<?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 'vital-signs' = 'Vital Signs', given as 'Vital Signs'})</span></p><p><b>code</b>: Blood pressure systolic & diastolic <span>(Details : {LOINC code '85354-9' = 'lood pressure panel with all children optional', given as 'Bood pressure panel with all children optional'})</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 'L' = 'Low', given as 'low'})</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 '368209003' = 'Right upper arm', given as 'Right arm'})</span></p><blockquote><p><b>component</b></p><p><b>code</b>: Systolic blood pressure <span>(Details : {LOINC code '8480-6' = 'Systolic blood pressure', given as 'Systolic blood pressure'}; {SNOMED CT code '271649006' = 'Systolic blood pressure', given as 'Systolic blood pressure'}; {http://acme.org/devices/clinical-codes code 'bp-s' = 'bp-s', given as 'Systolic Blood pressure'})</span></p><p><b>dataAbsentReason</b>: Not Asked <span>(Details : {http://hl7.org/fhir/data-absent-reason code 'not-asked' = 'Not Asked', given as 'Not Asked'})</span></p></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: Diastolic blood pressure <span>(Details : {LOINC code '8462-4' = 'Diastolic blood pressure', given as 'Diastolic blood pressure'})</span></p><p><b>dataAbsentReason</b>: Not Asked <span>(Details : {http://hl7.org/fhir/data-absent-reason code 'not-asked' = 'Not Asked', given as 'Not Asked'})</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 & 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 & 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>