Vital Signs

Overview

Vital Signs are represented as an FHIR Observation resources, restricted by US Core Vital Signs Profile. Each specific vital sign should also conform to its own profile as it is listed below:

Supported Profiles

Vital Sign	US Core Profile	Observation LOINC code
Systolic\Diastolic blood pressure	US Core Blood Pressure Profile	85354-9
Heart Rate	US Core Heart Rate Profile	8867-4
Respiratory rate	US Core Respiratory Rate Profile	9279-1
Body temperature	US Core Body Temperature Profile	8310-5
Body height	US Core Body Height Profile	8302-2
Body weight	US Core Body Weight Profile	29463-7
Pulse oximetry	US Core Pulse Oximetry Profile	59408-5 and 2708-6
BMI Percentile (2 - 20 years)	US Core Pediatric BMI for Age Observation Profile	59576-9
Pediatric Weight for Height Observation (Birth - 36 Months)	US Core Pediatric Weight for Height Observation Profile	77606-2
Head Occipital-frontal Circumference Percentile (Birth - 36 Months)	US Core Pediatric Head Occipital-frontal Circumference Percentile Profile	8289-1

Each Observation has next elements:

• a status
• a category code of “vital-signs”
• a LOINC code, if available, which tells you what is being measured
• a patient
• a clinically relevant time

Each Observation must support:

• a result value
  • if the result value is a numeric quantity, a standard UCUM unit
• a reason if the value is absent*
• component results

Must support elements, mandatory and optional search parameters

Observation must support these elements:

• status
• Slices for category
  • category:VSCat
    • coding
      -system
      -code
• code
• subject
• effectiveDateTime
• valueQuantity
• dataAbsentReason
• component
  -code
  -valueQuantity
  -dataAbsentReason

The following search parameters and search parameter combinations SHALL be supported:

SHALL support searching for all Observation for a patient using the patient and category search parameters:

GET [base url]/Observation?patient={Type/}[id]&category=http://terminology.hl7.org/CodeSystem/observation-category|vital-signs

SHALL support searching using the combination of the patient and code search parameters:

• including optional support for OR search on code (e.g.code={system|}|{code},{system|}|{code},...)

GET [base url]/Observation?patient={Type/}[id]&code={system|}|{code}{,{system|}|{code},...}

SHALL support searching using the combination of the patient and category and date search parameters:

• including support for these date comparators: gt,lt,ge,le
• including optional support for AND search on date (e.g.date={date}&date={date}...)
  GET [base url]/Observation?patient={Type/}[id]&category=http://terminology.hl7.org/CodeSystem/observation-category|vital-signs&date={gt|lt|ge|le}{date}}

The following search parameters and search parameter combinations SHOULD be supported:
SHOULD support searching using the combination of the patient and category and status search parameters:

• including support for OR search on status (e.g.status={system|}|{code},{system|}|{code},...)

GET [base url]/Observation?patient={Type/}[id]&category=http://terminology.hl7.org/CodeSystem/observation-category|vital-signs&status={system|}|{code}

SHOULD support searching using the combination of the patient and code and date search parameters:

• including optional support for OR search on code (e.g.code={system|}|{code},{system|}|{code},...)
• including support for these date comparators: gt,lt,ge,le
• including optional support for AND search on date (e.g.date={date}&date={date}...)

GET [base url]/Observation?patient={Type/}[id]&code={system|}|{code},{system|}|{code},...}&date={gt|lt|ge|le}{date}

The response to any search operation is always a list of resources in a Bundle or an Operation Outcome.

Observation By Patient Id

Search for Observation by patient.

METHOD GET

[base url]/Observation?patient={Type/}[id]

PARAMS
[base url] - FHIR base url
[id] - Id for the Patient

HEADERS

The Authorization token SHALL be obtained during Authentication and Authorization process. Goto Authentication and Authorization for further details.

Header	Type	Required/Optional	Value
Authorization	string	required	'Bearer'

RESPONSES

Code	Description	Comment
200	OK	The request was processed successfully
400	Bad request	Invalid request parameters or FHIR operation outcome resource returned
401	Unauthorized	This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource
404	no Route matched with those values	The request was able to communicate with a given server, but the server could not find what was requested
500	Internal Server Error	The server has encountered a situation it doesn't know how to handle

EXAMPLE:

curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Observation?patient=Patient/c5137fa5-3216-b12a-cbbc-a0c6bef361g7' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'

Observation By Id

Get Observation by ID.

METHOD GET

[base url]/Observation/{id}

or

[base url]/Observation?_id={id}

PARAMS
[base url] - FHIR base url
{id} - Id for Observation resource

HEADERS

The Authorization token SHALL be obtained during Authentication and Authorization process. Goto Authentication and Authorization for further details.

Header	Type	Required/Optional	Value
Authorization	string	required	'Bearer'

RESPONSES

Code	Description	Comment
200	OK	The request was processed successfully
400	Bad request	Invalid request parameters or FHIR operation outcome resource returned
401	Unauthorized	This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource
404	no Route matched with those values	The request was able to communicate with a given server, but the server could not find what was requested
500	Internal Server Error	The server has encountered a situation it doesn't know how to handle

EXAMPLE:

curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Observation/c5137fa5-3216-b12a-cbbc-a0c6bef361g7' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'

Observation by patient and category

Get Observations for the specified patient and category search parameters:

METHOD GET

`GET [base url]/Observation?patient={Type/}[id]&category=http://terminology.hl7.org/CodeSystem/observation-category|vital-signs`

PARAMS
[base url] - FHIR base url
[id] - patient id
{Type/} - Type for the Reference. Example: Patient

HEADERS

The Authorization token SHALL be obtained during Authentication and Authorization process. Goto Authentication and Authorization for further details.

Header	Type	Required/Optional	Value
Authorization	string	required	'Bearer'

RESPONSES

Code	Description	Comment
200	OK	The request was processed successfully
400	Bad request	Invalid request parameters or FHIR operation outcome resource returned
401	Unauthorized	This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource
404	no Route matched with those values	The request was able to communicate with a given server, but the server could not find what was requested
500	Internal Server Error	The server has encountered a situation it doesn't know how to handle

EXAMPLE:

curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Observation?patient=Patient/fe1cd986-1ac7-4c26-b8b3-d632a48408fd&category=http://terminology.hl7.org/CodeSystem/observation-category|vital-signs' \
--header 'Authorization: Bearer 1239b275-909e-4754-8f73-1e411fd6769e'

Observation by patient and code

Get Observations for the specified patient and code search parameters:

METHOD GET

`GET [base url]/Observation?patient={Type/}[id]&code={system|}|{code}{,{system|}|{code},...}`

PARAMS
[base url] - FHIR base url
[id] - patient id
{Type/} - Type for the Reference. Example: Patient
{code} - observation code
{system|} - terminology system used to represend observation code

HEADERS

The Authorization token SHALL be obtained during Authentication and Authorization process. Goto Authentication and Authorization for further details.

Header	Type	Required/Optional	Value
Authorization	string	required	'Bearer'

RESPONSES

Code	Description	Comment
200	OK	The request was processed successfully
400	Bad request	Invalid request parameters or FHIR operation outcome resource returned
401	Unauthorized	This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource
404	no Route matched with those values	The request was able to communicate with a given server, but the server could not find what was requested
500	Internal Server Error	The server has encountered a situation it doesn't know how to handle

EXAMPLE:

curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Observation?patient=Patient/fe1cd986-1ac7-4c26-b8b3-d632a48408fd&code=http://loinc.org|8867-4,http://loinc.org|9279-1,http://loinc.org|85354-9' \
--header 'Authorization: Bearer 1239b275-909e-4754-8f73-1e411fd6769e'

Observation by patient and category and date search parameters

Get Observations for the specified patient and category and date search parameters:

METHOD GET

`GET [base url]/Observation?patient={Type/}[id]&category=http://terminology.hl7.org/CodeSystem/observation-category|vital-signs&date={gt|lt|ge|le}{date}`

PARAMS

[base url] - FHIR base url
[id] - patient id
{Type/} - Type for the Reference. Example: Patient
{date} - observation effective date
{gt|lt|ge|le} - prefix for date value

HEADERS

The Authorization token SHALL be obtained during Authentication and Authorization process. Goto Authentication and Authorization for further details.

Header	Type	Required/Optional	Value
Authorization	string	required	'Bearer'

RESPONSES

Code	Description	Comment
200	OK	The request was processed successfully
400	Bad request	Invalid request parameters or FHIR operation outcome resource returned
401	Unauthorized	This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource
404	no Route matched with those values	The request was able to communicate with a given server, but the server could not find what was requested
500	Internal Server Error	The server has encountered a situation it doesn't know how to handle

EXAMPLE:

curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Observation?patient=Patient/fe1cd986-1ac7-4c26-b8b3-d632a48408fd&category=http://terminology.hl7.org/CodeSystem/observation-category|vital-signs&date=ge2020-01-01T00:00:00Z' \
--header 'Authorization: Bearer 1239b275-909e-4754-8f73-1e411fd6769e'

Observation by patient and category and status search parameters

Get Observations for the specified patient and category and status search parameters::

METHOD GET

`GET [base url]/Observation?patient={Type/}[id]&category=http://terminology.hl7.org/CodeSystem/observation-category|vital-signs&status={system|}|{code}`

PARAMS

[base url] - FHIR base url
[id] - patient id
{Type/} - Type for the Reference. Example: Patient
{date} - observation effective date
{gt|lt|ge|le} - prefix for date value

HEADERS

The Authorization token SHALL be obtained during Authentication and Authorization process. Goto Authentication and Authorization for further details.

Header	Type	Required/Optional	Value
Authorization	string	required	'Bearer'

RESPONSES

Code	Description	Comment
200	OK	The request was processed successfully
400	Bad request	Invalid request parameters or FHIR operation outcome resource returned
401	Unauthorized	This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource
404	no Route matched with those values	The request was able to communicate with a given server, but the server could not find what was requested
500	Internal Server Error	The server has encountered a situation it doesn't know how to handle

EXAMPLE:

curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Observation?patient=Patient/fe1cd986-1ac7-4c26-b8b3-d632a48408fd&category=http://terminology.hl7.org/CodeSystem/observation-category|vital-signs&status=final' \
--header 'Authorization: Bearer 1239b275-909e-4754-8f73-1e411fd6769e'

Observation by patient and code and date search parameters

Get Observations for the specified patient and code and date search parameters:

METHOD GET

`GET [base url]/Observation?patient={Type/}[id]&code={system|}|{code},{system|}|{code},...}&date={gt|lt|ge|le}{date}`

PARAMS
[base url] - FHIR base url
[id] - patient id
{Type/} - Type for the Reference. Example: Patient
{date} - observation effective date
{gt|lt|ge|le} - prefix for date value
{code} - observation code
{system|} - terminology system used to represend observation code

HEADERS

The Authorization token SHALL be obtained during Authentication and Authorization process. Goto Authentication and Authorization for further details.

Header	Type	Required/Optional	Value
Authorization	string	required	'Bearer'

RESPONSES

Code	Description	Comment
200	OK	The request was processed successfully
400	Bad request	Invalid request parameters or FHIR operation outcome resource returned
401	Unauthorized	This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource
404	no Route matched with those values	The request was able to communicate with a given server, but the server could not find what was requested
500	Internal Server Error	The server has encountered a situation it doesn't know how to handle

EXAMPLE:

curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Observation?patient=Patient/fe1cd986-1ac7-4c26-b8b3-d632a48408fd&code=http://loinc.org|8867-4,http://loinc.org|9279-1,http://loinc.org|85354-9&date=ge2020-01-01T00:00:00Z' \
--header 'Authorization: Bearer 1239b275-909e-4754-8f73-1e411fd6769e'