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 fields are returned if valued:

Terminology Bindings

Observation.category
  • Description
    • Codes for high level observation categories.
  • Details: Observation Category Codes
    System: http://terminology.hl7.org/CodeSystem/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

  • Details: Millennium Clinical Event Code
    System: https://fhir.cerner.com/<EHR source id>/codeSet/72

Observation.performer.extension
  • Description
    • Codes identifying the function of the performer.
  • Details: Performer function codes
    System: http://terminology.hl7.org/CodeSystem/v3-ParticipationType

  • Details: Participation codes
    System: http://terminology.hl7.org/CodeSystem/v2-0912

Observation.dataAbsentReason
  • Description
    • Codes for reasons data is absent.
  • Details: v4 data absentreason
    System: http://terminology.hl7.org/CodeSystem/data-absent-reason

Observation.valueCodeableConcept
  • Description
    • Codes for value of the observation.
  • Details: SNOMED CT
    System: http://snomed.info/sct

Observation.interpretation
  • Description
    • Codes identifying interpretations of observations.
  • Details: v3 Interpretation Codes
    System: http://terminology.hl7.org/CodeSystem/v3-ObservationInterpretation

  • Details: Interpretation Result
    System: https://fhir.cerner.com/<EHR source id>/codeSet/52

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

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

  • Details: Millennium Clinical Event Code
    System: https://fhir.cerner.com/<EHR source id>/codeSet/72

Observation.component.interpretation
  • Description
    • Codes identifying interpretations of observations.
  • Details: v3 Interpretation Codes
    System: http://terminology.hl7.org/CodeSystem/v3-ObservationInterpretation

  • Details: Interpretation Result
    System: https://fhir.cerner.com/<EHR source id>/codeSet/52

Observation.component.dataAbsentReason
  • Description
    • Codes for reasons data is absent.
  • Details: v4 data absentreason
    System: http://terminology.hl7.org/CodeSystem/data-absent-reason

Extensions

Search for labs, vitals, and alcohol/tobacco use Observations that meet supplied query parameters:

GET /Observation?:parameters

Authorization Types

Implementation Notes

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.
_revinclude No token Provenance resource entries to be returned as part of the bundle. Example:_revinclude=Provenance:target

Notes:

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"
        },
        "issued": "2020-06-11T04:05:33.000Z",
        "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"
        },
        "issued": "2020-06-11T04:05:33.000Z",
        "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"
        },
        "issued": "2020-06-11T04:05:33.000Z",
        "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/M-197292857",
      "resource": {
        "resourceType": "Observation",
        "id": "M-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"
          }
        ],
        "basedOn": [
          {
            "reference": "ServiceRequest/313764715"
          }
        ],
        "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/M-196190669",
      "resource": {
        "resourceType": "Observation",
        "id": "M-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/M-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/M-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"
        },
        "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/M-197412603",
      "resource": {
        "resourceType": "Observation",
        "id": "M-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>: Masked</p></div>"
        },
        "status": "preliminary",
        "category": [
          {
            "extension": [
              {
                "valueCode": "unknown",
                "url": "http://hl7.org/fhir/StructureDefinition/data-absent-reason"
              }
            ]
          }
        ],
        "code": {
          "coding": [
            {
              "system": "http://terminology.hl7.org/CodeSystem/data-absent-reason",
              "code": "masked",
              "display": "Masked"
            }
          ],
          "text": "Masked"
        },
        "subject": {
          "reference": "Patient/12742400"
        },
        "_effectiveDateTime": {
          "extension": [
            {
              "valueCode": "unknown",
              "url": "http://hl7.org/fhir/StructureDefinition/data-absent-reason"
            }
          ]
        },
        "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/M-197412603",
      "resource": {
        "resourceType": "Observation",
        "id": "M-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": [
          {
            "extension": [
              {
                "valueCode": "error",
                "url": "http://hl7.org/fhir/StructureDefinition/data-absent-reason"
              }
            ]
          }
        ],
        "code": {
          "coding": [
            {
              "system": "http://terminology.hl7.org/CodeSystem/data-absent-reason",
              "code": "error",
              "display": "Error"
            }
          ],
          "text": "Error"
        },
        "subject": {
          "reference": "Patient/12742401"
        },
        "_effectiveDateTime": {
          "extension": [
            {
              "valueCode": "error",
              "url": "http://hl7.org/fhir/StructureDefinition/data-absent-reason"
            }
          ]
        },
        "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

Example

Request

GET https://fhir-open.cerner.com/r4/ec2458f2-1e24-41c8-b71b-0e701af7583d/Observation/M-197292857

Response

Status: 200 OK
{
  "fullUrl": "https://fhir-open.cerner.com/r4/ec2458f2-1e24-41c8-b71b-0e701af7583d/Observation/M-197292857",
  "resource": {
    "resourceType": "Observation",
    "id": "M-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"
      }
    ],
    "basedOn": [
      {
        "reference": "ServiceRequest/313764715"
      }
    ],
    "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

Authorization Types

Provider (Vital Signs and Laboratory) | System (Vital Signs and Laboratory)

Note:

Headers

Authorization: <OAuth2 Bearer Token>
Content-Type: application/fhir+json

Body Fields

Name Required Type
resourceType Yes string
  • Description
    • The type of the FHIR resource.
  • Example
    • {
        "resourceType": "Observation"
      }
      
  • Notes
      • resourceType must be Observation.
status Yes code
  • Description
    • Codes identifying the lifecycle stage of an event.
  • Example
    • {
        "status": "final"
      }
      
  • Notes
      • Status codes final, amended and corrected are supported.
category Yes List of CodeableConcept
  • Description
    • A code that classifies the general type of observation being made.
  • Example
    • {
        "category": [
          {
            "coding": [
              {
                "system": 'http://terminology.hl7.org/CodeSystem/observation-category',
                "code": 'vital-signs',
                "display": 'Vital Signs'
              }
            ],
            "text": 'Vital Signs'
          }
        ]
      }
      
  • Notes
      • Vital Signs and Laboratory categories are supported.
      • Only one category may be supplied on create.
code Yes CodeableConcept
  • Description
    • Describes what was observed. Sometimes this is called the observation "name".
  • Example
    • {
        "code": {
          "coding": [
            {
              "system": 'http://loinc.org',
              "code": '8331-1'
            }
          ],
          "text": 'Temperature Oral'
        }
      }
      
  • Example
    • {
        "code": {
          "coding": [
            {
              "system": 'http://loinc.org',
              "code": '8302-2'
            },
            {
              "system": 'http://loinc.org',
              "code": '3137-7'
            }
          ],
          "text": 'Height/Length Measured'
        }
      }
      
subject Yes Reference
  • Description
    • Indicates the patient who the observation record is associated with.
  • Example
    • {
        "subject": {
          "reference": "Patient/631923"
        }
      }
      
  • Notes
      • Must only include references to Patient.
encounter No Reference
  • Description
    • Encounter during which the observation was first made.
  • Example
    • {
        "encounter": {
          "reference": "Encounter/631923"
        }
      }
      
effective[x] Yes dateTime
  • Description
    • Date and time the observation was made.
  • Example
    • {
        "effectiveDateTime": "2020-07-07T20:37:00.000Z"
      }
      
  • Notes
      • Only a type of dateTime is supported.
issued No instant
  • Description
    • Instant the observation was made.
  • Example
    • {
        "issued": "2020-07-06T21:02:47.000Z"
      }
      
performer No List of Reference
  • Description
    • Limited to "real" people rather than equipment.
  • Example
    • {
      "performer": [
          {
              "reference": 'Practitioner/12724064'
            }
        ]
      }
      
  • Notes
      • Must be a reference to Practitioner.
      • Vital Signs require performer.
performer.extension No performerFunction
  • Description
    • Distinguishes the type of involvement of the performer in the event.
  • Example
    • {
         "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'
           }
         ],
       }
      
  • Example
    • {
         "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"
            },
            {
               "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"
            },
            {
               "valueCodeableConcept":{
                  "coding":[
                     {
                        "system":"http://terminology.hl7.org/CodeSystem/v3-ParticipationType",
                        "code":"PRF",
                        "display":"performer"
                     }
                  ],
                  "text":"performer"
               },
               "url":"http://hl7.org/fhir/StructureDefinition/event-performerFunction"
            },
            {
               "valueCodeableConcept":{
                  "coding":[
                     {
                        "system":"http://terminology.hl7.org/CodeSystem/v3-ParticipationType",
                        "code":"AUTHEN",
                        "display":"authenticator"
                     }
                  ],
                  "text":"authenticator"
               },
               "url":"http://hl7.org/fhir/StructureDefinition/event-performerFunction"
            }
         ]
      }
      
  • Notes
      • Vital Signs supports LA and PPRF codes.
        • When only one performer is provided, the code must be LA.
        • When multiple performers are provided, then the code must be LA for one of the performers.
      • Laboratory supports LA , PPRF , PRF , OP and AUTHEN codes.
value[x] Yes Quantity | CodeableConcept | string | dateTime
  • Description
    • Value of the observation.
  • Example
    • {
        "valueQuantity":
        {
          "value": 162,
          "unit": 'cm',
          "system": 'http://unitsofmeasure.org',
          "code": 'cm'
        }
      }
      
  • Example
    • {
        "valueCodeableConcept": {
          "coding": [
            {
              "system": 'http://snomed.info/sct',
              "code": '373066001',
              "display": 'Yes (qualifier value)'
            }
          ],
          "text": 'Yes'
        }
      }
      
  • Example
    • {
        "valueString": '2'
      }
      
  • Example
    • {
        "valueDateTime": '2020-07-04T07:15:00Z'
      }
      
  • Notes
      • Vital Signs support writing observations with valueQuantity
      • Laboratory support valueQuantity, valueCodeableConcept, valueString and valueDateTime.
interpretation No List of CodeableConcept
  • Description
    • A categorical assessment of an observation value. For example, high, low, normal.
  • Example
    • {
        "interpretation": [
          {
            "coding": [
              {
                "system": 'https://fhir.cerner.com/ec2458f2-1e24-41c8-b71b-0e701af7583d/codeSet/52',
                "code": '211',
                "display": 'LOW',
                "userSelected": true
              }
            ],
            "text": 'LOW'
          }
        ]
      }
      
  • Example
    • {
        "interpretation": [
          {
            "coding": [
              {
                {
                  "system": 'http://terminology.hl7.org/CodeSystem/v3-ObservationInterpretation',
                  "code": 'L',
                  "display": 'Low'
                }
              ],
              "text": 'LOW'
            }
          ]
        }
      
  • Notes
      • Only one interpretation may be supplied.
note No List of Annotation
  • Description
    • Comments about the observation
  • Example
    • {
        "note": [
          {
            "authorReference": {
              "reference": 'Practitioner/62955753'
            },
            "time": '2018-08-17T09:55:42.000Z',
            "text": 'Charted at Incorrect Time'
          }
        ]
      }
      
referenceRange No List of BackboneElement
  • Description
    • Provides guidance for interpretating the observation.
  • Example
    • {
        "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'
            }
          }
        ]
      }
      
  • Notes
      • Only one referenceRange is supported
      • ReferenceRange.text is not supported when referenceRange.high and/or referenceRange.low are provided. Only a referenceRange.type of normal is supported.
referenceRange.low No SimpleQuantity
  • Description
    • Lower bound of the reference range.
  • Example
    • {
        "low": {
          "value": 35.2,
          "unit": 'degC',
          "system": 'http://unitsofmeasure.org',
          "code": 'Cel'
        }
      }
      
referenceRange.high No SimpleQuantity
  • Description
    • Upper bound of the reference range.
  • Example
    • {
        "low": {
          "value": 36.7,
          "unit": 'degC',
          "system": 'http://unitsofmeasure.org',
          "code": 'Cel'
        }
      }
      
referenceRange.text No string
  • Description
    • Text based reference range in an observation which may be used when a quantitative range is not appropriate for an observation.
  • Example
    • {
        "text": 'Negative'
      }
      
referenceRange.type No CodeableConcept
  • Description
    • Codes to indicate the what part of the targeted reference population it applies to.
  • Example
    • {
        "type": {
          "coding": [
            {
              "system": 'http://terminology.hl7.org/CodeSystem/referencerange-meaning',
              "code": 'normal',
              "display": 'Normal Range'
            }
          ],
          "text": 'Normal Range'
        }
      }
      
  • Notes
      • Only a ReferenceRange.type of normal is supported

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 Created
Cache-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/M-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

Authorization Types

Note:

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
  • Description
    • The type of the FHIR resource.
  • Example
    • {
        "resourceType": "Observation"
      }
      
  • Notes
      • resourceType must be Observation.
id Yes id
  • Description
    • The logical id of the resource to update.
  • Example
    • {
        "id": "M-197391609"
      }
      
  • Notes
    • The id value must match the Observation/<id> value.
identifier No Identifier
  • Description
    • A unique identifier assigned to the observation.
  • Example
    • {
        "system":"https://fhir.cerner.com/ceuuid",
        "value":"CE87caf4b7-9397-4667-9897-702218017c9e-197356031-2021061619245900"
      }
      
  • Notes
    • Identifier is required for Vital Signs and it can't be modified. Identifier is optional for Laboratory
status Yes code
  • Description
    • Codes identifying the lifecycle stage of an event.
  • Example
    • {
        "status": "corrected"
      }
      
  • Notes
      • Status codes amended and corrected are supported.
category Yes List of CodeableConcept
  • Description
    • A code that classifies the general type of observation being made.
  • Example
    • {
        "category": [
          {
            "coding": [
              {
                "system": 'http://terminology.hl7.org/CodeSystem/observation-category',
                "code": 'laboratory',
                "display": 'Laboratory'
              }
            ],
            "text": 'Laboratory'
          }
        ]
      }
      
  • Example
    • {
        "category": [
          {
            "coding": [
              {
                "system": 'http://terminology.hl7.org/CodeSystem/observation-category',
                "code": 'vital-signs',
                "display": 'Vital Signs'
              }
            ],
            "text": 'Vital Signs'
          }
        ]
      }
      
  • Notes
      • Updating a category is not allowed.
code Yes CodeableConcept
  • Description
    • Describes what was observed. Sometimes this is called the observation "name".
  • Example
    • {
        "code": {
          "coding": [
            {
              "system": "https://fhir.cerner.com/ec2458f2-1e24-41c8-b71b-0e701af7583d/codeSet/72",
              "code": "21704910",
              "display": "Potassium Level",
              "userSelected": true
            }
          ],
          "text": 'Potassium Level'
        }
      }
      
  • Example
    • {
        "code": {
          "coding": [
            {
                "system": "http://loinc.org",
                "code": "2823-3"
            }
        ],
        "text": "Potassium Level"
        }
      }
      
subject Yes Reference
  • Description
    • Indicates the patient who the observation record is associated with.
  • Example
    • {
        "subject": {
          "reference": "Patient/631923"
        }
      }
      
  • Notes
      • Must only include references to Patient.
      • Updates on Patient reference is not allowed.
encounter No Reference
  • Description
    • Encounter during which the observation was first made.
  • Example
    • {
        "encounter": {
          "reference": "Encounter/631923"
        }
      }
      
effective[x] Yes dateTime
  • Description
    • Date and time the observation was made.
  • Example
    • {
        "effectiveDateTime": "2020-07-07T20:37:00.000Z"
      }
      
  • Notes
      • Only a type of dateTime is supported.
issued No instant
  • Description
    • Instant the observation was made.
  • Example
    • {
        "issued": "2020-07-06T21:02:47.000Z"
      }
      
performer No List of Reference
  • Description
    • Limited to "real" people rather than equipment.
  • Example
    • {
      "performer": [
          {
              "reference": 'Practitioner/12724064'
            }
        ]
      }
      
  • Notes
      • Must be a reference to Practitioner.
performer.extension No performerFunction
  • Description
    • Distinguishes the type of involvement of the performer in the event.
  • Example
    • {
         "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'
           }
         ],
       }
      
  • Example
    • {
      "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"
         },
         {
            "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"
         },
         {
            "valueCodeableConcept":{
               "coding":[
                  {
                     "system":"http://terminology.hl7.org/CodeSystem/v3-ParticipationType",
                     "code":"PRF",
                     "display":"performer"
                  }
               ],
               "text":"performer"
            },
            "url":"http://hl7.org/fhir/StructureDefinition/event-performerFunction"
         },
         {
            "valueCodeableConcept":{
               "coding":[
                  {
                     "system":"http://terminology.hl7.org/CodeSystem/v3-ParticipationType",
                     "code":"AUTHEN",
                     "display":"authenticator"
                  }
               ],
               "text":"authenticator"
            },
            "url":"http://hl7.org/fhir/StructureDefinition/event-performerFunction"
         }
      ]
      }
      
  • Notes
      • Vital Signs supports LA and PPRF codes.
      • Laboratory supports LA , `PRF , PPRF , AUTHEN and OP extensions.
value[x] Yes Quantity | CodeableConcept | string | dateTime
  • Description
    • Value of the observation.
  • Example
    • {
        "valueQuantity":
        {
          "value": 162,
          "unit": 'cm',
          "system": 'http://unitsofmeasure.org',
          "code": 'cm'
        }
      }
      
  • Example
    • {
        "valueCodeableConcept": {
          "coding": [
            {
              "system": 'http://snomed.info/sct',
              "code": '373066001',
              "display": 'Yes (qualifier value)'
            }
          ],
          "text": 'Yes'
        }
      }
      
  • Example
    • {
        "valueString": '2'
      }
      
  • Example
    • {
        "valueDateTime": '2020-07-04T07:15:00Z'
      }
      
  • Notes
      • Laboratory support updating valueQuantity, valueCodeableConcept, valueString and valueDateTime to the same value type.
      • Vital Signs support only updating observations with valueQuantity to valueQuantity type
      • Updating value type to another is supported only for the Laboratory. The exception is valueDateTime cannot be updated to another value type and vice-versa
interpretation No List of CodeableConcept
  • Description
    • A categorical assessment of an observation value. For example, high, low, normal.
  • Example
    • {
        "interpretation": [
          {
            "coding": [
              {
                "system": 'https://fhir.cerner.com/ec2458f2-1e24-41c8-b71b-0e701af7583d/codeSet/52',
                "code": '211',
                "display": 'LOW',
                "userSelected": true
              }
            ],
            "text": 'LOW'
          }
        ]
      }
      
  • Example
    • {
        "interpretation": [
          {
            "coding": [
              {
                {
                  "system": 'http://terminology.hl7.org/CodeSystem/v3-ObservationInterpretation',
                  "code": 'L',
                  "display": 'Low'
                }
              ],
              "text": 'LOW'
            }
          ]
        }
      
  • Notes
      • Only one interpretation may be supplied.
note No List of Annotation
  • Description
    • Comments about the observation
  • Example
    • {
        "note": [
          {
            "authorReference": {
              "reference": 'Practitioner/62955753'
            },
            "time": '2018-08-17T09:55:42.000Z',
            "text": 'Charted at Incorrect Time'
          }
        ]
      }
      
referenceRange No List of BackboneElement
  • Description
    • Provides guidance for interpretating the observation.
  • Example
    • {
        "referenceRange": [
          {
            "low": {
              "value": 3.6,
              "unit": "mmol/L",
              "system": "http://unitsofmeasure.org",
              "code": "mmol/L"
          },
          "high": {
              "value": 5.2,
              "unit": "mmol/L",
              "system": "http://unitsofmeasure.org",
              "code": "mmol/L"
          },
          "type": {
              "coding": [
                  {
                      "system": "http://terminology.hl7.org/CodeSystem/referencerange-meaning",
                      "code": "normal",
                      "display": "Normal Range"
                  }
              ],
              "text": "Normal Range"
            }
          }
        ]
      }
      
  • Notes
      • Only one referenceRange is supported
      • ReferenceRange.text is not supported when referenceRange.high and/or referenceRange.low are provided. Only a referenceRange.type of normal is supported.
referenceRange.low No SimpleQuantity
  • Description
    • Lower bound of the reference range.
  • Example
    • {
        "low": {
          "value": 35.2,
          "unit": 'degC',
          "system": 'http://unitsofmeasure.org',
          "code": 'Cel'
        }
      }
      
referenceRange.high No SimpleQuantity
  • Description
    • Upper bound of the reference range.
  • Example
    • {
        "low": {
          "value": 36.7,
          "unit": 'degC',
          "system": 'http://unitsofmeasure.org',
          "code": 'Cel'
        }
      }
      
referenceRange.text No string
  • Description
    • Text based reference range in an observation which may be used when a quantitative range is not appropriate for an observation.
  • Example
    • {
        "text": 'Negative'
      }
      
referenceRange.type No CodeableConcept
  • Description
    • Codes to indicate the what part of the targeted reference population it applies to.
  • Example
    • {
        "type": {
          "coding": [
            {
              "system": 'http://terminology.hl7.org/CodeSystem/referencerange-meaning',
              "code": 'normal',
              "display": 'Normal Range'
            }
          ],
          "text": 'Normal Range'
        }
      }
      
  • Notes
      • Only a ReferenceRange.type of normal is supported

Example

Request

PUT https://fhir-ehr.cerner.com/r4/ec2458f2-1e24-41c8-b71b-0e701af7583d/Observation/M-196186655

Labs Body Example

{
  "resourceType": "Observation",
  "id": "M-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": "M-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 OK
Cache-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.