Observation

• Overview
• Terminology Bindings
• Extensions
• Search
  • Authorization Types
  • Parameters
  • Headers
  • Example
  • Example with RevInclude
  • Authorization Types
  • Errors
• Retrieve by id
  • Authorization Types
  • Example
  • Errors
• Create
  • Authorization Types
  • Headers
  • Body Fields
  • Example
  • Errors
• Update
  • Authorization Types
  • Headers
  • Body Fields
  • Example
  • Errors

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 HL7® FHIR® US Core Implementation Guide STU 4.0.0 Profiles are supported by this resource:

• US Core Laboratory Result Observation Profile
• US Core Smoking Status Observation Profile
• US Core Vital Signs Profile
• US Core Blood Pressure Profile
• US Core BMI Profile
• US Core Body Height Profile
• US Core Body Temperature Profile
• US Core Body Weight Profile
• US Core Head Circumference Profile
• US Core Heart Rate Profile
• US Core Pediatric BMI for Age Observation Profile
• US Core Pediatric Head Occipital-frontal Circumference Percentile Profile
• US Core Pediatric Weight for Height Observation Profile
• US Core Pulse Oximetry Profile
• US Core Respiratory Rate Profile

The following fields are returned if valued:

• Id
• Identifier
• Status
• Category (laboratory, social history, vital-signs)
• Code (Observation name or text)
• Subject (Patient)
• Encounter
• Effective date/time (collection date/time for laboratory)
• Extensions
• Issued (date/time observation made available, entered, verified)
• Performer
• Observation value or result
• For Observations with valueQuantity
  • Quantity comparator (<, <=, >, >=)
  • Quantity units
• For Observations with valueCodeableConcept
  • Codeable concept
• Data absent reason
• Interpretation (abnormal flagging)
• Note (comments)
• Reference range
  • low
  • high
  • type
  • text
• Member Observations (for limited use cases)
• Component (eg: systolic and diastolic for blood pressure)

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

• convertedMeasurement This extension returns a converted measurement of a different measurement system than the original quantity.
• performerFunction
• valueAttachment: URL for this extension is defined as: http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.valueAttachment This extension is defined and referenced from the newer version of FHIR. See Extensions for converting between versions and R5 Snapshot of Observation.value for more information.

Search

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

GET /Observation?:parameters

Authorization Types

Implementation Notes

• The comments field may have RTF or other formatted data rather than simple text. This is an issue that will be resolved in a future correction. We are investigating alternative solutions to fix this.

• Searching records with vital-signs category by code with proprietary system will result in empty response.

• 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. That is, all Observations on any given page of results are newer than all Observations on the next page of results.
  • 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.

Parameters

Name	Required?	Type	Description
_id	This or patient or subject	token	The logical resource id associated with the resource.
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. Defaults to 50 and maximum 200 observations can be returned
_revinclude	No	token	Provenance resource entries to be returned as part of the bundle. Example:_revinclude=Provenance:target

Notes:

• If _id is provided, no other parameters may be provided.

• Search by _id for observation labs supports multiple ids from single patient only.

• The subject parameter must represent a Patient resource and may use the :Patient modifier.

• It is recommended to search by either code or date (or both).

• The code parameter:

  • May be a list of comma separated values.

  • Searches only Observation.code. For example when fetching blood pressures the resource will be only be returned when the search is based on 85354-9(Systolic and Diastolic BP). Using the component codes 8480-6(Systolic BP) or 8462-4 (Diastolic BP) will not return the resource.

• The date and _lastUpdated parameters may be provided up to two times, and must use the eq, ge, gt, le, or lt prefixes. When a value is provided without a prefix, an implied eq prefix is used. When provided twice, the lower value must have a ge or gt prefix and the higher value must have an le or lt 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.

• When _count parameter is provided,
  • it won’t affect the first page, because all social history data will appear in the first page regardless of requested count.
  • Maximum supported count = 200.
  • Second page onward, returned item count may be less than requested.

• The _revinclude parameter may be provided once with the value Provenance:target. Example: _revinclude=Provenance:target

• The _revinclude parameter may be provided with the _id/patient/subject parameter. Example: patient=12457977&category=vital-signs&_revinclude=Provenance:target

• When _revinclude is provided in a request to the closed endpoint, the OAuth2 token must include the user/Provenance.read scope.

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"
        },
        "encounter": {
          "reference": "Encounter/18565902"
        },
        "effectiveDateTime": "2022-06-01T10:39:02Z",
        "issued": "2020-06-11T04:05:33.000Z",
        "performer": [
          {
            "reference": "Practitioner/15441459"
          }
        ],
        "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"
        },
        "encounter": {
          "reference": "Encounter/18565902"
        },
        "effectiveDateTime": "2022-06-01T10:39:02Z",
        "issued": "2020-06-11T04:05:33.000Z",
        "performer": [
          {
            "reference": "Practitioner/15441459"
          }
        ],
        "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"
        },
        "encounter": {
          "reference": "Encounter/18565902"
        },
        "effectiveDateTime": "2022-06-01T10:39:02Z",
        "issued": "2020-06-11T04:05:33.000Z",
        "performer": [
          {
            "reference": "Practitioner/15441459"
          }
        ],
        "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/VS-CV-55046871-SECT-8098",
      "resource": {
        "resourceType": "Observation",
        "id": "VS-CV-55046871-SECT-8098",
        "meta": {
          "versionId": "0",
          "lastUpdated": "2022-06-17T10:41:35Z"
        },
        "text": {
          "status": "generated",
          "div": "<div xmlns=\\"http://www.w3.org/1999/xhtml\\"><p><b>Observation</b></p><p><b>Patient Id</b>: 15116458</p><p><b>Status</b>: Final</p><p><b>Categories</b>: Vital Signs</p><p><b>Code</b>: SpO2</p><p><b>Result</b>: 95 %</p><p><b>Effective Date</b>: Jun  5, 2022  3:00 A.M. CDT</p></div>"
        },
        "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/eb2384f8-839e-4c6e-8b29-18e71db1a0b1/codeSet/72",
              "code": "3623994",
              "display": "SpO2",
              "userSelected": true
            },
            {
              "system": "http://loinc.org",
              "code": "2708-6",
              "display": "Oxygen saturation in Arterial blood"
            },
            {
              "system": "http://loinc.org",
              "code": "59408-5",
              "display": "Oxygen saturation in Arterial blood by Pulse oximetry"
            }
          ],
          "text": "SpO2"
        },
        "subject": {
          "reference": "Patient/12724066"
        },
        "encounter": {
          "reference": "Encounter/18565902"
        },
        "effectiveDateTime": "2022-06-05T08:00:38.000Z",
        "issued": "2022-06-05T08:00:38Z",
        "performer": [
          {
            "reference": "Practitioner/15441459"
          }
        ],
        "valueQuantity": {
          "value": 95,
          "unit": "%",
          "system": "http://unitsofmeasure.org",
          "code": "%"
        },
        "component": [
          {
            "code": {
              "coding": [
                {
                  "system": "https://fhir.cerner.com/eb2384f8-839e-4c6e-8b29-18e71db1a0b1/codeSet/72",
                  "code": "703569",
                  "display": "Oxygen Flow Rate",
                  "userSelected": true
                },
                {
                  "system": "http://loinc.org",
                  "code": "3151-8"
                }
              ],
              "text": "Oxygen Flow Rate"
            },
            "valueQuantity": {
              "value": 7,
              "unit": "L/min",
              "system": "http://unitsofmeasure.org",
              "code": "L/min"
            }
          },
          {
            "code": {
              "coding": [
                {
                  "system": "https://fhir.cerner.com/eb2384f8-839e-4c6e-8b29-18e71db1a0b1/codeSet/72",
                  "code": "2700657",
                  "display": "FIO2",
                  "userSelected": true
                },
                {
                  "system": "http://loinc.org",
                  "code": "3150-0",
                  "display": "Inhaled Oxygen concentration"
                }
              ],
              "text": "Inhaled Oxygen concentration"
            },
            "valueQuantity": {
              "value": 21,
              "unit": "%",
              "system": "http://unitsofmeasure.org",
              "code": "%"
            }
          }
        ]
      }
    },
    {
      "fullUrl": "https://fhir-open.cerner.com/r4/ec2458f2-1e24-41c8-b71b-0e701af7583d/Observation/L-206310347",
      "resource": {
        "resourceType": "Observation",
        "id": "L-206310347",
        "meta": {
          "versionId": "1",
          "lastUpdated": "2023-10-30T17:04:50.000Z"
        },
        "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>Code</b>: Glucose Level POC</p><p><b>Result</b>: 181 mg/dL</p><p><b>Effective Date</b>: Oct 30, 2023  5:04 P.M. UTC</p></div>"
        },
        "identifier": [
          {
            "system": "https://fhir.cerner.com/ceuuid",
            "value": "CE87caf4b7-9397-4667-9897-702218017c9e-206310347-2023103017044900"
          }
        ],
        "status": "final",
        "category": [
          {
            "extension": [
              {
                "valueCode": "unknown",
                "url": "http://hl7.org/fhir/StructureDefinition/data-absent-reason"
              }
            ]
          }
        ],
        "code": {
          "coding": [
            {
              "system": "https://fhir.cerner.com/ec2458f2-1e24-41c8-b71b-0e701af7583d/codeSet/72",
              "code": "2552299163",
              "display": "Glucose Level POC",
              "userSelected": true
            },
            {
              "system": "http://loinc.org",
              "code": "2339-0",
              "display": "Glucose [Mass/volume] in Blood",
              "userSelected": false
            }
          ],
          "text": "Glucose Level POC"
        },
        "subject": {
          "reference": "Patient/12724066"
        },
        "effectiveDateTime": "2023-10-30T17:04:46.000Z",
        "valueQuantity": {
          "value": 181,
          "unit": "mg/dL"
        },
        "note": [
          {
            "authorReference": {
              "reference": "Practitioner/1"
            },
            "time": "2023-10-30T17:04:49Z",
            "text": "Time : 2023-10-30T17:04:49.464400Z\\nAuthor : SYSTEM, SYSTEM Cerner\\nComment : Filed via Accuhealth"
          }
        ]
      },
      "search": {
        "mode": "match"
      }
    },
    {
      "fullUrl": "https://fhir-open.cerner.com/r4/ec2458f2-1e24-41c8-b71b-0e701af7583d/Observation/L-206310341",
      "resource": {
        "resourceType": "Observation",
        "id": "L-206310341",
        "meta": {
          "versionId": "1",
          "lastUpdated": "2023-10-30T17:04:45.000Z"
        },
        "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>Code</b>: Glucose Level POC</p><p><b>Result</b>: 189 mg/dL</p><p><b>Effective Date</b>: Oct 30, 2023  5:04 P.M. UTC</p></div>"
        },
        "identifier": [
          {
            "system": "https://fhir.cerner.com/ceuuid",
            "value": "CE87caf4b7-9397-4667-9897-702218017c9e-206310341-2023103017044500"
          }
        ],
        "status": "final",
        "category": [
          {
            "extension": [
              {
                "valueCode": "unknown",
                "url": "http://hl7.org/fhir/StructureDefinition/data-absent-reason"
              }
            ]
          }
        ],
        "code": {
          "coding": [
            {
              "system": "https://fhir.cerner.com/ec2458f2-1e24-41c8-b71b-0e701af7583d/codeSet/72",
              "code": "2552299163",
              "display": "Glucose Level POC",
              "userSelected": true
            },
            {
              "system": "http://loinc.org",
              "code": "2339-0",
              "display": "Glucose [Mass/volume] in Blood",
              "userSelected": false
            }
          ],
          "text": "Glucose Level POC"
        },
        "subject": {
          "reference": "Patient/12724066"
        },
        "effectiveDateTime": "2023-10-30T17:04:42.000Z",
        "valueQuantity": {
          "value": 189
        },
        "note": [
          {
            "authorReference": {
              "reference": "Practitioner/1"
            },
            "time": "2023-10-30T17:04:45Z",
            "text": "Time : 2023-10-30T17:04:45.459189Z\\nAuthor : SYSTEM, SYSTEM Cerner\\nComment : Filed via Accuhealth"
          }
        ]
      },
      "search": {
        "mode": "match"
      }
    },
    {
      "fullUrl": "https://fhir-open.cerner.com/r4/ec2458f2-1e24-41c8-b71b-0e701af7583d/Observation/VS-197292857",
      "resource": {
        "resourceType": "Observation",
        "id": "VS-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"
          }
        ],
        "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",
              "display": "Axillary temperature"
            },
            {
              "system": "http://loinc.org",
              "code": "8310-5",
              "display": "Body temperature"
            }
          ],
          "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/VS-196190669",
      "resource": {
        "resourceType": "Observation",
        "id": "VS-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",
              "display": "Body temperature - Temporal artery"
            },
            {
              "system": "http://loinc.org",
              "code": "8310-5",
              "display": "Body temperature"
            }
          ],
          "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/VS-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/VS-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"
        },
        "encounter": {
          "reference": "Encounter/18565902"
        },
        "effectiveDateTime": "2022-06-01T10:39:02Z",
        "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/L-197412603",
      "resource": {
        "resourceType": "Observation",
        "id": "L-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>: Hgb Bld-mCnc</p></div>"
        },
        "status": "preliminary",
        "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": "703535",
              "display": "Hgb Bld-mCnc",
              "userSelected": true
            },
            {
              "system": "http://loinc.org",
              "code": "718-7",
              "display": "Hgb Bld-mCnc"
            }
          ],
          "text": "Hgb Bld-mCnc"
        },
        "subject": {
          "reference": "Patient/12742400"
        },
        "effectiveDateTime": "2022-06-01T10:39:02Z",
        "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/L-197412603",
      "resource": {
        "resourceType": "Observation",
        "id": "L-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": [
          {
            "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": "703535",
              "display": "Hgb Bld-mCnc",
              "userSelected": true
            },
            {
              "system": "http://loinc.org",
              "code": "718-7",
              "display": "Hgb Bld-mCnc"
            }
          ],
          "text": "Hgb Bld-mCnc"
        },
        "subject": {
          "reference": "Patient/12742401"
        },
        "effectiveDateTime": "2022-06-01T10:38:02Z",
        "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

• Patient authorization read requests are working similarly to patient authorization search requests.

Example

Request

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

Response

Status: 200 OK

{
  "fullUrl": "https://fhir-open.cerner.com/r4/ec2458f2-1e24-41c8-b71b-0e701af7583d/Observation/VS-197292857",
  "resource": {
    "resourceType": "Observation",
    "id": "VS-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"
      }
    ],
    "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",
          "display": "Axillary temperature"
        },
        {
          "system": "http://loinc.org",
          "code": "8310-5",
          "display": "Body temperature"
        }
      ],
      "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

• See Understand Supported Vital Signs in the FHIR Observation Resource for a list of vital signs that are supported for the create operation.
• Components are supported only when writing Observation Blood Pressure and Pulse Oximetry Profiles.
• Individual systolic and diastolic components will be paired upon subsequent search or read as long as the blood pressures are paired in Millennium. See Configure Blood Pressure Event Set Pairing Hierarchy.
• Only the body fields mentioned below are supported. Unsupported fields will be ignored.
• Modifier fields should not be provided, and will cause the transaction to fail.
• Also supports creating observation with proprietary codes with the latest version of observation.

Authorization Types

Note:

• Vital Sign creates via a Provider persona requires an active relationship between the Provider and the Patient.

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. top of section
status	Yes	code
Description Codes identifying the lifecycle stage of an event. Example { "status": "final" } Notes Status codes final, amended and corrected are supported. top of section
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. top of section
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' } } top of section
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. top of section
encounter	No	Reference
Description Encounter during which the observation was first made. Example { "encounter": { "reference": "Encounter/631923" } } top of section
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. top of section
issued	No	instant
Description Instant the observation was made. Example { "issued": "2020-07-06T21:02:47.000Z" } top of section
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. top of section
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. top of section
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, valueAttachment and valueDateTime. top of section
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. top of section
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' } ] } top of section
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. top of section
referenceRange.low	No	SimpleQuantity
Description Lower bound of the reference range. Example { "low": { "value": 35.2, "unit": 'degC', "system": 'http://unitsofmeasure.org', "code": 'Cel' } } top of section
referenceRange.high	No	SimpleQuantity
Description Upper bound of the reference range. Example { "low": { "value": 36.7, "unit": 'degC', "system": 'http://unitsofmeasure.org', "code": 'Cel' } } top of section
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' } top of section
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 top of section
component	No	List of BackboneElement
Description Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations. Example { "code": { "coding": [ { "system": 'http://loinc.org', "code": '8480-6' } ], "text": 'Systolic Blood Pressure Invasive' }, "valueQuantity": { "value": 120, "unit": 'mmHg', "system": 'http://unitsofmeasure.org', "code": 'mm[Hg]' }, "interpretation": [ { "coding": [ { "system": 'http://terminology.hl7.org/CodeSystem/v3-ObservationInterpretation', "code": 'N' } ] } ], "referenceRange": [ { "low": { "value": 45.0, "unit": 'mmHg', "system": 'http://unitsofmeasure.org', "code": 'mm[Hg]' }, "high": { "value": 75.0, "unit": 'mmHg', "system": 'http://unitsofmeasure.org', "code": 'mm[Hg]' }, "type": { "coding": [ { "system": 'http://terminology.hl7.org/CodeSystem/referencerange-meaning', "code": 'normal' } ], "text": 'Normal Range' } } ] } Notes Component is required to create blood pressure. top of section
component.code	Yes	CodeableConcept
Description Describes what was observed. Sometimes this is called the observation "name". Example { "coding": [ { "system": 'http://loinc.org', "code": '8480-6' } ], "text": 'Systolic Blood Pressure Invasive' } top of section
component.value[x]	No	List of CodeableConcept
Description The information determined as a result of making the observation, if the information has a simple value. Example { "value": 120, "unit": 'mmHg', "system": 'http://unitsofmeasure.org', "code": 'mm[Hg]' } Notes Supports writing observations with only valueQuantity. top of section
component.interpretation	No	List of CodeableConcept
Description A categorical assessment of an observation value. For example, high, low, normal. Example { "coding": [ { "system": 'http://terminology.hl7.org/CodeSystem/v3-ObservationInterpretation', "code": 'N' } ], "text": 'NORMAL' } Notes Only one interpretation may be supplied. top of section
component.referenceRange	No	CodeableConcept
Description Guidance on how to interpret the value by comparison to a normal or recommended range. Example { "low": { "value": 45.0, "unit": 'mmHg', "system": 'http://unitsofmeasure.org', "code": 'mm[Hg]' }, "high": { "value": 75.0, "unit": 'mmHg', "system": 'http://unitsofmeasure.org', "code": 'mm[Hg]' }, "type": { "coding": [ { "system": 'http://terminology.hl7.org/CodeSystem/referencerange-meaning', "code": 'normal' } ], "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. top of section

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"
      }
    }
  ]
}

Vitals - Blood Pressure 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": "85354-9"
      }
    ],
    "text": "Blood pressure"
  },
  "subject": {
    "reference": "Patient/12457981"
  },
  "encounter": {
    "reference": "Encounter/97845408"
  },
  "effectiveDateTime": "2022-06-04T08:00:38.000Z",
  "issued": "2022-06-04T08:00:38Z",
  "component": [
    {
      "code": {
        "coding": [
          {
            "system": "http://loinc.org",
            "code": "8480-6"
          }
        ],
        "text": "Systolic Blood Pressure Invasive"
      },
      "valueQuantity": {
        "value": 120,
        "unit": "mmHg",
        "system": "http://unitsofmeasure.org",
        "code": "mm[Hg]"
      },
      "interpretation": [
        {
          "coding": [
            {
              "system": "http://terminology.hl7.org/CodeSystem/v3-ObservationInterpretation",
              "code": "N"
            }
          ]
        }
      ],
      "referenceRange": [
        {
          "low": {
            "value": 45.0,
            "unit": "mmHg",
            "system": "http://unitsofmeasure.org",
            "code": "mm[Hg]"
          },
          "high": {
            "value": 75.0,
            "unit": "mmHg",
            "system": "http://unitsofmeasure.org",
            "code": "mm[Hg]"
          },
          "type": {
            "coding": [
              {
                "system": "http://terminology.hl7.org/CodeSystem/referencerange-meaning",
                "code": "normal"
              }
            ],
            "text": "Normal Range"
          }
        }
      ]
    },
    {
      "code": {
        "coding": [
          {
            "system": "http://loinc.org",
            "code": "8462-4"
          }
        ],
        "text": "Diastolic Blood Pressure Invasive"
      },
      "valueQuantity": {
        "value": 80,
        "unit": "mmHg",
        "system": "http://unitsofmeasure.org",
        "code": "mm[Hg]"
      },
      "interpretation": [
        {
          "coding": [
            {
              "system": "http://terminology.hl7.org/CodeSystem/v3-ObservationInterpretation",
              "code": "N"
            }
          ]
        }
      ],
      "referenceRange": [
        {
          "low": {
            "value": 35.8,
            "unit": "mmHg",
            "system": "http://unitsofmeasure.org",
            "code": "mm[Hg]"
          },
          "high": {
            "value": 37.3,
            "unit": "mmHg",
            "system": "http://unitsofmeasure.org",
            "code": "mm[Hg]"
          },
          "type": {
            "coding": [
              {
                "system": "http://terminology.hl7.org/CodeSystem/referencerange-meaning",
                "code": "normal"
              }
            ],
            "text": "Normal Range"
          }
        }
      ]
    }
  ]
}

Vitals - Pulse Oximetry 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": "59408-5"
      }
    ],
    "text": "SpO2"
  },
  "subject": {
    "reference": "Patient/12457981"
  },
  "encounter": {
    "reference": "Encounter/97845408"
  },
  "effectiveDateTime": "2022-06-05T08:00:38.004Z",
  "issued": "2022-06-05T08:00:34Z",
  "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/15441459"
    }
  ],
  "component": [
    {
      "code": {
        "coding": [
          {
            "system": "http://loinc.org",
            "code": "3151-8",
            "display": "Inhaled oxygen flow rate"
          }
        ],
        "text": "Oxygen Flow Rate"
      },
      "valueQuantity": {
        "value": 7,
        "unit": "L/min",
        "system": "http://unitsofmeasure.org",
        "code": "L/min"
      }
    },
    {
      "code": {
        "coding": [
          {
            "system": "http://loinc.org",
            "code": "3150-0"
          }
        ],
        "text": "FIO2"
      },
      "valueQuantity": {
        "value": 21,
        "unit": "%",
        "system": "http://unitsofmeasure.org",
        "code": "%"
      }
    },
    {
      "code": {
        "coding": [
          {
            "system": "http://loinc.org",
            "code": "59408-5"
          }
        ],
        "text": "SpO2"
      },
      "valueQuantity": {
        "value": 96,
        "unit": "%",
        "system": "http://unitsofmeasure.org",
        "code": "%"
      }
    }
  ]
}

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/L-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

• Currently only laboratory and vital-signs are supported.
• Both read and write scopes are required.
• Updates on patient and category are not supported.
• Components are only supported for vital-sign blood pressure and pulse oximetry profiles
• See FHIR^® Update for additional details about update operations.

Authorization Types

Note:

• Vital Sign updates via a Provider persona requires an active relationship between the Provider and the Patient.

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. top of section
id	Yes	id
Description The logical id of the resource to update. Example { "id": "L-197391609" } Notes The id value must match the Observation/<id> value. top of section
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 top of section
status	Yes	code
Description Codes identifying the lifecycle stage of an event. Example { "status": "corrected" } Notes Status codes amended and corrected are supported. top of section
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. top of section
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" } } top of section
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. top of section
encounter	No	Reference
Description Encounter during which the observation was first made. Example { "encounter": { "reference": "Encounter/631923" } } top of section
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. top of section
issued	No	instant
Description Instant the observation was made. Example { "issued": "2020-07-06T21:02:47.000Z" } top of section
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. top of section
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. top of section
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 top of section
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. top of section
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' } ] } top of section
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. top of section
referenceRange.low	No	SimpleQuantity
Description Lower bound of the reference range. Example { "low": { "value": 35.2, "unit": 'degC', "system": 'http://unitsofmeasure.org', "code": 'Cel' } } top of section
referenceRange.high	No	SimpleQuantity
Description Upper bound of the reference range. Example { "low": { "value": 36.7, "unit": 'degC', "system": 'http://unitsofmeasure.org', "code": 'Cel' } } top of section
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' } top of section
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 top of section
component	No	List of BackboneElement
Description Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations. Example { "code": { "coding": [ { "system": 'http://loinc.org', "code": '8480-6' } ], "text": 'Systolic Blood Pressure Invasive' }, "valueQuantity": { "value": 120, "unit": 'mmHg', "system": 'http://unitsofmeasure.org', "code": 'mm[Hg]' }, "interpretation": [ { "coding": [ { "system": 'http://terminology.hl7.org/CodeSystem/v3-ObservationInterpretation', "code": 'N' } ] } ], "referenceRange": [ { "low": { "value": 45.0, "unit": 'mmHg', "system": 'http://unitsofmeasure.org', "code": 'mm[Hg]' }, "high": { "value": 75.0, "unit": 'mmHg', "system": 'http://unitsofmeasure.org', "code": 'mm[Hg]' }, "type": { "coding": [ { "system": 'http://terminology.hl7.org/CodeSystem/referencerange-meaning', "code": 'normal' } ], "text": 'Normal Range' } } ] } Notes Component is required to create blood pressure. top of section
component.code	Yes	CodeableConcept
Description Describes what was observed. Sometimes this is called the observation "name". Example { "coding": [ { "system": 'http://loinc.org', "code": '8480-6' } ], "text": 'Systolic Blood Pressure Invasive' } top of section
component.value[x]	No	List of CodeableConcept
Description The information determined as a result of making the observation, if the information has a simple value. Example { "value": 120, "unit": 'mmHg', "system": 'http://unitsofmeasure.org', "code": 'mm[Hg]' } Notes Supports writing observations with only valueQuantity. top of section
component.interpretation	No	List of CodeableConcept
Description A categorical assessment of an observation value. For example, high, low, normal. Example { "coding": [ { "system": 'http://terminology.hl7.org/CodeSystem/v3-ObservationInterpretation', "code": 'N' } ], "text": 'NORMAL' } Notes Only one interpretation may be supplied. top of section
component.referenceRange	No	CodeableConcept
Description Guidance on how to interpret the value by comparison to a normal or recommended range. Example { "low": { "value": 45.0, "unit": 'mmHg', "system": 'http://unitsofmeasure.org', "code": 'mm[Hg]' }, "high": { "value": 75.0, "unit": 'mmHg', "system": 'http://unitsofmeasure.org', "code": 'mm[Hg]' }, "type": { "coding": [ { "system": 'http://terminology.hl7.org/CodeSystem/referencerange-meaning', "code": 'normal' } ], "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. top of section

Example

Request

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

Labs Body Example

{
  "resourceType": "Observation",
  "id": "L-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."
    }
  ]
}

Request

PUT https://fhir-ehr.cerner.com/r4/ec2458f2-1e24-41c8-b71b-0e701af7583d/Observation/VS-197356031

Vitals Body Example

{
  "resourceType": "Observation",
  "id": "VS-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]"
  }
}

Request

PUT https://fhir-ehr.cerner.com/r4/ec2458f2-1e24-41c8-b71b-0e701af7583d/Observation/BP-59857018-59857020

Vitals - Blood Pressure Body Example

{
  "resourceType": "Observation",
  "id": "BP-59857018-59857020",
  "identifier": [
    {
      "system": "https://fhir.cerner.com/ceuuid",
      "value": "CEfda49233-ccfa-4ed4-afbc-9f5082c2bf0c-59857018-2022111805415000"
    },
    {
      "system": "https://fhir.cerner.com/ceuuid",
      "value": "CEfda49233-ccfa-4ed4-afbc-9f5082c2bf0c-59857020-2022111805415000"
    }
  ],
  "status": "corrected",
  "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": "85354-9",
        "display": "Blood pressure panel with all children optional"
      }
    ],
    "text": "Blood pressure"
  },
  "subject": {
    "reference": "Patient/15116458"
  },
  "encounter": {
    "reference": "Encounter/15687784"
  },
  "effectiveDateTime": "2022-06-09T08:00:58.000Z",
  "issued": "2022-06-09T08:00:58.000Z",
  "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/15441459"
    }
  ],
  "component": [
    {
      "code": {
        "coding": [
          {
            "system": "http://loinc.org",
            "code": "8480-6"
          }
        ],
        "text": "Systolic Blood Pressure Sitting"
      },
      "valueQuantity": {
        "value": 99,
        "unit": "mmHg",
        "system": "http://unitsofmeasure.org",
        "code": "mm[Hg]"
      },
      "interpretation": [
        {
          "coding": [
            {
              "system": "http://terminology.hl7.org/CodeSystem/v3-ObservationInterpretation",
              "code": "N",
              "display": "Normal"
            }
          ]
        }
      ],
      "referenceRange": [
        {
          "low": {
            "value": 35,
            "unit": "mmHg",
            "system": "http://unitsofmeasure.org",
            "code": "mm[Hg]"
          },
          "high": {
            "value": 37,
            "unit": "mmHg",
            "system": "http://unitsofmeasure.org",
            "code": "mm[Hg]"
          },
          "type": {
            "coding": [
              {
                "system": "http://terminology.hl7.org/CodeSystem/referencerange-meaning",
                "code": "normal",
                "display": "Normal Range"
              }
            ],
            "text": "Normal Range"
          }
        }
      ]
    },
    {
      "code": {
        "coding": [
          {
            "system": "http://loinc.org",
            "code": "8462-4"
          }
        ],
        "text": "Diastolic Blood Pressure Sitting"
      },
      "valueQuantity": {
        "value": 66,
        "unit": "mmHg",
        "system": "http://unitsofmeasure.org",
        "code": "mm[Hg]"
      },
      "interpretation": [
        {
          "coding": [
            {
              "system": "http://terminology.hl7.org/CodeSystem/v3-ObservationInterpretation",
              "code": "N",
              "display": "Normal"
            }
          ]
        }
      ],
      "referenceRange": [
        {
          "low": {
            "value": 35,
            "unit": "mmHg",
            "system": "http://unitsofmeasure.org",
            "code": "mm[Hg]"
          },
          "high": {
            "value": 37,
            "unit": "mmHg",
            "system": "http://unitsofmeasure.org",
            "code": "mm[Hg]"
          },
          "type": {
            "coding": [
              {
                "system": "http://terminology.hl7.org/CodeSystem/referencerange-meaning",
                "code": "normal",
                "display": "Normal Range"
              }
            ],
            "text": "Normal Range"
          }
        }
      ]
    }
  ]
}

Request

PUT https://fhir-ehr.cerner.com/r4/ec2458f2-1e24-41c8-b71b-0e701af7583d/Observation/VS-CV-78693473-SECT-8098

Vitals - Pulse Oximetry Body Example

{
  "resourceType": "Observation",
  "id": "VS-CV-83059963-SECT-8098",
  "identifier": [
    {
      "system": "https://fhir.cerner.com/cvuuid",
      "value": "8344a9b7-b1b7-406e-b303-1009edd66459"
    }
  ],
  "status": "amended",
  "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": "2708-6",
        "display": "Oxygen saturation in Arterial blood"
      },
      {
        "system": "http://loinc.org",
        "code": "59408-5",
        "display": "Oxygen saturation in Arterial blood by Pulse oximetry"
      }
    ],
    "text": "SpO2"
  },
  "subject": {
    "reference": "Patient/12457979"
  },
  "encounter": {
    "reference": "Encounter/97787491"
  },
  "effectiveDateTime": "2022-06-05T08:00:38.022Z",
  "issued": "2022-06-05T08:00:56Z",
  "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/15441459"
    }
  ],
  "valueQuantity": {
    "value": 44,
    "unit": "%",
    "system": "http://unitsofmeasure.org",
    "code": "%"
  },
  "component": [
    {
      "code": {
        "coding": [
          {
            "system": "http://loinc.org",
            "code": "3151-8",
            "display": "Inhaled oxygen flow rate"
          }
        ],
        "text": "Oxygen Flow Rate"
      },
      "valueQuantity": {
        "value": 55,
        "unit": "L/min",
        "system": "http://unitsofmeasure.org",
        "code": "L/min"
      }
    },
    {
      "code": {
        "coding": [
          {
            "system": "http://loinc.org",
            "code": "3150-0",
            "display": "Inhaled oxygen concentration"
          }
        ],
        "text": "FIO2"
      },
      "valueQuantity": {
        "value": 66,
        "unit": "%",
        "system": "http://unitsofmeasure.org",
        "code": "%"
      }
    }
  ]
}

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.