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Resource Profile: US Core Blood Pressure Profile

To promote interoperability and adoption through common implementation, this profile sets minimum expectations for the Observation resource to record, search, and fetch diastolic and systolic blood pressure observations with standard LOINC codes and UCUM units of measure. It is based on the US Core Vital Signs Profile and identifies which additional core elements, extensions, vocabularies, and value sets SHALL be present and constrains the way the elements are used when using the profile. It provides the floor for standards development for specific use cases.

Usage:

• This Resource Profile is not used by any profiles in this Implementation Guide

Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work.

• Differential Table
• Key Elements Table
• Snapshot Table
• Statistics/References
• All

This structure is derived from USCoreVitalSignsProfile

Name	Flags	Card.	Type	Description & Constraints
Observation		0..*	USCoreVitalSignsProfile	US Core Blood Pressure Profile
code	S	1..1	CodeableConcept	(USCDI) Blood Pressure Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 85354-9
Slices for component	S	2..*	BackboneElement	(USCDI) Component observations Slice: Unordered, Open by pattern:code
component:systolic	S	1..1	BackboneElement	(USCDI) Systolic Blood Pressure
code	S	1..1	CodeableConcept	(USCDI) Systolic Blood Pressure Code Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 8480-6
valueQuantity	S	0..1	Quantity	(USCDI) Vital Sign Component Value
value	S	1..1	decimal	(USCDI) Numerical value (with implicit precision)
unit	S	1..1	string	(USCDI) Unit representation
system	S	1..1	uri	(USCDI) System that defines coded unit form Fixed Value: http://unitsofmeasure.org
code	S	1..1	code	(USCDI) Coded form of the unit Fixed Value: mm[Hg]
component:diastolic	S	1..1	BackboneElement	(USCDI) Diastolic Blood Pressure
code	S	1..1	CodeableConcept	(USCDI) Diastolic Blood Pressure Code Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 8462-4
valueQuantity	S	0..1	Quantity	(USCDI) Vital Sign Component Value
value	S	1..1	decimal	(USCDI) Numerical value (with implicit precision)
unit	S	1..1	string	(USCDI) Unit representation
system	S	1..1	uri	(USCDI) System that defines coded unit form Fixed Value: http://unitsofmeasure.org
code	S	1..1	code	(USCDI) Coded form of the unit Fixed Value: mm[Hg]
Documentation for this format

Name	Flags	Card.	Type	Description & Constraints
Observation	C	0..*	USCoreVitalSignsProfile	US Core Blood Pressure Profile obs-6: dataAbsentReason SHALL only be present if Observation.value[x] is not present obs-7: If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present vs-2: If there is no component or hasMember element then either a value[x] or a data absent reason must be present.
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
status	?!SΣ	1..1	code	(USCDI) registered | preliminary | final | amended + Binding: ObservationStatus (required)
Slices for category	S	1..*	CodeableConcept	(USCDI) Classification of type of observation Slice: Unordered, Open by value:coding.code, value:coding.system Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
category:VSCat	S	1..1	CodeableConcept	(USCDI) Classification of type of observation Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
coding	SΣ	1..*	Coding	(USCDI) Code defined by a terminology system
system	SΣ	1..1	uri	(USCDI) Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category
code	SΣ	1..1	code	(USCDI) Symbol in syntax defined by the system Fixed Value: vital-signs
code	SΣ	1..1	CodeableConcept	(USCDI) Blood Pressure Binding: US Core Vital Signs ValueSet (extensible): The vital sign codes from the base FHIR and US Core Vital Signs. Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 85354-9
subject	SΣ	1..1	Reference(US Core Patient Profile)	(USCDI) Who and/or what the observation is about
effective[x]	SΣC	1..1		(USCDI) Often just a dateTime for Vital Signs vs-1: if Observation.effective[x] is dateTime and has a value then that value shall be precise to the day
effectiveDateTime			dateTime
value[x]	SΣC	0..1		(USCDI) Vital Signs Value Binding: VitalSignsUnits (extensible): Common UCUM units for recording Vital Signs.
valueQuantity			Quantity
dataAbsentReason	SC	0..1	CodeableConcept	(USCDI) Why the result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
Slices for component	SΣC	2..*	BackboneElement	(USCDI) Component observations Slice: Unordered, Open by pattern:code vs-3: If there is no a value a data absent reason must be present
component:All Slices				Content/Rules for all slices
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	SΣ	1..1	CodeableConcept	(USCDI) Type of component observation (code / type) Binding: US Core Vital Signs ValueSet (extensible): The vital sign codes from the base FHIR and US Core Vital Signs.
value[x]	SΣC	0..1		(USCDI) Vital Sign Component Value Binding: VitalSignsUnits (extensible): Common UCUM units for recording Vital Signs.
valueQuantity			Quantity
dataAbsentReason	SC	0..1	CodeableConcept	(USCDI) Why the component result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
component:systolic	SΣC	1..1	BackboneElement	(USCDI) Systolic Blood Pressure vs-3: If there is no a value a data absent reason must be present
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	SΣ	1..1	CodeableConcept	(USCDI) Systolic Blood Pressure Code Binding: US Core Vital Signs ValueSet (extensible): The vital sign codes from the base FHIR and US Core Vital Signs. Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 8480-6
value[x]	SΣC	0..1	Quantity	(USCDI) Vital Sign Component Value Binding: VitalSignsUnits (extensible): Common UCUM units for recording Vital Signs.
value	SΣ	1..1	decimal	(USCDI) Numerical value (with implicit precision)
comparator	?!Σ	0..1	code	< | <= | >= | > - how to understand the value Binding: QuantityComparator (required): How the Quantity should be understood and represented.
unit	SΣ	1..1	string	(USCDI) Unit representation
system	SΣC	1..1	uri	(USCDI) System that defines coded unit form Fixed Value: http://unitsofmeasure.org
code	SΣ	1..1	code	(USCDI) Coded form of the unit Fixed Value: mm[Hg]
dataAbsentReason	SC	0..1	CodeableConcept	(USCDI) Why the component result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
component:diastolic	SΣC	1..1	BackboneElement	(USCDI) Diastolic Blood Pressure vs-3: If there is no a value a data absent reason must be present
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	SΣ	1..1	CodeableConcept	(USCDI) Diastolic Blood Pressure Code Binding: US Core Vital Signs ValueSet (extensible): The vital sign codes from the base FHIR and US Core Vital Signs. Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 8462-4
value[x]	SΣC	0..1	Quantity	(USCDI) Vital Sign Component Value Binding: VitalSignsUnits (extensible): Common UCUM units for recording Vital Signs.
value	SΣ	1..1	decimal	(USCDI) Numerical value (with implicit precision)
comparator	?!Σ	0..1	code	< | <= | >= | > - how to understand the value Binding: QuantityComparator (required): How the Quantity should be understood and represented.
unit	SΣ	1..1	string	(USCDI) Unit representation
system	SΣC	1..1	uri	(USCDI) System that defines coded unit form Fixed Value: http://unitsofmeasure.org
code	SΣ	1..1	code	(USCDI) Coded form of the unit Fixed Value: mm[Hg]
dataAbsentReason	SC	0..1	CodeableConcept	(USCDI) Why the component result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
Observation.status	required	ObservationStatus http://hl7.org/fhir/ValueSet/observation-status|4.0.1 from the FHIR Standard
Observation.category	preferred	ObservationCategoryCodes http://hl7.org/fhir/ValueSet/observation-category from the FHIR Standard
Observation.category:VSCat	preferred	ObservationCategoryCodes http://hl7.org/fhir/ValueSet/observation-category from the FHIR Standard
Observation.code	extensible	Pattern: LOINC code 85354-9 http://hl7.org/fhir/us/core/ValueSet/us-core-vital-signs
Observation.value[x]	extensible	VitalSignsUnits http://hl7.org/fhir/ValueSet/ucum-vitals-common|4.0.1 from the FHIR Standard
Observation.dataAbsentReason	extensible	DataAbsentReason http://hl7.org/fhir/ValueSet/data-absent-reason from the FHIR Standard
Observation.component.code	extensible	UsCoreVitalSigns http://hl7.org/fhir/us/core/ValueSet/us-core-vital-signs
Observation.component.value[x]	extensible	VitalSignsUnits http://hl7.org/fhir/ValueSet/ucum-vitals-common|4.0.1 from the FHIR Standard
Observation.component.dataAbsentReason	extensible	DataAbsentReason http://hl7.org/fhir/ValueSet/data-absent-reason from the FHIR Standard
Observation.component:systolic.code	extensible	Pattern: LOINC code 8480-6 http://hl7.org/fhir/us/core/ValueSet/us-core-vital-signs
Observation.component:systolic.value[x]	extensible	VitalSignsUnits http://hl7.org/fhir/ValueSet/ucum-vitals-common|4.0.1 from the FHIR Standard
Observation.component:systolic.value[x].comparator	required	QuantityComparator http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1 from the FHIR Standard
Observation.component:systolic.dataAbsentReason	extensible	DataAbsentReason http://hl7.org/fhir/ValueSet/data-absent-reason from the FHIR Standard
Observation.component:diastolic.code	extensible	Pattern: LOINC code 8462-4 http://hl7.org/fhir/us/core/ValueSet/us-core-vital-signs
Observation.component:diastolic.value[x]	extensible	VitalSignsUnits http://hl7.org/fhir/ValueSet/ucum-vitals-common|4.0.1 from the FHIR Standard
Observation.component:diastolic.value[x].comparator	required	QuantityComparator http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1 from the FHIR Standard
Observation.component:diastolic.dataAbsentReason	extensible	DataAbsentReason http://hl7.org/fhir/ValueSet/data-absent-reason from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	Observation	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Observation	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Observation	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Observation	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Observation	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
obs-6	error	Observation	dataAbsentReason SHALL only be present if Observation.value[x] is not present : dataAbsentReason.empty() or value.empty()
obs-7	error	Observation	If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present : value.empty() or component.code.where(coding.intersect(%resource.code.coding).exists()).empty()
vs-1	error	Observation.effective[x]	if Observation.effective[x] is dateTime and has a value then that value shall be precise to the day : $this is dateTime implies $this.toString().length() >= 10
vs-2	error	Observation	If there is no component or hasMember element then either a value[x] or a data absent reason must be present. : (component.empty() and hasMember.empty()) implies (dataAbsentReason.exists() or value.exists())
vs-3	error	Observation.component, Observation.component:systolic, Observation.component:diastolic	If there is no a value a data absent reason must be present : value.exists() or dataAbsentReason.exists()

Name	Flags	Card.	Type	Description & Constraints
Observation	C	0..*	USCoreVitalSignsProfile	US Core Blood Pressure Profile obs-6: dataAbsentReason SHALL only be present if Observation.value[x] is not present obs-7: If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present vs-2: If there is no component or hasMember element then either a value[x] or a data absent reason must be present.
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	0..*	Identifier	Business Identifier for observation
basedOn	Σ	0..*	Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest)	Fulfills plan, proposal or order
partOf	Σ	0..*	Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy)	Part of referenced event
status	?!SΣ	1..1	code	(USCDI) registered | preliminary | final | amended + Binding: ObservationStatus (required)
Slices for category	S	1..*	CodeableConcept	(USCDI) Classification of type of observation Slice: Unordered, Open by value:coding.code, value:coding.system Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
category:VSCat	S	1..1	CodeableConcept	(USCDI) Classification of type of observation Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
coding	SΣ	1..*	Coding	(USCDI) Code defined by a terminology system
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	SΣ	1..1	uri	(USCDI) Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category
version	Σ	0..1	string	Version of the system - if relevant
code	SΣ	1..1	code	(USCDI) Symbol in syntax defined by the system Fixed Value: vital-signs
display	Σ	0..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
text	Σ	0..1	string	Plain text representation of the concept
code	SΣ	1..1	CodeableConcept	(USCDI) Blood Pressure Binding: US Core Vital Signs ValueSet (extensible): The vital sign codes from the base FHIR and US Core Vital Signs. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 85354-9
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
subject	SΣ	1..1	Reference(US Core Patient Profile)	(USCDI) Who and/or what the observation is about
focus	Σ	0..*	Reference(Resource)	What the observation is about, when it is not about the subject of record
encounter	Σ	0..1	Reference(Encounter)	Healthcare event during which this observation is made
effective[x]	SΣC	1..1		(USCDI) Often just a dateTime for Vital Signs vs-1: if Observation.effective[x] is dateTime and has a value then that value shall be precise to the day
effectiveDateTime			dateTime S
effectivePeriod			Period
issued	Σ	0..1	instant	Date/Time this version was made available
performer	Σ	0..*	Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson)	Who is responsible for the observation
value[x]	SΣC	0..1		(USCDI) Vital Signs Value Binding: VitalSignsUnits (extensible): Common UCUM units for recording Vital Signs.
valueQuantity			Quantity S
valueCodeableConcept			CodeableConcept
valueString			string
valueBoolean			boolean
valueInteger			integer
valueRange			Range
valueRatio			Ratio
valueSampledData			SampledData
valueTime			time
valueDateTime			dateTime
valuePeriod			Period
dataAbsentReason	SC	0..1	CodeableConcept	(USCDI) Why the result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation		0..*	CodeableConcept	High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
note		0..*	Annotation	Comments about the observation
bodySite		0..1	CodeableConcept	Observed body part Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
method		0..1	CodeableConcept	How it was done Binding: ObservationMethods (example): Methods for simple observations.
specimen		0..1	Reference(Specimen)	Specimen used for this observation
device		0..1	Reference(Device | DeviceMetric)	(Measurement) Device
referenceRange	C	0..*	BackboneElement	Provides guide for interpretation obs-3: Must have at least a low or a high or text
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
low	C	0..1	SimpleQuantity	Low Range, if relevant
high	C	0..1	SimpleQuantity	High Range, if relevant
type		0..1	CodeableConcept	Reference range qualifier Binding: ObservationReferenceRangeMeaningCodes (preferred): Code for the meaning of a reference range.
appliesTo		0..*	CodeableConcept	Reference range population Binding: ObservationReferenceRangeAppliesToCodes (example): Codes identifying the population the reference range applies to.
age		0..1	Range	Applicable age range, if relevant
text		0..1	string	Text based reference range in an observation
hasMember	Σ	0..*	Reference(QuestionnaireResponse | MolecularSequence | Vital Signs Profile)	Used when reporting vital signs panel components
derivedFrom	Σ	0..*	Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | MolecularSequence | Vital Signs Profile)	Related measurements the observation is made from
Slices for component	SΣC	2..*	BackboneElement	(USCDI) Component observations Slice: Unordered, Open by pattern:code vs-3: If there is no a value a data absent reason must be present
component:All Slices				Content/Rules for all slices
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	SΣ	1..1	CodeableConcept	(USCDI) Type of component observation (code / type) Binding: US Core Vital Signs ValueSet (extensible): The vital sign codes from the base FHIR and US Core Vital Signs.
value[x]	SΣC	0..1		(USCDI) Vital Sign Component Value Binding: VitalSignsUnits (extensible): Common UCUM units for recording Vital Signs.
valueQuantity			Quantity S
valueCodeableConcept			CodeableConcept
valueString			string
valueBoolean			boolean
valueInteger			integer
valueRange			Range
valueRatio			Ratio
valueSampledData			SampledData
valueTime			time
valueDateTime			dateTime
valuePeriod			Period
dataAbsentReason	SC	0..1	CodeableConcept	(USCDI) Why the component result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation		0..*	CodeableConcept	High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
referenceRange		0..*	See referenceRange (Observation)	Provides guide for interpretation of component result
component:systolic	SΣC	1..1	BackboneElement	(USCDI) Systolic Blood Pressure vs-3: If there is no a value a data absent reason must be present
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	SΣ	1..1	CodeableConcept	(USCDI) Systolic Blood Pressure Code Binding: US Core Vital Signs ValueSet (extensible): The vital sign codes from the base FHIR and US Core Vital Signs. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 8480-6
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
value[x]	SΣC	0..1	Quantity S	(USCDI) Vital Sign Component Value Binding: VitalSignsUnits (extensible): Common UCUM units for recording Vital Signs.
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
value	SΣ	1..1	decimal	(USCDI) Numerical value (with implicit precision)
comparator	?!Σ	0..1	code	< | <= | >= | > - how to understand the value Binding: QuantityComparator (required): How the Quantity should be understood and represented.
unit	SΣ	1..1	string	(USCDI) Unit representation
system	SΣC	1..1	uri	(USCDI) System that defines coded unit form Fixed Value: http://unitsofmeasure.org
code	SΣ	1..1	code	(USCDI) Coded form of the unit Fixed Value: mm[Hg]
dataAbsentReason	SC	0..1	CodeableConcept	(USCDI) Why the component result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation		0..*	CodeableConcept	High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
referenceRange		0..*	See referenceRange (Observation)	Provides guide for interpretation of component result
component:diastolic	SΣC	1..1	BackboneElement	(USCDI) Diastolic Blood Pressure vs-3: If there is no a value a data absent reason must be present
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	SΣ	1..1	CodeableConcept	(USCDI) Diastolic Blood Pressure Code Binding: US Core Vital Signs ValueSet (extensible): The vital sign codes from the base FHIR and US Core Vital Signs. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 8462-4
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
value[x]	SΣC	0..1	Quantity S	(USCDI) Vital Sign Component Value Binding: VitalSignsUnits (extensible): Common UCUM units for recording Vital Signs.
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
value	SΣ	1..1	decimal	(USCDI) Numerical value (with implicit precision)
comparator	?!Σ	0..1	code	< | <= | >= | > - how to understand the value Binding: QuantityComparator (required): How the Quantity should be understood and represented.
unit	SΣ	1..1	string	(USCDI) Unit representation
system	SΣC	1..1	uri	(USCDI) System that defines coded unit form Fixed Value: http://unitsofmeasure.org
code	SΣ	1..1	code	(USCDI) Coded form of the unit Fixed Value: mm[Hg]
dataAbsentReason	SC	0..1	CodeableConcept	(USCDI) Why the component result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation		0..*	CodeableConcept	High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
referenceRange		0..*	See referenceRange (Observation)	Provides guide for interpretation of component result
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
Observation.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding http://hl7.org/fhir/ValueSet/languages from the FHIR Standard
Observation.status	required	ObservationStatus http://hl7.org/fhir/ValueSet/observation-status|4.0.1 from the FHIR Standard
Observation.category	preferred	ObservationCategoryCodes http://hl7.org/fhir/ValueSet/observation-category from the FHIR Standard
Observation.category:VSCat	preferred	ObservationCategoryCodes http://hl7.org/fhir/ValueSet/observation-category from the FHIR Standard
Observation.code	extensible	Pattern: LOINC code 85354-9 http://hl7.org/fhir/us/core/ValueSet/us-core-vital-signs
Observation.value[x]	extensible	VitalSignsUnits http://hl7.org/fhir/ValueSet/ucum-vitals-common|4.0.1 from the FHIR Standard
Observation.dataAbsentReason	extensible	DataAbsentReason http://hl7.org/fhir/ValueSet/data-absent-reason from the FHIR Standard
Observation.interpretation	extensible	ObservationInterpretationCodes http://hl7.org/fhir/ValueSet/observation-interpretation from the FHIR Standard
Observation.bodySite	example	SNOMEDCTBodyStructures http://hl7.org/fhir/ValueSet/body-site from the FHIR Standard
Observation.method	example	ObservationMethods http://hl7.org/fhir/ValueSet/observation-methods from the FHIR Standard
Observation.referenceRange.type	preferred	ObservationReferenceRangeMeaningCodes http://hl7.org/fhir/ValueSet/referencerange-meaning from the FHIR Standard
Observation.referenceRange.appliesTo	example	ObservationReferenceRangeAppliesToCodes http://hl7.org/fhir/ValueSet/referencerange-appliesto from the FHIR Standard
Observation.component.code	extensible	UsCoreVitalSigns http://hl7.org/fhir/us/core/ValueSet/us-core-vital-signs
Observation.component.value[x]	extensible	VitalSignsUnits http://hl7.org/fhir/ValueSet/ucum-vitals-common|4.0.1 from the FHIR Standard
Observation.component.dataAbsentReason	extensible	DataAbsentReason http://hl7.org/fhir/ValueSet/data-absent-reason from the FHIR Standard
Observation.component.interpretation	extensible	ObservationInterpretationCodes http://hl7.org/fhir/ValueSet/observation-interpretation from the FHIR Standard
Observation.component:systolic.code	extensible	Pattern: LOINC code 8480-6 http://hl7.org/fhir/us/core/ValueSet/us-core-vital-signs
Observation.component:systolic.value[x]	extensible	VitalSignsUnits http://hl7.org/fhir/ValueSet/ucum-vitals-common|4.0.1 from the FHIR Standard
Observation.component:systolic.value[x].comparator	required	QuantityComparator http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1 from the FHIR Standard
Observation.component:systolic.dataAbsentReason	extensible	DataAbsentReason http://hl7.org/fhir/ValueSet/data-absent-reason from the FHIR Standard
Observation.component:systolic.interpretation	extensible	ObservationInterpretationCodes http://hl7.org/fhir/ValueSet/observation-interpretation from the FHIR Standard
Observation.component:diastolic.code	extensible	Pattern: LOINC code 8462-4 http://hl7.org/fhir/us/core/ValueSet/us-core-vital-signs
Observation.component:diastolic.value[x]	extensible	VitalSignsUnits http://hl7.org/fhir/ValueSet/ucum-vitals-common|4.0.1 from the FHIR Standard
Observation.component:diastolic.value[x].comparator	required	QuantityComparator http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1 from the FHIR Standard
Observation.component:diastolic.dataAbsentReason	extensible	DataAbsentReason http://hl7.org/fhir/ValueSet/data-absent-reason from the FHIR Standard
Observation.component:diastolic.interpretation	extensible	ObservationInterpretationCodes http://hl7.org/fhir/ValueSet/observation-interpretation from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	Observation	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Observation	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Observation	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Observation	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Observation	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
obs-3	error	Observation.referenceRange	Must have at least a low or a high or text : low.exists() or high.exists() or text.exists()
obs-6	error	Observation	dataAbsentReason SHALL only be present if Observation.value[x] is not present : dataAbsentReason.empty() or value.empty()
obs-7	error	Observation	If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present : value.empty() or component.code.where(coding.intersect(%resource.code.coding).exists()).empty()
vs-1	error	Observation.effective[x]	if Observation.effective[x] is dateTime and has a value then that value shall be precise to the day : $this is dateTime implies $this.toString().length() >= 10
vs-2	error	Observation	If there is no component or hasMember element then either a value[x] or a data absent reason must be present. : (component.empty() and hasMember.empty()) implies (dataAbsentReason.exists() or value.exists())
vs-3	error	Observation.component, Observation.component:systolic, Observation.component:diastolic	If there is no a value a data absent reason must be present : value.exists() or dataAbsentReason.exists()

This structure is derived from USCoreVitalSignsProfile

Summary

Mandatory: 4 elements(8 nested mandatory elements)
Must-Support: 16 elements
Fixed: 4 elements

Slices

This structure defines the following Slices:

• The element 1 is sliced based on the value of Observation.component

Maturity: 2

Differential View

This structure is derived from USCoreVitalSignsProfile

Name	Flags	Card.	Type	Description & Constraints
Observation		0..*	USCoreVitalSignsProfile	US Core Blood Pressure Profile
code	S	1..1	CodeableConcept	(USCDI) Blood Pressure Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 85354-9
Slices for component	S	2..*	BackboneElement	(USCDI) Component observations Slice: Unordered, Open by pattern:code
component:systolic	S	1..1	BackboneElement	(USCDI) Systolic Blood Pressure
code	S	1..1	CodeableConcept	(USCDI) Systolic Blood Pressure Code Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 8480-6
valueQuantity	S	0..1	Quantity	(USCDI) Vital Sign Component Value
value	S	1..1	decimal	(USCDI) Numerical value (with implicit precision)
unit	S	1..1	string	(USCDI) Unit representation
system	S	1..1	uri	(USCDI) System that defines coded unit form Fixed Value: http://unitsofmeasure.org
code	S	1..1	code	(USCDI) Coded form of the unit Fixed Value: mm[Hg]
component:diastolic	S	1..1	BackboneElement	(USCDI) Diastolic Blood Pressure
code	S	1..1	CodeableConcept	(USCDI) Diastolic Blood Pressure Code Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 8462-4
valueQuantity	S	0..1	Quantity	(USCDI) Vital Sign Component Value
value	S	1..1	decimal	(USCDI) Numerical value (with implicit precision)
unit	S	1..1	string	(USCDI) Unit representation
system	S	1..1	uri	(USCDI) System that defines coded unit form Fixed Value: http://unitsofmeasure.org
code	S	1..1	code	(USCDI) Coded form of the unit Fixed Value: mm[Hg]
Documentation for this format

Key Elements View

Name	Flags	Card.	Type	Description & Constraints
Observation	C	0..*	USCoreVitalSignsProfile	US Core Blood Pressure Profile obs-6: dataAbsentReason SHALL only be present if Observation.value[x] is not present obs-7: If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present vs-2: If there is no component or hasMember element then either a value[x] or a data absent reason must be present.
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
status	?!SΣ	1..1	code	(USCDI) registered | preliminary | final | amended + Binding: ObservationStatus (required)
Slices for category	S	1..*	CodeableConcept	(USCDI) Classification of type of observation Slice: Unordered, Open by value:coding.code, value:coding.system Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
category:VSCat	S	1..1	CodeableConcept	(USCDI) Classification of type of observation Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
coding	SΣ	1..*	Coding	(USCDI) Code defined by a terminology system
system	SΣ	1..1	uri	(USCDI) Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category
code	SΣ	1..1	code	(USCDI) Symbol in syntax defined by the system Fixed Value: vital-signs
code	SΣ	1..1	CodeableConcept	(USCDI) Blood Pressure Binding: US Core Vital Signs ValueSet (extensible): The vital sign codes from the base FHIR and US Core Vital Signs. Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 85354-9
subject	SΣ	1..1	Reference(US Core Patient Profile)	(USCDI) Who and/or what the observation is about
effective[x]	SΣC	1..1		(USCDI) Often just a dateTime for Vital Signs vs-1: if Observation.effective[x] is dateTime and has a value then that value shall be precise to the day
effectiveDateTime			dateTime
value[x]	SΣC	0..1		(USCDI) Vital Signs Value Binding: VitalSignsUnits (extensible): Common UCUM units for recording Vital Signs.
valueQuantity			Quantity
dataAbsentReason	SC	0..1	CodeableConcept	(USCDI) Why the result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
Slices for component	SΣC	2..*	BackboneElement	(USCDI) Component observations Slice: Unordered, Open by pattern:code vs-3: If there is no a value a data absent reason must be present
component:All Slices				Content/Rules for all slices
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	SΣ	1..1	CodeableConcept	(USCDI) Type of component observation (code / type) Binding: US Core Vital Signs ValueSet (extensible): The vital sign codes from the base FHIR and US Core Vital Signs.
value[x]	SΣC	0..1		(USCDI) Vital Sign Component Value Binding: VitalSignsUnits (extensible): Common UCUM units for recording Vital Signs.
valueQuantity			Quantity
dataAbsentReason	SC	0..1	CodeableConcept	(USCDI) Why the component result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
component:systolic	SΣC	1..1	BackboneElement	(USCDI) Systolic Blood Pressure vs-3: If there is no a value a data absent reason must be present
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	SΣ	1..1	CodeableConcept	(USCDI) Systolic Blood Pressure Code Binding: US Core Vital Signs ValueSet (extensible): The vital sign codes from the base FHIR and US Core Vital Signs. Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 8480-6
value[x]	SΣC	0..1	Quantity	(USCDI) Vital Sign Component Value Binding: VitalSignsUnits (extensible): Common UCUM units for recording Vital Signs.
value	SΣ	1..1	decimal	(USCDI) Numerical value (with implicit precision)
comparator	?!Σ	0..1	code	< | <= | >= | > - how to understand the value Binding: QuantityComparator (required): How the Quantity should be understood and represented.
unit	SΣ	1..1	string	(USCDI) Unit representation
system	SΣC	1..1	uri	(USCDI) System that defines coded unit form Fixed Value: http://unitsofmeasure.org
code	SΣ	1..1	code	(USCDI) Coded form of the unit Fixed Value: mm[Hg]
dataAbsentReason	SC	0..1	CodeableConcept	(USCDI) Why the component result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
component:diastolic	SΣC	1..1	BackboneElement	(USCDI) Diastolic Blood Pressure vs-3: If there is no a value a data absent reason must be present
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	SΣ	1..1	CodeableConcept	(USCDI) Diastolic Blood Pressure Code Binding: US Core Vital Signs ValueSet (extensible): The vital sign codes from the base FHIR and US Core Vital Signs. Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 8462-4
value[x]	SΣC	0..1	Quantity	(USCDI) Vital Sign Component Value Binding: VitalSignsUnits (extensible): Common UCUM units for recording Vital Signs.
value	SΣ	1..1	decimal	(USCDI) Numerical value (with implicit precision)
comparator	?!Σ	0..1	code	< | <= | >= | > - how to understand the value Binding: QuantityComparator (required): How the Quantity should be understood and represented.
unit	SΣ	1..1	string	(USCDI) Unit representation
system	SΣC	1..1	uri	(USCDI) System that defines coded unit form Fixed Value: http://unitsofmeasure.org
code	SΣ	1..1	code	(USCDI) Coded form of the unit Fixed Value: mm[Hg]
dataAbsentReason	SC	0..1	CodeableConcept	(USCDI) Why the component result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
Observation.status	required	ObservationStatus http://hl7.org/fhir/ValueSet/observation-status|4.0.1 from the FHIR Standard
Observation.category	preferred	ObservationCategoryCodes http://hl7.org/fhir/ValueSet/observation-category from the FHIR Standard
Observation.category:VSCat	preferred	ObservationCategoryCodes http://hl7.org/fhir/ValueSet/observation-category from the FHIR Standard
Observation.code	extensible	Pattern: LOINC code 85354-9 http://hl7.org/fhir/us/core/ValueSet/us-core-vital-signs
Observation.value[x]	extensible	VitalSignsUnits http://hl7.org/fhir/ValueSet/ucum-vitals-common|4.0.1 from the FHIR Standard
Observation.dataAbsentReason	extensible	DataAbsentReason http://hl7.org/fhir/ValueSet/data-absent-reason from the FHIR Standard
Observation.component.code	extensible	UsCoreVitalSigns http://hl7.org/fhir/us/core/ValueSet/us-core-vital-signs
Observation.component.value[x]	extensible	VitalSignsUnits http://hl7.org/fhir/ValueSet/ucum-vitals-common|4.0.1 from the FHIR Standard
Observation.component.dataAbsentReason	extensible	DataAbsentReason http://hl7.org/fhir/ValueSet/data-absent-reason from the FHIR Standard
Observation.component:systolic.code	extensible	Pattern: LOINC code 8480-6 http://hl7.org/fhir/us/core/ValueSet/us-core-vital-signs
Observation.component:systolic.value[x]	extensible	VitalSignsUnits http://hl7.org/fhir/ValueSet/ucum-vitals-common|4.0.1 from the FHIR Standard
Observation.component:systolic.value[x].comparator	required	QuantityComparator http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1 from the FHIR Standard
Observation.component:systolic.dataAbsentReason	extensible	DataAbsentReason http://hl7.org/fhir/ValueSet/data-absent-reason from the FHIR Standard
Observation.component:diastolic.code	extensible	Pattern: LOINC code 8462-4 http://hl7.org/fhir/us/core/ValueSet/us-core-vital-signs
Observation.component:diastolic.value[x]	extensible	VitalSignsUnits http://hl7.org/fhir/ValueSet/ucum-vitals-common|4.0.1 from the FHIR Standard
Observation.component:diastolic.value[x].comparator	required	QuantityComparator http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1 from the FHIR Standard
Observation.component:diastolic.dataAbsentReason	extensible	DataAbsentReason http://hl7.org/fhir/ValueSet/data-absent-reason from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	Observation	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Observation	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Observation	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Observation	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Observation	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
obs-6	error	Observation	dataAbsentReason SHALL only be present if Observation.value[x] is not present : dataAbsentReason.empty() or value.empty()
obs-7	error	Observation	If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present : value.empty() or component.code.where(coding.intersect(%resource.code.coding).exists()).empty()
vs-1	error	Observation.effective[x]	if Observation.effective[x] is dateTime and has a value then that value shall be precise to the day : $this is dateTime implies $this.toString().length() >= 10
vs-2	error	Observation	If there is no component or hasMember element then either a value[x] or a data absent reason must be present. : (component.empty() and hasMember.empty()) implies (dataAbsentReason.exists() or value.exists())
vs-3	error	Observation.component, Observation.component:systolic, Observation.component:diastolic	If there is no a value a data absent reason must be present : value.exists() or dataAbsentReason.exists()

Snapshot View

Name	Flags	Card.	Type	Description & Constraints
Observation	C	0..*	USCoreVitalSignsProfile	US Core Blood Pressure Profile obs-6: dataAbsentReason SHALL only be present if Observation.value[x] is not present obs-7: If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present vs-2: If there is no component or hasMember element then either a value[x] or a data absent reason must be present.
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	0..*	Identifier	Business Identifier for observation
basedOn	Σ	0..*	Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest)	Fulfills plan, proposal or order
partOf	Σ	0..*	Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy)	Part of referenced event
status	?!SΣ	1..1	code	(USCDI) registered | preliminary | final | amended + Binding: ObservationStatus (required)
Slices for category	S	1..*	CodeableConcept	(USCDI) Classification of type of observation Slice: Unordered, Open by value:coding.code, value:coding.system Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
category:VSCat	S	1..1	CodeableConcept	(USCDI) Classification of type of observation Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
coding	SΣ	1..*	Coding	(USCDI) Code defined by a terminology system
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	SΣ	1..1	uri	(USCDI) Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category
version	Σ	0..1	string	Version of the system - if relevant
code	SΣ	1..1	code	(USCDI) Symbol in syntax defined by the system Fixed Value: vital-signs
display	Σ	0..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
text	Σ	0..1	string	Plain text representation of the concept
code	SΣ	1..1	CodeableConcept	(USCDI) Blood Pressure Binding: US Core Vital Signs ValueSet (extensible): The vital sign codes from the base FHIR and US Core Vital Signs. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 85354-9
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
subject	SΣ	1..1	Reference(US Core Patient Profile)	(USCDI) Who and/or what the observation is about
focus	Σ	0..*	Reference(Resource)	What the observation is about, when it is not about the subject of record
encounter	Σ	0..1	Reference(Encounter)	Healthcare event during which this observation is made
effective[x]	SΣC	1..1		(USCDI) Often just a dateTime for Vital Signs vs-1: if Observation.effective[x] is dateTime and has a value then that value shall be precise to the day
effectiveDateTime			dateTime S
effectivePeriod			Period
issued	Σ	0..1	instant	Date/Time this version was made available
performer	Σ	0..*	Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson)	Who is responsible for the observation
value[x]	SΣC	0..1		(USCDI) Vital Signs Value Binding: VitalSignsUnits (extensible): Common UCUM units for recording Vital Signs.
valueQuantity			Quantity S
valueCodeableConcept			CodeableConcept
valueString			string
valueBoolean			boolean
valueInteger			integer
valueRange			Range
valueRatio			Ratio
valueSampledData			SampledData
valueTime			time
valueDateTime			dateTime
valuePeriod			Period
dataAbsentReason	SC	0..1	CodeableConcept	(USCDI) Why the result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation		0..*	CodeableConcept	High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
note		0..*	Annotation	Comments about the observation
bodySite		0..1	CodeableConcept	Observed body part Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
method		0..1	CodeableConcept	How it was done Binding: ObservationMethods (example): Methods for simple observations.
specimen		0..1	Reference(Specimen)	Specimen used for this observation
device		0..1	Reference(Device | DeviceMetric)	(Measurement) Device
referenceRange	C	0..*	BackboneElement	Provides guide for interpretation obs-3: Must have at least a low or a high or text
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
low	C	0..1	SimpleQuantity	Low Range, if relevant
high	C	0..1	SimpleQuantity	High Range, if relevant
type		0..1	CodeableConcept	Reference range qualifier Binding: ObservationReferenceRangeMeaningCodes (preferred): Code for the meaning of a reference range.
appliesTo		0..*	CodeableConcept	Reference range population Binding: ObservationReferenceRangeAppliesToCodes (example): Codes identifying the population the reference range applies to.
age		0..1	Range	Applicable age range, if relevant
text		0..1	string	Text based reference range in an observation
hasMember	Σ	0..*	Reference(QuestionnaireResponse | MolecularSequence | Vital Signs Profile)	Used when reporting vital signs panel components
derivedFrom	Σ	0..*	Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | MolecularSequence | Vital Signs Profile)	Related measurements the observation is made from
Slices for component	SΣC	2..*	BackboneElement	(USCDI) Component observations Slice: Unordered, Open by pattern:code vs-3: If there is no a value a data absent reason must be present
component:All Slices				Content/Rules for all slices
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	SΣ	1..1	CodeableConcept	(USCDI) Type of component observation (code / type) Binding: US Core Vital Signs ValueSet (extensible): The vital sign codes from the base FHIR and US Core Vital Signs.
value[x]	SΣC	0..1		(USCDI) Vital Sign Component Value Binding: VitalSignsUnits (extensible): Common UCUM units for recording Vital Signs.
valueQuantity			Quantity S
valueCodeableConcept			CodeableConcept
valueString			string
valueBoolean			boolean
valueInteger			integer
valueRange			Range
valueRatio			Ratio
valueSampledData			SampledData
valueTime			time
valueDateTime			dateTime
valuePeriod			Period
dataAbsentReason	SC	0..1	CodeableConcept	(USCDI) Why the component result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation		0..*	CodeableConcept	High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
referenceRange		0..*	See referenceRange (Observation)	Provides guide for interpretation of component result
component:systolic	SΣC	1..1	BackboneElement	(USCDI) Systolic Blood Pressure vs-3: If there is no a value a data absent reason must be present
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	SΣ	1..1	CodeableConcept	(USCDI) Systolic Blood Pressure Code Binding: US Core Vital Signs ValueSet (extensible): The vital sign codes from the base FHIR and US Core Vital Signs. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 8480-6
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
value[x]	SΣC	0..1	Quantity S	(USCDI) Vital Sign Component Value Binding: VitalSignsUnits (extensible): Common UCUM units for recording Vital Signs.
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
value	SΣ	1..1	decimal	(USCDI) Numerical value (with implicit precision)
comparator	?!Σ	0..1	code	< | <= | >= | > - how to understand the value Binding: QuantityComparator (required): How the Quantity should be understood and represented.
unit	SΣ	1..1	string	(USCDI) Unit representation
system	SΣC	1..1	uri	(USCDI) System that defines coded unit form Fixed Value: http://unitsofmeasure.org
code	SΣ	1..1	code	(USCDI) Coded form of the unit Fixed Value: mm[Hg]
dataAbsentReason	SC	0..1	CodeableConcept	(USCDI) Why the component result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation		0..*	CodeableConcept	High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
referenceRange		0..*	See referenceRange (Observation)	Provides guide for interpretation of component result
component:diastolic	SΣC	1..1	BackboneElement	(USCDI) Diastolic Blood Pressure vs-3: If there is no a value a data absent reason must be present
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	SΣ	1..1	CodeableConcept	(USCDI) Diastolic Blood Pressure Code Binding: US Core Vital Signs ValueSet (extensible): The vital sign codes from the base FHIR and US Core Vital Signs. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 8462-4
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
value[x]	SΣC	0..1	Quantity S	(USCDI) Vital Sign Component Value Binding: VitalSignsUnits (extensible): Common UCUM units for recording Vital Signs.
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
value	SΣ	1..1	decimal	(USCDI) Numerical value (with implicit precision)
comparator	?!Σ	0..1	code	< | <= | >= | > - how to understand the value Binding: QuantityComparator (required): How the Quantity should be understood and represented.
unit	SΣ	1..1	string	(USCDI) Unit representation
system	SΣC	1..1	uri	(USCDI) System that defines coded unit form Fixed Value: http://unitsofmeasure.org
code	SΣ	1..1	code	(USCDI) Coded form of the unit Fixed Value: mm[Hg]
dataAbsentReason	SC	0..1	CodeableConcept	(USCDI) Why the component result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation		0..*	CodeableConcept	High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
referenceRange		0..*	See referenceRange (Observation)	Provides guide for interpretation of component result
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
Observation.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding http://hl7.org/fhir/ValueSet/languages from the FHIR Standard
Observation.status	required	ObservationStatus http://hl7.org/fhir/ValueSet/observation-status|4.0.1 from the FHIR Standard
Observation.category	preferred	ObservationCategoryCodes http://hl7.org/fhir/ValueSet/observation-category from the FHIR Standard
Observation.category:VSCat	preferred	ObservationCategoryCodes http://hl7.org/fhir/ValueSet/observation-category from the FHIR Standard
Observation.code	extensible	Pattern: LOINC code 85354-9 http://hl7.org/fhir/us/core/ValueSet/us-core-vital-signs
Observation.value[x]	extensible	VitalSignsUnits http://hl7.org/fhir/ValueSet/ucum-vitals-common|4.0.1 from the FHIR Standard
Observation.dataAbsentReason	extensible	DataAbsentReason http://hl7.org/fhir/ValueSet/data-absent-reason from the FHIR Standard
Observation.interpretation	extensible	ObservationInterpretationCodes http://hl7.org/fhir/ValueSet/observation-interpretation from the FHIR Standard
Observation.bodySite	example	SNOMEDCTBodyStructures http://hl7.org/fhir/ValueSet/body-site from the FHIR Standard
Observation.method	example	ObservationMethods http://hl7.org/fhir/ValueSet/observation-methods from the FHIR Standard
Observation.referenceRange.type	preferred	ObservationReferenceRangeMeaningCodes http://hl7.org/fhir/ValueSet/referencerange-meaning from the FHIR Standard
Observation.referenceRange.appliesTo	example	ObservationReferenceRangeAppliesToCodes http://hl7.org/fhir/ValueSet/referencerange-appliesto from the FHIR Standard
Observation.component.code	extensible	UsCoreVitalSigns http://hl7.org/fhir/us/core/ValueSet/us-core-vital-signs
Observation.component.value[x]	extensible	VitalSignsUnits http://hl7.org/fhir/ValueSet/ucum-vitals-common|4.0.1 from the FHIR Standard
Observation.component.dataAbsentReason	extensible	DataAbsentReason http://hl7.org/fhir/ValueSet/data-absent-reason from the FHIR Standard
Observation.component.interpretation	extensible	ObservationInterpretationCodes http://hl7.org/fhir/ValueSet/observation-interpretation from the FHIR Standard
Observation.component:systolic.code	extensible	Pattern: LOINC code 8480-6 http://hl7.org/fhir/us/core/ValueSet/us-core-vital-signs
Observation.component:systolic.value[x]	extensible	VitalSignsUnits http://hl7.org/fhir/ValueSet/ucum-vitals-common|4.0.1 from the FHIR Standard
Observation.component:systolic.value[x].comparator	required	QuantityComparator http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1 from the FHIR Standard
Observation.component:systolic.dataAbsentReason	extensible	DataAbsentReason http://hl7.org/fhir/ValueSet/data-absent-reason from the FHIR Standard
Observation.component:systolic.interpretation	extensible	ObservationInterpretationCodes http://hl7.org/fhir/ValueSet/observation-interpretation from the FHIR Standard
Observation.component:diastolic.code	extensible	Pattern: LOINC code 8462-4 http://hl7.org/fhir/us/core/ValueSet/us-core-vital-signs
Observation.component:diastolic.value[x]	extensible	VitalSignsUnits http://hl7.org/fhir/ValueSet/ucum-vitals-common|4.0.1 from the FHIR Standard
Observation.component:diastolic.value[x].comparator	required	QuantityComparator http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1 from the FHIR Standard
Observation.component:diastolic.dataAbsentReason	extensible	DataAbsentReason http://hl7.org/fhir/ValueSet/data-absent-reason from the FHIR Standard
Observation.component:diastolic.interpretation	extensible	ObservationInterpretationCodes http://hl7.org/fhir/ValueSet/observation-interpretation from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	Observation	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Observation	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Observation	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Observation	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Observation	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
obs-3	error	Observation.referenceRange	Must have at least a low or a high or text : low.exists() or high.exists() or text.exists()
obs-6	error	Observation	dataAbsentReason SHALL only be present if Observation.value[x] is not present : dataAbsentReason.empty() or value.empty()
obs-7	error	Observation	If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present : value.empty() or component.code.where(coding.intersect(%resource.code.coding).exists()).empty()
vs-1	error	Observation.effective[x]	if Observation.effective[x] is dateTime and has a value then that value shall be precise to the day : $this is dateTime implies $this.toString().length() >= 10
vs-2	error	Observation	If there is no component or hasMember element then either a value[x] or a data absent reason must be present. : (component.empty() and hasMember.empty()) implies (dataAbsentReason.exists() or value.exists())
vs-3	error	Observation.component, Observation.component:systolic, Observation.component:diastolic	If there is no a value a data absent reason must be present : value.exists() or dataAbsentReason.exists()

This structure is derived from USCoreVitalSignsProfile

Summary

Mandatory: 4 elements(8 nested mandatory elements)
Must-Support: 16 elements
Fixed: 4 elements

Slices

This structure defines the following Slices:

• The element 1 is sliced based on the value of Observation.component

Maturity: 2