Observation

• Overview
• Terminology Bindings
• Custom Extensions
• Search
  • Parameters
  • Headers
  • Example
  • Errors and Informational messages

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:

• Temperature
• Systolic BP
• Diastolic BP
• Respiratory Rate
• Pulse (Heart Rate)
• SPO2
• Height
• Weight
• Inhaled O2 saturation

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.

Search

GET /Observation?:parameters

Implementation Notes

• The API returns the most current charted Observation list.
• The API returns values in reverse chronological order by the most currently charted date.
• The API returns charted content in final status. It will not return charted content that is marked as cancelled or entered-in-error.
• The Narrative includes additional information pertaining to the observation, and should be shown to the user to ensure completeness of clinical content and context.

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:

• See details regarding special date requirements.
• See details regarding pagination requirements.
• If the date parameter is null in the query, the API will return all qualifying records.
• If a single date parameter is used in the query, the response will include all qualifying records dated that day.
• If a valid date range is used in the query, the API will return all qualifying records within the dates specified.
• If an invalid date range is used in the query, the API will error with code 500. Please refer to Special information regarding date parameters.
• Developers are strongly encouraged to specify date ranges to prevent an inordinate number of records from being returned.

Headers

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

Example

Request

GET https://fhir-myrecord.sandboxcerner.com/dstu2/123abc/Observation?patientId=D4292B7B-AEDF-4CEF-B783-BD3AA1B0DD27

Response

Status: 200 OK

{
  "resourceType": "Bundle",
  "id": "9842e38b-38f4-4fd3-81aa-075d0b9ca5f1",
  "meta": {
    "lastUpdated": "2018-04-10T09:21:56.996-04:00"
  },
  "type": "searchset",
  "link": [
    {
      "relation": "self",
      "url": "https://fhir-myrecord.sandboxcerner.com/dstu2/0e885770-571b-4c0c-b30f-21df9a058d0d/Observation?patientId=D4292B7B-AEDF-4CEF-B783-BD3AA1B0DD27&_format=json&page=2"
    },
    {
      "relation": "next",
      "url": "https://fhir-myrecord.sandboxcerner.com/dstu2/0e885770-571b-4c0c-b30f-21df9a058d0d/Observation?patientId=D4292B7B-AEDF-4CEF-B783-BD3AA1B0DD27&_format=json&page=3"
    }
  ],
  "entry": [
    {
      "resource": {
        "resourceType": "Observation",
        "text": {
          "status": "additional",
          "div": "<ul ccdRefId="ZVitalSigns.Vital_Signs.63413.35246"><li>Weight : 88/ kg</li></ul>"
        },
        "identifier": [
          {
            "use": "official",
            "value": "ZVitalSigns.Vital_Signs.63413.35246"
          }
        ],
        "status": "final",
        "code": {
          "coding": [
            {
              "system": "http://loinc.org",
              "code": "3141-9",
              "display": "Wt"
            }
          ],
          "text": "Wt"
        },
        "subject": {
          "reference": "Patient/7568F2F3-FC76-4185-A540-1DB56331A387"
        },
        "effectiveDateTime": "2015-06-22",
        "valueQuantity": {
          "value": 88,
          "unit": "kg",
          "system": "http://unitsofmeasure.org/"
        }
      }
    },
    {
      "resource": {
        "resourceType": "Observation",
        "text": {
          "status": "additional",
          "div": "<ul ccdRefId="ZVitalSigns.Vital_Signs.63413.35248"><li>Inhaled Oxygen Concentration : 36</li></ul>"
        },
        "identifier": [
          {
            "use": "official",
            "value": "ZVitalSigns.Vital_Signs.63413.35248"
          }
        ],
        "status": "final",
        "code": {
          "coding": [
            {
              "system": "http://loinc.org",
              "code": "3150-0",
              "display": "A_FIO2%Act"
            }
          ],
          "text": "A_FIO2%Act"
        },
        "subject": {
          "reference": "Patient/7568F2F3-FC76-4185-A540-1DB56331A387"
        },
        "effectiveDateTime": "2015-06-22",
        "valueQuantity": {
          "value": 36,
          "unit": "%",
          "system": "http://unitsofmeasure.org/"
        }
      }
    },
    {
      "resource": {
        "resourceType": "Observation",
        "text": {
          "status": "additional",
          "div": "<ul ccdRefId="ZVitalSigns.Vital_Signs.63413.35250"><li>Body Temperature : 38 Cel</li></ul>"
        },
        "identifier": [
          {
            "use": "official",
            "value": "ZVitalSigns.Vital_Signs.63413.35250"
          }
        ],
        "status": "final",
        "code": {
          "coding": [
            {
              "system": "http://loinc.org",
              "code": "8310-5",
              "display": "A_Temperature"
            }
          ],
          "text": "A_Temperature"
        },
        "subject": {
          "reference": "Patient/7568F2F3-FC76-4185-A540-1DB56331A387"
        },
        "effectiveDateTime": "2015-06-22",
        "valueQuantity": {
          "value": 38,
          "unit": "Cel",
          "system": "http://unitsofmeasure.org/"
        }
      }
    },
    {
      "resource": {
        "resourceType": "Observation",
        "text": {
          "status": "additional",
          "div": "<ul ccdRefId="ZVitalSigns.Vital_Signs.63413.35260"><li>Respirations : 18</li></ul>"
        },
        "identifier": [
          {
            "use": "official",
            "value": "ZVitalSigns.Vital_Signs.63413.35260"
          }
        ],
        "status": "final",
        "code": {
          "coding": [
            {
              "system": "http://loinc.org",
              "code": "9279-1",
              "display": "A_Respirations"
            }
          ],
          "text": "A_Respirations"
        },
        "subject": {
          "reference": "Patient/7568F2F3-FC76-4185-A540-1DB56331A387"
        },
        "effectiveDateTime": "2015-06-22",
        "valueQuantity": {
          "value": 18,
          "unit": "/min",
          "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.
papi028	Provides the date range that had start date as null.
papi029	Provides the date range that was used to run the search.