{
  "resourceType": "StructureDefinition",
  "id": "zib-BloodPressure",
  "meta": {
    "lastUpdated": "2018-03-07T14:11:51.444+00:00"
  },
  "url": "http://nictiz.nl/fhir/StructureDefinition/zib-BloodPressure",
  "version": "2.0",
  "name": "Zib BloodPressure",
  "title": "HCIM BloodPressure",
  "status": "draft",
  "date": "2017-09-06T10:02:17.702+00:00",
  "publisher": "Nictiz",
  "contact": [
    {
      "name": "Nictiz",
      "telecom": [
        {
          "system": "email",
          "value": "info@nictiz.nl",
          "use": "work"
        }
      ]
    }
  ],
  "description": "This profile is derived from the HL7 Vital Signs profile for Blood Pressure in order to add mappings from the Dutch Health and Care Information models (Dutch: Zorginformatiebouwsteen or ZIB) BloodPresurre version 3.1, release 2017 and to provide extensions for missing concepts if needed.\r\n\r\nThe blood pressure is a parameter for determining the condition of the blood circulation and is expressed in systolic and diastolic pressure in mmHg.",
  "purpose": "Blood pressure is measured to gain an indication of the health condition of the patient’s cardiovascular system.",
  "copyright": "CC0",
  "fhirVersion": "3.0.1",
  "mapping": [
    {
      "identity": "hcim-bloodpressure-v1.2-2015EN",
      "uri": "https://zibs.nl/wiki/BloodPressure-v1.2(2015EN)",
      "name": "HCIM BloodPressure-v1.2(2015EN)"
    },
    {
      "identity": "hcim-bloodpressure-v3.0-2016EN",
      "uri": "https://zibs.nl/wiki/BloodPressure-v3.0(2016EN)",
      "name": "HCIM BloodPressure-v3.0(2016EN)"
    },
    {
      "identity": "hcim-bloodpressure-v3.1-2017EN",
      "uri": "https://zibs.nl/wiki/BloodPressure-v3.1(2017EN)",
      "name": "HCIM BloodPressure-v3.1(2017EN)"
    }
  ],
  "kind": "resource",
  "abstract": false,
  "type": "Observation",
  "baseDefinition": "http://nictiz.nl/fhir/StructureDefinition/bp",
  "derivation": "constraint",
  "differential": {
    "element": [
      {
        "id": "Observation",
        "path": "Observation",
        "alias": [
          "Bloeddruk"
        ],
        "mapping": [
          {
            "identity": "hcim-bloodpressure-v1.2-2015EN",
            "map": "NL-CM:12.4.1"
          },
          {
            "identity": "hcim-bloodpressure-v3.0-2016EN",
            "map": "NL-CM:12.4.1"
          },
          {
            "identity": "hcim-bloodpressure-v3.1-2017EN",
            "map": "NL-CM:12.4.1"
          }
        ]
      },
      {
        "id": "Observation.effective[x]",
        "path": "Observation.effective[x]",
        "short": "BloodPressureDateTime",
        "alias": [
          "BloeddrukDatumTijd"
        ],
        "mapping": [
          {
            "identity": "hcim-bloodpressure-v1.2-2015EN",
            "map": "NL-CM:12.4.5"
          },
          {
            "identity": "hcim-bloodpressure-v3.0-2016EN",
            "map": "NL-CM:12.4.5"
          },
          {
            "identity": "hcim-bloodpressure-v3.1-2017EN",
            "map": "NL-CM:12.4.5"
          }
        ]
      },
      {
        "id": "Observation.comment",
        "path": "Observation.comment",
        "short": "Comment",
        "definition": "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": [
          "Toelichting"
        ],
        "mapping": [
          {
            "identity": "hcim-bloodpressure-v1.2-2015EN",
            "map": "NL-CM:12.4.6"
          },
          {
            "identity": "hcim-bloodpressure-v3.0-2016EN",
            "map": "NL-CM:12.4.6"
          },
          {
            "identity": "hcim-bloodpressure-v3.1-2017EN",
            "map": "NL-CM:12.4.6"
          }
        ]
      },
      {
        "id": "Observation.bodySite",
        "path": "Observation.bodySite",
        "short": "MeasuringLocation",
        "definition": "Anatomical location where the blood pressure was measured.",
        "alias": [
          "MeetLocatie"
        ],
        "binding": {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
              "valueString": "BodySite"
            }
          ],
          "strength": "extensible",
          "description": "MeetLocatieCodelijst",
          "valueSetReference": {
            "reference": "http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.12.4.4--20171231000000",
            "display": "MeetLocatieCodelijst"
          }
        },
        "mapping": [
          {
            "identity": "hcim-bloodpressure-v1.2-2015EN",
            "map": "NL-CM:12.4.10"
          },
          {
            "identity": "hcim-bloodpressure-v3.0-2016EN",
            "map": "NL-CM:12.4.10"
          },
          {
            "identity": "hcim-bloodpressure-v3.1-2017EN",
            "map": "NL-CM:12.4.10"
          }
        ]
      },
      {
        "id": "Observation.method",
        "path": "Observation.method",
        "short": "MeasuringMethod",
        "definition": "The type of method used to measure blood pressure.",
        "alias": [
          "Meetmethode"
        ],
        "binding": {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
              "valueString": "ObservationMethod"
            }
          ],
          "strength": "extensible",
          "description": "MeetmethodeCodelijst",
          "valueSetReference": {
            "reference": "http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.12.4.1--20171231000000",
            "display": "MeetmethodeCodelijst"
          }
        },
        "mapping": [
          {
            "identity": "hcim-bloodpressure-v1.2-2015EN",
            "map": "NL-CM:12.4.7"
          },
          {
            "identity": "hcim-bloodpressure-v3.0-2016EN",
            "map": "NL-CM:12.4.7"
          },
          {
            "identity": "hcim-bloodpressure-v3.1-2017EN",
            "map": "NL-CM:12.4.7"
          }
        ]
      },
      {
        "id": "Observation.component",
        "path": "Observation.component",
        "slicing": {
          "discriminator": [
            {
              "type": "value",
              "path": "code.coding.code"
            }
          ],
          "ordered": false,
          "rules": "open"
        }
      },
      {
        "id": "Observation.component:SystolicBP",
        "path": "Observation.component",
        "sliceName": "SystolicBP",
        "min": 1,
        "max": "1"
      },
      {
        "id": "Observation.component:SystolicBP.valueQuantity:valueQuantity",
        "path": "Observation.component.valueQuantity",
        "sliceName": "valueQuantity",
        "short": "SystolicBloodPressure recorded with UCUM",
        "definition": "The highest (peak) systematic arterial blood pressure - measured in the contraction stage or systole of the cardiac cycle.",
        "alias": [
          "SystolischeBloeddruk"
        ],
        "min": 1,
        "mapping": [
          {
            "identity": "hcim-bloodpressure-v1.2-2015EN",
            "map": "NL-CM:12.4.2"
          },
          {
            "identity": "hcim-bloodpressure-v3.0-2016EN",
            "map": "NL-CM:12.4.2"
          },
          {
            "identity": "hcim-bloodpressure-v3.1-2017EN",
            "map": "NL-CM:12.4.2"
          }
        ]
      },
      {
        "id": "Observation.component:DiastolicBP",
        "path": "Observation.component",
        "sliceName": "DiastolicBP",
        "min": 1,
        "max": "1"
      },
      {
        "id": "Observation.component:DiastolicBP.valueQuantity:valueQuantity",
        "path": "Observation.component.valueQuantity",
        "sliceName": "valueQuantity",
        "short": "DiastolicBloodPressure recorded with UCUM",
        "definition": "The lowest systematic arterial blood pressure - measured in the relaxation stage or diastole of the cardiac cycle.",
        "alias": [
          "DiastolischeBloeddruk"
        ],
        "min": 1,
        "mapping": [
          {
            "identity": "hcim-bloodpressure-v1.2-2015EN",
            "map": "NL-CM:12.4.3"
          },
          {
            "identity": "hcim-bloodpressure-v3.0-2016EN",
            "map": "NL-CM:12.4.3"
          },
          {
            "identity": "hcim-bloodpressure-v3.1-2017EN",
            "map": "NL-CM:12.4.3"
          }
        ]
      },
      {
        "id": "Observation.component:AverageBloodPressure",
        "path": "Observation.component",
        "sliceName": "AverageBloodPressure",
        "max": "1"
      },
      {
        "id": "Observation.component:AverageBloodPressure.code",
        "path": "Observation.component.code",
        "comment": "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."
      },
      {
        "id": "Observation.component:AverageBloodPressure.code.coding",
        "path": "Observation.component.code.coding",
        "slicing": {
          "discriminator": [
            {
              "type": "value",
              "path": "code"
            }
          ],
          "ordered": false,
          "rules": "open"
        }
      },
      {
        "id": "Observation.component:AverageBloodPressure.code.coding:ABPCodeLOINC",
        "path": "Observation.component.code.coding",
        "sliceName": "ABPCodeLOINC"
      },
      {
        "id": "Observation.component:AverageBloodPressure.code.coding:ABPCodeLOINC.system",
        "path": "Observation.component.code.coding.system",
        "fixedUri": "http://loinc.org"
      },
      {
        "id": "Observation.component:AverageBloodPressure.code.coding:ABPCodeLOINC.code",
        "path": "Observation.component.code.coding.code",
        "fixedCode": "8478-0"
      },
      {
        "id": "Observation.component:AverageBloodPressure.code.coding:ABPCodeSNOMED",
        "path": "Observation.component.code.coding",
        "sliceName": "ABPCodeSNOMED"
      },
      {
        "id": "Observation.component:AverageBloodPressure.code.coding:ABPCodeSNOMED.system",
        "path": "Observation.component.code.coding.system",
        "fixedUri": "http://snomed.info/sct"
      },
      {
        "id": "Observation.component:AverageBloodPressure.code.coding:ABPCodeSNOMED.code",
        "path": "Observation.component.code.coding.code",
        "fixedCode": "6797001"
      },
      {
        "id": "Observation.component:AverageBloodPressure.valueQuantity:valueQuantity",
        "path": "Observation.component.valueQuantity",
        "short": "AverageBloodPressure recorded with UCUM",
        "definition": "Average blood pressure during one cycle of the heart contracting and relaxing.\r\nEstimated 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": [
          "GemiddeldeBloeddruk"
        ],
        "type": [
          {
            "code": "Quantity"
          }
        ],
        "mapping": [
          {
            "identity": "hcim-bloodpressure-v1.2-2015EN",
            "map": "NL-CM:12.4.4"
          },
          {
            "identity": "hcim-bloodpressure-v3.0-2016EN",
            "map": "NL-CM:12.4.4"
          },
          {
            "identity": "hcim-bloodpressure-v3.1-2017EN",
            "map": "NL-CM:12.4.4"
          }
        ]
      },
      {
        "id": "Observation.component:AverageBloodPressure.valueQuantity:valueQuantity.code",
        "path": "Observation.component.valueQuantity.code",
        "fixedCode": "mm[Hg]"
      },
      {
        "id": "Observation.component:diastolicEndpoint",
        "path": "Observation.component",
        "sliceName": "diastolicEndpoint",
        "short": "DiastolicEndpoint",
        "max": "1"
      },
      {
        "id": "Observation.component:diastolicEndpoint.code",
        "path": "Observation.component.code",
        "comment": "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.",
        "alias": [
          "Component Test",
          "Component Name"
        ]
      },
      {
        "id": "Observation.component:diastolicEndpoint.code.coding",
        "path": "Observation.component.code.coding",
        "slicing": {
          "discriminator": [
            {
              "type": "value",
              "path": "code"
            }
          ],
          "ordered": false,
          "rules": "open"
        }
      },
      {
        "id": "Observation.component:diastolicEndpoint.code.coding:DiastolicEndpointCode",
        "path": "Observation.component.code.coding",
        "sliceName": "DiastolicEndpointCode"
      },
      {
        "id": "Observation.component:diastolicEndpoint.code.coding:DiastolicEndpointCode.system",
        "path": "Observation.component.code.coding.system",
        "fixedUri": "http://snomed.info/sct"
      },
      {
        "id": "Observation.component:diastolicEndpoint.code.coding:DiastolicEndpointCode.code",
        "path": "Observation.component.code.coding.code",
        "fixedCode": "85549003"
      },
      {
        "id": "Observation.component:diastolicEndpoint.valueCodeableConcept",
        "path": "Observation.component.valueCodeableConcept",
        "short": "DiastolicEndpoint",
        "definition": "Registration of the Korotkoff sound used to measure diastolic pressure with the auscultatory method.",
        "alias": [
          "DiastolischEindpunt"
        ],
        "type": [
          {
            "code": "CodeableConcept"
          }
        ],
        "binding": {
          "strength": "extensible",
          "description": "DiastolischEindpuntCodelijst",
          "valueSetReference": {
            "reference": "http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.12.4.2--20171231000000",
            "display": "DiastolischEindpuntCodelijst"
          }
        },
        "mapping": [
          {
            "identity": "hcim-bloodpressure-v1.2-2015EN",
            "map": "NL-CM:12.4.8"
          },
          {
            "identity": "hcim-bloodpressure-v3.0-2016EN",
            "map": "NL-CM:12.4.8"
          },
          {
            "identity": "hcim-bloodpressure-v3.1-2017EN",
            "map": "NL-CM:12.4.8"
          }
        ]
      },
      {
        "id": "Observation.component:cuffType",
        "path": "Observation.component",
        "sliceName": "cuffType",
        "max": "1"
      },
      {
        "id": "Observation.component:cuffType.code",
        "path": "Observation.component.code",
        "comment": "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.",
        "alias": [
          "Component Test",
          "Component Name"
        ]
      },
      {
        "id": "Observation.component:cuffType.code.coding",
        "path": "Observation.component.code.coding",
        "slicing": {
          "discriminator": [
            {
              "type": "value",
              "path": "code"
            }
          ],
          "ordered": false,
          "rules": "open"
        }
      },
      {
        "id": "Observation.component:cuffType.code.coding:CuffTypeCodeLOINC",
        "path": "Observation.component.code.coding",
        "sliceName": "CuffTypeCodeLOINC"
      },
      {
        "id": "Observation.component:cuffType.code.coding:CuffTypeCodeLOINC.system",
        "path": "Observation.component.code.coding.system",
        "fixedUri": "http://loinc.org"
      },
      {
        "id": "Observation.component:cuffType.code.coding:CuffTypeCodeLOINC.code",
        "path": "Observation.component.code.coding.code",
        "fixedCode": "8358-4"
      },
      {
        "id": "Observation.component:cuffType.code.coding:CuffTypeCodeSNOMED",
        "path": "Observation.component.code.coding",
        "sliceName": "CuffTypeCodeSNOMED"
      },
      {
        "id": "Observation.component:cuffType.code.coding:CuffTypeCodeSNOMED.system",
        "path": "Observation.component.code.coding.system",
        "fixedUri": "http://snomed.info/sct"
      },
      {
        "id": "Observation.component:cuffType.code.coding:CuffTypeCodeSNOMED.code",
        "path": "Observation.component.code.coding.code",
        "fixedCode": "70665002"
      },
      {
        "id": "Observation.component:cuffType.valueCodeableConcept:valueCodeableConcept",
        "path": "Observation.component.valueCodeableConcept",
        "short": "CuffType",
        "definition": "The size of the cuff used in the measurement.",
        "alias": [
          "ManchetType"
        ],
        "type": [
          {
            "code": "CodeableConcept"
          }
        ],
        "binding": {
          "strength": "extensible",
          "description": "ManchetTypeCodelijst",
          "valueSetReference": {
            "reference": "http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.12.4.3--20171231000000",
            "display": "ManchetTypeCodelijst"
          }
        },
        "mapping": [
          {
            "identity": "hcim-bloodpressure-v1.2-2015EN",
            "map": "NL-CM:12.4.9"
          },
          {
            "identity": "hcim-bloodpressure-v3.0-2016EN",
            "map": "NL-CM:12.4.9"
          },
          {
            "identity": "hcim-bloodpressure-v3.1-2017EN",
            "map": "NL-CM:12.4.9"
          }
        ]
      },
      {
        "id": "Observation.component:position",
        "path": "Observation.component",
        "sliceName": "position",
        "max": "1"
      },
      {
        "id": "Observation.component:position.code",
        "path": "Observation.component.code"
      },
      {
        "id": "Observation.component:position.code.coding",
        "path": "Observation.component.code.coding",
        "slicing": {
          "discriminator": [
            {
              "type": "value",
              "path": "code"
            }
          ],
          "ordered": false,
          "rules": "open"
        }
      },
      {
        "id": "Observation.component:position.code.coding:BodyPositionSNOMED",
        "path": "Observation.component.code.coding",
        "sliceName": "BodyPositionSNOMED",
        "short": "Body position",
        "definition": "Body position for blood pressure measurement"
      },
      {
        "id": "Observation.component:position.code.coding:bodyPositionSNOMED.system",
        "path": "Observation.component.code.coding.system",
        "fixedUri": "http://snomed.info/sct"
      },
      {
        "id": "Observation.component:position.code.coding:bodyPositionSNOMED.code",
        "path": "Observation.component.code.coding.code",
        "fixedCode": "424724000"
      },
      {
        "id": "Observation.component:position.code.coding:BodyPositionLOINC",
        "path": "Observation.component.code.coding",
        "sliceName": "BodyPositionLOINC"
      },
      {
        "id": "Observation.component:position.code.coding:BodyPositionLOINC.system",
        "path": "Observation.component.code.coding.system",
        "fixedUri": "http://loinc.org"
      },
      {
        "id": "Observation.component:position.code.coding:BodyPositionLOINC.code",
        "path": "Observation.component.code.coding.code",
        "fixedCode": "8361-8"
      },
      {
        "id": "Observation.component:position.valueCodeableConcept",
        "path": "Observation.component.valueCodeableConcept",
        "short": "Position",
        "definition": "The position of the patient when the blood pressure was measured.",
        "alias": [
          "Houding"
        ],
        "type": [
          {
            "code": "CodeableConcept"
          }
        ],
        "binding": {
          "strength": "extensible",
          "description": "HoudingCodelijst",
          "valueSetReference": {
            "reference": "http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.12.4.5--20171231000000",
            "display": "HoudingCodelijst"
          }
        },
        "mapping": [
          {
            "identity": "hcim-bloodpressure-v1.2-2015EN",
            "map": "NL-CM:12.4.11"
          },
          {
            "identity": "hcim-bloodpressure-v3.0-2016EN",
            "map": "NL-CM:12.4.11"
          },
          {
            "identity": "hcim-bloodpressure-v3.1-2017EN",
            "map": "NL-CM:12.4.11"
          }
        ]
      }
    ]
  }
}