "extension": [
          {
            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
            "valueBoolean": true
          }
        ],
        "path": "Observation.component.valueQuantity.unit",
        "min": 1
      },
      {
        "id": "Observation.component:average_DBP.value[x]:valueQuantity.system",
        "path": "Observation.component.valueQuantity.system",
        "min": 1,
        "fixedUri": "http://unitsofmeasure.org"
      },
      {
        "id": "Observation.component:average_DBP.value[x]:valueQuantity.code",
        "path": "Observation.component.valueQuantity.code",
        "min": 1,
        "fixedCode": "mm[Hg]"
      },
      {
        "id": "Observation.component:average_DBP.dataAbsentReason",
        "path": "Observation.component.dataAbsentReason",
        "max": "0"
      },
      {
        "id": "Observation.component:average_DBP.interpretation",
        "path": "Observation.component.interpretation",
        "max": "0"
      },
      {
        "id": "Observation.component:average_DBP.referenceRange",
        "path": "Observation.component.referenceRange",
        "max": "0"
      }
    ]
  }
}