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  1. FHIR Specification Feedback
  2. FHIR-43459

Which blood pressure measurements should contribute to the average?

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    • Icon: Change Request Change Request
    • Resolution: Not Persuasive
    • Icon: Medium Medium
    • US Core (FHIR)
    • 7.0.0-ballot
    • Cross-Group Projects
    • STU
    • US Core Average Blood Pressure Profile
    • 13.111.1,13.111.1.3.2,13.111.1.3.3
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      RE:

      I would like the specification to clarify whether the system is expected to compute the average blood pressure from available blood pressure observations, and if so, which observations and which method of averaging.

      Decision:

      The commenter is correct that

      ... the intention might be that the system only returns an Average Blood Pressure if the average is what was documented by the user or the average is what is stored in the system prior to the query.

      The US Core Average Blood Pressure Profile profile, like all US Core Profiles, is a content data model designed to sets minimum expectations for exchanging data, and is not confined to any particular protocol. Providing guidance on how the average are calculated or which protocol should be used is out of scope. It is the data sources responsibility to use the appropriate Profile for their use case.

       

      RE:

      When a FHIR search requests all vital signs for a patient but doesn't specify a single date range, what should be returned as the Average Blood Pressure for that patient

      Answer:

      This is a FHIR RESTul search API, and it would look like:

      GET [base]/Observation?patient=1134281&category=http://terminology.hl7.org/CodeSystem/observation-category|vital-signs

      It fetches a bundle of all Observation resources for the specified patient and a category code = "vital-signs" (including Average Blood Pressures)

      RE:

      Should multiple averages be computed and returned?

      Answer:

      No, this is not a FHIR RESTful search, but rather an operation $stats on Observation.

      GET [base]/Observation?patient=1186747&code=http://loinc.org|85354-9

      RE:

      What if the FHIR search request includes only a single datetime?What if the FHIR search request includes only a single datetime? What if the FHIR search request includes two or more date ranges? What if the multiple date ranges do overlap, and what if they don't?

      In the case that a user-entered average is documented in the system and doesn't need to be computed for the query, should it be returned if the period of the average only partially overlaps with the date range specified by the search query?

       

      Answer:

      This profile does not change the behavior of a FHIR RESTul search API, For a discussion of how the date parameter searches on a date/time or period, see the FHIR specification.

      RE:

      I would like the specification to clarify how the date search parameter interacts with the period of the average blood pressure.

      Decision:
      US Core Guide provides these FHIR RESTful Search API Requirements but references the FHIR base specification for how to search by date.

      Show
      RE: I would like the specification to clarify whether the system is expected to compute the average blood pressure from available blood pressure observations, and if so, which observations and which method of averaging. Decision : The commenter is correct that ... the intention might be that the system only returns an Average Blood Pressure if the average is what was documented by the user or the average is what is stored in the system prior to the query. The US Core Average Blood Pressure Profile profile, like all US Core Profiles, is a content data model designed to sets minimum expectations for exchanging data, and is not confined to any particular protocol. Providing guidance on how the average are calculated or which protocol should be used is out of scope.  It is the data sources responsibility to use the appropriate Profile for their use case.   RE: When a FHIR search requests all vital signs for a patient but doesn't specify a single date range, what should be returned as the Average Blood Pressure for that patient Answer: This is a  FHIR RESTul search API , and it would look like: GET [base] /Observation?patient=1134281&category= http://terminology.hl7.org/CodeSystem/observation-category |vital-signs It fetches a bundle of all Observation resources for the specified patient and a category code = "vital-signs" (including Average Blood Pressures) RE: Should multiple averages be computed and returned? Answer: No, this is not a FHIR RESTful search, but rather an operation $stats  on Observation. GET [base] /Observation?patient=1186747&code= http://loinc.org |85354-9 RE: What if the FHIR search request includes only a single datetime?What if the FHIR search request includes only a single datetime? What if the FHIR search request includes two or more date ranges? What if the multiple date ranges do overlap, and what if they don't? In the case that a user-entered average is documented in the system and doesn't need to be computed for the query, should it be returned if the period of the average only partially overlaps with the date range specified by the search query?   Answer: This profile does not change the behavior of a FHIR RESTul search API , For a discussion of how the date parameter searches on a date/time or period, see the  FHIR specification . RE: I would like the specification to clarify how the date search parameter interacts with the period of the average blood pressure. Decision: US Core Guide provides these FHIR RESTful Search API Requirements  but references the FHIR base specification for how to search by date.
    • Isaac Vetter/Eric Haas: 40-0-1

    Description

      It will be common for the patient to have discrete blood pressure measurements, which the specification already supports returning as a blood pressure at a datetime. It sounds like the requirements for Average Blood Pressure are that the average should be computed from these discrete measurements based on the search query, or at least this would be one way to return one or more averages and satisfy the requirements.

      When a FHIR search requests all vital signs for a patient but doesn't specify a single date range, what should be returned as the Average Blood Pressure for that patient? Should multiple averages be computed and returned? What if the FHIR search request includes only a single datetime? What if the FHIR search request includes two or more date ranges? What if the multiple date ranges do overlap, and what if they don't?

      I would like the specification to clarify whether the system is expected to compute the average blood pressure from available blood pressure observations, and if so, which observations and which method of averaging.

      I think that the intention might be that the system only returns an Average Blood Pressure if the average is what was documented by the user or the average is what is stored in the system prior to the query.

      In the case that a user-entered average is documented in the system and doesn't need to be computed for the query, should it be returned if the period of the average only partially overlaps with the date range specified by the search query?

      I would like the specification to clarify how the date search parameter interacts with the period of the average blood pressure.

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            beaton@epic.com BenEaton
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