4.15 Observation リソース

Home ＞ Clinical ＞ Observation [observation]

Simple assertions and measurements made about a patient, device or other subject.

The resource name as it appears in a RESTful URL is [root]/observation/

Observations are a central element in healthcare, used to support diagnosis, monitor progress, determine baselines and patterns and even capture demographic characteristics. Fundamentally, observations are simple name/value pair assertions with little structure, though there are several resources such as DiagnosticReport to manage and represent rich aggregation patterns for observations. Expected uses for this resource include:

• Vital signs: temperature, blood pressure, respiration rate
• Laboratory Data and other Diagnostic Measures
• Measurements emitted by Devices
• Clinical assessments such as APGAR
• Personal characteristics: height, weight, eye-color
• Diagnoses (Note: trackable conditions, allergies, adverse reactions and more complex structures are handled elsewhere)
• Social history: tobacco use, family supports, cognitive status
• Core characteristics: pregnancy status, death assertion

Alternate definitions: Schema/Schematron, Resource Profile

• Inv-1: Must have at least one of value or components (xpath: exists(*[starts-with(local-name(.), 'value')]) or exists(f:component))
• Inv-2: Can only have normal range if value is a quantity (xpath: exists(f:valueQuantity) or not(exists(f:normalRange)))

• The element that contains the actual value of the result has a variable name depending on the type. The name is "value" + the type name, ignoring parameters, with a capital on the first letter, e.g. valueInterval or valueString
• The obtainedDateTime or obtainedPeriod is the time that the observation is most relevant as an observation of the subject. For a biological subject (e.g. a human patient), this is the physiologically relevant time of the observation. In the case of an observation on a specimen, this represents the start and end of the specimen collection (which may include multiple specimens). In the case of an observation obtained directly from a subject (e.g., BP, Chest X-ray), this represent the start and end time of the observation process.
• At its simplest, these resource instances can consist of only a type and a value. The relevance of other properties will vary based on the type of observation. Normal range may be useful for systolic blood pressure, but has little relevance for something like "pregnancy status"
• Profiles will be created to provide guidance on capturing certain types of simple observations. This resource focuses on the level of detail captured by most systems. However, any "simple" observation can easily be broken into numerous components and sub-components to provide additional information relevant in certain circumstances. As with other resources, extensions can be used to introduce this additional complexity.

Search Parameters for RESTful searches. The standard parameters also apply. See Searching for more information.