Observation Resource

Observation is a FHIR resource that is "used to support diagnosis, monitor progress, determine baselines and patterns and even capture demographic characteristics." As such, Observations have a wide range of uses and show up in a wide range of places. FHIR Observations are mapped to OpenMRS Obs objects.

Supported Elements

The following properties are supported by the OpenMRS FHIR Module:

```
Observation.id
```
```
Observation.code
```
```
Observation.category
```
```
Observation.status
```
```
Observation.interpretation
```
```
Observation.issued
```
Observation.encounter
Observation.basedOn
Observation.subject
Observation.value[x]

OpenMRS ↔ FHIR Mapping

OpenMRS Data Model	FHIR Resource Element
Obs.uuid	Observation.id
Obs.concept	Observation.code
^Obs.concept	Observation.category
Obs.status	Observation.status
Obs.interpretation	Observation.interpretation
Obs.dateCreated	Observation.issued
Obs.encounter	Observation.encounter
Obs.order	Observation.basedOn
Obs.person	Observation.subject
Obs.value[x]	Observation.value[x]

¹category is determined by a simple mapping table (fhir_observation_category_map) that maps between the FHIR observation category value-set (if possible) and a particular conceptClass. By default, the following categories will be mapped if the expected versions of them exist in the concept dictionary:

Category	Concept Class
laboratory	Test
procedure	Procedure
exam	Finding

² value[x] mappings between OMRS and Observation are largely one-to-one where possible. Numeric values are generally mapped to valueQuantity; coded observations are mapped to valueCodeableConcept, etc.

Code System Mapping

The FHIR2 module has a fairly generic system for mapping between OpenMRS concepts and observation codes. The FHIR2 module will send and accept codes from any coding system it knows about. A few of the common ones (note that these should usually be available by default):

URL	Code System
http://loinc.org	LOINC
http://snomed.info/sct	SNOMED CT
https://openconceptlab.org/orgs/CIEL/sources/CIEL	CIEL

In addition, the FHIR module will send and accept the concept UUID without any system as a reference to that concept. The FHIR module can be instructed to use other systems as well. Mappings between system URLs and the underlying OpenMRS concept sources are maintained in a simple mapping table (fhir_concept_source). Adding a new entry to the table will add a newly supported concept system.

Available RESTful Endpoints

Note: placeholder "{release}" below must be replaced by the FHIR Release - currently "R3" and "R4" are implemented. See more on the FHIR Release support page.

GET

URL	Description
/ws/fhir2/{release}/Observation	Gets all observations
/ws/fhir2/{release}/Observation/{uuid}	Gets a specific observation
/ws/fhir2/{release}/Observation?{query}	Searches for observations matching the provided criteria

Supported Search Parameters

Parameter	Value Type	Description
date	date	Searches for observations by the observation date and time
code	token	Searches for observations with particular codes (concepts)
category	token	Searches for observations by the observation category
encounter	reference	Searches the encounter in which this observation was recorded
subject	reference	Searches for observations by a given patient
subject.identifier	token	Searches for observations by the patient identifier
subject.given	string	Searches for observations based on the patient's given name(s)
subject.family	string	Searches for observations based on the patient's family name
subject.name	string	Searches for observations based on the patient's full or partial name
patient	reference	Searches for observations by a given patient
patient.identifier	token	Searches for observations by the patient identifier
patient.given	string	Searches for observations based on the patient's given name(s)
patient.family	string	Searches for observations based on the patient's family name
patient.name	string	Searches for observations based on the patient's full or partial name
has-member	reference	Searches for an observation group that contains a given observation
has-member.code	token	Searches for an observation group that contains an observation with the provided code
value-concept	token	Searches for an observation whose value is a concept that matches the provided concept code
value-date	date	Searches for an observation whose value is a date by the specified date range.
_id		Searches based on the exact UUID of the person record
_lastUpdated	date	Searches based on the the dateCreated field for the observation record

¹ See the notes on category mapping above

Supported _includes

Include	Description
Observation:encounter	Includes the encounter for any observations in the result set
Observation:patient	Includes the patient for any observations in the result set
Observation:has-member	Includes the observation group members for any observation group in the result set

Supported _revincludes

Include	Description
Observation:has-member	Includes the observation group observation for any searches that match an observation group memeber
DiagnosticReport:result	Includes the diagnostic report (if any) for which this observation is a result

POST

URL	Description
/ws/fhir2/{release}/Observation	Creates a new observation

DELETE

URL	Description
/ws/fhir2/{release}/Observation/{uuid}	Deletes (voids) the specified observation

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