DIPS Core Implementation Guide - Local Development build (v0.1.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

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Resource Profile: NoImplVitalSignsObservationBloodpressure

The local measurement of arterial blood pressure, which is a surrogate for arterial pressure in the systemic circulation.

To record the systemic arterial blood pressure of an individual.

Usages:

• Examples for this Profile: Observation/noimpl-bloodpressure-instance

You can also check for usages in the FHIR IG Statistics

Formal Views of Profile Content

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

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

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Observation	C	0..*	observation-bp	FHIR Blood Pressure Profile Norway Constraints: obs-6, obs-7, vs-2
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
Slices for identifier	Σ	0..*	Identifier	Business Identifier for observation Slice: Unordered, Open by value:system
identifier:RelativeEhrUri	Σ	0..1	Identifier	Business Identifier for observation
system	Σ	1..1	uri	The namespace for the identifier value Fixed Value: http://dips.no/fhir/namingsystem/dips-RelativeEhrUri
value	Σ	1..1	string	The value that is unique Example General: 123456
identifier:VersionIdependentId	Σ	0..1	Identifier	Business Identifier for observation
system	Σ	1..1	uri	The namespace for the identifier value Fixed Value: http://dips.no/fhir/namingsystem/dips-VersionIndependentId
value	Σ	1..1	string	The value that is unique Example General: 123456
identifier:Id	Σ	0..1	Identifier	Business Identifier for observation
system	Σ	1..1	uri	The namespace for the identifier value Fixed Value: http://dips.no/fhir/namingsystem/dips-ObservationId
value	Σ	1..1	string	The value that is unique Example General: 123456
identifier:ExternalId	Σ	0..1	Identifier	Business Identifier for observation
system	Σ	1..1	uri	The namespace for the identifier value Fixed Value: http://dips.no/fhir/namingsystem/externalId
value	Σ	1..1	string	The value that is unique Example General: 123456
identifier:ExternalFhirId	Σ	0..*	Identifier	Business Identifier for observation
system	Σ	1..1	uri	The namespace for the identifier value Fixed Value: http://dips.no/fhir/namingsystem/external-fhirid
value	Σ	1..1	string	The value that is unique Example General: 123456
status	?!SΣ	1..1	code	registered | preliminary | final | amended + Binding: ObservationStatus (required)
Slices for category	S	1..*	CodeableConcept	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	Classification of type of observation Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
coding	SΣ	1..*	Coding	Code defined by a terminology system
system	SΣ	1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category
code	SΣ	1..1	code	Symbol in syntax defined by the system Fixed Value: vital-signs
code	SΣ	1..1	CodeableConcept	Blood Pressure Binding: VitalSigns (extensible): This identifies the vital sign result type.
Slices for coding	Σ	1..*	Coding	Code defined by a terminology system Slice: Unordered, Open by value:code, value:system
coding:BPCode	Σ	1..1	Coding	Code defined by a terminology system
system	Σ	1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
code	Σ	1..1	code	Symbol in syntax defined by the system Fixed Value: 85354-9
subject	SΣ	1..1	Reference(DIPSPatient)	Who and/or what the observation is about
encounter	Σ	0..1	Reference(DIPSR4Encounter)	Healthcare event during which this observation is made
effective[x]	SΣC	1..1	dateTime	Often just a dateTime for Vital Signs Constraints: vs-1
Slices for performer	Σ	1..*	Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson)	Who is responsible for the observation Slice: Unordered, Open by type:type
performer:Author	Σ	0..*	Reference(DIPSPractitionerRole | DIPSPractitioner)	Who is responsible for the observation
performer:organization	Σ	0..*	Reference(DIPSOrganization)	Who is responsible for the observation
Slices for value[x]	SΣC	0..1	Quantity	Vital Signs value are recorded using the Quantity data type. For supporting observations such as Cuff size could use other datatypes such as CodeableConcept. Slice: Unordered, Closed by type:$this
dataAbsentReason	SC	0..1	CodeableConcept	Why the result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
Slices for component	SΣC	2..*	BackboneElement	Used when reporting systolic and diastolic blood pressure. Slice: Unordered, Open by value:code.coding.code, value:code.coding.system Constraints: vs-3
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	Type of component observation (code / type) Binding: VitalSigns (extensible): This identifies the vital sign result type.
value[x]	SΣC	0..1		Vital Sign Value recorded with UCUM Binding: VitalSignsUnits (extensible): Common UCUM units for recording Vital Signs.
valueQuantity			Quantity
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	Why the component result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
component:SystolicBP	SΣC	1..1	BackboneElement	Peak systemic arterial blood pressure - measured in systolic or contraction phase of the heart cycle. Constraints: vs-3
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	SΣ	1..1	CodeableConcept	Type of component observation (code / type) Binding: VitalSigns (extensible): This identifies the vital sign result type.
Slices for coding	Σ	1..*	Coding	Systolic Blood Pressure Slice: Unordered, Open by value:code, value:system
Slices for coding				Content/Rules for all slices
coding:SBPCode	Σ	1..1	Coding	Systolic Blood Pressure
system	Σ	1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
code	Σ	1..1	code	Symbol in syntax defined by the system Fixed Value: 8480-6
coding:SystolicSnomed	Σ	0..1	Coding	Systolic Blood Pressure
system	Σ	1..1	uri	Identity of the terminology system Fixed Value: http://snomed.info/sct
code	Σ	1..1	code	Symbol in syntax defined by the system Fixed Value: 4471000202106
value[x]	SΣC	0..1	Quantity	Vital Sign Value recorded with UCUM Binding: VitalSignsUnits (extensible): Common UCUM units for recording Vital Signs.
value	SΣ	1..1	decimal	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	Unit representation
system	SΣC	1..1	uri	System that defines coded unit form Fixed Value: http://unitsofmeasure.org
code	SΣ	1..1	code	Coded responses from the common UCUM units for vital signs value set. Fixed Value: mm[Hg]
component:DiastolicBP	SΣC	1..1	BackboneElement	Minimum systemic arterial blood pressure - measured in the diastolic or relaxation phase of the heart cycle. Constraints: vs-3
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	SΣ	1..1	CodeableConcept	Type of component observation (code / type) Binding: VitalSigns (extensible): This identifies the vital sign result type.
Slices for coding	Σ	1..*	Coding	Diastolic Blood Pressure Slice: Unordered, Open by value:code, value:system
Slices for coding				Content/Rules for all slices
coding:DBPCode	Σ	1..1	Coding	Diastolic Blood Pressure
system	Σ	1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
code	Σ	1..1	code	Symbol in syntax defined by the system Fixed Value: 8462-4
coding:DiastolicBPSnomed	Σ	0..1	Coding	Diastolic Blood Pressure
system	Σ	1..1	uri	Identity of the terminology system Fixed Value: http://snomed.info/sct
code	Σ	1..1	code	Symbol in syntax defined by the system Fixed Value: 4481000202108
value[x]	SΣC	0..1	Quantity	Vital Sign Value recorded with UCUM Binding: VitalSignsUnits (extensible): Common UCUM units for recording Vital Signs.
value	SΣ	1..1	decimal	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	Unit representation
system	SΣC	1..1	uri	System that defines coded unit form Fixed Value: http://unitsofmeasure.org
code	SΣ	1..1	code	Coded responses from the common UCUM units for vital signs value set. Fixed Value: mm[Hg]
component:MeanArterialPressure	SΣC	0..1	BackboneElement	The average arterial pressure that occurs over the entire course of the heart contraction and relaxation cycle. Constraints: vs-3
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	SΣ	1..1	CodeableConcept	Type of component observation (code / type) Binding: VitalSigns (extensible): This identifies the vital sign result type.
Slices for coding	Σ	1..*	Coding	Mean Arterial Pressure Slice: Unordered, Open by value:code, value:system
Slices for coding				Content/Rules for all slices
coding:MAPCode	Σ	1..1	Coding	Mean Arterial Pressure loinc code
system	Σ	1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
code	Σ	1..1	code	Symbol in syntax defined by the system Fixed Value: 8478-0
coding:MAPSnomedCode	Σ	0..1	Coding	Mean Arterial Pressure snomed code
system	Σ	1..1	uri	Identity of the terminology system Fixed Value: http://snomed.info/sct
code	Σ	1..1	code	Symbol in syntax defined by the system Fixed Value: 4501000202102
value[x]	SΣC	0..1	Quantity	Vital Sign Value recorded with UCUM Binding: VitalSignsUnits (extensible): Common UCUM units for recording Vital Signs.
value	Σ	1..1	decimal	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	Σ	1..1	string	Unit representation
system	ΣC	1..1	uri	System that defines coded unit form Fixed Value: http://unitsofmeasure.org
code	Σ	1..1	code	Coded form of the unit Fixed Value: mm[Hg]
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
Observation.status	Base	required	ObservationStatus	📍4.0.1	FHIR Std.
Observation.category	Base	preferred	Observation Category Codes	📍4.0.1	FHIR Std.
Observation.category:VSCat	Base	preferred	Observation Category Codes	📍4.0.1	FHIR Std.
Observation.code	Base	extensible	Vital Signs	📍4.0.1	FHIR Std.
Observation.dataAbsentReason	Base	extensible	DataAbsentReason	📍4.0.1	FHIR Std.
Observation.bodySite.​coding	Base	extensible	NoDomainVitalSignsObservationBloodpressureBodySite	📦0.1.0	This IG
Observation.method.coding	Base	extensible	NoImplVitalSignsObservationBloodPressureMeasurementMethod	📦0.1.0	This IG
Observation.component.​code	Base	extensible	Vital Signs	📍4.0.1	FHIR Std.
Observation.component.​value[x]	Base	extensible	Vital Signs Units	📍4.0.1	FHIR Std.
Observation.component.​dataAbsentReason	Base	extensible	DataAbsentReason	📍4.0.1	FHIR Std.
Observation.component:SystolicBP.​code	Base	extensible	Vital Signs	📍4.0.1	FHIR Std.
Observation.component:SystolicBP.​value[x]	Base	extensible	Vital Signs Units	📍4.0.1	FHIR Std.
Observation.component:SystolicBP.​value[x].comparator	Base	required	QuantityComparator	📍4.0.1	FHIR Std.
Observation.component:DiastolicBP.​code	Base	extensible	Vital Signs	📍4.0.1	FHIR Std.
Observation.component:DiastolicBP.​value[x]	Base	extensible	Vital Signs Units	📍4.0.1	FHIR Std.
Observation.component:DiastolicBP.​value[x].comparator	Base	required	QuantityComparator	📍4.0.1	FHIR Std.
Observation.component:MeanArterialPressure.​code	Base	extensible	Vital Signs	📍4.0.1	FHIR Std.
Observation.component:MeanArterialPressure.​value[x]	Base	extensible	Vital Signs Units	📍4.0.1	FHIR Std.
Observation.component:MeanArterialPressure.​value[x].comparator	Base	required	QuantityComparator	📍4.0.1	FHIR Std.

Constraints

Id	Grade	Path(s)	Description	Expression
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:SystolicBP, Observation.component:DiastolicBP, Observation.component:MeanArterialPressure	If there is no a value a data absent reason must be present	value.exists() or dataAbsentReason.exists()

This structure is derived from observation-bp

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Observation		0..*	observation-bp	FHIR Blood Pressure Profile Norway
Slices for identifier		0..*	Identifier	Business Identifier for observation Slice: Unordered, Open by value:system
identifier:RelativeEhrUri		0..1	Identifier	Business Identifier for observation
id		0..0		Unique id for inter-element referencing
use		0..0		usual | official | temp | secondary | old (If known)
type		0..0		Description of identifier
system		1..1	uri	The namespace for the identifier value Fixed Value: http://dips.no/fhir/namingsystem/dips-RelativeEhrUri
value		1..1	string	The value that is unique
period		0..0		Time period when id is/was valid for use
assigner		0..0		Organization that issued id (may be just text)
identifier:VersionIdependentId		0..1	Identifier	Business Identifier for observation
use		0..0		usual | official | temp | secondary | old (If known)
type		0..0		Description of identifier
system		1..1	uri	The namespace for the identifier value Fixed Value: http://dips.no/fhir/namingsystem/dips-VersionIndependentId
value		1..1	string	The value that is unique
period		0..0		Time period when id is/was valid for use
assigner		0..0		Organization that issued id (may be just text)
identifier:Id		0..1	Identifier	Business Identifier for observation
id		0..0		Unique id for inter-element referencing
use		0..0		usual | official | temp | secondary | old (If known)
type		0..0		Description of identifier
system		1..1	uri	The namespace for the identifier value Fixed Value: http://dips.no/fhir/namingsystem/dips-ObservationId
value		1..1	string	The value that is unique
period		0..0		Time period when id is/was valid for use
assigner		0..0		Organization that issued id (may be just text)
identifier:ExternalId		0..1	Identifier	Business Identifier for observation
id		0..0		Unique id for inter-element referencing
use		0..0		usual | official | temp | secondary | old (If known)
type		0..0		Description of identifier
system		1..1	uri	The namespace for the identifier value Fixed Value: http://dips.no/fhir/namingsystem/externalId
value		1..1	string	The value that is unique
period		0..0		Time period when id is/was valid for use
assigner		0..0		Organization that issued id (may be just text)
identifier:ExternalFhirId		0..*	Identifier	Business Identifier for observation
id		0..0		Unique id for inter-element referencing
use		0..0		usual | official | temp | secondary | old (If known)
type		0..0		Description of identifier
system		1..1	uri	The namespace for the identifier value Fixed Value: http://dips.no/fhir/namingsystem/external-fhirid
value		1..1	string	The value that is unique
period		0..0		Time period when id is/was valid for use
assigner		0..0		Organization that issued id (may be just text)
Slices for category				Content/Rules for all slices
category:VSCat		1..1	CodeableConcept	Classification of type of observation
id		0..0		Unique id for inter-element referencing
coding
id		0..0		Unique id for inter-element referencing
version		0..0		Version of the system - if relevant
userSelected		0..0		If this coding was chosen directly by the user
text		0..0		Plain text representation of the concept
code
id		0..0		Unique id for inter-element referencing
coding		1..*	Coding	Code defined by a terminology system
Slices for coding				Content/Rules for all slices
coding:BPCode		1..1	Coding	Code defined by a terminology system
id		0..0		Unique id for inter-element referencing
version		0..0		Version of the system - if relevant
userSelected		0..0		If this coding was chosen directly by the user
text		0..0		Plain text representation of the concept
subject		1..1	Reference(DIPSPatient)	Who and/or what the observation is about
focus		0..0		What the observation is about, when it is not about the subject of record
encounter		0..1	Reference(DIPSR4Encounter)	Healthcare event during which this observation is made
effective[x]		1..1	dateTime	Often just a dateTime for Vital Signs
Slices for performer		1..*	Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson)	Who is responsible for the observation Slice: Unordered, Open by type:type
performer:Author		0..*	Reference(DIPSPractitionerRole | DIPSPractitioner)	Who is responsible for the observation
performer:organization		0..*	Reference(DIPSOrganization)	Who is responsible for the observation
note		0..0		Comments about the observation
bodySite		0..0		Observed body part Binding: NoDomainVitalSignsObservationBloodpressureBodySite (extensible)
method		0..0		Method of measurement of blood pressure. Binding: NoImplVitalSignsObservationBloodPressureMeasurementMethod (extensible)
device		0..0		(Measurement) Device
referenceRange		0..0		Provides guide for interpretation
Slices for component				Content/Rules for all slices
component:SystolicBP		1..1	BackboneElement	Peak systemic arterial blood pressure - measured in systolic or contraction phase of the heart cycle.
id		0..0		Unique id for inter-element referencing
code
id		0..0		Unique id for inter-element referencing
coding		1..*	Coding	Systolic Blood Pressure
Slices for coding				Content/Rules for all slices
coding:SBPCode		1..1	Coding	Systolic Blood Pressure
id		0..0		Unique id for inter-element referencing
version		0..0		Version of the system - if relevant
userSelected		0..0		If this coding was chosen directly by the user
coding:SystolicSnomed		0..1	Coding	Systolic Blood Pressure
system		1..1	uri	Identity of the terminology system Fixed Value: http://snomed.info/sct
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 4471000202106
text		0..0		Plain text representation of the concept
value[x]
id		0..0		Unique id for inter-element referencing
dataAbsentReason		0..0		Why the component result is missing
interpretation		0..0		High, low, normal, etc.
component:DiastolicBP		1..1	BackboneElement	Minimum systemic arterial blood pressure - measured in the diastolic or relaxation phase of the heart cycle.
id		0..0		Unique id for inter-element referencing
code
id		0..0		Unique id for inter-element referencing
coding		1..*	Coding	Diastolic Blood Pressure
Slices for coding				Content/Rules for all slices
coding:DBPCode		1..1	Coding	Diastolic Blood Pressure
id		0..0		Unique id for inter-element referencing
version		0..0		Version of the system - if relevant
userSelected		0..0		If this coding was chosen directly by the user
coding:DiastolicBPSnomed		0..1	Coding	Diastolic Blood Pressure
system		1..1	uri	Identity of the terminology system Fixed Value: http://snomed.info/sct
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 4481000202108
text		0..0		Plain text representation of the concept
value[x]
id		0..0		Unique id for inter-element referencing
dataAbsentReason		0..0		Why the component result is missing
interpretation		0..0		High, low, normal, etc.
component:MeanArterialPressure		0..1	BackboneElement	The average arterial pressure that occurs over the entire course of the heart contraction and relaxation cycle.
id		0..0		Unique id for inter-element referencing
code		1..1	CodeableConcept	Type of component observation (code / type)
id		0..0		Unique id for inter-element referencing
Slices for coding		1..*	Coding	Mean Arterial Pressure Slice: Unordered, Open by value:code, value:system
Slices for coding				Content/Rules for all slices
coding:MAPCode		1..1	Coding	Mean Arterial Pressure loinc code
id		0..0		Unique id for inter-element referencing
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
version		0..0		Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 8478-0
userSelected		0..0		If this coding was chosen directly by the user
coding:MAPSnomedCode		0..1	Coding	Mean Arterial Pressure snomed code
system		1..1	uri	Identity of the terminology system Fixed Value: http://snomed.info/sct
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 4501000202102
text		0..0		Plain text representation of the concept
value[x]		0..1	Quantity	Vital Sign Value recorded with UCUM
id		0..0		Unique id for inter-element referencing
value		1..1	decimal	Numerical value (with implicit precision)
unit		1..1	string	Unit representation
system		1..1	uri	System that defines coded unit form Fixed Value: http://unitsofmeasure.org
code		1..1	code	Coded form of the unit Fixed Value: mm[Hg]
dataAbsentReason		0..0		Why the component result is missing
interpretation		0..0		High, low, normal, etc.
Documentation for this format

Terminology Bindings (Differential)

Path	Status	Usage	ValueSet	Version	Source
Observation.bodySite.​coding	Base	extensible	NoDomainVitalSignsObservationBloodpressureBodySite	📦0.1.0	This IG
Observation.method.coding	Base	extensible	NoImplVitalSignsObservationBloodPressureMeasurementMethod	📦0.1.0	This IG

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Observation	C	0..*	observation-bp	FHIR Blood Pressure Profile Norway Constraints: obs-6, obs-7, vs-2
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 This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained		0..*	Resource	Contained, inline Resources
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
Slices for identifier	Σ	0..*	Identifier	Business Identifier for observation Slice: Unordered, Open by value:system
identifier:RelativeEhrUri	Σ	0..1	Identifier	Business Identifier for observation
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	Σ	1..1	uri	The namespace for the identifier value Fixed Value: http://dips.no/fhir/namingsystem/dips-RelativeEhrUri
value	Σ	1..1	string	The value that is unique Example General: 123456
identifier:VersionIdependentId	Σ	0..1	Identifier	Business Identifier for observation
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	Σ	1..1	uri	The namespace for the identifier value Fixed Value: http://dips.no/fhir/namingsystem/dips-VersionIndependentId
value	Σ	1..1	string	The value that is unique Example General: 123456
identifier:Id	Σ	0..1	Identifier	Business Identifier for observation
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	Σ	1..1	uri	The namespace for the identifier value Fixed Value: http://dips.no/fhir/namingsystem/dips-ObservationId
value	Σ	1..1	string	The value that is unique Example General: 123456
identifier:ExternalId	Σ	0..1	Identifier	Business Identifier for observation
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	Σ	1..1	uri	The namespace for the identifier value Fixed Value: http://dips.no/fhir/namingsystem/externalId
value	Σ	1..1	string	The value that is unique Example General: 123456
identifier:ExternalFhirId	Σ	0..*	Identifier	Business Identifier for observation
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	Σ	1..1	uri	The namespace for the identifier value Fixed Value: http://dips.no/fhir/namingsystem/external-fhirid
value	Σ	1..1	string	The value that is unique Example General: 123456
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	registered | preliminary | final | amended + Binding: ObservationStatus (required)
Slices for category	S	1..*	CodeableConcept	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	Classification of type of observation Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
coding	SΣ	1..*	Coding	Code defined by a terminology system
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	SΣ	1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category
code	SΣ	1..1	code	Symbol in syntax defined by the system Fixed Value: vital-signs
display	Σ	0..1	string	Representation defined by the system
code	SΣ	1..1	CodeableConcept	Blood Pressure Binding: VitalSigns (extensible): This identifies the vital sign result type.
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
Slices for coding	Σ	1..*	Coding	Code defined by a terminology system Slice: Unordered, Open by value:code, value:system
coding:BPCode	Σ	1..1	Coding	Code defined by a terminology system
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	Σ	1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
code	Σ	1..1	code	Symbol in syntax defined by the system Fixed Value: 85354-9
display	Σ	0..1	string	Representation defined by the system
subject	SΣ	1..1	Reference(DIPSPatient)	Who and/or what the observation is about
encounter	Σ	0..1	Reference(DIPSR4Encounter)	Healthcare event during which this observation is made
effective[x]	SΣC	1..1	dateTime	Often just a dateTime for Vital Signs Constraints: vs-1
issued	Σ	0..1	instant	Date/Time this version was made available
Slices for performer	Σ	1..*	Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson)	Who is responsible for the observation Slice: Unordered, Open by type:type
performer:Author	Σ	0..*	Reference(DIPSPractitionerRole | DIPSPractitioner)	Who is responsible for the observation
performer:organization	Σ	0..*	Reference(DIPSOrganization)	Who is responsible for the observation
Slices for value[x]	SΣC	0..1	Quantity	Vital Signs value are recorded using the Quantity data type. For supporting observations such as Cuff size could use other datatypes such as CodeableConcept. Slice: Unordered, Closed by type:$this
dataAbsentReason	SC	0..1	CodeableConcept	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.
specimen		0..1	Reference(Specimen)	Specimen used for this 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	Used when reporting systolic and diastolic blood pressure. Slice: Unordered, Open by value:code.coding.code, value:code.coding.system Constraints: vs-3
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	Type of component observation (code / type) Binding: VitalSigns (extensible): This identifies the vital sign result type.
value[x]	SΣC	0..1		Vital Sign Value recorded with UCUM Binding: VitalSignsUnits (extensible): Common UCUM units for recording Vital Signs.
valueQuantity			Quantity
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	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:SystolicBP	SΣC	1..1	BackboneElement	Peak systemic arterial blood pressure - measured in systolic or contraction phase of the heart cycle. Constraints: vs-3
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	Type of component observation (code / type) Binding: VitalSigns (extensible): This identifies the vital sign result type.
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
Slices for coding	Σ	1..*	Coding	Systolic Blood Pressure Slice: Unordered, Open by value:code, value:system
Slices for coding				Content/Rules for all slices
coding:SBPCode	Σ	1..1	Coding	Systolic Blood Pressure
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	Σ	1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
code	Σ	1..1	code	Symbol in syntax defined by the system Fixed Value: 8480-6
display	Σ	0..1	string	Representation defined by the system
coding:SystolicSnomed	Σ	0..1	Coding	Systolic Blood Pressure
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	Σ	1..1	uri	Identity of the terminology system Fixed Value: http://snomed.info/sct
version	Σ	0..1	string	Version of the system - if relevant
code	Σ	1..1	code	Symbol in syntax defined by the system Fixed Value: 4471000202106
display	Σ	0..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
value[x]	SΣC	0..1	Quantity	Vital Sign Value recorded with UCUM Binding: VitalSignsUnits (extensible): Common UCUM units for recording Vital Signs.
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
value	SΣ	1..1	decimal	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	Unit representation
system	SΣC	1..1	uri	System that defines coded unit form Fixed Value: http://unitsofmeasure.org
code	SΣ	1..1	code	Coded responses from the common UCUM units for vital signs value set. Fixed Value: mm[Hg]
referenceRange		0..*	See referenceRange (Observation)	Provides guide for interpretation of component result
component:DiastolicBP	SΣC	1..1	BackboneElement	Minimum systemic arterial blood pressure - measured in the diastolic or relaxation phase of the heart cycle. Constraints: vs-3
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	Type of component observation (code / type) Binding: VitalSigns (extensible): This identifies the vital sign result type.
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
Slices for coding	Σ	1..*	Coding	Diastolic Blood Pressure Slice: Unordered, Open by value:code, value:system
Slices for coding				Content/Rules for all slices
coding:DBPCode	Σ	1..1	Coding	Diastolic Blood Pressure
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	Σ	1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
code	Σ	1..1	code	Symbol in syntax defined by the system Fixed Value: 8462-4
display	Σ	0..1	string	Representation defined by the system
coding:DiastolicBPSnomed	Σ	0..1	Coding	Diastolic Blood Pressure
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	Σ	1..1	uri	Identity of the terminology system Fixed Value: http://snomed.info/sct
version	Σ	0..1	string	Version of the system - if relevant
code	Σ	1..1	code	Symbol in syntax defined by the system Fixed Value: 4481000202108
display	Σ	0..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
value[x]	SΣC	0..1	Quantity	Vital Sign Value recorded with UCUM Binding: VitalSignsUnits (extensible): Common UCUM units for recording Vital Signs.
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
value	SΣ	1..1	decimal	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	Unit representation
system	SΣC	1..1	uri	System that defines coded unit form Fixed Value: http://unitsofmeasure.org
code	SΣ	1..1	code	Coded responses from the common UCUM units for vital signs value set. Fixed Value: mm[Hg]
referenceRange		0..*	See referenceRange (Observation)	Provides guide for interpretation of component result
component:MeanArterialPressure	SΣC	0..1	BackboneElement	The average arterial pressure that occurs over the entire course of the heart contraction and relaxation cycle. Constraints: vs-3
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	Type of component observation (code / type) Binding: VitalSigns (extensible): This identifies the vital sign result type.
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
Slices for coding	Σ	1..*	Coding	Mean Arterial Pressure Slice: Unordered, Open by value:code, value:system
Slices for coding				Content/Rules for all slices
coding:MAPCode	Σ	1..1	Coding	Mean Arterial Pressure loinc code
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	Σ	1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
code	Σ	1..1	code	Symbol in syntax defined by the system Fixed Value: 8478-0
display	Σ	0..1	string	Representation defined by the system
coding:MAPSnomedCode	Σ	0..1	Coding	Mean Arterial Pressure snomed code
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	Σ	1..1	uri	Identity of the terminology system Fixed Value: http://snomed.info/sct
version	Σ	0..1	string	Version of the system - if relevant
code	Σ	1..1	code	Symbol in syntax defined by the system Fixed Value: 4501000202102
display	Σ	0..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
value[x]	SΣC	0..1	Quantity	Vital Sign Value recorded with UCUM Binding: VitalSignsUnits (extensible): Common UCUM units for recording Vital Signs.
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
value	Σ	1..1	decimal	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	Σ	1..1	string	Unit representation
system	ΣC	1..1	uri	System that defines coded unit form Fixed Value: http://unitsofmeasure.org
code	Σ	1..1	code	Coded form of the unit Fixed Value: mm[Hg]
referenceRange		0..*	See referenceRange (Observation)	Provides guide for interpretation of component result
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
Observation.language	Base	preferred	Common Languages	📍4.0.1	FHIR Std.
Observation.status	Base	required	ObservationStatus	📍4.0.1	FHIR Std.
Observation.category	Base	preferred	Observation Category Codes	📍4.0.1	FHIR Std.
Observation.category:VSCat	Base	preferred	Observation Category Codes	📍4.0.1	FHIR Std.
Observation.code	Base	extensible	Vital Signs	📍4.0.1	FHIR Std.
Observation.dataAbsentReason	Base	extensible	DataAbsentReason	📍4.0.1	FHIR Std.
Observation.interpretation	Base	extensible	Observation Interpretation Codes	📍4.0.1	FHIR Std.
Observation.bodySite.​coding	Base	extensible	NoDomainVitalSignsObservationBloodpressureBodySite	📦0.1.0	This IG
Observation.method.coding	Base	extensible	NoImplVitalSignsObservationBloodPressureMeasurementMethod	📦0.1.0	This IG
Observation.referenceRange.​type	Base	preferred	Observation Reference Range Meaning Codes	📍4.0.1	FHIR Std.
Observation.referenceRange.​appliesTo	Base	example	Observation Reference Range Applies To Codes	📍4.0.1	FHIR Std.
Observation.component.​code	Base	extensible	Vital Signs	📍4.0.1	FHIR Std.
Observation.component.​value[x]	Base	extensible	Vital Signs Units	📍4.0.1	FHIR Std.
Observation.component.​dataAbsentReason	Base	extensible	DataAbsentReason	📍4.0.1	FHIR Std.
Observation.component.​interpretation	Base	extensible	Observation Interpretation Codes	📍4.0.1	FHIR Std.
Observation.component:SystolicBP.​code	Base	extensible	Vital Signs	📍4.0.1	FHIR Std.
Observation.component:SystolicBP.​value[x]	Base	extensible	Vital Signs Units	📍4.0.1	FHIR Std.
Observation.component:SystolicBP.​value[x].comparator	Base	required	QuantityComparator	📍4.0.1	FHIR Std.
Observation.component:DiastolicBP.​code	Base	extensible	Vital Signs	📍4.0.1	FHIR Std.
Observation.component:DiastolicBP.​value[x]	Base	extensible	Vital Signs Units	📍4.0.1	FHIR Std.
Observation.component:DiastolicBP.​value[x].comparator	Base	required	QuantityComparator	📍4.0.1	FHIR Std.
Observation.component:MeanArterialPressure.​code	Base	extensible	Vital Signs	📍4.0.1	FHIR Std.
Observation.component:MeanArterialPressure.​value[x]	Base	extensible	Vital Signs Units	📍4.0.1	FHIR Std.
Observation.component:MeanArterialPressure.​value[x].comparator	Base	required	QuantityComparator	📍4.0.1	FHIR Std.

Constraints

Id	Grade	Path(s)	Description	Expression
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:SystolicBP, Observation.component:DiastolicBP, Observation.component:MeanArterialPressure	If there is no a value a data absent reason must be present	value.exists() or dataAbsentReason.exists()

This structure is derived from observation-bp

Summary

Mandatory: 4 elements(24 nested mandatory elements)
Fixed: 15 elements
Prohibited: 67 elements

Structures

This structure refers to these other structures:

• DIPSPatient (http://dips.no/fhir/R4/StructureDefinition/DIPSPatient)
• DIPSR4Encounter (http://dips.no/fhir/R4/StructureDefinition/DIPSR4Encounter)
• DIPSPractitionerRole (http://dips.no/fhir/R4/StructureDefinition/DIPSPractitionerRole)
• DIPSPractitioner (http://dips.no/fhir/R4/StructureDefinition/DIPSPractitioner)
• DIPSOrganization (http://dips.no/fhir/R4/StructureDefinition/DIPSOrganization)

Slices

This structure defines the following Slices:

• The element 1 is sliced based on the value of Observation.identifier
• The element 1 is sliced based on the value of Observation.performer
• The element 2 is sliced based on the values of Observation.component.code.coding

Key Elements View

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Observation	C	0..*	observation-bp	FHIR Blood Pressure Profile Norway Constraints: obs-6, obs-7, vs-2
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
Slices for identifier	Σ	0..*	Identifier	Business Identifier for observation Slice: Unordered, Open by value:system
identifier:RelativeEhrUri	Σ	0..1	Identifier	Business Identifier for observation
system	Σ	1..1	uri	The namespace for the identifier value Fixed Value: http://dips.no/fhir/namingsystem/dips-RelativeEhrUri
value	Σ	1..1	string	The value that is unique Example General: 123456
identifier:VersionIdependentId	Σ	0..1	Identifier	Business Identifier for observation
system	Σ	1..1	uri	The namespace for the identifier value Fixed Value: http://dips.no/fhir/namingsystem/dips-VersionIndependentId
value	Σ	1..1	string	The value that is unique Example General: 123456
identifier:Id	Σ	0..1	Identifier	Business Identifier for observation
system	Σ	1..1	uri	The namespace for the identifier value Fixed Value: http://dips.no/fhir/namingsystem/dips-ObservationId
value	Σ	1..1	string	The value that is unique Example General: 123456
identifier:ExternalId	Σ	0..1	Identifier	Business Identifier for observation
system	Σ	1..1	uri	The namespace for the identifier value Fixed Value: http://dips.no/fhir/namingsystem/externalId
value	Σ	1..1	string	The value that is unique Example General: 123456
identifier:ExternalFhirId	Σ	0..*	Identifier	Business Identifier for observation
system	Σ	1..1	uri	The namespace for the identifier value Fixed Value: http://dips.no/fhir/namingsystem/external-fhirid
value	Σ	1..1	string	The value that is unique Example General: 123456
status	?!SΣ	1..1	code	registered | preliminary | final | amended + Binding: ObservationStatus (required)
Slices for category	S	1..*	CodeableConcept	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	Classification of type of observation Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
coding	SΣ	1..*	Coding	Code defined by a terminology system
system	SΣ	1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category
code	SΣ	1..1	code	Symbol in syntax defined by the system Fixed Value: vital-signs
code	SΣ	1..1	CodeableConcept	Blood Pressure Binding: VitalSigns (extensible): This identifies the vital sign result type.
Slices for coding	Σ	1..*	Coding	Code defined by a terminology system Slice: Unordered, Open by value:code, value:system
coding:BPCode	Σ	1..1	Coding	Code defined by a terminology system
system	Σ	1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
code	Σ	1..1	code	Symbol in syntax defined by the system Fixed Value: 85354-9
subject	SΣ	1..1	Reference(DIPSPatient)	Who and/or what the observation is about
encounter	Σ	0..1	Reference(DIPSR4Encounter)	Healthcare event during which this observation is made
effective[x]	SΣC	1..1	dateTime	Often just a dateTime for Vital Signs Constraints: vs-1
Slices for performer	Σ	1..*	Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson)	Who is responsible for the observation Slice: Unordered, Open by type:type
performer:Author	Σ	0..*	Reference(DIPSPractitionerRole | DIPSPractitioner)	Who is responsible for the observation
performer:organization	Σ	0..*	Reference(DIPSOrganization)	Who is responsible for the observation
Slices for value[x]	SΣC	0..1	Quantity	Vital Signs value are recorded using the Quantity data type. For supporting observations such as Cuff size could use other datatypes such as CodeableConcept. Slice: Unordered, Closed by type:$this
dataAbsentReason	SC	0..1	CodeableConcept	Why the result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
Slices for component	SΣC	2..*	BackboneElement	Used when reporting systolic and diastolic blood pressure. Slice: Unordered, Open by value:code.coding.code, value:code.coding.system Constraints: vs-3
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	Type of component observation (code / type) Binding: VitalSigns (extensible): This identifies the vital sign result type.
value[x]	SΣC	0..1		Vital Sign Value recorded with UCUM Binding: VitalSignsUnits (extensible): Common UCUM units for recording Vital Signs.
valueQuantity			Quantity
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	Why the component result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
component:SystolicBP	SΣC	1..1	BackboneElement	Peak systemic arterial blood pressure - measured in systolic or contraction phase of the heart cycle. Constraints: vs-3
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	SΣ	1..1	CodeableConcept	Type of component observation (code / type) Binding: VitalSigns (extensible): This identifies the vital sign result type.
Slices for coding	Σ	1..*	Coding	Systolic Blood Pressure Slice: Unordered, Open by value:code, value:system
Slices for coding				Content/Rules for all slices
coding:SBPCode	Σ	1..1	Coding	Systolic Blood Pressure
system	Σ	1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
code	Σ	1..1	code	Symbol in syntax defined by the system Fixed Value: 8480-6
coding:SystolicSnomed	Σ	0..1	Coding	Systolic Blood Pressure
system	Σ	1..1	uri	Identity of the terminology system Fixed Value: http://snomed.info/sct
code	Σ	1..1	code	Symbol in syntax defined by the system Fixed Value: 4471000202106
value[x]	SΣC	0..1	Quantity	Vital Sign Value recorded with UCUM Binding: VitalSignsUnits (extensible): Common UCUM units for recording Vital Signs.
value	SΣ	1..1	decimal	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	Unit representation
system	SΣC	1..1	uri	System that defines coded unit form Fixed Value: http://unitsofmeasure.org
code	SΣ	1..1	code	Coded responses from the common UCUM units for vital signs value set. Fixed Value: mm[Hg]
component:DiastolicBP	SΣC	1..1	BackboneElement	Minimum systemic arterial blood pressure - measured in the diastolic or relaxation phase of the heart cycle. Constraints: vs-3
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	SΣ	1..1	CodeableConcept	Type of component observation (code / type) Binding: VitalSigns (extensible): This identifies the vital sign result type.
Slices for coding	Σ	1..*	Coding	Diastolic Blood Pressure Slice: Unordered, Open by value:code, value:system
Slices for coding				Content/Rules for all slices
coding:DBPCode	Σ	1..1	Coding	Diastolic Blood Pressure
system	Σ	1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
code	Σ	1..1	code	Symbol in syntax defined by the system Fixed Value: 8462-4
coding:DiastolicBPSnomed	Σ	0..1	Coding	Diastolic Blood Pressure
system	Σ	1..1	uri	Identity of the terminology system Fixed Value: http://snomed.info/sct
code	Σ	1..1	code	Symbol in syntax defined by the system Fixed Value: 4481000202108
value[x]	SΣC	0..1	Quantity	Vital Sign Value recorded with UCUM Binding: VitalSignsUnits (extensible): Common UCUM units for recording Vital Signs.
value	SΣ	1..1	decimal	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	Unit representation
system	SΣC	1..1	uri	System that defines coded unit form Fixed Value: http://unitsofmeasure.org
code	SΣ	1..1	code	Coded responses from the common UCUM units for vital signs value set. Fixed Value: mm[Hg]
component:MeanArterialPressure	SΣC	0..1	BackboneElement	The average arterial pressure that occurs over the entire course of the heart contraction and relaxation cycle. Constraints: vs-3
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	SΣ	1..1	CodeableConcept	Type of component observation (code / type) Binding: VitalSigns (extensible): This identifies the vital sign result type.
Slices for coding	Σ	1..*	Coding	Mean Arterial Pressure Slice: Unordered, Open by value:code, value:system
Slices for coding				Content/Rules for all slices
coding:MAPCode	Σ	1..1	Coding	Mean Arterial Pressure loinc code
system	Σ	1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
code	Σ	1..1	code	Symbol in syntax defined by the system Fixed Value: 8478-0
coding:MAPSnomedCode	Σ	0..1	Coding	Mean Arterial Pressure snomed code
system	Σ	1..1	uri	Identity of the terminology system Fixed Value: http://snomed.info/sct
code	Σ	1..1	code	Symbol in syntax defined by the system Fixed Value: 4501000202102
value[x]	SΣC	0..1	Quantity	Vital Sign Value recorded with UCUM Binding: VitalSignsUnits (extensible): Common UCUM units for recording Vital Signs.
value	Σ	1..1	decimal	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	Σ	1..1	string	Unit representation
system	ΣC	1..1	uri	System that defines coded unit form Fixed Value: http://unitsofmeasure.org
code	Σ	1..1	code	Coded form of the unit Fixed Value: mm[Hg]
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
Observation.status	Base	required	ObservationStatus	📍4.0.1	FHIR Std.
Observation.category	Base	preferred	Observation Category Codes	📍4.0.1	FHIR Std.
Observation.category:VSCat	Base	preferred	Observation Category Codes	📍4.0.1	FHIR Std.
Observation.code	Base	extensible	Vital Signs	📍4.0.1	FHIR Std.
Observation.dataAbsentReason	Base	extensible	DataAbsentReason	📍4.0.1	FHIR Std.
Observation.bodySite.​coding	Base	extensible	NoDomainVitalSignsObservationBloodpressureBodySite	📦0.1.0	This IG
Observation.method.coding	Base	extensible	NoImplVitalSignsObservationBloodPressureMeasurementMethod	📦0.1.0	This IG
Observation.component.​code	Base	extensible	Vital Signs	📍4.0.1	FHIR Std.
Observation.component.​value[x]	Base	extensible	Vital Signs Units	📍4.0.1	FHIR Std.
Observation.component.​dataAbsentReason	Base	extensible	DataAbsentReason	📍4.0.1	FHIR Std.
Observation.component:SystolicBP.​code	Base	extensible	Vital Signs	📍4.0.1	FHIR Std.
Observation.component:SystolicBP.​value[x]	Base	extensible	Vital Signs Units	📍4.0.1	FHIR Std.
Observation.component:SystolicBP.​value[x].comparator	Base	required	QuantityComparator	📍4.0.1	FHIR Std.
Observation.component:DiastolicBP.​code	Base	extensible	Vital Signs	📍4.0.1	FHIR Std.
Observation.component:DiastolicBP.​value[x]	Base	extensible	Vital Signs Units	📍4.0.1	FHIR Std.
Observation.component:DiastolicBP.​value[x].comparator	Base	required	QuantityComparator	📍4.0.1	FHIR Std.
Observation.component:MeanArterialPressure.​code	Base	extensible	Vital Signs	📍4.0.1	FHIR Std.
Observation.component:MeanArterialPressure.​value[x]	Base	extensible	Vital Signs Units	📍4.0.1	FHIR Std.
Observation.component:MeanArterialPressure.​value[x].comparator	Base	required	QuantityComparator	📍4.0.1	FHIR Std.

Constraints

Id	Grade	Path(s)	Description	Expression
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:SystolicBP, Observation.component:DiastolicBP, Observation.component:MeanArterialPressure	If there is no a value a data absent reason must be present	value.exists() or dataAbsentReason.exists()

Differential View

This structure is derived from observation-bp

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Observation		0..*	observation-bp	FHIR Blood Pressure Profile Norway
Slices for identifier		0..*	Identifier	Business Identifier for observation Slice: Unordered, Open by value:system
identifier:RelativeEhrUri		0..1	Identifier	Business Identifier for observation
id		0..0		Unique id for inter-element referencing
use		0..0		usual | official | temp | secondary | old (If known)
type		0..0		Description of identifier
system		1..1	uri	The namespace for the identifier value Fixed Value: http://dips.no/fhir/namingsystem/dips-RelativeEhrUri
value		1..1	string	The value that is unique
period		0..0		Time period when id is/was valid for use
assigner		0..0		Organization that issued id (may be just text)
identifier:VersionIdependentId		0..1	Identifier	Business Identifier for observation
use		0..0		usual | official | temp | secondary | old (If known)
type		0..0		Description of identifier
system		1..1	uri	The namespace for the identifier value Fixed Value: http://dips.no/fhir/namingsystem/dips-VersionIndependentId
value		1..1	string	The value that is unique
period		0..0		Time period when id is/was valid for use
assigner		0..0		Organization that issued id (may be just text)
identifier:Id		0..1	Identifier	Business Identifier for observation
id		0..0		Unique id for inter-element referencing
use		0..0		usual | official | temp | secondary | old (If known)
type		0..0		Description of identifier
system		1..1	uri	The namespace for the identifier value Fixed Value: http://dips.no/fhir/namingsystem/dips-ObservationId
value		1..1	string	The value that is unique
period		0..0		Time period when id is/was valid for use
assigner		0..0		Organization that issued id (may be just text)
identifier:ExternalId		0..1	Identifier	Business Identifier for observation
id		0..0		Unique id for inter-element referencing
use		0..0		usual | official | temp | secondary | old (If known)
type		0..0		Description of identifier
system		1..1	uri	The namespace for the identifier value Fixed Value: http://dips.no/fhir/namingsystem/externalId
value		1..1	string	The value that is unique
period		0..0		Time period when id is/was valid for use
assigner		0..0		Organization that issued id (may be just text)
identifier:ExternalFhirId		0..*	Identifier	Business Identifier for observation
id		0..0		Unique id for inter-element referencing
use		0..0		usual | official | temp | secondary | old (If known)
type		0..0		Description of identifier
system		1..1	uri	The namespace for the identifier value Fixed Value: http://dips.no/fhir/namingsystem/external-fhirid
value		1..1	string	The value that is unique
period		0..0		Time period when id is/was valid for use
assigner		0..0		Organization that issued id (may be just text)
Slices for category				Content/Rules for all slices
category:VSCat		1..1	CodeableConcept	Classification of type of observation
id		0..0		Unique id for inter-element referencing
coding
id		0..0		Unique id for inter-element referencing
version		0..0		Version of the system - if relevant
userSelected		0..0		If this coding was chosen directly by the user
text		0..0		Plain text representation of the concept
code
id		0..0		Unique id for inter-element referencing
coding		1..*	Coding	Code defined by a terminology system
Slices for coding				Content/Rules for all slices
coding:BPCode		1..1	Coding	Code defined by a terminology system
id		0..0		Unique id for inter-element referencing
version		0..0		Version of the system - if relevant
userSelected		0..0		If this coding was chosen directly by the user
text		0..0		Plain text representation of the concept
subject		1..1	Reference(DIPSPatient)	Who and/or what the observation is about
focus		0..0		What the observation is about, when it is not about the subject of record
encounter		0..1	Reference(DIPSR4Encounter)	Healthcare event during which this observation is made
effective[x]		1..1	dateTime	Often just a dateTime for Vital Signs
Slices for performer		1..*	Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson)	Who is responsible for the observation Slice: Unordered, Open by type:type
performer:Author		0..*	Reference(DIPSPractitionerRole | DIPSPractitioner)	Who is responsible for the observation
performer:organization		0..*	Reference(DIPSOrganization)	Who is responsible for the observation
note		0..0		Comments about the observation
bodySite		0..0		Observed body part Binding: NoDomainVitalSignsObservationBloodpressureBodySite (extensible)
method		0..0		Method of measurement of blood pressure. Binding: NoImplVitalSignsObservationBloodPressureMeasurementMethod (extensible)
device		0..0		(Measurement) Device
referenceRange		0..0		Provides guide for interpretation
Slices for component				Content/Rules for all slices
component:SystolicBP		1..1	BackboneElement	Peak systemic arterial blood pressure - measured in systolic or contraction phase of the heart cycle.
id		0..0		Unique id for inter-element referencing
code
id		0..0		Unique id for inter-element referencing
coding		1..*	Coding	Systolic Blood Pressure
Slices for coding				Content/Rules for all slices
coding:SBPCode		1..1	Coding	Systolic Blood Pressure
id		0..0		Unique id for inter-element referencing
version		0..0		Version of the system - if relevant
userSelected		0..0		If this coding was chosen directly by the user
coding:SystolicSnomed		0..1	Coding	Systolic Blood Pressure
system		1..1	uri	Identity of the terminology system Fixed Value: http://snomed.info/sct
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 4471000202106
text		0..0		Plain text representation of the concept
value[x]
id		0..0		Unique id for inter-element referencing
dataAbsentReason		0..0		Why the component result is missing
interpretation		0..0		High, low, normal, etc.
component:DiastolicBP		1..1	BackboneElement	Minimum systemic arterial blood pressure - measured in the diastolic or relaxation phase of the heart cycle.
id		0..0		Unique id for inter-element referencing
code
id		0..0		Unique id for inter-element referencing
coding		1..*	Coding	Diastolic Blood Pressure
Slices for coding				Content/Rules for all slices
coding:DBPCode		1..1	Coding	Diastolic Blood Pressure
id		0..0		Unique id for inter-element referencing
version		0..0		Version of the system - if relevant
userSelected		0..0		If this coding was chosen directly by the user
coding:DiastolicBPSnomed		0..1	Coding	Diastolic Blood Pressure
system		1..1	uri	Identity of the terminology system Fixed Value: http://snomed.info/sct
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 4481000202108
text		0..0		Plain text representation of the concept
value[x]
id		0..0		Unique id for inter-element referencing
dataAbsentReason		0..0		Why the component result is missing
interpretation		0..0		High, low, normal, etc.
component:MeanArterialPressure		0..1	BackboneElement	The average arterial pressure that occurs over the entire course of the heart contraction and relaxation cycle.
id		0..0		Unique id for inter-element referencing
code		1..1	CodeableConcept	Type of component observation (code / type)
id		0..0		Unique id for inter-element referencing
Slices for coding		1..*	Coding	Mean Arterial Pressure Slice: Unordered, Open by value:code, value:system
Slices for coding				Content/Rules for all slices
coding:MAPCode		1..1	Coding	Mean Arterial Pressure loinc code
id		0..0		Unique id for inter-element referencing
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
version		0..0		Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 8478-0
userSelected		0..0		If this coding was chosen directly by the user
coding:MAPSnomedCode		0..1	Coding	Mean Arterial Pressure snomed code
system		1..1	uri	Identity of the terminology system Fixed Value: http://snomed.info/sct
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 4501000202102
text		0..0		Plain text representation of the concept
value[x]		0..1	Quantity	Vital Sign Value recorded with UCUM
id		0..0		Unique id for inter-element referencing
value		1..1	decimal	Numerical value (with implicit precision)
unit		1..1	string	Unit representation
system		1..1	uri	System that defines coded unit form Fixed Value: http://unitsofmeasure.org
code		1..1	code	Coded form of the unit Fixed Value: mm[Hg]
dataAbsentReason		0..0		Why the component result is missing
interpretation		0..0		High, low, normal, etc.
Documentation for this format

Terminology Bindings (Differential)

Path	Status	Usage	ValueSet	Version	Source
Observation.bodySite.​coding	Base	extensible	NoDomainVitalSignsObservationBloodpressureBodySite	📦0.1.0	This IG
Observation.method.coding	Base	extensible	NoImplVitalSignsObservationBloodPressureMeasurementMethod	📦0.1.0	This IG

Snapshot View

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Observation	C	0..*	observation-bp	FHIR Blood Pressure Profile Norway Constraints: obs-6, obs-7, vs-2
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 This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained		0..*	Resource	Contained, inline Resources
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
Slices for identifier	Σ	0..*	Identifier	Business Identifier for observation Slice: Unordered, Open by value:system
identifier:RelativeEhrUri	Σ	0..1	Identifier	Business Identifier for observation
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	Σ	1..1	uri	The namespace for the identifier value Fixed Value: http://dips.no/fhir/namingsystem/dips-RelativeEhrUri
value	Σ	1..1	string	The value that is unique Example General: 123456
identifier:VersionIdependentId	Σ	0..1	Identifier	Business Identifier for observation
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	Σ	1..1	uri	The namespace for the identifier value Fixed Value: http://dips.no/fhir/namingsystem/dips-VersionIndependentId
value	Σ	1..1	string	The value that is unique Example General: 123456
identifier:Id	Σ	0..1	Identifier	Business Identifier for observation
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	Σ	1..1	uri	The namespace for the identifier value Fixed Value: http://dips.no/fhir/namingsystem/dips-ObservationId
value	Σ	1..1	string	The value that is unique Example General: 123456
identifier:ExternalId	Σ	0..1	Identifier	Business Identifier for observation
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	Σ	1..1	uri	The namespace for the identifier value Fixed Value: http://dips.no/fhir/namingsystem/externalId
value	Σ	1..1	string	The value that is unique Example General: 123456
identifier:ExternalFhirId	Σ	0..*	Identifier	Business Identifier for observation
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	Σ	1..1	uri	The namespace for the identifier value Fixed Value: http://dips.no/fhir/namingsystem/external-fhirid
value	Σ	1..1	string	The value that is unique Example General: 123456
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	registered | preliminary | final | amended + Binding: ObservationStatus (required)
Slices for category	S	1..*	CodeableConcept	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	Classification of type of observation Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
coding	SΣ	1..*	Coding	Code defined by a terminology system
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	SΣ	1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category
code	SΣ	1..1	code	Symbol in syntax defined by the system Fixed Value: vital-signs
display	Σ	0..1	string	Representation defined by the system
code	SΣ	1..1	CodeableConcept	Blood Pressure Binding: VitalSigns (extensible): This identifies the vital sign result type.
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
Slices for coding	Σ	1..*	Coding	Code defined by a terminology system Slice: Unordered, Open by value:code, value:system
coding:BPCode	Σ	1..1	Coding	Code defined by a terminology system
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	Σ	1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
code	Σ	1..1	code	Symbol in syntax defined by the system Fixed Value: 85354-9
display	Σ	0..1	string	Representation defined by the system
subject	SΣ	1..1	Reference(DIPSPatient)	Who and/or what the observation is about
encounter	Σ	0..1	Reference(DIPSR4Encounter)	Healthcare event during which this observation is made
effective[x]	SΣC	1..1	dateTime	Often just a dateTime for Vital Signs Constraints: vs-1
issued	Σ	0..1	instant	Date/Time this version was made available
Slices for performer	Σ	1..*	Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson)	Who is responsible for the observation Slice: Unordered, Open by type:type
performer:Author	Σ	0..*	Reference(DIPSPractitionerRole | DIPSPractitioner)	Who is responsible for the observation
performer:organization	Σ	0..*	Reference(DIPSOrganization)	Who is responsible for the observation
Slices for value[x]	SΣC	0..1	Quantity	Vital Signs value are recorded using the Quantity data type. For supporting observations such as Cuff size could use other datatypes such as CodeableConcept. Slice: Unordered, Closed by type:$this
dataAbsentReason	SC	0..1	CodeableConcept	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.
specimen		0..1	Reference(Specimen)	Specimen used for this 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	Used when reporting systolic and diastolic blood pressure. Slice: Unordered, Open by value:code.coding.code, value:code.coding.system Constraints: vs-3
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	Type of component observation (code / type) Binding: VitalSigns (extensible): This identifies the vital sign result type.
value[x]	SΣC	0..1		Vital Sign Value recorded with UCUM Binding: VitalSignsUnits (extensible): Common UCUM units for recording Vital Signs.
valueQuantity			Quantity
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	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:SystolicBP	SΣC	1..1	BackboneElement	Peak systemic arterial blood pressure - measured in systolic or contraction phase of the heart cycle. Constraints: vs-3
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	Type of component observation (code / type) Binding: VitalSigns (extensible): This identifies the vital sign result type.
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
Slices for coding	Σ	1..*	Coding	Systolic Blood Pressure Slice: Unordered, Open by value:code, value:system
Slices for coding				Content/Rules for all slices
coding:SBPCode	Σ	1..1	Coding	Systolic Blood Pressure
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	Σ	1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
code	Σ	1..1	code	Symbol in syntax defined by the system Fixed Value: 8480-6
display	Σ	0..1	string	Representation defined by the system
coding:SystolicSnomed	Σ	0..1	Coding	Systolic Blood Pressure
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	Σ	1..1	uri	Identity of the terminology system Fixed Value: http://snomed.info/sct
version	Σ	0..1	string	Version of the system - if relevant
code	Σ	1..1	code	Symbol in syntax defined by the system Fixed Value: 4471000202106
display	Σ	0..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
value[x]	SΣC	0..1	Quantity	Vital Sign Value recorded with UCUM Binding: VitalSignsUnits (extensible): Common UCUM units for recording Vital Signs.
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
value	SΣ	1..1	decimal	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	Unit representation
system	SΣC	1..1	uri	System that defines coded unit form Fixed Value: http://unitsofmeasure.org
code	SΣ	1..1	code	Coded responses from the common UCUM units for vital signs value set. Fixed Value: mm[Hg]
referenceRange		0..*	See referenceRange (Observation)	Provides guide for interpretation of component result
component:DiastolicBP	SΣC	1..1	BackboneElement	Minimum systemic arterial blood pressure - measured in the diastolic or relaxation phase of the heart cycle. Constraints: vs-3
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	Type of component observation (code / type) Binding: VitalSigns (extensible): This identifies the vital sign result type.
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
Slices for coding	Σ	1..*	Coding	Diastolic Blood Pressure Slice: Unordered, Open by value:code, value:system
Slices for coding				Content/Rules for all slices
coding:DBPCode	Σ	1..1	Coding	Diastolic Blood Pressure
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	Σ	1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
code	Σ	1..1	code	Symbol in syntax defined by the system Fixed Value: 8462-4
display	Σ	0..1	string	Representation defined by the system
coding:DiastolicBPSnomed	Σ	0..1	Coding	Diastolic Blood Pressure
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	Σ	1..1	uri	Identity of the terminology system Fixed Value: http://snomed.info/sct
version	Σ	0..1	string	Version of the system - if relevant
code	Σ	1..1	code	Symbol in syntax defined by the system Fixed Value: 4481000202108
display	Σ	0..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
value[x]	SΣC	0..1	Quantity	Vital Sign Value recorded with UCUM Binding: VitalSignsUnits (extensible): Common UCUM units for recording Vital Signs.
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
value	SΣ	1..1	decimal	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	Unit representation
system	SΣC	1..1	uri	System that defines coded unit form Fixed Value: http://unitsofmeasure.org
code	SΣ	1..1	code	Coded responses from the common UCUM units for vital signs value set. Fixed Value: mm[Hg]
referenceRange		0..*	See referenceRange (Observation)	Provides guide for interpretation of component result
component:MeanArterialPressure	SΣC	0..1	BackboneElement	The average arterial pressure that occurs over the entire course of the heart contraction and relaxation cycle. Constraints: vs-3
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	Type of component observation (code / type) Binding: VitalSigns (extensible): This identifies the vital sign result type.
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
Slices for coding	Σ	1..*	Coding	Mean Arterial Pressure Slice: Unordered, Open by value:code, value:system
Slices for coding				Content/Rules for all slices
coding:MAPCode	Σ	1..1	Coding	Mean Arterial Pressure loinc code
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	Σ	1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
code	Σ	1..1	code	Symbol in syntax defined by the system Fixed Value: 8478-0
display	Σ	0..1	string	Representation defined by the system
coding:MAPSnomedCode	Σ	0..1	Coding	Mean Arterial Pressure snomed code
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	Σ	1..1	uri	Identity of the terminology system Fixed Value: http://snomed.info/sct
version	Σ	0..1	string	Version of the system - if relevant
code	Σ	1..1	code	Symbol in syntax defined by the system Fixed Value: 4501000202102
display	Σ	0..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
value[x]	SΣC	0..1	Quantity	Vital Sign Value recorded with UCUM Binding: VitalSignsUnits (extensible): Common UCUM units for recording Vital Signs.
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
value	Σ	1..1	decimal	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	Σ	1..1	string	Unit representation
system	ΣC	1..1	uri	System that defines coded unit form Fixed Value: http://unitsofmeasure.org
code	Σ	1..1	code	Coded form of the unit Fixed Value: mm[Hg]
referenceRange		0..*	See referenceRange (Observation)	Provides guide for interpretation of component result
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
Observation.language	Base	preferred	Common Languages	📍4.0.1	FHIR Std.
Observation.status	Base	required	ObservationStatus	📍4.0.1	FHIR Std.
Observation.category	Base	preferred	Observation Category Codes	📍4.0.1	FHIR Std.
Observation.category:VSCat	Base	preferred	Observation Category Codes	📍4.0.1	FHIR Std.
Observation.code	Base	extensible	Vital Signs	📍4.0.1	FHIR Std.
Observation.dataAbsentReason	Base	extensible	DataAbsentReason	📍4.0.1	FHIR Std.
Observation.interpretation	Base	extensible	Observation Interpretation Codes	📍4.0.1	FHIR Std.
Observation.bodySite.​coding	Base	extensible	NoDomainVitalSignsObservationBloodpressureBodySite	📦0.1.0	This IG
Observation.method.coding	Base	extensible	NoImplVitalSignsObservationBloodPressureMeasurementMethod	📦0.1.0	This IG
Observation.referenceRange.​type	Base	preferred	Observation Reference Range Meaning Codes	📍4.0.1	FHIR Std.
Observation.referenceRange.​appliesTo	Base	example	Observation Reference Range Applies To Codes	📍4.0.1	FHIR Std.
Observation.component.​code	Base	extensible	Vital Signs	📍4.0.1	FHIR Std.
Observation.component.​value[x]	Base	extensible	Vital Signs Units	📍4.0.1	FHIR Std.
Observation.component.​dataAbsentReason	Base	extensible	DataAbsentReason	📍4.0.1	FHIR Std.
Observation.component.​interpretation	Base	extensible	Observation Interpretation Codes	📍4.0.1	FHIR Std.
Observation.component:SystolicBP.​code	Base	extensible	Vital Signs	📍4.0.1	FHIR Std.
Observation.component:SystolicBP.​value[x]	Base	extensible	Vital Signs Units	📍4.0.1	FHIR Std.
Observation.component:SystolicBP.​value[x].comparator	Base	required	QuantityComparator	📍4.0.1	FHIR Std.
Observation.component:DiastolicBP.​code	Base	extensible	Vital Signs	📍4.0.1	FHIR Std.
Observation.component:DiastolicBP.​value[x]	Base	extensible	Vital Signs Units	📍4.0.1	FHIR Std.
Observation.component:DiastolicBP.​value[x].comparator	Base	required	QuantityComparator	📍4.0.1	FHIR Std.
Observation.component:MeanArterialPressure.​code	Base	extensible	Vital Signs	📍4.0.1	FHIR Std.
Observation.component:MeanArterialPressure.​value[x]	Base	extensible	Vital Signs Units	📍4.0.1	FHIR Std.
Observation.component:MeanArterialPressure.​value[x].comparator	Base	required	QuantityComparator	📍4.0.1	FHIR Std.

Constraints

Id	Grade	Path(s)	Description	Expression
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:SystolicBP, Observation.component:DiastolicBP, Observation.component:MeanArterialPressure	If there is no a value a data absent reason must be present	value.exists() or dataAbsentReason.exists()

This structure is derived from observation-bp

Summary

Mandatory: 4 elements(24 nested mandatory elements)
Fixed: 15 elements
Prohibited: 67 elements

Structures

This structure refers to these other structures:

• DIPSPatient (http://dips.no/fhir/R4/StructureDefinition/DIPSPatient)
• DIPSR4Encounter (http://dips.no/fhir/R4/StructureDefinition/DIPSR4Encounter)
• DIPSPractitionerRole (http://dips.no/fhir/R4/StructureDefinition/DIPSPractitionerRole)
• DIPSPractitioner (http://dips.no/fhir/R4/StructureDefinition/DIPSPractitioner)
• DIPSOrganization (http://dips.no/fhir/R4/StructureDefinition/DIPSOrganization)

Slices

This structure defines the following Slices:

• The element 1 is sliced based on the value of Observation.identifier
• The element 1 is sliced based on the value of Observation.performer
• The element 2 is sliced based on the values of Observation.component.code.coding