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:
- Id
- Status
- Category (laboratory, social history)
- Patient
- Patient encounter
- Effective date/time (collection date/time for laboratory)
- Issue date/time (date/time observation made available, entered, verified)
- Observation (name or text)
- Observation value or result
- For Observations with
valueQuantity
- Interpretation (abnormal flagging)
- Reference range
- Comments
- Related Observations (currently for limited use cases)
- Components (eg: systolic and diastolic for blood pressure)
Terminology Bindings
Observation.category |
|
Observation.code |
Observation.interpretation |
|
Observation.component.code |
Search
Search for labs, vitals, and alcohol/tobacco use Observations that meet supplied query parameters:
GET /Observation?:parameters
Implementation Notes
-
Currently, the
comments
field may have RTF or other formatted data rather than simple text. This is an issue that will be resolved in R4. -
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 by page. That is, all Observations on any given page of results are newer than all Observations on the next page of results. Sort order within pages is not guaranteed.
- If the query uses the
_lastUpdated
query parameter, results are sorted by last updated date/time in descending order by page, not by effective date/time.
Authorization Types
Parameters
Name | Required? | Type | Description |
---|---|---|---|
patient |
This or subject
|
reference |
The subject that the observation is about (if patient). 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 . Capped at 100 . |
Notes:
-
The
subject
parameter must represent a Patient resource and may use the:Patient
modifier. -
It is recommended to search by either
code
ordate
(or both). - The
code
parameter:- May be a list of comma separated values. A system must be provided for each code.
- Searches Observation.code and Observation.component.code.
-
The
date
and_lastUpdated
parameters may be provided up to two times, and must use theeq
,ge
,gt
,le
, orlt
prefixes. When a value is provided without a prefix, an impliedeq
prefix is used. When provided twice, the lower value must have age
orgt
prefix and the higher value must have anle
orlt
prefix. -
The
date
and_lastUpdated
parameters may not be provided together. - The
_lastUpdated
query 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.
Headers
Accept: application/json+fhir
Authorization: <OAuth2 Bearer Token>
Example
Request
GET https://fhir-open.cerner.com/dstu2/ec2458f2-1e24-41c8-b71b-0e701af7583d/Observation?patient=12724067
Response
Status: 200 OK
{
"resourceType": "Bundle",
"id": "32633969-4644-4075-8403-3c2169cb3ce1",
"type": "searchset",
"link": [
{
"relation": "self",
"url": "https://fhir-open.cerner.com/dstu2/ec2458f2-1e24-41c8-b71b-0e701af7583d/Observation?patient=12724067&_count=50"
}
],
"entry": [
{
"fullUrl": "https://fhir-open.cerner.com/dstu2/ec2458f2-1e24-41c8-b71b-0e701af7583d/Observation/93-73033575",
"resource": {
"resourceType": "Observation",
"id": "93-73033575",
"meta": {
"versionId": "73033575",
"lastUpdated": "2019-12-26T19:25:58.000Z"
},
"text": {
"status": "generated",
"div": "<div><p><b>Observation</b></p><p><b>Patient</b>: 12724067</p><p><b>Date</b>: Dec 26, 2019 7:25 P.M. UTC</p><p><b>Status</b>: Final</p><p><b>Category</b>: Social History</p><p><b>Code</b>: Tobacco</p></div>"
},
"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"
}
],
"text": "Tobacco"
},
"subject": {
"reference": "Patient/12724067"
},
"issued": "2019-12-26T19:25:58.000Z",
"dataAbsentReason": {
"coding": [
{
"system": "http://hl7.org/fhir/data-absent-reason",
"code": "unknown",
"display": "Unknown"
}
],
"text": "Unknown"
},
"related": [
{
"type": "has-member",
"target": {
"reference": "Observation/73033575-q4625825"
}
}
]
}
},
{
"fullUrl": "https://fhir-open.cerner.com/dstu2/ec2458f2-1e24-41c8-b71b-0e701af7583d/Observation/73033575-q4625825",
"resource": {
"resourceType": "Observation",
"id": "73033575-q4625825",
"meta": {
"versionId": "73033575",
"lastUpdated": "2019-12-26T19:25:58.000Z"
},
"text": {
"status": "generated",
"div": "<div><p><b>Observation</b></p><p><b>Patient</b>: 12724067</p><p><b>Date</b>: Dec 26, 2019 7:25 P.M. UTC</p><p><b>Status</b>: Final</p><p><b>Category</b>: Social History</p><p><b>Question</b>: SHX Tobacco use</p><p><b>Response</b>: Never (less than 100 in lifetime)</p></div>"
},
"status": "final",
"category": {
"coding": [
{
"system": "http://hl7.org/fhir/observation-category",
"code": "social-history",
"display": "Social History"
}
],
"text": "Social History"
},
"code": {
"text": "SHX Tobacco use"
},
"subject": {
"reference": "Patient/12724067"
},
"issued": "2019-12-26T19:25:58.000Z",
"valueCodeableConcept": {
"text": "Never (less than 100 in lifetime)"
}
}
},
{
"fullUrl": "https://fhir-open.cerner.com/dstu2/ec2458f2-1e24-41c8-b71b-0e701af7583d/Observation/M197281704",
"resource": {
"resourceType": "Observation",
"id": "M197281704",
"meta": {
"versionId": "1-197281703",
"lastUpdated": "2020-03-13T16:29:54.000Z"
},
"text": {
"status": "generated",
"div": "<div><p><b>Observation</b></p><p><b>Patient</b>: 12724067</p><p><b>Status</b>: Final</p><p><b>Category</b>: Laboratory</p><p><b>Code</b>: Estimated Creatinine Clearance</p><p><b>Result</b>: 122.60 mL/min</p><p><b>Date</b>: Mar 13, 2020 4:29 P.M. UTC</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": "2164-2"
}
],
"text": "Estimated Creatinine Clearance"
},
"subject": {
"reference": "Patient/12724067"
},
"encounter": {
"reference": "Encounter/97953480"
},
"effectiveDateTime": "2020-03-13T16:29:54.000Z",
"issued": "2020-03-13T16:29:54.000Z",
"valueQuantity": {
"value": 122.6,
"unit": "mL/min",
"system": "http://unitsofmeasure.org",
"code": "mL/min"
}
}
},
{
"fullUrl": "https://fhir-open.cerner.com/dstu2/ec2458f2-1e24-41c8-b71b-0e701af7583d/Observation/BP-197198008-197198010",
"resource": {
"resourceType": "Observation",
"id": "BP-197198008-197198010",
"meta": {
"versionId": "1-197198007-1-197198009",
"lastUpdated": "2019-12-26T19:23:27.000Z"
},
"text": {
"status": "generated",
"div": "<div><p><b>Observation</b></p><p><b>Patient</b>: 12724067</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: 138 mmHg Diastolic Blood Pressure: 90 mmHg</p><p><b>Risk Level</b>: Normal</p><p><b>Date</b>: Dec 26, 2019 7:23 P.M. UTC</p><p><b>Risk Level Detail</b>: Systolic Blood Pressure: 90-140 mmHg Diastolic Blood Pressure: 60-90 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"
}
],
"text": "Blood pressure"
},
"subject": {
"reference": "Patient/12724067"
},
"encounter": {
"reference": "Encounter/97939521"
},
"effectiveDateTime": "2019-12-26T19:23:00.000Z",
"issued": "2019-12-26T19:23:23.000Z",
"interpretation": {
"coding": [
{
"system": "http://hl7.org/fhir/v2/0078",
"code": "N",
"display": "Normal"
}
]
},
"component": [
{
"code": {
"coding": [
{
"system": "http://loinc.org",
"code": "8480-6"
}
],
"text": "Systolic Blood Pressure"
},
"valueQuantity": {
"value": 138,
"unit": "mmHg",
"system": "http://unitsofmeasure.org",
"code": "mm[Hg]"
},
"referenceRange": [
{
"low": {
"value": 90,
"unit": "mmHg",
"system": "http://unitsofmeasure.org",
"code": "mm[Hg]"
},
"high": {
"value": 140,
"unit": "mmHg",
"system": "http://unitsofmeasure.org",
"code": "mm[Hg]"
},
"text": "90-140 mmHg"
}
]
},
{
"code": {
"coding": [
{
"system": "http://loinc.org",
"code": "8462-4"
},
{
"system": "http://loinc.org",
"code": "8462-4"
}
],
"text": "Diastolic Blood Pressure"
},
"valueQuantity": {
"value": 90,
"unit": "mmHg",
"system": "http://unitsofmeasure.org",
"code": "mm[Hg]"
},
"referenceRange": [
{
"low": {
"value": 60,
"unit": "mmHg",
"system": "http://unitsofmeasure.org",
"code": "mm[Hg]"
},
"high": {
"value": 90,
"unit": "mmHg",
"system": "http://unitsofmeasure.org",
"code": "mm[Hg]"
},
"text": "60-90 mmHg"
}
]
}
]
}
},
{
"fullUrl": "https://fhir-open.cerner.com/dstu2/ec2458f2-1e24-41c8-b71b-0e701af7583d/Observation/M197198002",
"resource": {
"resourceType": "Observation",
"id": "M197198002",
"meta": {
"versionId": "1-197198001",
"lastUpdated": "2019-12-26T19:23:12.000Z"
},
"text": {
"status": "generated",
"div": "<div><p><b>Observation</b></p><p><b>Patient</b>: 12724067</p><p><b>Status</b>: Final</p><p><b>Category</b>: Vital Signs</p><p><b>Code</b>: Height/Length Measured</p><p><b>Result</b>: 180 cm</p><p><b>Date</b>: Dec 26, 2019 7:21 P.M. UTC</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://loinc.org",
"code": "3137-7"
}
],
"text": "Height/Length Measured"
},
"subject": {
"reference": "Patient/12724067"
},
"encounter": {
"reference": "Encounter/97939521"
},
"effectiveDateTime": "2019-12-26T19:21:00.000Z",
"issued": "2019-12-26T19:22:59.000Z",
"valueQuantity": {
"value": 180,
"unit": "cm",
"system": "http://unitsofmeasure.org",
"code": "cm"
}
}
}
]
}
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.