Observation
Overview
The Observation resource provides measurements or simple assertions about a patient that are useful for establishing baselines or trends, monitoring a patient’s progress, and establishing diagnoses. Most observations are simple name/value pair assertions 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 HL7® FHIR® US Core Implementation Guide STU 4.0.0 Profiles are supported by this resource:
- US Core Laboratory Result Observation Profile
- US Core Smoking Status Observation Profile
- US Core Vital Signs Profile
- US Core Blood Pressure Profile
- US Core BMI Profile
- US Core Body Height Profile
- US Core Body Temperature Profile
- US Core Body Weight Profile
- US Core Head Circumference Profile
- US Core Heart Rate Profile
- US Core Pediatric BMI for Age Observation Profile
- US Core Pediatric Head Occipital-frontal Circumference Percentile Profile
- US Core Pediatric Weight for Height Observation Profile
- US Core Pulse Oximetry Profile
- US Core Respiratory Rate Profile
The following fields are returned if valued:
- Id
- Identifier
- Status
- Category (laboratory, social history, vital-signs)
- Code (Observation name or text)
- Subject (Patient)
- Encounter
- Effective date/time (collection date/time for laboratory)
- Extensions
- Issued (date/time observation made available, entered, verified)
- Performer
- Observation value or result
- For Observations with
valueQuantity - For Observations with
valueCodeableConcept - Data absent reason
- Interpretation (abnormal flagging)
- Note (comments)
- Reference range
- Member Observations (for limited use cases)
- Component (eg: systolic and diastolic for blood pressure)
Terminology Bindings
| Observation.category |
|
| Observation.code |
|
| Observation.performer.extension |
|
| Observation.dataAbsentReason |
|
| Observation.valueCodeableConcept |
|
| Observation.interpretation |
|
| Observation.component.code |
|
| Observation.component.interpretation |
|
| Observation.component.dataAbsentReason |
|
Extensions
- convertedMeasurement This extension returns a converted measurement of a different measurement system than the original quantity.
- performerFunction
- valueAttachment: URL for this extension is defined as:
http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.valueAttachmentThis extension is defined and referenced from the newer version of FHIR. See Extensions for converting between versions and R5 Snapshot of Observation.value for more information.
Search
Search for labs, vitals, and alcohol/tobacco use Observations that meet supplied query parameters:
GET /Observation?:parameters
Authorization Types
Implementation Notes
-
The
commentsfield may have RTF or other formatted data rather than simple text. This is an issue that will be resolved in a future correction. We are investigating alternative solutions to fix this. -
Social History results won’t be affected by date and _lastUpdated parameters, results may contain social history records out of the given timeframe.
-
Searching records with vital-signs category by code with proprietary system will result in empty response.
-
When multiple pages of Observation results are returned for a single query:
- All Social history Observations (if any qualify for the query) will be returned on the first page of results. This means that the next bullet does not apply to Social history Observations.
- Results are sorted by effective date/time in descending order. That is, all Observations on any given page of results are newer than all Observations on the next page of results.
- If the query uses the
_lastUpdatedquery parameter, results are sorted by last updated date/time in descending order by page, not by effective date/time.
Parameters
| Name | Required? | Type | Description |
|---|---|---|---|
patient |
This or subject
|
reference |
The subject (Patient) that the observation is about. Example: patient=12345
|
subject |
This or patient
|
reference |
The subject (Patient) that the observation is about. Example: subject=Patient/12345 or subject:Patient=12345
|
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 and maximum 200 observations can be returned |
_revinclude |
No | token |
Provenance resource entries to be returned as part of the bundle. Example:_revinclude=Provenance:target |
Notes:
-
The
subjectparameter must represent a Patient resource and may use the:Patientmodifier. -
It is recommended to search by either
codeordate(or both). - The
codeparameter:-
May be a list of comma separated values.
-
Searches only
Observation.code. For example when fetching blood pressures the resource will be only be returned when the search is based on85354-9(Systolic and Diastolic BP). Using the component codes8480-6(Systolic BP)or8462-4 (Diastolic BP)will not return the resource.
-
-
The
dateand_lastUpdatedparameters may be provided up to two times, and must use theeq,ge,gt,le, orltprefixes. When a value is provided without a prefix, an impliedeqprefix is used. When provided twice, the lower value must have ageorgtprefix and the higher value must have anleorltprefix. -
The
dateand_lastUpdatedparameters may not be provided together. -
The
_lastUpdatedquery will only qualify clinically significant updates. For example, changes to the value or code, and other significant fields. Minor updates, like some non-clinically relevant note updates, will not qualify. - When
_countparameter is provided,- it won’t affect the first page, because all social history data will appear in the first page regardless of requested count.
- Maximum supported count = 200.
- Second page onward, returned item count may be less than requested.
-
The
_revincludeparameter may be provided once with the valueProvenance:target. Example:_revinclude=Provenance:target -
The
_revincludeparameter may be provided with thepatient/subjectparameter. Example:patient=12457977&category=vital-signs&_revinclude=Provenance:target - When
_revincludeis provided in a request to the closed endpoint, the OAuth2 token must include theuser/Provenance.readscope.
Headers
Accept: application/json+fhir
Authorization: <OAuth2 Bearer Token>Example
Request
GET https://fhir-open.cerner.com/r4/ec2458f2-1e24-41c8-b71b-0e701af7583d/Observation?patient=12724066
Response
Status: 200 OK{
"resourceType": "Bundle",
"id": "79c71e5b-2793-4ace-bc5e-190e38784e80",
"type": "searchset",
"link": [
{
"relation": "self",
"url": "https://fhir-open.cerner.com/r4/ec2458f2-1e24-41c8-b71b-0e701af7583d/Observation?patient=12724066"
}
],
"entry": [
{
"fullUrl": "https://fhir-open.cerner.com/r4/ec2458f2-1e24-41c8-b71b-0e701af7583d/Observation/SH-1-73080191",
"resource": {
"resourceType": "Observation",
"id": "SH-1-73080191",
"meta": {
"versionId": "73080191",
"lastUpdated": "2020-06-11T04:05:33.000Z"
},
"text": {
"status": "generated",
"div": "<div xmlns='http://www.w3.org/1999/xhtml'><p><b>Observation</b></p><p><b>Patient Id</b>: 12724066</p><p><b>Status</b>: Final</p><p><b>Categories</b>: Social History</p><p><b>Code</b>: Alcohol</p><p><b>Issued Date</b>: Jun 11, 2020 4:05 A.M. UTC</p></div>"
},
"status": "final",
"category": [
{
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "social-history",
"display": "Social History"
}
],
"text": "Social History"
}
],
"code": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "363905002",
"display": "Details of alcohol drinking behavior (observable entity)"
}
],
"text": "Alcohol"
},
"subject": {
"reference": "Patient/12724066"
},
"encounter": {
"reference": "Encounter/18565902"
},
"effectiveDateTime": "2022-06-01T10:39:02Z",
"issued": "2020-06-11T04:05:33.000Z",
"performer": [
{
"reference": "Practitioner/15441459"
}
],
"hasMember": [
{
"reference": "Observation/SH-73080191-q4625817"
},
{
"reference": "Observation/SH-73080191-q4625813"
}
]
}
},
{
"fullUrl": "https://fhir-open.cerner.com/r4/ec2458f2-1e24-41c8-b71b-0e701af7583d/Observation/SH-73080191-q4625817",
"resource": {
"resourceType": "Observation",
"id": "SH-73080191-q4625817",
"meta": {
"versionId": "73080191",
"lastUpdated": "2020-06-11T04:05:33.000Z"
},
"text": {
"status": "generated",
"div": "<div xmlns='http://www.w3.org/1999/xhtml'><p><b>Observation</b></p><p><b>Patient Id</b>: 12724066</p><p><b>Status</b>: Final</p><p><b>Categories</b>: Social History</p><p><b>Question</b>: SHX Alcohol use</p><p><b>Response</b>: Past</p><p><b>Issued Date</b>: Jun 11, 2020 4:05 A.M. UTC</p></div>"
},
"status": "final",
"category": [
{
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "social-history",
"display": "Social History"
}
],
"text": "Social History"
}
],
"code": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "363905002",
"display": "Details of alcohol drinking behavior (observable entity)"
}
],
"text": "SHX Alcohol use"
},
"subject": {
"reference": "Patient/12724066"
},
"encounter": {
"reference": "Encounter/18565902"
},
"effectiveDateTime": "2022-06-01T10:39:02Z",
"issued": "2020-06-11T04:05:33.000Z",
"performer": [
{
"reference": "Practitioner/15441459"
}
],
"valueCodeableConcept": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "410513005",
"display": "In the past (qualifier value)"
}
],
"text": "Past"
}
}
},
{
"fullUrl": "https://fhir-open.cerner.com/r4/ec2458f2-1e24-41c8-b71b-0e701af7583d/Observation/SH-73080191-q4625813",
"resource": {
"resourceType": "Observation",
"id": "SH-73080191-q4625813",
"meta": {
"versionId": "73080191",
"lastUpdated": "2020-06-11T04:05:33.000Z"
},
"text": {
"status": "generated",
"div": "<div xmlns='http://www.w3.org/1999/xhtml'><p><b>Observation</b></p><p><b>Patient Id</b>: 12724066</p><p><b>Status</b>: Final</p><p><b>Categories</b>: Social History</p><p><b>Question</b>: SHX Alcohol type</p><p><b>Response</b>: Liquor</p><p><b>Issued Date</b>: Jun 11, 2020 4:05 A.M. UTC</p></div>"
},
"status": "final",
"category": [
{
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "social-history",
"display": "Social History"
}
],
"text": "Social History"
}
],
"code": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "363905002",
"display": "Details of alcohol drinking behavior (observable entity)"
}
],
"text": "SHX Alcohol type"
},
"subject": {
"reference": "Patient/12724066"
},
"encounter": {
"reference": "Encounter/18565902"
},
"effectiveDateTime": "2022-06-01T10:39:02Z",
"issued": "2020-06-11T04:05:33.000Z",
"performer": [
{
"reference": "Practitioner/15441459"
}
],
"valueCodeableConcept": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "6524003",
"display": "Distilled spirits (substance)"
}
],
"text": "Liquor"
}
}
},
{
"fullUrl": "https://fhir-open.cerner.com/r4/ec2458f2-1e24-41c8-b71b-0e701af7583d/Observation/VS-CV-55046871-SECT-8098",
"resource": {
"resourceType": "Observation",
"id": "VS-CV-55046871-SECT-8098",
"meta": {
"versionId": "0",
"lastUpdated": "2022-06-17T10:41:35Z"
},
"text": {
"status": "generated",
"div": "<div xmlns=\\"http://www.w3.org/1999/xhtml\\"><p><b>Observation</b></p><p><b>Patient Id</b>: 15116458</p><p><b>Status</b>: Final</p><p><b>Categories</b>: Vital Signs</p><p><b>Code</b>: SpO2</p><p><b>Result</b>: 95 %</p><p><b>Effective Date</b>: Jun 5, 2022 3:00 A.M. CDT</p></div>"
},
"status": "final",
"category": [
{
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital Signs"
}
],
"text": "Vital Signs"
}
],
"code": {
"coding": [
{
"system": "https://fhir.cerner.com/eb2384f8-839e-4c6e-8b29-18e71db1a0b1/codeSet/72",
"code": "3623994",
"display": "SpO2",
"userSelected": true
},
{
"system": "http://loinc.org",
"code": "2708-6"
},
{
"system": "http://loinc.org",
"code": "59408-5"
}
],
"text": "SpO2"
},
"subject": {
"reference": "Patient/12724066"
},
"encounter": {
"reference": "Encounter/18565902"
},
"effectiveDateTime": "2022-06-05T08:00:38.000Z",
"issued": "2022-06-05T08:00:38Z",
"performer": [
{
"reference": "Practitioner/15441459"
}
],
"valueQuantity": {
"value": 95,
"unit": "%",
"system": "http://unitsofmeasure.org",
"code": "%"
},
"component": [
{
"code": {
"coding": [
{
"system": "https://fhir.cerner.com/eb2384f8-839e-4c6e-8b29-18e71db1a0b1/codeSet/72",
"code": "703569",
"display": "Oxygen Flow Rate",
"userSelected": true
},
{
"system": "http://loinc.org",
"code": "3151-8"
}
],
"text": "Oxygen Flow Rate"
},
"valueQuantity": {
"value": 7,
"unit": "L/min",
"system": "http://unitsofmeasure.org",
"code": "L/min"
}
},
{
"code": {
"coding": [
{
"system": "https://fhir.cerner.com/eb2384f8-839e-4c6e-8b29-18e71db1a0b1/codeSet/72",
"code": "2700657",
"display": "FIO2",
"userSelected": true
},
{
"system": "http://loinc.org",
"code": "3150-0",
"display": "Inhaled Oxygen concentration"
}
],
"text": "Inhaled Oxygen concentration"
},
"valueQuantity": {
"value": 21,
"unit": "%",
"system": "http://unitsofmeasure.org",
"code": "%"
}
}
]
}
},
{
"fullUrl": "https://fhir-open.cerner.com/r4/ec2458f2-1e24-41c8-b71b-0e701af7583d/Observation/VS-197292857",
"resource": {
"resourceType": "Observation",
"id": "VS-197292857",
"meta": {
"versionId": "1",
"lastUpdated": "2020-07-06T21:13:24.000Z"
},
"text": {
"status": "generated",
"div": "<div xmlns="http://www.w3.org/1999/xhtml"><p><b>Observation</b></p><p><b>Patient Id</b>: 12724066</p><p><b>Status</b>: Final</p><p><b>Categories</b>: Vital Signs</p><p><b>Code</b>: Temperature Axillary</p><p><b>Result</b>: 27 degC</p><p><b>Interpretation</b>: LOW</p><p><b>Effective Date</b>: Jul 6, 2020 9:11 P.M. UTC</p><p><b>Reference Range</b>: 35.2-36.7 degC</p></div>"
},
"identifier": [
{
"system": "https://fhir.cerner.com/ceuuid",
"value": "CE87caf4b7-9397-4667-9897-702218017c9e-197292857-2020070621132500"
}
],
"status": "final",
"category": [
{
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital Signs"
}
],
"text": "Vital Signs"
}
],
"code": {
"coding": [
{
"system": "https://fhir.cerner.com/ec2458f2-1e24-41c8-b71b-0e701af7583d/codeSet/72",
"code": "703535",
"display": "Temperature Axillary",
"userSelected": true
},
{
"system": "http://loinc.org",
"code": "8328-7"
},
{
"system": "http://loinc.org",
"code": "8310-5"
}
],
"text": "Temperature Axillary"
},
"subject": {
"reference": "Patient/12724066"
},
"encounter": {
"reference": "Encounter/97953477"
},
"effectiveDateTime": "2020-07-06T21:11:00.000Z",
"issued": "2020-07-06T21:13:23.000Z",
"performer": [
{
"extension": [
{
"valueCodeableConcept": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/v2-0912",
"code": "OP",
"display": "ordering provider"
}
],
"text": "ordering provider"
},
"url": "http://hl7.org/fhir/StructureDefinition/event-performerFunction"
}
],
"reference": "Practitioner/1994008"
},
{
"extension": [
{
"valueCodeableConcept": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/v3-ParticipationType",
"code": "LA",
"display": "legal authenticator"
}
],
"text": "legal authenticator"
},
"url": "http://hl7.org/fhir/StructureDefinition/event-performerFunction"
},
{
"valueCodeableConcept": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/v3-ParticipationType",
"code": "PPRF",
"display": "primary performer"
}
],
"text": "primary performer"
},
"url": "http://hl7.org/fhir/StructureDefinition/event-performerFunction"
}
],
"reference": "Practitioner/1974008"
}
],
"valueQuantity": {
"value": 27,
"unit": "degC",
"system": "http://unitsofmeasure.org",
"code": "Cel"
},
"interpretation": [
{
"coding": [
{
"system": "https://fhir.cerner.com/ec2458f2-1e24-41c8-b71b-0e701af7583d/codeSet/52",
"code": "211",
"display": "LOW",
"userSelected": true
},
{
"system": "http://terminology.hl7.org/CodeSystem/v3-ObservationInterpretation",
"code": "L",
"display": "Low"
}
],
"text": "LOW"
}
],
"referenceRange": [
{
"low": {
"value": 35.2,
"unit": "degC",
"system": "http://unitsofmeasure.org",
"code": "Cel"
},
"high": {
"value": 36.7,
"unit": "degC",
"system": "http://unitsofmeasure.org",
"code": "Cel"
},
"type": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/referencerange-meaning",
"code": "normal",
"display": "Normal Range"
}
],
"text": "Normal Range"
}
}
]
}
}
]
}Note: The examples provided here are non-normative and replaying them in the public sandbox is not guaranteed to yield the results shown on the site.
Example with RevInclude
Authorization Types
Request
GET https://fhir-ehr.cerner.com/r4/ec2458f2-1e24-41c8-b71b-0e701af7583d/Observation?patient=12457977&category=vital-signs&_revinclude=Provenance:target
Response
Status: 200 OK{
"resourceType": "Bundle",
"id": "79c71e5b-2793-4ace-bc5e-190e38784e80",
"type": "searchset",
"link": [
{
"relation": "self",
"url": "https://fhir-ehr.cerner.com/r4/ec2458f2-1e24-41c8-b71b-0e701af7583d/Observation?Observation?patient=12457977&category=vital-signs&_revinclude=Provenance%3Atarget"
}
],
"entry": [
{
"fullUrl": "https://fhir-ehr.cerner.com/r4/ec2458f2-1e24-41c8-b71b-0e701af7583d/Observation/VS-196190669",
"resource": {
"resourceType": "Observation",
"id": "VS-196190669",
"meta": {
"versionId": "2",
"lastUpdated": "2017-02-25T02:41:03.000Z"
},
"text": {
"status": "generated",
"div": "<div xmlns="http://www.w3.org/1999/xhtml"><p><b>Observation</b></p><p><b>Patient Id</b>:12457977</p><p><b>Status</b>: Entered in Error</p><p><b>Categories</b>: Vital Signs</p><p><b>Code</b>: Temperature Temporal Artery</p><p><b>Result</b>: 39 degC</p><p><b>Interpretation</b>: Normal</p><p><b>Effective Date</b>: Feb 24, 2017 8:37 P.M. CST</p><p><b>Reference Range</b>: 36-38 degC</p></div>"
},
"identifier": [
{
"system": "https://fhir.cerner.com/ceuuid",
"value": "CE87caf4b7-9397-4667-9897-702218017c9e-196190669-2017022502373000"
}
],
"status": "entered-in-error",
"category": [
{
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital Signs"
}
],
"text": "Vital Signs"
}
],
"code": {
"coding": [
{
"system": "https://fhir.cerner.com/ec2458f2-1e24-41c8-b71b-0e701af7583d/codeSet/72",
"code": "4157752",
"display": "Temperature Temporal Artery",
"userSelected": true
},
{
"system": "http://loinc.org",
"code": "75539-7"
},
{
"system": "http://loinc.org",
"code": "8310-5"
}
],
"text": "Temperature Temporal Artery"
},
"subject": {
"reference": "Patient/12457977"
},
"encounter": {
"reference": "Encounter/97697398"
},
"effectiveDateTime": "2017-02-25T02:37:00.000Z",
"issued": "2017-02-25T02:41:03.000Z",
"performer": [
{
"extension": [
{
"valueCodeableConcept": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/v3-ParticipationType",
"code": "LA",
"display": "legal authenticator"
}
],
"text": "legal authenticator"
},
"url": "http://hl7.org/fhir/StructureDefinition/event-performerFunction"
},
{
"valueCodeableConcept": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/v3-ParticipationType",
"code": "PPRF",
"display": "primary performer"
}
],
"text": "primary performer"
},
"url": "http://hl7.org/fhir/StructureDefinition/event-performerFunction"
}
],
"reference": "Practitioner/11638346"
}
],
"valueQuantity": {
"value": 39,
"unit": "degC",
"system": "http://unitsofmeasure.org",
"code": "Cel"
},
"interpretation": [
{
"coding": [
{
"system": "https://fhir.cerner.com/ec2458f2-1e24-41c8-b71b-0e701af7583d/codeSet/52",
"code": "214",
"userSelected": true
},
{
"system": "http://terminology.hl7.org/CodeSystem/v3-ObservationInterpretation",
"code": "N",
"display": "Normal"
}
]
}
],
"note": [
{
"authorReference": {
"reference": "Practitioner/11638346"
},
"time": "2017-02-25T02:41:03.000Z",
"text": "Other\\n"
}
],
"referenceRange": [
{
"low": {
"value": 36,
"unit": "degC",
"system": "http://unitsofmeasure.org",
"code": "Cel"
},
"high": {
"value": 38,
"unit": "degC",
"system": "http://unitsofmeasure.org",
"code": "Cel"
},
"type": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/referencerange-meaning",
"code": "normal",
"display": "Normal Range"
}
],
"text": "Normal Range"
}
}
]
},
"search": {
"mode": "match"
}
},
{
"fullUrl": "https://fhir-ehr.cerner.com/r4/ec2458f2-1e24-41c8-b71b-0e701af7583d/Provenance/vit-4",
"resource": {
"resourceType": "Provenance",
"id": "vit-4",
"meta": {
"versionId": "4",
"lastUpdated": "2020-12-03T16:28:02Z"
},
"text": {
"status": "generated",
"div": "<div xmlns='http://www.w3.org/1999/xhtml'><p><b>Provenance</b></p><p><b>Target</b>:</p><ul><li>Observation/VS-196190669</li></ul><p><b>Recorded</b>: Oct 25, 2019 9:57 A.M. CDT</p><p><b>Agents</b>:</p><dl><dt>Unknown</dt><dd><b>Agent Type</b>: Author</dd><dd><b>Agent Role</b>: Source</dd></dl><p><b>Entity Source</b>: DocumentReference/S-100</p></div>"
},
"target": [
{
"reference": "Observation/VS-196190669"
}
],
"recorded": "2019-10-25T14:57:43Z",
"agent": [
{
"type": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/provenance-participant-type",
"code": "author"
}
],
"text": "Author"
},
"role": [
{
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/contractsignertypecodes",
"code": "SOURCE"
}
],
"text": "Source"
}
],
"who": {
"reference": "Organization/101",
"display": "Unknown"
}
}
],
"entity": [
{
"role": "source",
"what": {
"reference": "DocumentReference/S-100"
}
}
]
},
"search": {
"mode": "include"
}
}
]
}Note: The examples provided here are non-normative and replaying them in the public sandbox is not guaranteed to yield the results shown on the site.
Patient Authorization Request
GET https://fhir-ehr.cerner.com/r4/ec2458f2-1e24-41c8-b71b-0e701af7583d/Observation?patient=12742400
Response
Status: 200 OK{
"resourceType": "Bundle",
"id": "4927bb8b-c8c9-43c4-8553-e21bac8ad557",
"type": "searchset",
"link": [
{
"relation": "self",
"url": "https://fhir-ehr.cerner.com/r4/ec2458f2-1e24-41c8-b71b-0e701af7583d/Observation?patient=12742400"
},
{
"relation": "next",
"url": "https://fhir-ehr.cerner.com/r4/ec2458f2-1e24-41c8-b71b-0e701af7583d/Observation?patient=12742400&-pageContext=T3BlblBsYXRmb3JtRmhpckNvbnRleHQ9dHJ1ZSZwYWdlQ29udGV4dD05YmVjN2M5My01ZmQyLTRjM2UtYjE2OS0yMTY0OTM0ZDFmODQmY29uY2VwdD1jaGFydGVkX29ic2VydmF0aW9u&-pageDirection=NEXT"
}
],
"entry": [
{
"fullUrl": "https://fhir-ehr.cerner.com/r4/ec2458f2-1e24-41c8-b71b-0e701af7583d/Observation/SH-81-73121985",
"resource": {
"resourceType": "Observation",
"id": "SH-81-73121985",
"meta": {
"versionId": "73121985",
"lastUpdated": "2020-12-11T16:38:37.000Z"
},
"text": {
"status": "generated",
"div": "<div xmlns="http://www.w3.org/1999/xhtml"><p><b>Observation</b></p><p><b>Patient Id</b>: 12742400</p><p><b>Status</b>: Final</p><p><b>Categories</b>: Social History</p><p><b>Code</b>: Substance Abuse</p><p><b>Issued Date</b>: Dec 11, 2020 4:38 P.M. UTC</p></div>"
},
"status": "final",
"category": [
{
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "social-history",
"display": "Social History"
}
],
"text": "Social History"
}
],
"code": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "363908000",
"display": "Details of drug misuse behavior (observable entity)"
}
],
"text": "Substance Abuse"
},
"subject": {
"reference": "Patient/12742400"
},
"encounter": {
"reference": "Encounter/18565902"
},
"effectiveDateTime": "2022-06-01T10:39:02Z",
"issued": "2020-12-11T16:38:37.000Z",
"hasMember": [
{
"reference": "Observation/SH-73121985-q4625833"
}
]
}
},
{
"fullUrl": "https://fhir-ehr.cerner.com/r4/ec2458f2-1e24-41c8-b71b-0e701af7583d/Observation/L-197412603",
"resource": {
"resourceType": "Observation",
"id": "L-197412603",
"text": {
"status": "generated",
"div": "<div xmlns="http://www.w3.org/1999/xhtml"><p><b>Observation</b></p><p><b>Patient Id</b>: 12742400</p><p><b>Status</b>: Preliminary</p><p><b>Code</b>: Hgb Bld-mCnc</p></div>"
},
"status": "preliminary",
"category": [
{
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "laboratory",
"display": "Laboratory"
}
],
"text": "Laboratory"
}
],
"code": {
"coding": [
{
"system": "https://fhir.cerner.com/ec2458f2-1e24-41c8-b71b-0e701af7583d/codeSet/72",
"code": "703535",
"display": "Hgb Bld-mCnc",
"userSelected": true
},
{
"system": "http://loinc.org",
"code": "718-7",
"display": "Hgb Bld-mCnc"
}
],
"text": "Hgb Bld-mCnc"
},
"subject": {
"reference": "Patient/12742400"
},
"effectiveDateTime": "2022-06-01T10:39:02Z",
"dataAbsentReason": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/data-absent-reason",
"code": "masked",
"display": "Masked"
}
],
"text": "Masked"
}
}
}
]
}Note: The examples provided here are non-normative and replaying them in the public sandbox is not guaranteed to yield the results shown on the site.
Patient Authorization Request For Entered in Error Status
GET https://fhir-ehr.cerner.com/r4/ec2458f2-1e24-41c8-b71b-0e701af7583d/Observation?patient=12742401
Response
Status: 200 OK{
"resourceType": "Bundle",
"id": "4927bb8b-c8c9-43c4-8553-e21bac8ad557",
"type": "searchset",
"link": [
{
"relation": "self",
"url": "https://fhir-ehr.cerner.com/r4/ec2458f2-1e24-41c8-b71b-0e701af7583d/Observation?patient=12742401"
},
{
"relation": "next",
"url": "https://fhir-ehr.cerner.com/r4/ec2458f2-1e24-41c8-b71b-0e701af7583d/Observation?patient=12742401&-pageContext=T3BlblBsYXRmb3JtRmhpckNvbnRleHQ9dHJ1ZSZwYWdlQ29udGV4dD05YmVjN2M5My01ZmQyLTRjM2UtYjE2OS0yMTY0OTM0ZDFmODQmY29uY2VwdD1jaGFydGVkX29ic2VydmF0aW9u&-pageDirection=NEXT"
}
],
"entry": [
{
"fullUrl": "https://fhir-ehr.cerner.com/r4/ec2458f2-1e24-41c8-b71b-0e701af7583d/Observation/L-197412603",
"resource": {
"resourceType": "Observation",
"id": "L-197412603",
"text": {
"status": "generated",
"div": "<div xmlns="http://www.w3.org/1999/xhtml"><p><b>Observation</b></p><p><b>Patient Id</b>: 12742401</p><p><b>Status</b>: Entered in Error</p><p><b>Code</b>: Error</p></div>"
},
"status": "entered-in-error ",
"category": [
{
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "laboratory",
"display": "Laboratory"
}
],
"text": "Laboratory"
}
],
"code": {
"coding": [
{
"system": "https://fhir.cerner.com/ec2458f2-1e24-41c8-b71b-0e701af7583d/codeSet/72",
"code": "703535",
"display": "Hgb Bld-mCnc",
"userSelected": true
},
{
"system": "http://loinc.org",
"code": "718-7",
"display": "Hgb Bld-mCnc"
}
],
"text": "Hgb Bld-mCnc"
},
"subject": {
"reference": "Patient/12742401"
},
"effectiveDateTime": "2022-06-01T10:38:02Z",
"dataAbsentReason": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/data-absent-reason",
"code": "error",
"display": "Error"
}
],
"text": "Error"
}
}
}
]
}Note: The examples provided here are non-normative and replaying them in the public sandbox is not guaranteed to yield the results shown on the site.
Errors
The common errors and OperationOutcomes may be returned.
Retrieve by id
List an individual Observation by its id:
GET /Observation/:id
Authorization Types
Implementation Notes
- Patient authorization read requests are working similarly to patient authorization search requests.
Example
Request
GET https://fhir-open.cerner.com/r4/ec2458f2-1e24-41c8-b71b-0e701af7583d/Observation/VS-197292857
Response
Status: 200 OK{
"fullUrl": "https://fhir-open.cerner.com/r4/ec2458f2-1e24-41c8-b71b-0e701af7583d/Observation/VS-197292857",
"resource": {
"resourceType": "Observation",
"id": "VS-197292857",
"meta": {
"versionId": "1",
"lastUpdated": "2020-07-06T21:13:24.000Z"
},
"text": {
"status": "generated",
"div": "<div xmlns="http://www.w3.org/1999/xhtml"><p><b>Observation</b></p><p><b>Patient Id</b>: 12724066</p><p><b>Status</b>: Final</p><p><b>Categories</b>: Vital Signs</p><p><b>Code</b>: Temperature Axillary</p><p><b>Result</b>: 27 degC</p><p><b>Interpretation</b>: LOW</p><p><b>Effective Date</b>: Jul 6, 2020 9:11 P.M. UTC</p><p><b>Reference Range</b>: 35.2-36.7 degC</p></div>"
},
"identifier": [
{
"system": "https://fhir.cerner.com/ceuuid",
"value": "CE87caf4b7-9397-4667-9897-702218017c9e-197292857-2020070621132500"
}
],
"status": "final",
"category": [
{
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital Signs"
}
],
"text": "Vital Signs"
}
],
"code": {
"coding": [
{
"system": "https://fhir.cerner.com/ec2458f2-1e24-41c8-b71b-0e701af7583d/codeSet/72",
"code": "703535",
"display": "Temperature Axillary",
"userSelected": true
},
{
"system": "http://loinc.org",
"code": "8328-7"
},
{
"system": "http://loinc.org",
"code": "8310-5"
}
],
"text": "Temperature Axillary"
},
"subject": {
"reference": "Patient/12724066"
},
"encounter": {
"reference": "Encounter/97953477"
},
"effectiveDateTime": "2020-07-06T21:11:00.000Z",
"issued": "2020-07-06T21:13:23.000Z",
"performer": [
{
"extension": [
{
"valueCodeableConcept": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/v2-0912",
"code": "OP",
"display": "ordering provider"
}
],
"text": "ordering provider"
},
"url": "http://hl7.org/fhir/StructureDefinition/event-performerFunction"
}
],
"reference": "Practitioner/1994008"
},
{
"extension": [
{
"valueCodeableConcept": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/v3-ParticipationType",
"code": "LA",
"display": "legal authenticator"
}
],
"text": "legal authenticator"
},
"url": "http://hl7.org/fhir/StructureDefinition/event-performerFunction"
},
{
"valueCodeableConcept": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/v3-ParticipationType",
"code": "PPRF",
"display": "primary performer"
}
],
"text": "primary performer"
},
"url": "http://hl7.org/fhir/StructureDefinition/event-performerFunction"
}
],
"reference": "Practitioner/1974008"
}
],
"valueQuantity": {
"value": 27,
"unit": "degC",
"system": "http://unitsofmeasure.org",
"code": "Cel"
},
"interpretation": [
{
"coding": [
{
"system": "https://fhir.cerner.com/ec2458f2-1e24-41c8-b71b-0e701af7583d/codeSet/52",
"code": "211",
"display": "LOW",
"userSelected": true
},
{
"system": "http://terminology.hl7.org/CodeSystem/v3-ObservationInterpretation",
"code": "L",
"display": "Low"
}
],
"text": "LOW"
}
],
"referenceRange": [
{
"low": {
"value": 35.2,
"unit": "degC",
"system": "http://unitsofmeasure.org",
"code": "Cel"
},
"high": {
"value": 36.7,
"unit": "degC",
"system": "http://unitsofmeasure.org",
"code": "Cel"
},
"type": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/referencerange-meaning",
"code": "normal",
"display": "Normal Range"
}
],
"text": "Normal Range"
}
}
]
}
}Note: The examples provided here are non-normative and replaying them in the public sandbox is not guaranteed to yield the results shown on the site.
Errors
The common errors and OperationOutcomes may be returned.
Create
Create a new Observation.
POST /Observation
Implementation Notes
- See Understand Supported Vital Signs in the FHIR Observation Resource for a list of vital signs that are supported for the create operation.
- Components are not currently supported when writing Blood Pressures.
- Individual systolic and diastolic components will be paired upon subsequent search or read as long as the blood pressures are paired in Millennium. See Configure Blood Pressure Event Set Pairing Hierarchy.
- Only the body fields mentioned below are supported. Unsupported fields will be ignored.
- Modifier fields should not be provided, and will cause the transaction to fail.
- Also supports creating observation with proprietary codes with the latest version of observation.
Authorization Types
Note:
- Vital Sign creates via a Provider persona requires an active relationship between the Provider and the Patient.
Headers
Authorization: <OAuth2 Bearer Token>
Content-Type: application/fhir+jsonBody Fields
| Name | Required | Type | |
|---|---|---|---|
resourceType
|
Yes |
string |
|
|
|||
status
|
Yes |
code |
|
|
|||
category
|
Yes |
List of CodeableConcept |
|
|
|||
code
|
Yes |
CodeableConcept |
|
|
|||
subject
|
Yes |
Reference |
|
|
|||
encounter
|
No |
Reference |
|
|
|||
effective[x]
|
Yes |
dateTime |
|
|
|||
issued
|
No |
instant |
|
|
|||
performer
|
No |
List of Reference |
|
|
|||
performer.extension
|
No |
performerFunction |
|
|
|||
value[x]
|
Yes |
Quantity | CodeableConcept | string | dateTime |
|
|
|||
interpretation
|
No |
List of CodeableConcept |
|
|
|||
note
|
No |
List of Annotation |
|
|
|||
referenceRange
|
No |
List of BackboneElement |
|
|
|||
referenceRange.low
|
No |
SimpleQuantity |
|
|
|||
referenceRange.high
|
No |
SimpleQuantity |
|
|
|||
referenceRange.text
|
No |
string |
|
|
|||
referenceRange.type
|
No |
CodeableConcept |
|
|
|||
Example
Request
POST https://fhir-ehr.cerner.com/r4/ec2458f2-1e24-41c8-b71b-0e701af7583d/Observation
Vitals Body Example
{
"resourceType": "Observation",
"status": "final",
"category": [
{
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital Signs"
}
],
"text": "Vital Signs"
}
],
"code": {
"coding": [
{
"system": "http://loinc.org",
"code": "8331-1"
}
],
"text": "Temperature Oral"
},
"subject": {
"reference": "Patient/12457981"
},
"encounter": {
"reference": "Encounter/97845408"
},
"effectiveDateTime": "2020-04-03T19:21:00.000Z",
"issued": "2020-04-03T19:21:40.000Z",
"performer": [
{
"extension": [
{
"valueCodeableConcept": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/v3-ParticipationType",
"code": "LA",
"display": "legal authenticator"
}
],
"text": "legal authenticator"
},
"url": "http://hl7.org/fhir/StructureDefinition/event-performerFunction"
}
],
"reference": "Practitioner/11638321"
}
],
"valueQuantity": {
"value": 37.2,
"unit": "degC",
"system": "http://unitsofmeasure.org",
"code": "Cel"
},
"interpretation": [
{
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/v3-ObservationInterpretation",
"code": "N",
"display": "Normal"
}
]
}
],
"note": [
{
"authorReference": {
"reference": "Practitioner/11638321"
},
"time": "2020-09-03T15:03:10.000Z",
"text": "No additional test require"
}
],
"referenceRange": [
{
"low": {
"value": 35.8,
"unit": "degC",
"system": "http://unitsofmeasure.org",
"code": "Cel"
},
"high": {
"value": 37.3,
"unit": "degC",
"system": "http://unitsofmeasure.org",
"code": "Cel"
},
"type": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/referencerange-meaning",
"code": "normal",
"display": "Normal Range"
}
],
"text": "Normal Range"
}
}
]
}Labs Body Example
{
"resourceType": "Observation",
"status": "final",
"category": [
{
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "laboratory",
"display": "Laboratory"
}
],
"text": "Laboratory"
}
],
"code": {
"coding": [
{
"system": "http://loinc.org",
"code": "718-7",
"display": "Hemoglobin [Mass/volume] in Blood"
}
],
"text": "Hemoglobin"
},
"subject": {
"reference": "Patient/2798003"
},
"encounter": {
"reference": "Encounter/2673896"
},
"issued": "2020-07-30T20:42:00.000Z",
"effectiveDateTime": "2020-07-30T20:42:00.000Z",
"performer": [
{
"reference": "Practitioner/1477926"
}
],
"valueQuantity": {
"value": 13.2,
"unit": "mg/dL",
"system": "http://unitsofmeasure.org",
"code": "mg/dL"
},
"interpretation": [
{
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/v3-ObservationInterpretation",
"code": "N",
"display": "Normal"
}
],
"text": "Normal"
}
],
"referenceRange": [
{
"low": {
"value": 12.0,
"unit": "g/dL",
"system": "http://unitsofmeasure.org",
"code": "g/dL"
},
"high": {
"value": 15.5,
"unit": "g/dL",
"system": "http://unitsofmeasure.org",
"code": "g/dL"
}
}
],
"note": [
{
"authorReference": {
"reference": "Practitioner/1477926"
},
"time": "2020-07-30T20:42:15.000Z",
"text": "Specimen slightly hemolyzed."
}
]
}Response
Status: 201 CreatedCache-Control: no-cache Content-Length: 0 Content-Type: text/html Date: Mon, 16 Nov 2020 22:05:40 GMT Etag: W/"1" Location: https://fhir-ehr.cerner.com/r4/ec2458f2-1e24-41c8-b71b-0e701af7583d/Observation/L-197392513 Last-Modified: Mon, 16 Nov 2020 22:05:40 GMT Vary: Origin X-Request-Id: 30a3177d-0987-460d-bb27-a5bb6303f03e
The ETag response header indicates the current If-Match version to use on a subsequent update.
Note: The examples provided here are non-normative and replaying them in the public sandbox is not guaranteed to yield the results shown on the site.
Errors
The common errors and OperationOutcomes may be returned.
Update
Update an existing Observation.
PUT /Observation/:id
Implementation Notes
- Currently only
laboratoryandvital-signsare supported. - Both read and write scopes are required.
- Updates on patient and category are not supported.
- See FHIR® Update for additional details about update operations.
Authorization Types
Note:
- Vital Sign updates via a Provider persona requires an active relationship between the Provider and the Patient.
Headers
Authorization: <OAuth2 Bearer Token>
Content-Type: application/fhir+json
If-Match: W/"<Current version of the Observation resource>"Body Fields
| Name | Required | Type | |
|---|---|---|---|
resourceType
|
Yes |
string |
|
|
|||
id
|
Yes |
id |
|
|
|||
identifier
|
No |
Identifier |
|
|
|||
status
|
Yes |
code |
|
|
|||
category
|
Yes |
List of CodeableConcept |
|
|
|||
code
|
Yes |
CodeableConcept |
|
|
|||
subject
|
Yes |
Reference |
|
|
|||
encounter
|
No |
Reference |
|
|
|||
effective[x]
|
Yes |
dateTime |
|
|
|||
issued
|
No |
instant |
|
|
|||
performer
|
No |
List of Reference |
|
|
|||
performer.extension
|
No |
performerFunction |
|
|
|||
value[x]
|
Yes |
Quantity | CodeableConcept | string | dateTime |
|
|
|||
interpretation
|
No |
List of CodeableConcept |
|
|
|||
note
|
No |
List of Annotation |
|
|
|||
referenceRange
|
No |
List of BackboneElement |
|
|
|||
referenceRange.low
|
No |
SimpleQuantity |
|
|
|||
referenceRange.high
|
No |
SimpleQuantity |
|
|
|||
referenceRange.text
|
No |
string |
|
|
|||
referenceRange.type
|
No |
CodeableConcept |
|
|
|||
Example
Request
PUT https://fhir-ehr.cerner.com/r4/ec2458f2-1e24-41c8-b71b-0e701af7583d/Observation/L-196186655
Labs Body Example
{
"resourceType": "Observation",
"id": "L-196186655",
"status": "corrected",
"meta": {
"source": "43ba6d6a-1006-4546-bf28-48d84a98dbb1"
},
"category": [
{
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "laboratory",
"display": "Laboratory"
}
],
"text": "Laboratory"
}
],
"code": {
"coding": [
{
"system": "https://fhir.cerner.com/ec2458f2-1e24-41c8-b71b-0e701af7583d/codeSet/72",
"code": "21704910",
"display": "Potassium Level",
"userSelected": true
}
],
"text": "Potassium Level"
},
"subject": {
"reference": "Patient/12457981"
},
"encounter": {
"reference": "Encounter/2673896"
},
"issued": "2020-07-30T20:42:00.000Z",
"effectiveDateTime": "2020-07-30T20:42:00.000Z",
"performer": [
{
"reference": "Practitioner/1477926"
}
],
"valueQuantity": {
"value": 13.2,
"unit": "mg/dL",
"system": "http://unitsofmeasure.org",
"code": "mg/dL"
},
"interpretation": [
{
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/v3-ObservationInterpretation",
"code": "N",
"display": "Normal"
}
],
"text": "Normal"
}
],
"referenceRange": [
{
"low": {
"value": 12.0,
"unit": "g/dL",
"system": "http://unitsofmeasure.org",
"code": "g/dL"
},
"high": {
"value": 15.5,
"unit": "g/dL",
"system": "http://unitsofmeasure.org",
"code": "g/dL"
}
}
],
"note": [
{
"authorReference": {
"reference": "Practitioner/1477926"
},
"time": "2020-07-30T20:42:15.000Z",
"text": "Specimen slightly hemolyzed."
}
]
}Vitals Body Example
{
"resourceType": "Observation",
"id": "VS-197356031",
"identifier": [
{
"system": "https://fhir.cerner.com/ceuuid",
"value": "CE87caf4b7-9397-4667-9897-702218017c9e-197356031-2021061619245900"
}
],
"status": "corrected",
"category": [
{
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital Signs"
}
],
"text": "Vital Signs"
}
],
"code": {
"coding": [
{
"system": "https://fhir.cerner.com/d242a518-4074-4bd4-a3a6-adfe0c5c1c51/codeSet/72",
"code": "703558",
"display": "Temperature Oral",
"userSelected": true
}
],
"text": "Temperature Oral"
},
"subject": {
"reference": "Patient/12457979"
},
"encounter": {
"reference": "Encounter/97787491"
},
"effectiveDateTime": "2020-07-04T07:15:00.000Z",
"issued": "2021-05-06T20:07:14.000Z",
"performer": [
{
"extension": [
{
"valueCodeableConcept": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/v3-ParticipationType",
"code": "LA",
"display": "legal authenticator"
}
],
"text": "legal authenticator"
},
"url": "http://hl7.org/fhir/StructureDefinition/event-performerFunction"
}
],
"reference": "Practitioner/1"
}
],
"valueQuantity": {
"value": 123,
"unit": "mmHg",
"system": "http://unitsofmeasure.org",
"code": "mm[Hg]"
}
}Response
Status: 200 OKCache-Control: no-cache Content-Length: 0 Content-Type: text/html Date: Thu, 19 Nov 2020 17:39:58 GMT Etag: W/"3" Last-Modified: Thu, 19 Nov 2020 17:39:58 GMT Vary: Origin X-Request-Id: f3c2b8d6-01d8-4dfc-b278-b67e76c7f834
The ETag response header indicates the current If-Match version to use on a subsequent update.
Note: The examples provided here are non-normative and replaying them in the public sandbox is not guaranteed to yield the results shown on the site.
Errors
The common errors and OperationOutcomes may be returned.