Release 4

Observation-example-2minute-apgar-score.json

Orders and Observations Work GroupMaturity Level: N/AStandards Status: InformativeCompartments: Device, Encounter, Patient, Practitioner, RelatedPerson

Raw JSON (canonical form + also see JSON Format Specification)

Example of a 2 minute Apgar score with individual score as components

{
  "resourceType": "Observation",
  "id": "2minute-apgar-score",
  "text": {
    "status": "generated",
    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative with Details</b></p><p><b>id</b>: 2minute-apgar-score</p><p><b>contained</b>: </p><p><b>status</b>: final</p><p><b>category</b>: Survey <span>(Details : {http://terminology.hl7.org/CodeSystem/observation-category code 'survey' = 'Survey', given as 'Survey'})</span></p><p><b>code</b>: 2 minute Apgar Score <span>(Details : {LOINC code '9273-4' = '2 minute Apgar Score', given as '2 minute Apgar Score'})</span></p><p><b>subject</b>: id: newborn; 12345; active; Peter James Chalmers ; gender: male; birthDate: May 18, 2016</p><p><b>effective</b>: May 18, 2016 10:33:22 PM</p><p><b>performer</b>: <a>Practitioner/example</a></p><p><b>value</b>: 5 {score}<span> (Details: UCUM code {score} = '{score}')</span></p><blockquote><p><b>component</b></p><p><b>code</b>: Apgar color score <span>(Details : {SNOMED CT code '249227004' = 'Apgar color score', given as 'Apgar color score'})</span></p><p><b>value</b>: 1. Good color in body with bluish hands or feet <span>(Details : {LOINC code 'LA6723-6' = 'Good color in body with bluish hands or feet', given as 'Good color in body with bluish hands or feet'}; {http://acme.ped/apgarcolor code '1' = '1)</span></p></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: Apgar respiratory effort score <span>(Details : {SNOMED CT code '249223000' = 'Apgar heart rate score', given as 'Apgar heart rate score'})</span></p><p><b>value</b>: 1. Fewer than 100 beats per minute <span>(Details : {LOINC code 'LA6720-2' = 'Grimace during suctioning', given as 'Fewer than 100 beats per minute'}; {http://acme.ped/apgarheartrate code '1' = '1)</span></p></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: Apgar response to stimulus score <span>(Details : {SNOMED CT code '249226008' = 'Apgar response to stimulus score', given as 'Apgar response to stimulus score'})</span></p><p><b>value</b>: 1. Grimace during suctioning <span>(Details : {LOINC code 'LA6721-0' = 'Grimace and pulling away, cough, or sneeze during suctioning', given as 'Grimace during suctioning'}; {http://acme.ped/apgarreflexirritability code '1' = '1)</span></p></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: Apgar muscle tone score <span>(Details : {SNOMED CT code '249225007' = 'Apgar muscle tone score', given as 'Apgar muscle tone score'})</span></p><p><b>value</b>: 1. Some flexion of arms and legs <span>(Details : {LOINC code 'LA6714-5' = 'Some flexion of arms and legs', given as 'Some flexion of arms and legs'}; {http://acme.ped/apgarmuscletone code '1' = '1)</span></p></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: Apgar respiratory effort score <span>(Details : {SNOMED CT code '249224006' = 'Apgar respiratory effort score', given as 'Apgar respiratory effort score'})</span></p><p><b>value</b>: 1. Weak cry; may sound like whimpering, slow or irregular breathing <span>(Details : {LOINC code 'LA6726-9' = 'Weak cry; may sound like whimpering, slow or irregular breathing', given as 'Weak cry; may sound like whimpering, slow or irregular breathing'}; {http://acme.ped/apgarrespiratoryeffort code '1' = '1)</span></p></blockquote></div>"
  },
  "contained": [
    {
      "resourceType": "Patient",
      "id": "newborn",
      "identifier": [
        {
          "system": "http://acmehealthcare/org/mrns",
          "value": "12345"
        }
      ],
      "active": true,
      "name": [
        {
          "family": "Chalmers",
          "given": [
            "Peter",
            "James"
          ]
        }
      ],
      "gender": "male",
      "birthDate": "2016-05-18",
      "_birthDate": {
        "extension": [
          {
            "url": "http://hl7.org/fhir/StructureDefinition/patient-birthTime",
            "valueDateTime": "2016-05-18T10:28:45Z"
          }
        ]
      }
    }
  ],
  "status": "final",
  "category": [
    {
      "coding": [
        {
          "system": "http://terminology.hl7.org/CodeSystem/observation-category",
          "code": "survey",
          "display": "Survey"
        }
      ],
      "text": "Survey"
    }
  ],
  "code": {
    "coding": [
      {
        "system": "http://loinc.org",
        "code": "9273-4",
        "display": "2 minute Apgar Score"
      }
    ],
    "text": "2 minute Apgar Score"
  },
  "subject": {
    "reference": "#newborn"
  },
  "effectiveDateTime": "2016-05-18T22:33:22Z",
  "performer": [
    {
      "reference": "Practitioner/example"
    }
  ],
  "valueQuantity": {
    "value": 5,
    "system": "http://unitsofmeasure.org",
    "code": "{score}"
  },
  "component": [
    {
      "code": {
        "coding": [
          {
            "system": "http://snomed.info/sct",
            "code": "249227004",
            "display": "Apgar color score"
          }
        ],
        "text": "Apgar color score"
      },
      "valueCodeableConcept": {
        "coding": [
          {
            "extension": [
              {
                "url": "http://hl7.org/fhir/StructureDefinition/ordinalValue",
                "valueDecimal": 1
              }
            ],
            "system": "http://loinc.org",
            "code": "LA6723-6",
            "display": "Good color in body with bluish hands or feet"
          },
          {
            "system": "http://acme.ped/apgarcolor",
            "code": "1"
          }
        ],
        "text": "1. Good color in body with bluish hands or feet"
      }
    },
    {
      "code": {
        "coding": [
          {
            "system": "http://snomed.info/sct",
            "code": "249223000",
            "display": "Apgar heart rate score"
          }
        ],
        "text": "Apgar respiratory effort score"
      },
      "valueCodeableConcept": {
        "coding": [
          {
            "extension": [
              {
                "url": "http://hl7.org/fhir/StructureDefinition/ordinalValue",
                "valueDecimal": 1
              }
            ],
            "system": "http://loinc.org",
            "code": "LA6720-2",
            "display": "Fewer than 100 beats per minute"
          },
          {
            "system": "http://acme.ped/apgarheartrate",
            "code": "1"
          }
        ],
        "text": "1. Fewer than 100 beats per minute"
      }
    },
    {
      "code": {
        "coding": [
          {
            "system": "http://snomed.info/sct",
            "code": "249226008",
            "display": "Apgar response to stimulus score"
          }
        ],
        "text": "Apgar response to stimulus score"
      },
      "valueCodeableConcept": {
        "coding": [
          {
            "extension": [
              {
                "url": "http://hl7.org/fhir/StructureDefinition/ordinalValue",
                "valueDecimal": 1
              }
            ],
            "system": "http://loinc.org",
            "code": "LA6721-0",
            "display": "Grimace during suctioning"
          },
          {
            "system": "http://acme.ped/apgarreflexirritability",
            "code": "1"
          }
        ],
        "text": "1. Grimace during suctioning"
      }
    },
    {
      "code": {
        "coding": [
          {
            "system": "http://snomed.info/sct",
            "code": "249225007",
            "display": "Apgar muscle tone score"
          }
        ],
        "text": "Apgar muscle tone score"
      },
      "valueCodeableConcept": {
        "coding": [
          {
            "extension": [
              {
                "url": "http://hl7.org/fhir/StructureDefinition/ordinalValue",
                "valueDecimal": 1
              }
            ],
            "system": "http://loinc.org",
            "code": "LA6714-5",
            "display": "Some flexion of arms and legs"
          },
          {
            "system": "http://acme.ped/apgarmuscletone",
            "code": "1"
          }
        ],
        "text": "1. Some flexion of arms and legs"
      }
    },
    {
      "code": {
        "coding": [
          {
            "system": "http://snomed.info/sct",
            "code": "249224006",
            "display": "Apgar respiratory effort score"
          }
        ],
        "text": "Apgar respiratory effort score"
      },
      "valueCodeableConcept": {
        "coding": [
          {
            "extension": [
              {
                "url": "http://hl7.org/fhir/StructureDefinition/ordinalValue",
                "valueDecimal": 1
              }
            ],
            "system": "http://loinc.org",
            "code": "LA6726-9",
            "display": "Weak cry; may sound like whimpering, slow or irregular breathing"
          },
          {
            "system": "http://acme.ped/apgarrespiratoryeffort",
            "code": "1"
          }
        ],
        "text": "1. Weak cry; may sound like whimpering, slow or irregular breathing"
      }
    }
  ]
}

Usage note: every effort has been made to ensure that the examples are correct and useful, but they are not a normative part of the specification.