---
tags: USCDI v4
title: Vital Signs
cat: moderate
---

<style>.markdown-body { max-width: 1500px; }</style>

## :new: Vital Signs Data Elements

Physiologic measurements of a patient that indicate the status of the body’s life sustaining functions.

<!-- quote -->

Draft


Final


<!-- table -->

DATA ELEMENT|APPLICABLE VOCABULARY STANDARD(S)|US Core V6 Proposal
---|---|---
**Average Blood Pressure**<br/>Arithmetic average of systolic and diastolic components of two of more blood pressure readings in a specified time period or according to a specified algorithm or protocol. <br/><br/>Examples include but are not limited to 3-day morning and evening home monitoring, clinical encounter repeat average, and 24-hour ambulatory measurement.|Both standards are required.<br/><br/>Logical Observation Identifiers Names and Codes (LOINC) version 2.74 <br/><br/>The Unified Code of Units for Measure, Revision 2.1|:new: US Core Mean Blood Pressure Profile using [Vital Signs with Qualifying Elements (CIMI):Average Blood Pressure](http://hl7.org/fhir/us/vitals/STU1/StructureDefinition-average-blood-pressure.html) as a blueprint

### Known issues

1. ONC is clarified the definition (MAP vs Mean) (although if you review the submission and comments it is pretty clear they mean Average Blood Pressure)

>Card-X comments to ONC on this data element:
...Our Hypertension Management use case team (https://confluence.hl7.org/display/COD/CardX+-+Hypertension+Management) is actively working on leveraging – and extending – existing standards to represent Average Blood Pressure in accurate, meaningful and actionable terms for clinical decision making. We note that the concept of Average Blood Pressure is not the same as the concept of Mean Arterial Pressure. We urge ONC to clarify the data element definition to specifically refer to “arithmetic mean”. ....

>USCDI v4 referenced this submission https://www.healthit.gov/isa/taxonomy/term/1391/draft-uscdi-v4#uscdi-proposal-mode-uscdi-data-element-page-display which in turn included a discussion and reference to http://hl7.org/fhir/us/vitals/STU1/StructureDefinition-average-blood-pressure.html, which can turn it more complex. :point_down:

### Review existing US Realm profiles for guidance.

- [Vital Signs with Qualifying Elements (CIMI)](http://build.fhir.org/ig/HL7/cimi-vital-signs/branches/master/StructureDefinition-average-blood-pressure.html)

Profile in a nutshell: Blood pressure panel mean (e.g., N BPs/N) systolic and mean diastolic ([LOINC 96607-7](https://loinc.org/96607-7))

Add note to include protocol "Information about the protocol used to determine averages SHOULD be supplied in Observation.note.text (for example, ‘ 24-hour ambulatory measurement.’)"

### Decisions

:new: US Core Mean Blood Pressure Profile (see table)

- Blood pressure panel mean (e.g., N BPs/N) systolic and mean diastolic ([LOINC 96607-7](https://loinc.org/96607-7))
- Add implementation guidance on protocol: e.g., *Information about the protocol used to determine averages SHOULD be supplied in Observation.note.text (for example, ‘ 24-hour ambulatory measurement.’)*
- Add implementation guidance on CIMI and Card-X extensions

### :arrow_right: [Average Blood Pressure Profile and Examples](https://healthedata1.github.io/USCDI4-Sandbox/artifacts.html#average-blood-pressure)

### IG Updates

- [ ] USCDI Mapping Table
- [ ] :new: US Core Profile/Extensions
- [ ] New Example(s)

---