Observation Create (R4) - Blood Pressure (Systolic and Diastolic)

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paresh pradhan

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Mar 24, 2022, 7:45:37 PM3/24/22
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Hi Cerner Team,
Could you please provide us a sample request for Observation Create (R4) -Vitals-  Blood Pressure  (Systolic and Diastolic)? The request I am sending I am getting error - 422 Unprocessable Entity. This is urgent for one of our integration.
Our system account id is - 9a0a**********************97e92 

Thanks,
Paresh

paresh pradhan

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Mar 25, 2022, 9:39:12 AM3/25/22
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Hi Cerner Team,
Could you please respond to my email? This is urgent for one of our Cerner integration.   Could you please  provide us a sample request for Observation Create (R4) -Vitals-  Blood Pressure  (Systolic and Diastolic)? I am getting 422 Unprocessable Entity.
Our system account id is - 9a0a**********************97e92 

Thanks,
Paresh


paresh pradhan

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Apr 11, 2022, 8:48:15 AM4/11/22
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Hi Cerner Team,
Any update on  this?Could you please  provide us a sample request for Observation Create (R4) -Vitals-  Blood Pressure  (Systolic and Diastolic)? I am getting 422 Unprocessable Entity.
Our system account id is - 9a0a**********************97e92 
Thanks,
Paresh


Fenil Desani (Cerner)

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Apr 15, 2022, 1:40:22 PM4/15/22
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Hello Paresh,

Please provide the X-Request-Id of your failure.

Thanks,
Fenil

paresh pradhan

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Apr 15, 2022, 2:08:00 PM4/15/22
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Hi Fenil,
Please find below X-Request-Id
X-Request-Id3f7ff602-dd19-4ef6-ab1a-c85e1d3f265e+0849.
Thanks,
Paresh

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Fenil Desani (Cerner)

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Apr 18, 2022, 10:26:24 AM4/18/22
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It's not able to identify the unit of measure. Would you mind sharing the POST body?

paresh pradhan

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Apr 18, 2022, 12:07:03 PM4/18/22
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Hi Fenil,
I tried again -- the code was   "code""bpm" the previous request ID. I changed it to -  "code""/min". Please find below the latest Request ID with the post body.
Thank you so much.
Paresh
X-Request-Id751c6dd4-6b5b-4fd7-860d-034219e9b001+4522
Post Body -
{
    "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""8889-8",
                "display""Blood pressure panel with all children optional"
            }
        ],
        "text""Blood pressure"
    },
    "subject": {
        "reference""Patient/12457978"
    },
    "encounter": {
        "reference""Encounter/97943536"
    },
    "effectiveDateTime""2021-02-08T18:41:00.000Z",
    "issued""2021-02-08T18:42:00.000Z",
    "performer": [
        {
            "reference""Practitioner/744111"
        }
    ],
    "valueQuantity": {
        "value"108.0,
        "unit""bpm",
        "system""http://unitsofmeasure.org",
        "code""/min"
    }
}

Michael Spohnholtz WA-Seattle

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Apr 18, 2022, 1:03:06 PM4/18/22
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Always best to query an existing value in the EHR with FHIR, to fully understand the expected values to POST.  This was a query on blood pressure for out EHR:
 "valueQuantity": {
                            "value": 135,
                            "unit": "mmHg",
                            "system": "http://unitsofmeasure.org",
                            "code": "mm[Hg]"
                        },

Note bpm ("beats per min" relate to heart rate / pulse rate / etc)

paresh pradhan

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Apr 19, 2022, 7:48:37 AM4/19/22
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Thank you so much Michael!
I did query for the patient -  12457978 in Cerner sandbox and found unit - mmHg and code - mm[Hg]. It did not work, same error code-422 and Unprocessable entity  . No details about the error so I was trying different unit and code (bpm and /min) combination. Please find below the Post Body and the request-id in postman. I tried to send the "value quantity" as component but that also didn't work and tried blood pressure code (
So any help would be highly appreciated.

X-Request-Id: 2fd48419-b346-4bf4-bc3f-804d55bc8f64+1401

{
    "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": "8889-8",
                "display": "Blood pressure panel with all children optional"
            }
        ],
        "text": "Blood pressure"
    },
    "subject": {
        "reference": "Patient/12457978"
    },
    "encounter": {
        "reference": "Encounter/97943536"
    },
    "effectiveDateTime": "2022-04-19T18:41:00.000Z",
    "issued": "2021-02-08T18:42:00.000Z",
    "performer": [
        {
            "reference": "Practitioner/744111"
        }
    ],
    "valueQuantity": {
        "value": 140,

Fenil Desani (Cerner)

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Apr 19, 2022, 10:06:01 AM4/19/22
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That LOINC doesn't seem to be mapped on our side. Please use other LOINC such as 8454-1
 {
"system": "http://loinc.org",
"code": "8454-1",
"display": "Diastolic blood pressure--standing"
}

paresh pradhan

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Apr 19, 2022, 11:36:45 AM4/19/22
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Thank you so much Fenil!
I really appreciate your help!!. Could you please send me LONIC code for (Systolic blood pressure) and  (heart rate / pulse rate)?
Also please confirm  "component":" is supported for Blood Pressure.
Thanks again.
Regards,
Paresh

paresh pradhan

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Apr 19, 2022, 11:37:39 AM4/19/22
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Any document Cerner- LONIC code mapping?
Regards,
Paresh

paresh pradhan

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Apr 22, 2022, 3:15:59 PM4/22/22
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Hi Fenil,
I am trying below Lonic codes for Systolic blood pressure and Heart rate by Pulse oximetry but getting error code - 422. Please find below the request Ids. Could you please help me to resolve this? 
Regards,
Paresh
Systolic blood pressure- - X-Request-Id: 9526bae9-5e15-4456-92e7-0532a02d53f9+8430
            {
                "system": "http://loinc.org",
                "code": "8480-6",
                "display": "Systolic blood pressure--standing"
            }
           
        Heart rate by Pulse oximetry-     X-Request-Id: bd784d48-ddf2-4e49-9838-42bb09fb7541+1610

            {
                "system": "http://loinc.org",
                "code": "8889-8",
                "display": "Heart rate by Pulse oximetry"
            }
     

On Tuesday, April 19, 2022 at 10:06:01 AM UTC-4 Fenil Desani (Cerner) wrote:

Fenil Desani (Cerner)

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Apr 25, 2022, 10:15:30 AM4/25/22
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The following values are mapped in our public Sandbox. Try from the following for the purpose of testing. 
Systolic blood pressure--sitting
LOINC 
8459-0

Systolic blood pressure--standing
LOINC
8460-8

Heart rate --supine
LOINC
68999-2

Heart rate --sitting
LOINC
69000-8

Heart rate --standing
LOINC
69001-6

Heart rate Peripheral artery by palpation
LOINC
8893-0

Heart rate Cardiac apex by Auscultation
LOINC
8890-6

Heart rate.beat-to-beat by EKG
LOINC
76282-3

paresh pradhan

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Apr 25, 2022, 10:51:45 AM4/25/22
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Thank you so much!
Regards,
Paresh

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