The FHIR profiles used for the Observations Event Message Bundle

FHIR Profiles

The following FHIR profiles are used to form the Observations Event Message Bundle:

Bundle Structure

Specifies referencing within the Event Message Bundle.


Observations (open in new TAB)

Observations Event data item mapping to FHIR profiles

This Mapping table defines the FHIR elements that SHALL be used to encode the Healthy Child Event Specification data items for each DCH Event Message payload.
Some common data item mappings, such as patient, publisher or Date/Time of event information, are defined within the Header mapping table and SHALL be considered in parallel with the payload mapping.

The Child Health Event data items are fulfilled by elements within the FHIR resources listed below:

DCH Data Item FHIR resource element Mandatory/Required/Optional  
Date CareConnect-Encounter-1.period.start Mandatory  
ODS Site Code CareConnect-Location-1.identifier (ODS Site Code) Mandatory  
Professional Name CareConnect-Practitioner-1.name Mandatory  
SDS Job Role Name CareConnect-PractitionerRole-1.code (SDS Job Role Name) Mandatory  
Encounter Type CareConnect-Encounter-1.type (childHealthEncounterType) Mandatory  

Observation measurement data items are fulfilled as Observation.valueQuantity elements within separate instances of a FHIR Observation resource.

All Observations are Required

DCH Data Item FHIR resource element Note
Birth Weight CareConnect-Observation-1.valueQuantity Observation.code SHALL use 364589006 | Birth weight |
Birth Head Circumference CareConnect-Observation-1.valueQuantity Observation.code SHALL use 169876006 | Birth head circumference |
Head circumference CareConnect-Observation-1.valueQuantity Observation.code SHALL use 363812007 | Head circumference |
Weight CareConnect-Observation-1.valueQuantity Observation.code SHALL use 27113001 | Body weight |
Body Height CareConnect-Observation-1.valueQuantity Observation.code SHALL use 50373000 | Body height |
Body Length CareConnect-Observation-1.valueQuantity Observation.code SHALL use 248334005 | Length of body |
BMI Centile CareConnect-Observation-1.valueQuantity Observation.code SHALL use 896691000000102 | Child body mass index centile |
Systolic Blood Pressure CareConnect-BloodPressure-Observation-1.component[systolicComponent].valueQuantity *
Diastolic Blood Pressure CareConnect-BloodPressure-Observation-1.component[diastolicComponent].valueQuantity *
Heart Rate CareConnect-HeartRate-Observation-1.valueQuantity  
Temperature CareConnect-BodyTemperature-Observation-1.valueQuantity For child health, a further Observation.code of 386725007 | Body temperature | should be added, with userSelected set to true
Respiration Rate CareConnect-RespiratoryRate-Observation-1.valueQuantity  
O2 Saturation CareConnect-OxygenSaturation-Observation-1.valueQuantity For child health, a further Observation.code of 431314004 | Peripheral oxygen saturation | should be added, with userSelected set to true
NCMP Withdrawal Reason CareConnect-Observation-1.valueCodeableConcept.Coding.code **

* Relevant blood pressure measurement SNOMED CT coding is fixed in the CareConnect-BloodPressure-Observation-1 profile.
Additional Blood Pressure observations may be reported using further Observation.component elements. For which, Observation.component.code SHALL be coded with the relevant SNOMED CT concept « 75367002 | Blood pressure | {i.e. descendant of}

** Observation.valueCodeableConcept SHALL be coded with the relevant SNOMED CT concept « 376251000000101 | Excluded from national child measurement programme | {i.e. descendant of}

Resource Population Requirements and Guidance

The following requirements and resource population guidance should be followed in addition to the requirements and guidance outlined in the data item mapping above and in the Event Header requirements page.

Bundle

Resource Cardinality 1..1
Element Cardinality Additional Guidance
type 1..1 Fixed value: message

Event-MessageHeader-1

The Event-MessageHeader-1 resource included as part of the event message SHALL conform to the Event-MessageHeader-1 constrained FHIR profile and the additional population guidance as per the table below:

Resource Cardinality 1..1
Element Cardinality Additional Guidance
extension(messageEventType) 1..1  
event 1..1 Fixed Value: “​observations-1 | Observations”
responsible 1..1 This will reference the responsible Organization resource
focus 1..1 This will reference the CareConnect-Encounter-1 resource which contains information relating to the event message.

CareConnect-Organization-1

The CareConnect-Organization-1 resource included as part of the event message SHALL conform to the CareConnect-Organization-1 constrained FHIR profile and the additional population guidance as per the table below:

Resource Cardinality 1..*
Element Cardinality Additional Guidance
identifier.system 1..1 Fixed value: https://fhir.nhs.uk/Id/ods-organization-code
identifier.value 1..1 Organisation’s ODS Organization Code
name 1..1 Organisation’s Name

CareConnect-HealthcareService-1

The CareConnect-HealthcareService-1 resource included as part of the event message SHALL conform to the CareConnect-HealthcareService-1 constrained FHIR profile and the additional population guidance as per the table below:

Resource Cardinality 1..1
Element Cardinality Additional Guidance
providedBy 1..1 This will reference the ‘sender’ organization of the event message.
type 1..1 This will represent the type of service responsible for the event message. This will have a fixed value from the ValueSet CareConnect-CareSettingType-1
specialty 1..1 HealthcareService.specialty SHALL use a value from https://fhir.nhs.uk/STU3/ValueSet/DCH-Specialty-1

CareConnect-Patient-1

The CareConnect-Patient-1 resource included as part of the event message SHALL conform to the CareConnect-Patient-1 constrained FHIR profile and the additional population guidance as per the table below:

Resource Cardinality 1..1
Element Cardinality Additional Guidance
identifier 1..1 Patient NHS Number SHALL be included within the nhsNumber identifier slice
name (official) 1..1 Patients name as registered on PDS, included within the resource as the official name element slice
birthDate 1..1 The patient birth date shall be included in the patient resource

CareConnect-Encounter-1

The CareConnect-Encounter-1 resource included as part of the event message SHALL conform to the CareConnect-Encounter-1 constrained FHIR profile and the additional population guidance as per the table below:

Resource Cardinality 1..1
Element Cardinality Additional Guidance
Encounter.type.coding(childHealthEncounterType) 1..1 Encounter.type.coding(childHealthEncounterType) SHALL use a value from https://fhir.nhs.uk/STU3/ValueSet/DCH-ChildHealthEncounterType-1
Encounter.reason.coding(snomedCT) 1..1 Encounter.reason.coding(snomedCT) SHALL use a value from https://fhir.nhs.uk/STU3/ValueSet/DCH-AdmissionReason-1
serviceProvider 1..1 This will reference the Organisation resource hosting the Encounter
location 1..1 This will reference the Encounter’s Location
subject 1..1 This will reference the patient resource representing the subject of this event

CareConnect-Location-1

The CareConnect-Location-1 resource included as part of the event message SHALL conform to the CareConnect-Location-1 constrained FHIR profile and the additional population guidance as per the table below:

Resource Cardinality 0..1

CareConnect-Practitioner-1

The CareConnect-Practitioner-1 resource included as part of the event message SHALL conform to the CareConnect-Practitioner-1 constrained FHIR profile and the additional population guidance as per the table below:

Resource Cardinality TBC

CareConnect-PractitionerRole-1

The CareConnect-PractitionerRole-1 resource included as part of the event message SHALL conform to the CareConnect-PractitionerRole-1 constrained FHIR profile and the additional population guidance as per the table below:

Resource Cardinality TBC
Element Cardinality Additional Guidance
organization 1..1 This will reference the Organization resource responsible for the event
practitioner 1..1 This will reference the Practitioner resource responsible for the event
PractitionerRole.code(careProfessionalType) 1..1 PractitionerRole.code(careProfessionalType) SHALL use a value from https://fhir.nhs.uk/STU3/ValueSet/DCH-ProfessionalType-1
PractitionerRole.code(keyWorkerStatus) 0..1 If Practitioner is a key worker, PractitionerRole.codekeyWorkerStatus SHALL use a value from https://fhir.nhs.uk/STU3/ValueSet/DCH-KeyWorkerStatus-1
PractitionerRole.specialty 1..1 PractitionerRole.specialty SHALL use a value from https://fhir.nhs.uk/STU3/ValueSet/DCH-Specialty-1

CareConnect-Observation-1

The CareConnect-Observation-1 resource included as part of the event message SHALL conform to the CareConnect-Observation-1 constrained FHIR profile and the additional population guidance as per the table below:

Resource Cardinality TBC
Element Cardinality Additional Guidance
subject 1..1 This will reference the patient resource representing the subject of this event
context 1..1 This will reference the encounter resource representing the context of this event
performer 1..1 This will reference the practitioner resource representing the performer of this observation

For each of the Observation resources representing Observations observations:

CareConnect-Observation-1 (Weight)

Element Cardinality Additional Guidance
Observation.category 1..1  
Observation.category.coding 1..* 1 vital-signs category, optional SNOMED category
Observation.category.coding .system 1..1 Fixed Value: http://hl7.org/fhir/observation-category
Observation.category.coding.code 1..1 Fixed Value: vital-signs
Observation.category.coding.display 0..1 Fixed Value: Vital Signs
Observation.code 1..1  
Observation.code.coding 2..2 1 loinc coded observation and 1 SNOMED equivalent
Observation.code.coding .system 1..1 Fixed Value: http://loinc.org
Observation.code.coding.code 1..1 Fixed Value: 29463-7
Observation.code 1..1 Observation.code SHALL use a value from https://fhir.nhs.uk/STU3/ValueSet/DCH-Weight-1
Observation.valueQuantity 1..1  
Observation.valueQuantity.value 1..1 Numerical value (to 3 decimal places)
Observation.valueQuantity.unit 1..1 Unit representation
Observation.valueQuantity.system 1..1 Fixed Value: http://unitsofmeasure.org
Observation.valueQuantity.code 1..1 Observation.valueQuantity.code SHALL use a value from http://hl7.org/fhir/stu3/valueset-ucum-bodyweight.html

CareConnect-Observation-1 (Height)

Element Cardinality Additional Guidance
Observation.category 1..1  
Observation.category.coding 1..* 1 vital-signs category, optional SNOMED category
Observation.category.coding .system 1..1 Fixed Value: http://hl7.org/fhir/observation-category
Observation.category.coding.code 1..1 Fixed Value: vital-signs
Observation.category.coding.display 0..1 Fixed Value: Vital Signs
Observation.code 1..1  
Observation.code.coding 2..2 1 loinc coded observation and 1 SNOMED equivalent
Observation.code.coding .system 1..1 Fixed Value: http://loinc.org
Observation.code.coding.code 1..1 Fixed Value: 8302-2
Observation.code.coding .system 1..1 Fixed Value: http://snomed.info/sct
Observation.code.coding.code 1..1 Fixed Value: 50373000
Observation.code.coding.display 1..1 Fixed Value: Body height
Observation.valueQuantity 1..1  
Observation.valueQuantity.value 1..1 Numerical value (to 1 decimal place)
Observation.valueQuantity.unit 1..1 Unit representation
Observation.valueQuantity.system 1..1 Fixed Value: http://unitsofmeasure.org
Observation.valueQuantity.code 1..1 Observation.valueQuantity.code SHALL use a value from http://hl7.org/fhir/stu3/valueset-ucum-bodylength.html

CareConnect-Observation-1 (Length)

Element Cardinality Additional Guidance
Observation.category 1..1  
Observation.category.coding 1..* 1 vital-signs category, optional SNOMED category
Observation.category.coding .system 1..1 Fixed Value: http://hl7.org/fhir/observation-category
Observation.category.coding.code 1..1 Fixed Value: vital-signs
Observation.category.coding.display 0..1 Fixed Value: Vital Signs
Observation.code 1..1  
Observation.code.coding 2..2 1 loinc coded observation and 1 SNOMED equivalent
Observation.code.coding .system 1..1 Fixed Value: http://loinc.org
Observation.code.coding.code 1..1 Fixed Value: 8306-3
Observation.code.coding .system 1..1 Fixed Value: http://snomed.info/sct
Observation.code.coding.code 1..1 Fixed Value: 248334005
Observation.code.coding.display 1..1 Fixed Value: Length of body
Observation.valueQuantity 1..1  
Observation.valueQuantity.value 1..1 Numerical value (to 1 decimal place)
Observation.valueQuantity.unit 1..1 Unit representation
Observation.valueQuantity.system 1..1 Fixed Value: http://unitsofmeasure.org
Observation.valueQuantity.code 1..1 Observation.valueQuantity.code SHALL use a value from http://hl7.org/fhir/stu3/valueset-ucum-bodylength.html

CareConnect-Observation-1 (HeadCircumference)

Element Cardinality Additional Guidance
Observation.category 1..1  
Observation.category.coding 1..* 1 vital-signs category, optional SNOMED category
Observation.category.coding .system 1..1 Fixed Value: http://hl7.org/fhir/observation-category
Observation.category.coding.code 1..1 Fixed Value: vital-signs
Observation.category.coding.display 0..1 Fixed Value: Vital Signs
Observation.code 1..1  
Observation.code.coding 2..2 1 loinc coded observation and 1 SNOMED equivalent
Observation.code.coding .system 1..1 Fixed Value: http://loinc.org
Observation.code.coding.code 1..1 Fixed Value: 8287-5
Observation.code 1..1 Observation.code SHALL use a value from https://fhir.nhs.uk/STU3/ValueSet/DCH-HeadCircumferenceSnCT-1
Observation.valueQuantity 1..1  
Observation.valueQuantity.value 1..1 Numerical value (to 1 decimal place)
Observation.valueQuantity.unit 1..1 Unit representation
Observation.valueQuantity.system 1..1 Fixed Value: http://unitsofmeasure.org
Observation.valueQuantity.code 1..1 Observation.valueQuantity.code SHALL use a value from http://hl7.org/fhir/stu3/valueset-ucum-bodylength.html

CareConnect-Observation-1 (BMICentile)

Element Cardinality Additional Guidance
Observation.code 1..1  
Observation.code.coding .system 1..1 Fixed Value: http://snomed.info/sct
Observation.code.coding.code 1..1 Fixed Value: 896691000000102
Observation.code.coding.display 1..1 Fixed Value: Child body mass index centile
Observation.valueQuantity 1..1  
Observation.valueQuantity.value 1..1 Numerical value (with implicit precision)
Observation.valueQuantity.unit 1..1 Fixed Value: percentage
Observation.valueQuantity.system 1..1 Fixed Value: http://unitsofmeasure.org
Observation.valueQuantity.code 1..1 Fixed Value: %

CareConnect-Observation-1 (NCMPWithdrawal)

Element Cardinality Additional Guidance
Observation.code 1..1  
Observation.code.coding .system 1..1 Fixed Value: http://snomed.info/sct
Observation.code.coding.code 1..1 Fixed Value: 376251000000101
Observation.code.coding.display 1..1 Fixed Value: Excluded from national child measurement programme
Observation.valueCodeableConcept 1..1 Observation.valueCodeableConcept.code SHALL use a value from https://fhir.nhs.uk/STU3/ValueSet/DCH-NCMPWithdrawalReason-1

CareConnect-BloodPressure-Observation-1

The CareConnect-BloodPressure-Observation-1 resource included as part of the event message SHALL conform to the CareConnect-BloodPressure-Observation-1 constrained FHIR profile and the additional population guidance as per the table below:

Resource Cardinality TBC

CareConnect-HeartRate-Observation-1

The CareConnect-HeartRate-Observation-1 resource included as part of the event message SHALL conform to the CareConnect-HeartRate-Observation-1 constrained FHIR profile and the additional population guidance as per the table below:

Resource Cardinality TBC

CareConnect-BodyTemperature-Observation-1

The CareConnect-BodyTemperature-Observation-1 resource included as part of the event message SHALL conform to the CareConnect-BodyTemperature-Observation-1 constrained FHIR profile and the additional population guidance as per the table below:

Resource Cardinality TBC

CareConnect-RespiratoryRate-Observation-1

The CareConnect-RespiratoryRate-Observation-1 resource included as part of the event message SHALL conform to the CareConnect-RespiratoryRate-Observation-1 constrained FHIR profile and the additional population guidance as per the table below:

Resource Cardinality TBC

CareConnect-OxygenSaturation-Observation-1

The CareConnect-OxygenSaturation-Observation-1 resource included as part of the event message SHALL conform to the CareConnect-OxygenSaturation-Observation-1 constrained FHIR profile and the additional population guidance as per the table below:

Resource Cardinality TBC

Observations Example

This example models a post-partum Observations panel comprising Observations for:

  • Birth weight
  • Length of body
  • Birth head circumference
  • Heart rate
  • Respiratory rate
  • Blood pressure
  • Body temperature
  • Hemoglobin saturation with oxygen

Profile Change Mappings for Observations

Profiles used in Demographics Update Event Messages 1.2.1-Release Candidate are replaced with:

Demographic-Event-Messages Demographic-Event-Messages-CareConnect
DCH-Bundle-1 Bundle
DCH-MessageHeader-1 Event-MessageHeader-1
CareConnect-Organization-1 CareConnect-Organization-1
DCH-HealthcareService-1 CareConnect-HealthcareService-1
CareConnect-DCH-Patient-1 CareConnect-Patient-1
CareConnect-DCH-Encounter-1 CareConnect-Encounter-1
CareConnect-Location-1 CareConnect-Location-1
CareConnect-DCH-Practitioner-1 CareConnect-Practitioner-1
CareConnect-DCH-PractitionerRole-1 CareConnect-PractitionerRole-1
CareConnect-DCH-Weight-Observation-1 CareConnect-Observation-1
CareConnect-DCH-Height-Observation-1 CareConnect-Observation-1
CareConnect-DCH-Length-Observation-1 CareConnect-Observation-1
CareConnect-DCH-HeadCircumference-Observation-1 CareConnect-Observation-1
CareConnect-DCH-BMICentile-Observation-1 CareConnect-Observation-1
CareConnect-BloodPressure-Observation-1 CareConnect-BloodPressure-Observation-1
CareConnect-HeartRate-Observation-1 CareConnect-HeartRate-Observation-1
CareConnect-BodyTemperature-Observation-1 CareConnect-BodyTemperature-Observation-1
CareConnect-RespiratoryRate-Observation-1 CareConnect-RespiratoryRate-Observation-1
CareConnect-OxygenSaturation-Observation-1 CareConnect-OxygenSaturation-Observation-1
CareConnect-DCH-NCMPWithdrawal-Observation-1 CareConnect-Observation-1
Tags: fhir