<?xml version=“1.0” encoding=“UTF-8”?> <Observation xmlns=“hl7.org/fhir”>

      <id value="blood-pressure-cancel"/>
      <meta>
              <profile value="http://hl7.org/fhir/StructureDefinition/vitalsigns"/>

  <security>
    <system value="http://terminology.hl7.org/CodeSystem/v3-ActReason"/>
    <code value="HTEST"/>
    <display value="test health data"/>
  </security>
</meta><!--   EH  Narrative created by build
      <text>
              <status value="generated"/>
              <div xmlns="http://www.w3.org/1999/xhtml">Sept 17, 2012: Systolic Blood pressure 107/60 mmHg (low)</div>
      </text>
--><identifier>
              <system value="urn:ietf:rfc:3986"/>
              <value value="urn:uuid:187e0c12-8dd2-67e2-99b2-bf273c878281"/>
      </identifier>
      <status value="cancelled"/>
      <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 &amp; 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 &amp; 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/v3-ObservationInterpretation"/>
                      <code value="L"/>
                      <display value="low"/>
              </coding>
              <text value="Below low normal"/>
      </interpretation>
      <note><text value="In this example, the blood pressure measurements are not available due to cancellation of the order.  Data absent reason is present for each component"/></note><!--   for an observation with components, these cannot disagree with the flags on the components   --><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 usefully 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 instance shows the concept. The other codes only have a LOINC code   --><code><!--   LOINC - always recommended to have a LOINC code   --><coding>
                              <system value="http://loinc.org"/>
                              <code value="8480-6"/>
                              <display value="Systolic blood pressure"/>
                      </coding><!--   SNOMED CT Codes - becoming more common   --><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><!--   that shows the concept. The next two names only have a LOINC code   --></code><!--   no value due to some error
  <valueQuantity>
    <value value="107"/>
    <unit value="mm[Hg]"/>
  </valueQuantity>
--><dataAbsentReason>
                      <coding>
                              <system value="http://terminology.hl7.org/CodeSystem/data-absent-reason"/>
                              <code value="not-asked"/>
                              <display value="Not Asked"/>
                      </coding>
              </dataAbsentReason>
      </component>
      <component>
              <code>
                      <coding>
                              <system value="http://loinc.org"/>
                              <code value="8462-4"/>
                              <display value="Diastolic blood pressure"/>
                      </coding>
              </code><!--   no value due to some error
  <valueQuantity>
    <value value="60"/>
    <unit value="mm[Hg]"/>
  </valueQuantity>
--><dataAbsentReason>
                      <coding>
                              <system value="http://terminology.hl7.org/CodeSystem/data-absent-reason"/>
                              <code value="not-asked"/>
                              <display value="Not Asked"/>
                      </coding>
              </dataAbsentReason>
      </component>

</Observation>