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=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:

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.