Stream: implementers
Topic: Blood Pressure: Observation.code or component
Samantha Wang (Sep 04 2018 at 20:24):
Looking for commentary on how to represent diastolic and systolic BP.
It seems to me that they might belong in Observation.Component.Code; however, guidance from QICore (http://hl7.org/fhir/us/qicore/2018Jan/qdm-to-qicore.html) suggests that: "A general rule of thumb is QI Core / FHIR components apply only when the inherent value of the observation is defined by the parent observation. The result is that the content will determine if a QDM component maps to Observation.code or to Observation.component.code."
Does anyone have a good case to represent Diastolic or Systolic as their own distinct observation, within Observation.Code? Or is anyone doing this today? Or is the community treating these as components?
Eric Haas (Sep 04 2018 at 20:34):
this is documented here in the Observation vitals profile:
http://build.fhir.org/observation-vitalsigns.html
Eric Haas (Sep 04 2018 at 20:36):
STU3 link: http://hl7.org/fhir/observation-vitalsigns.html
Stefan Lang (Sep 04 2018 at 20:38):
even closer: http://hl7.org/fhir/bp.html ;-)
Samantha Wang (Sep 04 2018 at 21:53):
Thank you! Getting more into application of this FHIR resource... BP is used in quality measure for Screening for High BP and follow-up (CMS22v7 - https://ecqi.healthit.gov/system/files/ecqm/measures/CMS22v7.html). The specification doesn't explicitly call out the use of a QDM Component attribute. Is that expected? Or does that surprise anyone?
Richard Townley-O'Neill (Sep 04 2018 at 23:09):
The R4 profile has corrected the cardinalities of coding, system and code. Compare http://hl7.org/fhir/bp.html with http://build.fhir.org/bp.html
Eric Haas (Sep 04 2018 at 23:16):
The profile is for international use and so does not constrain to single jurisdictional requirement. @Bryn Rhodes has profiled these for Quality measures I believe?
Bryn Rhodes (Sep 04 2018 at 23:22):
Within QICore, and for blood pressures represented within QDM specifically, we reference the US Core vital signs profile: http://hl7.org/fhir/us/qicore/PhysicalExam.html#Physical_Exam.2C_Performed
Bryn Rhodes (Sep 04 2018 at 23:22):
How that actually happens is the subject of the upcoming connectathon :)
Bryn Rhodes (Sep 04 2018 at 23:24):
It's true that QDM doesn't use components to model the systolic and diastolic, that's because historically QDM hasn't done that (the component attribute of Physical Exam, Performed was introduced in QDM 5).
Last updated: Apr 12 2022 at 19:14 UTC
