<?xml version=“1.0” encoding=“UTF-8”?> <Observation xmlns=“hl7.org/fhir”>
<id value="blood-pressure-dar"/> <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> <identifier> <system value="urn:ietf:rfc:3986"/> <value value="urn:uuid:187e0c12-8dd2-67e2-99b2-bf273c878281"/> </identifier> <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/v3-ObservationInterpretation"/> <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><!-- Should have a refrange as well --></component><component> <code> <coding> <system value="http://loinc.org"/> <code value="8462-4"/> <display value="Diastolic blood pressure"/> </coding> </code><!-- Here the Diastolic measurement is missing and we give a reason using the DataAbsentReason element --><dataAbsentReason> <coding> <system value="http://terminology.hl7.org/CodeSystem/data-absent-reason"/> <code value="not-performed"/> <display value="Not Performed"/> </coding> </dataAbsentReason><!-- Should have a refrange as well --></component></Observation>