Observation

Overview

The Observation resource provides measurements or simple assertions about a patient. Observations are crucial to supporting diagnoses, monitoring progress, and establishing baselines or trends. Most observations are simply a name and value or result but some observations, such as blood pressure, group other observations together logically. Examples of common observations are: Laboratory results (blood sugar, hemoglobin), Vital signs (temperature, blood pressure), Personal characteristics (height, weight), and Social history (tobacco/alcohol use, employment status). Pathology reports, radiology reports, and other textual reports should be represented by the DiagnosticReport resource.

The following fields will be returned if valued:

Terminology Bindings

Observation.category
  • Description
    • Codes for high level observation categories.
  • Details: Observation Category Codes
    System: http://hl7.org/fhir/observation-category

Observation.code
  • Description
    • Codes identifying names of simple observations.
  • Details: LOINC
    System: http://loinc.org

  • Details: SNOMED CT
    System: http://snomed.info/sct

Observation.interpretation
  • Description
    • Codes identifying interpretations of observations.
  • Details: v2 Interpretation Codes
    System: http://hl7.org/fhir/v2/0078

Observation.component.code
  • Description
    • Codes identifying names of simple observations.
  • Details: LOINC
    System: http://loinc.org

  • Details: SNOMED CT
    System: http://snomed.info/sct

Search for labs, vitals, and alcohol/tobacco use Observations that meet supplied query parameters:

GET /Observation?:parameters

Implementation Notes

Authorization Types

Parameters

Name Required? Type Description
patient This or subject reference The subject that the observation is about (if patient). Example: patient=1316024
subject This or patient reference The subject (Patient) that the observation is about. Example: subject=Patient/1316024 or subject:Patient=1316024
code N token The code or component-code of the observation type. Example: code=http://loinc.org|3094-0,http://loinc.org|3139-3
date N date Date range into which the observation falls. Example: date=gt2014-09-24 or date=lt2015-09-24T12:00:00.000Z
_lastUpdated N date Date range in which the observation was last updated. Example: _lastUpdated=gt2014-09-24 or _lastUpdated=lt2015-09-24T12:00:00.000Z
category N token The category of observations. Example: category=laboratory
_count N number The maximum number of results to return per page. Defaults to 50. Capped at 100.

Notes:

Headers

Accept: application/json+fhir
Authorization: <OAuth2 Bearer Token>

Example

Request

GET https://fhir-open.sandboxcerner.com/dstu2/0b8a0111-e8e6-4c26-a91c-5069cbc6b1ca/Observation?patient=3998008

Response

Status: 200 OK
{
  "resourceType": "Bundle",
  "id": "41ac49a5-cfc1-4342-929f-2a1cad724d8a",
  "type": "searchset",
  "link": [
    {
      "relation": "self",
      "url": "https://fhir-open.sandboxcerner.com/dstu2/0b8a0111-e8e6-4c26-a91c-5069cbc6b1ca/Observation?patient=3998008&_count=50"
    }
  ],
  "entry": [
    {
      "fullUrl": "https://fhir-open.sandboxcerner.com/dstu2/0b8a0111-e8e6-4c26-a91c-5069cbc6b1ca/Observation/93-5525867",
      "resource": {
        "resourceType": "Observation",
        "id": "93-5525867",
        "meta": {
          "versionId": "1252402",
          "lastUpdated": "2016-01-26T21:58:41.000Z"
        },
        "status": "final",
        "category": {
          "coding": [
            {
              "system": "http://hl7.org/fhir/observation-category",
              "code": "social-history",
              "display": "Social History"
            }
          ],
          "text": "Social History"
        },
        "code": {
          "coding": [
            {
              "system": "http://snomed.info/sct",
              "code": "229819007",
              "display": "Tobacco use and exposure (observable entity)"
            },
            {
              "system": "http://loinc.org",
              "code": "72166-2",
              "display": "Tobacco smoking status NHIS"
            }
          ],
          "text": "Tobacco"
        },
        "subject": {
          "reference": "Patient/3998008"
        },
        "valueCodeableConcept": {
          "text": "Medium Risk"
        },
        "related": [
          {
            "type": "has-member",
            "target": {
              "reference": "Observation/5525867-q6930400"
            }
          },
          {
            "type": "has-member",
            "target": {
              "reference": "Observation/5525867-q6930404-0"
            }
          },
          {
            "type": "has-member",
            "target": {
              "reference": "Observation/5525867-q6930404-1"
            }
          },
          {
            "type": "has-member",
            "target": {
              "reference": "Observation/5525867-q6930316"
            }
          },
          {
            "type": "has-member",
            "target": {
              "reference": "Observation/5525867-q6930360"
            }
          },
          {
            "type": "has-member",
            "target": {
              "reference": "Observation/5525867-q6930372"
            }
          },
          {
            "type": "has-member",
            "target": {
              "reference": "Observation/5525867-q6930368"
            }
          },
          {
            "type": "has-member",
            "target": {
              "reference": "Observation/5525867-q6930376"
            }
          }
        ]
      }
    },
    {
      "fullUrl": "https://fhir-open.sandboxcerner.com/dstu2/0b8a0111-e8e6-4c26-a91c-5069cbc6b1ca/Observation/5525867-q6930400",
      "resource": {
        "resourceType": "Observation",
        "id": "5525867-q6930400",
        "meta": {
          "versionId": "1252402",
          "lastUpdated": "2016-01-26T21:58:41.000Z"
        },
        "status": "final",
        "category": {
          "coding": [
            {
              "system": "http://hl7.org/fhir/observation-category",
              "code": "social-history",
              "display": "Social History"
            }
          ],
          "text": "Social History"
        },
        "code": {
          "coding": [
            {
              "system": "http://loinc.org",
              "code": "72166-2"
            }
          ],
          "text": "SHX Tobacco use"
        },
        "subject": {
          "reference": "Patient/3998008"
        },
        "issued": "2016-01-26T21:58:41.000Z",
        "valueCodeableConcept": {
          "coding": [
            {
              "system": "http://snomed.info/sct",
              "code": "428041000124106",
              "display": "Occasional tobacco smoker (finding)"
            }
          ],
          "text": "Current some day smoker"
        }
      }
    },
    {
      "fullUrl": "https://fhir-open.sandboxcerner.com/dstu2/0b8a0111-e8e6-4c26-a91c-5069cbc6b1ca/Observation/5525867-q6930404-0",
      "resource": {
        "resourceType": "Observation",
        "id": "5525867-q6930404-0",
        "meta": {
          "versionId": "1252402",
          "lastUpdated": "2016-01-26T21:58:41.000Z"
        },
        "status": "final",
        "category": {
          "coding": [
            {
              "system": "http://hl7.org/fhir/observation-category",
              "code": "social-history",
              "display": "Social History"
            }
          ],
          "text": "Social History"
        },
        "code": {
          "text": "SHX Tobacco type"
        },
        "subject": {
          "reference": "Patient/3998008"
        },
        "issued": "2016-01-26T21:58:41.000Z",
        "valueCodeableConcept": {
          "text": "Cigarettes"
        }
      }
    },
    {
      "fullUrl": "https://fhir-open.sandboxcerner.com/dstu2/0b8a0111-e8e6-4c26-a91c-5069cbc6b1ca/Observation/5525867-q6930404-1",
      "resource": {
        "resourceType": "Observation",
        "id": "5525867-q6930404-1",
        "meta": {
          "versionId": "1252402",
          "lastUpdated": "2016-01-26T21:58:41.000Z"
        },
        "status": "final",
        "category": {
          "coding": [
            {
              "system": "http://hl7.org/fhir/observation-category",
              "code": "social-history",
              "display": "Social History"
            }
          ],
          "text": "Social History"
        },
        "code": {
          "text": "SHX Tobacco type"
        },
        "subject": {
          "reference": "Patient/3998008"
        },
        "issued": "2016-01-26T21:58:41.000Z",
        "valueCodeableConcept": {
          "text": "Chewing tobacco"
        }
      }
    },
    {
      "fullUrl": "https://fhir-open.sandboxcerner.com/dstu2/0b8a0111-e8e6-4c26-a91c-5069cbc6b1ca/Observation/5525867-q6930316",
      "resource": {
        "resourceType": "Observation",
        "id": "5525867-q6930316",
        "meta": {
          "versionId": "1252402",
          "lastUpdated": "2016-01-26T21:58:41.000Z"
        },
        "status": "final",
        "category": {
          "coding": [
            {
              "system": "http://hl7.org/fhir/observation-category",
              "code": "social-history",
              "display": "Social History"
            }
          ],
          "text": "Social History"
        },
        "code": {
          "text": "SHX Tobacco number of years"
        },
        "subject": {
          "reference": "Patient/3998008"
        },
        "issued": "2016-01-26T21:58:41.000Z",
        "valueString": "10"
      }
    },
    {
      "fullUrl": "https://fhir-open.sandboxcerner.com/dstu2/0b8a0111-e8e6-4c26-a91c-5069cbc6b1ca/Observation/5525867-q6930360",
      "resource": {
        "resourceType": "Observation",
        "id": "5525867-q6930360",
        "meta": {
          "versionId": "1252402",
          "lastUpdated": "2016-01-26T21:58:41.000Z"
        },
        "status": "final",
        "category": {
          "coding": [
            {
              "system": "http://hl7.org/fhir/observation-category",
              "code": "social-history",
              "display": "Social History"
            }
          ],
          "text": "Social History"
        },
        "code": {
          "text": "SHX Tobacco started at age"
        },
        "subject": {
          "reference": "Patient/3998008"
        },
        "issued": "2016-01-26T21:58:41.000Z",
        "valueString": "22 Years"
      }
    },
    {
      "fullUrl": "https://fhir-open.sandboxcerner.com/dstu2/0b8a0111-e8e6-4c26-a91c-5069cbc6b1ca/Observation/5525867-q6930372",
      "resource": {
        "resourceType": "Observation",
        "id": "5525867-q6930372",
        "meta": {
          "versionId": "1252402",
          "lastUpdated": "2016-01-26T21:58:41.000Z"
        },
        "status": "final",
        "category": {
          "coding": [
            {
              "system": "http://hl7.org/fhir/observation-category",
              "code": "social-history",
              "display": "Social History"
            }
          ],
          "text": "Social History"
        },
        "code": {
          "text": "SHX Tobacco readiness to change"
        },
        "subject": {
          "reference": "Patient/3998008"
        },
        "issued": "2016-01-26T21:58:41.000Z",
        "valueCodeableConcept": {
          "coding": [
            {
              "system": "http://snomed.info/sct",
              "code": "373067005",
              "display": "No (qualifier value)"
            }
          ],
          "text": "No"
        }
      }
    },
    {
      "fullUrl": "https://fhir-open.sandboxcerner.com/dstu2/0b8a0111-e8e6-4c26-a91c-5069cbc6b1ca/Observation/5525867-q6930368",
      "resource": {
        "resourceType": "Observation",
        "id": "5525867-q6930368",
        "meta": {
          "versionId": "1252402",
          "lastUpdated": "2016-01-26T21:58:41.000Z"
        },
        "status": "final",
        "category": {
          "coding": [
            {
              "system": "http://hl7.org/fhir/observation-category",
              "code": "social-history",
              "display": "Social History"
            }
          ],
          "text": "Social History"
        },
        "code": {
          "text": "SHX Tobacco previous treatment"
        },
        "subject": {
          "reference": "Patient/3998008"
        },
        "issued": "2016-01-26T21:58:41.000Z",
        "valueCodeableConcept": {
          "coding": [
            {
              "system": "http://snomed.info/sct",
              "code": "260413007",
              "display": "None (qualifier value)"
            }
          ],
          "text": "None"
        }
      }
    },
    {
      "fullUrl": "https://fhir-open.sandboxcerner.com/dstu2/0b8a0111-e8e6-4c26-a91c-5069cbc6b1ca/Observation/5525867-q6930376",
      "resource": {
        "resourceType": "Observation",
        "id": "5525867-q6930376",
        "meta": {
          "versionId": "1252402",
          "lastUpdated": "2016-01-26T21:58:41.000Z"
        },
        "status": "final",
        "category": {
          "coding": [
            {
              "system": "http://hl7.org/fhir/observation-category",
              "code": "social-history",
              "display": "Social History"
            }
          ],
          "text": "Social History"
        },
        "code": {
          "text": "SHX Tobacco household concerns"
        },
        "subject": {
          "reference": "Patient/3998008"
        },
        "issued": "2016-01-26T21:58:41.000Z",
        "valueCodeableConcept": {
          "coding": [
            {
              "system": "http://snomed.info/sct",
              "code": "373066001",
              "display": "Yes (qualifier value)"
            }
          ],
          "text": "Yes"
        }
      }
    },
    {
      "fullUrl": "https://fhir-open.sandboxcerner.com/dstu2/0b8a0111-e8e6-4c26-a91c-5069cbc6b1ca/Observation/93-a5525861",
      "resource": {
        "resourceType": "Observation",
        "id": "93-a5525861",
        "meta": {
          "versionId": "5525861",
          "lastUpdated": "2016-01-26T21:58:41.000Z"
        },
        "status": "final",
        "category": {
          "coding": [
            {
              "system": "http://hl7.org/fhir/observation-category",
              "code": "social-history",
              "display": "Social History"
            }
          ],
          "text": "Social History"
        },
        "code": {
          "coding": [
            {
              "system": "http://snomed.info/sct",
              "code": "229819007",
              "display": "Tobacco use and exposure (observable entity)"
            },
            {
              "system": "http://loinc.org",
              "code": "72166-2",
              "display": "Tobacco smoking status NHIS"
            }
          ],
          "text": "Tobacco"
        },
        "subject": {
          "reference": "Patient/3998008"
        },
        "valueCodeableConcept": {
          "text": "Medium Risk"
        }
      }
    },
    {
      "fullUrl": "https://fhir-open.sandboxcerner.com/dstu2/0b8a0111-e8e6-4c26-a91c-5069cbc6b1ca/Observation/BP-5851294-5851296",
      "resource": {
        "resourceType": "Observation",
        "id": "BP-5851294-5851296",
        "meta": {
          "versionId": "1-5851293-1-5851295",
          "lastUpdated": "2016-01-26T20:03:52.000Z"
        },
        "text": {
          "status": "generated",
          "div": "<div><p><b>Observation</b></p><p><b>Patient</b>: 3998008</p><p><b>Status</b>: final</p><p><b>Category</b>: Vital Signs</p><p><b>Code</b>: Systolic Blood Pressure: Systolic Blood Pressure Diastolic Blood Pressure: Diastolic Blood Pressure</p><p><b>Result</b>: Systolic Blood Pressure: 125 mmHg Diastolic Blood Pressure: 117 mmHg</p><p><b>Risk Level</b>: &gt;HHI</p><p><b>Date</b>: 2016-01-26T20:01:00.000Z</p><p><b>Risk Level Detail</b>: Systolic Blood Pressure: Low: 80 mmHg High: 120 mmHg Diastolic Blood Pressure: Low: 70 mmHg High: 80 mmHg</p></div>"
        },
        "status": "final",
        "category": {
          "coding": [
            {
              "system": "http://hl7.org/fhir/observation-category",
              "code": "vital-signs",
              "display": "Vital Signs"
            }
          ],
          "text": "Vital Signs"
        },
        "code": {
          "coding": [
            {
              "system": "http://snomed.info/sct",
              "code": "75367002",
              "display": "Blood pressure (observable entity)"
            },
            {
              "system": "http://loinc.org",
              "code": "55284-4",
              "display": "Blood pressure systolic and diastolic"
            }
          ],
          "text": "Blood pressure"
        },
        "subject": {
          "reference": "Patient/3998008"
        },
        "encounter": {
          "reference": "Encounter/3651924"
        },
        "effectiveDateTime": "2016-01-26T20:01:00.000Z",
        "issued": "2016-01-26T20:01:08.000Z",
        "interpretation": {
          "coding": [
            {
              "system": "http://hl7.org/fhir/v2/0078",
              "code": ">",
              "display": "Off scale high"
            }
          ],
          "text": ">HHI"
        },
        "component": [
          {
            "code": {
              "coding": [
                {
                  "system": "http://loinc.org",
                  "code": "8480-6",
                  "display": "INTRAVASCULAR SYSTOLIC:PRES:PT:ARTERIAL SYSTEM:QN:"
                },
                {
                  "system": "http://loinc.org",
                  "code": "8480-6",
                  "display": "Systolic blood pressure"
                }
              ],
              "text": "Systolic Blood Pressure"
            },
            "valueQuantity": {
              "value": 125,
              "unit": "mmHg",
              "system": "http://unitsofmeasure.org",
              "code": "mm[Hg]"
            },
            "referenceRange": [
              {
                "low": {
                  "value": 80,
                  "unit": "mmHg",
                  "system": "http://unitsofmeasure.org",
                  "code": "mm[Hg]"
                },
                "high": {
                  "value": 120,
                  "unit": "mmHg",
                  "system": "http://unitsofmeasure.org",
                  "code": "mm[Hg]"
                }
              }
            ]
          },
          {
            "code": {
              "coding": [
                {
                  "system": "http://loinc.org",
                  "code": "8462-4",
                  "display": "INTRAVASCULAR DIASTOLIC:PRES:PT:ARTERIAL SYSTEM:QN:"
                },
                {
                  "system": "http://loinc.org",
                  "code": "8462-4",
                  "display": "Diastolic blood pressure"
                }
              ],
              "text": "Diastolic Blood Pressure"
            },
            "valueQuantity": {
              "value": 117,
              "unit": "mmHg",
              "system": "http://unitsofmeasure.org",
              "code": "mm[Hg]"
            },
            "referenceRange": [
              {
                "low": {
                  "value": 70,
                  "unit": "mmHg",
                  "system": "http://unitsofmeasure.org",
                  "code": "mm[Hg]"
                },
                "high": {
                  "value": 80,
                  "unit": "mmHg",
                  "system": "http://unitsofmeasure.org",
                  "code": "mm[Hg]"
                }
              }
            ]
          }
        ]
      }
    },
    {
      "fullUrl": "https://fhir-open.sandboxcerner.com/dstu2/0b8a0111-e8e6-4c26-a91c-5069cbc6b1ca/Observation/M5851276",
      "resource": {
        "resourceType": "Observation",
        "id": "M5851276",
        "meta": {
          "versionId": "1-5851275",
          "lastUpdated": "2016-01-26T19:54:14.000Z"
        },
        "text": {
          "status": "generated",
          "div": "<div><p><b>Observation</b></p><p><b>Patient</b>: 3998008</p><p><b>Status</b>: Auth (Verified)</p><p><b>Category</b>: Laboratory</p><p><b>Code</b>: RBC</p><p><b>Result</b>: 5 x10(3)/mcL</p><p><b>Risk Level</b>: Normal</p><p><b>Date</b>: 2016-01-26T19:41:00.000Z</p><p><b>Risk Level Detail</b>: Low: 4 x10(3)/mcL High: 6 x10(3)/mcL</p></div>"
        },
        "status": "final",
        "category": {
          "coding": [
            {
              "system": "http://hl7.org/fhir/observation-category",
              "code": "laboratory",
              "display": "Laboratory"
            }
          ],
          "text": "Laboratory"
        },
        "code": {
          "coding": [
            {
              "system": "http://loinc.org",
              "code": "789-8",
              "display": "ERYTHROCYTES:NCNC:PT:BLD:QN:AUTOMATED COUNT"
            }
          ],
          "text": "RBC"
        },
        "subject": {
          "reference": "Patient/3998008"
        },
        "encounter": {
          "reference": "Encounter/3651924"
        },
        "effectiveDateTime": "2016-01-26T19:41:00.000Z",
        "issued": "2016-01-26T19:54:07.000Z",
        "valueQuantity": {
          "value": 5,
          "unit": "x10(3)/mcL",
          "system": "http://unitsofmeasure.org",
          "code": "10*3/uL"
        },
        "interpretation": {
          "coding": [
            {
              "system": "http://hl7.org/fhir/v2/0078",
              "code": "N",
              "display": "Normal"
            }
          ]
        },
        "comments": "{\\rtf1\\ansi\\ansicpg1252\\uc0\\deff0{\\fonttbl\r\n{\\f0\\fswiss\\fcharset0\\fprq2 Arial;}\r\n{\\f1\\froman\\fcharset2\\fprq2 Symbol;}}\r\n{\\colortbl;\\red0\\green0\\blue0;\\red255\\green255\\blue255;}\r\n{\\*\\generator TX_RTF32 10.1.323.501;}\r\n\\deftab1134\\pard\\plain\\f0\\fs24\\cb2\\chshdng0\\chcfpat0\\chcbpat2 This is interpretative data for RBC.  This should apply to all routed to service resources.\\par\\pard\\par }",
        "referenceRange": [
          {
            "low": {
              "value": 4,
              "unit": "x10(3)/mcL",
              "system": "http://unitsofmeasure.org",
              "code": "10*3/uL"
            },
            "high": {
              "value": 6,
              "unit": "x10(3)/mcL",
              "system": "http://unitsofmeasure.org",
              "code": "10*3/uL"
            }
          }
        ]
      }
    }
  ]
}

Errors

The common errors may be returned.