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

      <id value="blood-pressure-cancel"/>
      <meta>
              <profile value="http://hl7.org/fhir/StructureDefinition/vitalsigns"/>
      </meta>
      <!--    EH  Narrative created by build
      <text>
              <status value="generated"/>
              <div xmlns="http://www.w3.org/1999/xhtml">Sept 17, 2012: Systolic Blood pressure 107/60 mmHg (low)</div>
      </text>
-->
      <text><status value="generated"/><div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative with Details</b></p><p><b>id</b>: blood-pressure-cancel</p><p><b>meta</b>: </p><p><b>identifier</b>: urn:uuid:187e0c12-8dd2-67e2-99b2-bf273c878281</p><p><b>status</b>: cancelled</p><p><b>category</b>: Vital Signs <span>(Details : {http://hl7.org/fhir/observation-category code &#39;vital-signs&#39; = &#39;Vital Signs&#39;, given as &#39;Vital Signs&#39;})</span></p><p><b>code</b>: Blood pressure systolic &amp; diastolic <span>(Details : {LOINC code &#39;85354-9&#39; = &#39;lood pressure panel with all children optional&#39;, given as &#39;Bood pressure panel with all children optional&#39;})</span></p><p><b>subject</b>: <a>Patient/example</a></p><p><b>effective</b>: Sep 17, 2012</p><p><b>performer</b>: <a>Practitioner/example</a></p><p><b>interpretation</b>: Below low normal <span>(Details : {http://hl7.org/fhir/v2/0078 code &#39;L&#39; = &#39;Low&#39;, given as &#39;low&#39;})</span></p><p><b>comment</b>: In this example, the blood pressure measurements are not available due to cancellation of the order.  Data absent reason is present for each component</p><p><b>bodySite</b>: Right arm <span>(Details : {SNOMED CT code &#39;368209003&#39; = &#39;Right upper arm&#39;, given as &#39;Right arm&#39;})</span></p><blockquote><p><b>component</b></p><p><b>code</b>: Systolic blood pressure <span>(Details : {LOINC code &#39;8480-6&#39; = &#39;Systolic blood pressure&#39;, given as &#39;Systolic blood pressure&#39;}; {SNOMED CT code &#39;271649006&#39; = &#39;Systolic blood pressure&#39;, given as &#39;Systolic blood pressure&#39;}; {http://acme.org/devices/clinical-codes code &#39;bp-s&#39; = &#39;bp-s&#39;, given as &#39;Systolic Blood pressure&#39;})</span></p><p><b>dataAbsentReason</b>: Not Asked <span>(Details : {http://hl7.org/fhir/data-absent-reason code &#39;not-asked&#39; = &#39;Not Asked&#39;, given as &#39;Not Asked&#39;})</span></p></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: Diastolic blood pressure <span>(Details : {LOINC code &#39;8462-4&#39; = &#39;Diastolic blood pressure&#39;, given as &#39;Diastolic blood pressure&#39;})</span></p><p><b>dataAbsentReason</b>: Not Asked <span>(Details : {http://hl7.org/fhir/data-absent-reason code &#39;not-asked&#39; = &#39;Not Asked&#39;, given as &#39;Not Asked&#39;})</span></p></blockquote></div></text><identifier>
              <system value="urn:ietf:rfc:3986"/>
              <value value="urn:uuid:187e0c12-8dd2-67e2-99b2-bf273c878281"/>
      </identifier>
      <status value="cancelled"/>
      <category>
              <coding>
                      <system value="http://hl7.org/fhir/observation-category"/>
                      <code value="vital-signs"/>
                      <display value="Vital Signs"/>
              </coding>
      </category>
      <code>

<!– replaced by 85354-9

              <coding>
                      <system value="http://loinc.org"/>
                      <code value="55284-4"/>
                      <display value="Blood pressure systolic &amp; diastolic"/>
              </coding>
-->
              <coding>
                      <system value="http://loinc.org"/>
                      <code value="85354-9"/>
                      <display value="Bood pressure panel with all children optional"/>
              </coding>
              <text value="Blood pressure systolic &amp; diastolic"/>
      </code>
      <subject>
              <reference value="Patient/example"/>
      </subject>
      <effectiveDateTime value="2012-09-17"/>
      <performer>
              <reference value="Practitioner/example"/>
      </performer>
      <!--   an interpretation offered to the combination observation
      generally, it would only be appropriate to offer an interpretation
      of an observation that has no value if it has "COMP" (component)
      observations   -->
      <interpretation>
              <coding>
                      <system value="http://hl7.org/fhir/v2/0078"/>
                      <code value="L"/>
                      <display value="low"/>
              </coding>
              <text value="Below low normal"/>
      </interpretation>
      <comment value="In this example, the blood pressure measurements are not available due to cancellation of the order.  Data absent reason is present for each component"/>
      <!--   for an observation with components, these cannot disagree with the flags on the components   -->
      <bodySite>
              <coding>
                      <system value="http://snomed.info/sct"/>
                      <code value="368209003"/>
                      <display value="Right arm"/>
              </coding>
      </bodySite>
      <component>
              <!--  
         Observations are often coded in multiple code systems.
         - LOINC provides a very specific code (though not usefully more specific in this particular case)
         - snomed provides a clinically relevant code that is usually less granular than LOINC
         - the source system provides its own code, which may be less or more granular than LOINC
       this instance shows the concept. The other codes only have a LOINC code   -->
              <code>
                      <!--   LOINC - always recommended to have a LOINC code   -->
                      <coding>
                              <system value="http://loinc.org"/>
                              <code value="8480-6"/>
                              <display value="Systolic blood pressure"/>
                      </coding>
                      <!--   SNOMED CT Codes - becoming more common   -->
                      <coding>
                              <system value="http://snomed.info/sct"/>
                              <code value="271649006"/>
                              <display value="Systolic blood pressure"/>
                      </coding>
                      <!--   Also, a local code specific to the source system   -->
                      <coding>
                              <system value="http://acme.org/devices/clinical-codes"/>
                              <code value="bp-s"/>
                              <display value="Systolic Blood pressure"/>
                      </coding>
                      <!--   that shows the concept. The next two names only have a LOINC code   -->
              </code>
              <!--   no value due to some error
  <valueQuantity>
    <value value="107"/>
    <unit value="mm[Hg]"/>
  </valueQuantity>
-->
              <dataAbsentReason>
                      <coding>
                              <system value="http://hl7.org/fhir/data-absent-reason"/>
                              <code value="not-asked"/>
                              <display value="Not Asked"/>
                      </coding>
              </dataAbsentReason>
      </component>
      <component>
              <code>
                      <coding>
                              <system value="http://loinc.org"/>
                              <code value="8462-4"/>
                              <display value="Diastolic blood pressure"/>
                      </coding>
              </code>
              <!--   no value due to some error
  <valueQuantity>
    <value value="60"/>
    <unit value="mm[Hg]"/>
  </valueQuantity>
-->
              <dataAbsentReason>
                      <coding>
                              <system value="http://hl7.org/fhir/data-absent-reason"/>
                              <code value="not-asked"/>
                              <display value="Not Asked"/>
                      </coding>
              </dataAbsentReason>
      </component>

</Observation>