Stream: Orders and Observation WG
Topic: bodyPosition extension
Angie Romano (Jul 27 2018 at 19:18):
Hello,
Does anyone have example json for a DTSU3 blood pressure observation result that includes the bodyPosition extension? I'm trying to mock up some data on a local instance of the HAPI-FHIR-jpaserver-example server and I can't seem to get the extension coded correctly for the server to accept it.
thank you in advance!
Lloyd McKenzie (Jul 27 2018 at 19:24):
<?xml version="1.0" encoding="UTF-8"?>
<Observation xmlns="http://hl7.org/fhir" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xsi:schemaLocation="http://hl7.org/fhir ../../../../../../../Documents/SVN/FHIR/build/schema/fhir-single.xsd">
<id value="blood-pressure"/>
<meta>
<profile value="http://hl7.org/fhir/StructureDefinition/vitalsigns"/>
</meta>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml">
<p>
<b>Generated Narrative with Details</b>
</p>
<p>
<b>id</b>: blood-pressure</p>
<p>
<b>meta</b>: </p>
<p>
<b>identifier</b>: urn:uuid:187e0c12-8dd2-67e2-99b2-bf273c878281</p>
<p>
<b>basedOn</b>: </p>
<p>
<b>status</b>: final</p>
<p>
<b>category</b>: Vital Signs <span>(Details : {http://terminology.hl7.org/CodeSystem/observation-category code 'vital-signs' = 'Vital Signs', given as 'Vital Signs'})</span>
</p>
<p>
<b>code</b>: Blood pressure systolic & diastolic <span>(Details : {LOINC code '85354-9' = 'Blood pressure panel with all children optional', given as 'Blood pressure panel with all children optional'})</span>
</p>
<p>
<b>subject</b>: <a>Patient/example</a>
</p>
<p>
<b>effective</b>: Sep 17, 2012</p>
<p>
<b>performer</b>: <a>Practitioner/example</a>
</p>
<p>
<b>interpretation</b>: Below low normal <span>(Details : {http://terminology.hl7.org/CodeSystem/v2-0078 code 'L' = 'Low', given as 'low'})</span>
</p>
<p>
<b>bodySite</b>: Right arm <span>(Details : {SNOMED CT code '368209003' = 'Right upper arm', given as 'Right arm'})</span>
</p>
<blockquote>
<p>
<b>component</b>
</p>
<p>
<b>code</b>: Systolic blood pressure <span>(Details : {LOINC code '8480-6' = 'Systolic blood pressure', given as 'Systolic blood pressure'}; {SNOMED CT code '271649006' = 'Systolic blood pressure', given as 'Systolic blood pressure'}; {http://acme.org/devices/clinical-codes code 'bp-s' = 'bp-s', given as 'Systolic Blood pressure'})</span>
</p>
<p>
<b>value</b>: 107 mmHg<span> (Details: UCUM code mm[Hg] = 'mmHg')</span>
</p>
<p>
<b>interpretation</b>: Normal <span>(Details : {http://terminology.hl7.org/CodeSystem/v2-0078 code 'N' = 'Normal', given as 'normal'})</span>
</p>
</blockquote>
<blockquote>
<p>
<b>component</b>
</p>
<p>
<b>code</b>: Diastolic blood pressure <span>(Details : {LOINC code '8462-4' = 'Diastolic blood pressure', given as 'Diastolic blood pressure'})</span>
</p>
<p>
<b>value</b>: 60 mmHg<span> (Details: UCUM code mm[Hg] = 'mmHg')</span>
</p>
<p>
<b>interpretation</b>: Below low normal <span>(Details : {http://terminology.hl7.org/CodeSystem/v2-0078 code 'L' = 'Low', given as 'low'})</span>
</p>
</blockquote>
</div>
</text>
<extension url="http://hl7.org/fhir/StructureDefinition/observation-bodyPosition">
<valueCodeableConcept>
<coding>
<system value="http://snomed.info/sct"/>
<code value="33586001"/>
<display value="Sitting position"
</coding>
</valueCodeableConcept>
</extension>
<identifier>
<system value="urn:ietf:rfc:3986"/>
<value value="urn:uuid:187e0c12-8dd2-67e2-99b2-bf273c878281"/>
</identifier>
<!-- demonstrating the use of the baseOn element with a fictive identifier -->
<basedOn>
<identifier>
<system value="https://acme.org/identifiers"/>
<value value="1234"/>
</identifier>
</basedOn>
<status value="final"/>
<category>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/observation-category"/>
<code value="vital-signs"/>
<display value="Vital Signs"/>
</coding>
</category>
<code>
<!-- replaced by 85354-9
<coding>
<system value="http://loinc.org"/>
<code value="85354-9"/>
<display value="Blood pressure systolic & diastolic"/>
</coding>
-->
<coding>
<system value="http://loinc.org"/>
<code value="85354-9"/>
<display value="Blood pressure panel with all children optional"/>
</coding>
<text value="Blood pressure systolic & diastolic"/>
</code>
<subject>
<reference value="Patient/example"/>
</subject>
<effectiveDateTime value="2012-09-17"/>
<performer>
<reference value="Practitioner/example"/>
</performer>
<!-- an interpretation offered to the combination observation
generally, it would only be appropriate to offer an interpretation
of an observation that has no value if it has "COMP" (component)
observations -->
<interpretation>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/v2-0078"/>
<code value="L"/>
<display value="low"/>
</coding>
<text value="Below low normal"/>
</interpretation>
<!-- The BodySite can be captured in a LOINC code but am showing it here to demonstrate populating the element -->
<bodySite>
<coding>
<system value="http://snomed.info/sct"/>
<code value="368209003"/>
<display value="Right arm"/>
</coding>
</bodySite>
<component>
<!--
Observations are often coded in multiple code systems.
- LOINC provides a very specific code (though not more specific in this particular case)
- snomed provides a clinically relevant code that is usually less granular than LOINC
- the source system provides its own code, which may be less or more granular than LOINC
this is shown here to demonstrate the concept of translations within the codeableConcept datatype. The diastolic code below only has a LOINC code
-->
<code>
<!-- LOINC -code -->
<coding>
<system value="http://loinc.org"/>
<code value="8480-6"/>
<display value="Systolic blood pressure"/>
</coding>
<!-- SNOMED CT Codes -->
<coding>
<system value="http://snomed.info/sct"/>
<code value="271649006"/>
<display value="Systolic blood pressure"/>
</coding>
<!-- Also, a local code specific to the source system -->
<coding>
<system value="http://acme.org/devices/clinical-codes"/>
<code value="bp-s"/>
<display value="Systolic Blood pressure"/>
</coding>
</code>
<valueQuantity>
<value value="107"/>
<unit value="mmHg"/>
<system value="http://unitsofmeasure.org"/>
<code value="mm[Hg]"/>
</valueQuantity>
<!-- an interpretation for the individual composite observation -->
<interpretation>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/v2-0078"/>
<code value="N"/>
<display value="normal"/>
</coding>
<text value="Normal"/>
</interpretation>
<!-- Should have a refrange as well -->
</component>
<component>
<!-- this codes only has a LOINC code -->
<code>
<coding>
<system value="http://loinc.org"/>
<code value="8462-4"/>
<display value="Diastolic blood pressure"/>
</coding>
</code>
<valueQuantity>
<value value="60"/>
<unit value="mmHg"/>
<system value="http://unitsofmeasure.org"/>
<code value="mm[Hg]"/>
</valueQuantity>
<!-- an interpretation for the individual composite observation -->
<interpretation>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/v2-0078"/>
<code value="L"/>
<display value="low"/>
</coding>
<text value="Below low normal"/>
</interpretation>
<!-- Should have a refrange as well -->
</component>
</Observation>
Angie Romano (Jul 27 2018 at 19:36):
Thank you @Lloyd McKenzie! that gave me what I needed. :grinning:
Eric Haas (Jul 27 2018 at 20:46):
just added to the CI Build here: http://build.fhir.org/observation-example-map-sitting.html
Eric Haas (Jul 27 2018 at 20:47):
for R4
Last updated: Apr 12 2022 at 19:14 UTC
