Observation

Overview

For the Observation resource query,the API returns observation names and values for elements that the Soarian client has configured as appropriate for the API. The ONC (Office of the National Coordinator) CCDS (common clinical data set) definition includes at least two types of data relevant to this resource: smoking status and vital signs. The API will return any data, not marked as erroneous, the client has configured as relevant for the API. Note that ONC has clarified CCDS sex as the sex recorded at birth and this may be included in the Observation resource if client-configured as part of the social history template. Data is returned in the sequence defined for these sections. The configuration of qualifying data (data configured for social history and vital signs sections) is a single configuration that applies to both the API and the Consolidated Clinical Document Architecture (C-CDA) document, social history and vital signs sections, available to the patients.

The API handles vital signs similarly to results in the DiagnosticReport resource; the API returns vital sign names, values, and units of measure in reverse chronological order by charted date. Since each vital sign value is individually dated and the value is unambiguously relevant for that date, this resource supports date-based queries for vital signs. Vital signs include:

Social History data, such as smoking status, birth sex or any additional client-configured qualifying data, reflects a currently charted state and the most current values will always be returned. ONC requires specific smoking status values and codes which will be returned in the structured portion of the response; charted names will be represented in the narrative extension.

Terminology Bindings

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

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

Custom Extensions

The bundle extension can be returned, see possible codes in the errors section below.

GET /Observation?:parameters

Implementation Notes

Parameters

Name Required? Type Description
patientId Y reference The patient identifier provided in a pre-requisite authorization step.
date N date as adjusted per implementation notes Null or specific date or a date range.

Notes:

Headers

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

Example

Request

GET https://fhir-myrecord.sandboxcerner.com/dstu2/123abc/Observation?patientId=FCC941D7-60B9-491D-BEED-27629E47CD4E

Response

Status: 200 OK
{
  "resourceType": "Bundle",
  "id": "44900955-4315-4c77-a85e-8a8800677d3f",
  "meta": {
    "lastUpdated": "2017-05-30T02:44:10.364-04:00"
  },
  "extension": [
    {
      "url": "http://cerner.hs.fhir.com/StructureDefinition/bundle-result-messages",
      "valueExtension": {
        "url": "http://cerner.hs.fhir.com/StructureDefinition/bundle-result-messages",
        "extension": [
          {
            "url": "Severity",
            "valueString": "info"
          },
          {
            "url": "Code",
            "valueString": "papi029"
          },
          {
            "url": "Message",
            "valueString": "Information provided is from 2017-05-01 through 2017-05-30 inclusive."
          }
        ]
      }
    }
  ],
  "type": "searchset",
  "link": [
    {
      "relation": "self",
      "url": "base-url/bf615549-44cc-4899-bfa9-2cfd86bf358c/Observation?patientId=FCC941D7-60B9-491D-BEED-27629E47CD4E&_format=json"
    }
  ],
  "entry": [
    {
      "resource": {
        "resourceType": "Observation",
        "text": {
          "status": "additional",
          "div": "<ul ccdRefId=\"ZSocial_History.Social_History.121415.91005.value.0\"><li>Tobacco Use? : Light Tobacco Smoker</li></ul>"
        },
        "identifier": [
          {
            "use": "official",
            "value": "ZSocial_History.Social_History.121415.91005.value.0"
          }
        ],
        "status": "final",
        "code": {
          "coding": [
            {
              "system": "http://loinc.org",
              "code": "72166-2",
              "display": "A_Tobacco?"
            }
          ],
          "text": "A_Tobacco?"
        },
        "subject": {
          "reference": "Patient/FCC941D7-60B9-491D-BEED-27629E47CD4E"
        },
        "effectiveDateTime": "2017-05-23",
        "valueCodeableConcept": {
          "coding": [
            {
              "system": "http://snomed.info/sct",
              "code": "428061000124105",
              "display": "Light Tobacco Smoker"
            }
          ],
          "text": "Light Tobacco Smoker"
        }
      }
    },
    {
      "resource": {
        "resourceType": "Observation",
        "text": {
          "status": "additional",
          "div": "<ul ccdRefId=\"ZSocial_History.Social_History.117449.86444.value.0\"><li>Patient Birth Sex : Unknown</li></ul>"
        },
        "identifier": [
          {
            "use": "official",
            "value": "ZSocial_History.Social_History.117449.86444.value.0"
          }
        ],
        "status": "final",
        "code": {
          "coding": [
            {
              "system": "http://loinc.org",
              "code": "76689-9",
              "display": "Patient_BirthSex"
            }
          ],
          "text": "Patient_BirthSex"
        },
        "subject": {
          "reference": "Patient/FCC941D7-60B9-491D-BEED-27629E47CD4E"
        },
        "effectiveDateTime": "2017-04-21",
        "valueCodeableConcept": {
          "coding": [
            {
              "system": "http://hl7.org/fhir/v3/NullFlavor",
              "code": "UNK",
              "display": "Unknown"
            }
          ],
          "text": "Unknown"
        }
      }
    },
    {
      "resource": {
        "resourceType": "Observation",
        "text": {
          "status": "additional",
          "div": "<ul ccdRefId=\"ZVitalSigns.Vitals.121415.91009\"><li>A_Temperature : 97 F</li></ul>"
        },
        "identifier": [
          {
            "use": "official",
            "value": "ZVitalSigns.Vitals.121415.91009"
          }
        ],
        "status": "final",
        "code": {
          "coding": [
            {
              "system": "http://loinc.org",
              "code": "8310-5",
              "display": "A_Temperature"
            }
          ],
          "text": "A_Temperature"
        },
        "subject": {
          "reference": "Patient/FCC941D7-60B9-491D-BEED-27629E47CD4E"
        },
        "effectiveDateTime": "2017-05-23",
        "valueQuantity": {
          "value": 36.111154,
          "unit": "Cel",
          "system": "http://unitsofmeasure.org/"
        }
      }
    }
  ]
}

Errors and Informational messages

The common errors and informational messages can be returned.

These additional informational messages may be returned within the bundle extension:

Code Message
papi016 No relevant clinical data exists.