# FHIR Observation

Language Version: EN | [CH](https://hackmd.io/xcA3Jw2oT5qThxFV8YZ9JQ)

FHIR Vital Sign Profiles:
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Official Documentation: [https://build.fhir.org/observation-vitalsigns.html](https://build.fhir.org/observation-vitalsigns.html)

The official documentation is not beginner friendly.

Extended Specification
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In the field of medicine and healthcare, numerous scenarios for information exchange lack standardization. For instance, IoT devices such as smart rings, smart watches, smart earphones, smart clothing, etc. These devices can record a variety of biomedical signals and offer many diverse applications. However, there’s presently no specification for the FHIR standard in these scenarios. Many of these innovative IoT -based vital sign monitoring devices lack FHIR specification and need to be proposed.

Video: [http://fhir.tcumi.com:51888/user5/24/2024-03-08_CSVtoFHIR.mp4](http://fhir.tcumi.com:51888/user5/24/2024-03-08_CSVtoFHIR.mp4)

Vital Sign Profile Extension
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1. A documentation that is easier to understand and implement is needed. The current publicly announced FHIR specification are difficult to understand.

a. Official documentation on vital signs specification: [https://build.fhir.org/observation-vitalsigns.html](https://build.fhir.org/observation-vitalsigns.html)

b. Simple Excel table on vital signs specification: [https://docs.google.com/spreadsheets/d/1bvwwGwCNP22X3ZtdvXHs9_SdEGLW1nTV/edit?rtpof=true&sd=true](https://docs.google.com/spreadsheets/d/1bvwwGwCNP22X3ZtdvXHs9_SdEGLW1nTV/edit?rtpof=true&sd=true)

c. Official documentation on physical activity measurement: [https://build.fhir.org/ig/HL7/physical-activity/measures.html](https://build.fhir.org/ig/HL7/physical-activity/measures.html)

2. Specification for extended scenarios.

a. Measuring Body temperature from finger temperature.

Implementation of JSON format of FHIR specification using the Class and Instance concepts
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Purpose:

1. Easier implementation of FHIR for developers.

JSON Class for PHR Body Temperature
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Steps:

1. Get JSON example from the official documentation and make it simpler.
2. Convert the JSON example to a JSON object.
3. Modify the Observation (JSON object). Fileds that can be modified include: subject reference, effective date time, value quantity, etc.)
4. Modified Observation becomes a new observation.

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" : "8310-5",
      "display" : "Body temperature"   }],
    "text" : "Body temperature"
  },
  "subject" : {    "reference" : "Patient/example"  },
  "effectiveDateTime" : "1999-07-02",
  "valueQuantity" : {
    "value" : 36.5,
    "unit" : "C",
    "system" : "http://unitsofmeasure.org",
    "code" : "Cel"
  }
}

### Fields to be filled in the Instance

1. subject.reference
- Can refer to anonymous Patient for PHR server (Documentation: [https://hackmd.io/dMUkWuKyQDWxkr3IMe-yWQ#For-PHR-or-AI](https://hackmd.io/dMUkWuKyQDWxkr3IMe-yWQ#For-PHR-or-AI))
2. effectiveDateTime
3. valueQuantity.value

Similar JSON classes in the same scenarios.
--------------------------------------------

In the vital signs scenario, JSON class for Body temperature or heart rate or other vital sign observations will have similar structures.

Below are the comparison between FHIR Observation class for Heart rate and Oxygen saturation.

Other FHIR Observation Scenarios, types of observation data to be recorded, the fields included, and the data type.
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1. One Observation produces multiple values (e.g. blood pressure)
2. Continues observation, large volume of data
3. Other scenarios (proposed by ChatGPT: [https://chat.openai.com/share/cbc41b03-80d1-47ae-b3f0-756aff6e0691](https://chat.openai.com/share/cbc41b03-80d1-47ae-b3f0-756aff6e0691))

Introduction of FHIR Observation
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### Examples

Note: Before uploading the Observation, you need to create a FHIR Patient on the server. In the Observation, modify the subject.reference to the Patient id uploaded earlier. In the example below, replace Patient/example with Patient/your_id

{
  "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" : "8867-4",
      "display" : "Heart rate"
    }],
    "text" : "Heart rate"
  },
  "subject" : {
    "reference" : "Patient/example"
  },
  "effectiveDateTime" : "1999-07-02",
  "valueQuantity" : {
    "value" : 44,
    "unit" : "beats/minute",
    "system" : "http://unitsofmeasure.org",
    "code" : "/min"
  }
}

Other Observation examples available on Google Drive: [https://drive.google.com/drive/folders/1RFCAufR0v_8QDfObempBv4MpdYaiRCzK](https://drive.google.com/drive/folders/1RFCAufR0v_8QDfObempBv4MpdYaiRCzK)

How to POST Observation for vital sign data?
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Please click [here](https://drive.google.com/file/d/15eTXHpTMqI39W1Cfl1et4ZZJ9DR5YF2k/view)