Observation

Overview

The Observation resource represents measurements and simple assertions made about patients, devices, or other subjects. This includes vital signs, laboratory results, clinical assessments, and other clinical observations.

Important: Always validate Observation resource support and available operations by retrieving the current CapabilityStatement from /metadata before implementing integrations.

Resource Schema

The Observation resource follows the HL7 FHIR R4 Observation specification.

Key elements include:

• identifier - Business identifiers for the observation
• basedOn - Fulfills plan, proposal or order
• partOf - Part of referenced event
• status - Registered, preliminary, final, amended, corrected, cancelled, entered-in-error, unknown
• category - Classification of type of observation
• code - Type of observation (LOINC, SNOMED CT)
• subject - Who and/or what the observation is about
• focus - What the observation is about when not about subject
• encounter - Healthcare event during which observation was made
• effectiveDateTime - Clinically relevant time/time-period for observation
• effectivePeriod - Clinically relevant time/time-period for observation
• issued - Date/Time this version was made available
• performer - Who is responsible for the observation
• valueQuantity - Actual result
• valueCodeableConcept - Actual result
• valueString - Actual result
• valueBoolean - Actual result
• valueInteger - Actual result
• valueRange - Actual result
• valueRatio - Actual result
• valueSampledData - Actual result
• valueTime - Actual result
• valueDateTime - Actual result
• valuePeriod - Actual result
• dataAbsentReason - Why the result is missing
• interpretation - High, low, normal, etc.
• note - Comments about the observation
• bodySite - Observed body part
• method - How it was done
• specimen - Specimen used for this observation
• device - (Measurement) Device
• referenceRange - Provides guide for interpretation
• hasMember - Related resource that belongs to the Observation group
• derivedFrom - Related measurements the observation is made from
• component - Component results

Example Observation Resource

{
  "resourceType": "Observation",
  "id": "12345",
  "identifier": [{
    "use": "official",
    "system": "http://hospital.example.org/observations",
    "value": "OBS-2024-001"
  }],
  "status": "final",
  "category": [{
    "coding": [{
      "system": "http://terminology.hl7.org/CodeSystem/observation-category",
      "code": "vital-signs",
      "display": "Vital Signs"
    }]
  }],
  "code": {
    "coding": [{
      "system": "http://loinc.org",
      "code": "8480-6",
      "display": "Systolic blood pressure"
    }]
  },
  "subject": {
    "reference": "Patient/12345"
  },
  "encounter": {
    "reference": "Encounter/67890"
  },
  "effectiveDateTime": "2024-01-15T10:30:00Z",
  "issued": "2024-01-15T10:35:00Z",
  "performer": [{
    "reference": "Practitioner/67890"
  }],
  "valueQuantity": {
    "value": 120,
    "unit": "mmHg",
    "system": "http://unitsofmeasure.org",
    "code": "mm[Hg]"
  },
  "interpretation": [{
    "coding": [{
      "system": "http://terminology.hl7.org/CodeSystem/v3-ObservationInterpretation",
      "code": "N",
      "display": "Normal"
    }]
  }],
  "referenceRange": [{
    "low": {
      "value": 90,
      "unit": "mmHg",
      "system": "http://unitsofmeasure.org",
      "code": "mm[Hg]"
    },
    "high": {
      "value": 140,
      "unit": "mmHg",
      "system": "http://unitsofmeasure.org",
      "code": "mm[Hg]"
    },
    "type": {
      "coding": [{
        "system": "http://terminology.hl7.org/CodeSystem/referencerange-meaning",
        "code": "normal",
        "display": "Normal Range"
      }]
    }
  }]
}

Supported Profiles

This API supports the following FHIR profiles:

• HL7 FHIR R4 Observation

Operations

The Certified API Observation resource supports the following standard operations. However, support varies by the targeted CareRecord or solution.

CareRecord / Solution	Create	Read	Update	Search
GEHRIMED	-	Yes	-	Yes
myAvatar	Yes	Yes	Yes	Yes
myEvolv	-	Yes	-	Yes
myUnity	-	Yes	-	Yes

Search

info

Not all Netsmart solutions support Observation search. See supported operations table above and consult your target solution's documentation for more information.

This operation retrieves a list of resources by these query parameters.

Standard Parameters

info

Although marked as optional, this API requires either a category or code be provided with the search.

Name	Type	Description
patient	reference	REQUIRED The subject that the observation is about (if patient)
category	token	The classification of the type of observation
code	token	The code of the observation type
date	date	Obtained date/time. If the obtained element is a period, a date that falls in the period.
encounter	reference	Encounter related to the observation

Search Examples

Via POST

The POST method is recommended as it keeps health information out of the URL.

Production

Search by Patient and Code

curl -X POST https://fhir.netsmartcloud.com/uscore/v1/Observation/_search \
    -H "Authorization: {Bearer Token}" \
    -H "Accept: application/fhir+json" \
    -H "Content-Type: application/x-form-urlencoded" \
    -d "patient=Patient/147" \
    -d "code=2708-6"

Preview

Search by Patient and Code

curl -X POST https://fhirtest.netsmartcloud.com/uscore/v1/Observation/_search \
    -H "Authorization: {Bearer Token}" \
    -H "Accept: application/fhir+json" \
    -H "Content-Type: application/x-form-urlencoded" \
    -d "patient=Patient/147" \
    -d "code=2708-6"

Via GET

Production

Search by Patient and Code

curl -X GET "https://fhir.netsmartcloud.com/uscore/v1/Observation?patient=Patient/147&code=2708-6" \
    -H "Authorization: {Bearer Token}" \
    -H "Accept: application/fhir+json"

Preview

Search by Patient and Code

curl -X GET "https://fhirtest.netsmartcloud.com/v4/Observation?patient=Patient/147&code=2708-6" \
    -H "Authorization: {Bearer Token}" \
    -H "Accept: application/fhir+json"

Error Handling

For information about error responses when working with Observation resources, see Common Errors.

Common Observation-related errors include:

• Missing required patient reference
• Invalid observation codes or LOINC codes
• Missing required category or code parameters in search
• Malformed observation dates or values

Integration Patterns

Vital Signs Monitoring

Retrieve patient's vital signs:

# Get vital signs observations
curl -X GET "https://fhir.netsmartcloud.com/v4/Observation?patient=12345&category=vital-signs" \
    -H "Authorization: Bearer {token}" \
    -H "Accept: application/fhir+json"

Laboratory Results

Track lab results over time:

# Get lab results by date range
curl -X GET "https://fhir.netsmartcloud.com/v4/Observation?patient=12345&category=laboratory&date=ge2024-01-01" \
    -H "Authorization: Bearer {token}" \
    -H "Accept: application/fhir+json"

Clinical Decision Support

Retrieve specific observation types:

# Get blood pressure readings
curl -X GET "https://fhir.netsmartcloud.com/v4/Observation?patient=12345&code=8480-6" \
    -H "Authorization: Bearer {token}" \
    -H "Accept: application/fhir+json"

Encounter-Based Observations

Get observations from specific encounters:

# Get observations from encounter
curl -X GET "https://fhir.netsmartcloud.com/v4/Observation?encounter=67890" \
    -H "Authorization: Bearer {token}" \
    -H "Accept: application/fhir+json"

Relationships to Other Resources

The Observation resource connects to many clinical resources:

• Patient - The individual being observed
• Practitioner - Healthcare providers making observations
• Encounter - Clinical encounters during which observations are made
• Device - Medical devices generating observations
• Condition - Health conditions supported by observations
• Goal - Treatment goals tracked through observations
• Procedure - Procedures that generate observations

Support

For questions about Observation resource implementation or clinical data integration, contact Netsmart support through your designated support channels.