{
"description": "An Obervation resource as defined by the Dutch Health and Care Information models (Dutch: Zorginformatiebouwsteen or ZIB) ApgarScore v1.0(2017EN).\\r\\n\\r\\nThe Apgar score represents the overall clinical status of a newborn child. This is evaluated one, five and ten minutes after birth based on 5 parameters: Appearance, Pulse, Grimace, Activity, Respiration. If the score measured at 5 minutes is < 8, the Apgar score is measured again at 10, 15, 20 minutes etc. until the score = 8.",
"_filename": "zib-ApgarScore.json",
"package_name": "nictiz.fhir.nl.stu3.zib2017",
"date": null,
"derivation": "constraint",
"publisher": "Nictiz",
"fhirVersion": "3.0.2",
"purpose": "# Purpose of HCIM\r\nThe Apgar score is primarily meant to rapidly determine the clinical condition of the newborn child and whether extra care is required. A low Apgar score can be caused by developmental disorders, prenatal accidents or negative influences during birth. The Apgar score remains a snapshot in time and cannot be used to predict the locomotive or mental development of a child.",
"name": "Zib ApgarScore",
"mapping": [ {
"uri": "https://zibs.nl/wiki/ApgarScore-v1.0(2017EN)",
"name": "HCIM ApgarScore-v1.0(2017EN)",
"identity": "hcim-apgarscore-v1.0-2017EN"
} ],
"abstract": false,
"copyright": "CC0",
"type": "Observation",
"experimental": null,
"resourceType": "StructureDefinition",
"title": "HCIM ApgarScore",
"package_version": "2.2.13",
"status": "active",
"id": "69e611d0-a81f-4cbd-9c4f-da2dadbd1178",
"kind": "resource",
"url": "http://nictiz.nl/fhir/StructureDefinition/zib-ApgarScore",
"version": "1.0.2",
"differential": {
"element": [ {
"id": "Observation",
"path": "Observation",
"short": "ApgarScore",
"mapping": [ {
"map": "NL-CM:12.16.1",
"comment": "ApgarScore",
"identity": "hcim-apgarscore-v1.0-2017EN"
} ],
"constraint": [ {
"key": "zib-apgarscore-1",
"human": "Exactly one of the time code slices SHALL be used for Observation.code",
"severity": "error",
"expression": "code.coding.where(system='http://loinc.org').where(code='9272-6' or code='9274-2' or code='9271-8').count()=1"
}, {
"key": "zib-apgarscore-2",
"human": "Components for 1 minute Apgar score are only allowed when Observation.code indicates 1 minute Apgar score",
"severity": "error",
"expression": "component.code.coding.where(system='http://loinc.org').where(code='32410-3' or code='32406-1' or code='32407-9' or code='32409-5' or code='32408-7').exists() implies code.coding.where(system='http://loinc.org').where(code='9272-6').exists()"
}, {
"key": "zib-apgarscore-3",
"human": "Components for 5 minute Apgar score are only allowed when Observation.code indicates 5 minute Apgar score",
"severity": "error",
"expression": "component.code.coding.where(system='http://loinc.org').where(code='32415-2' or code='32411-1' or code='32412-9' or code='32414-5' or code='32413-7').exists() implies code.coding.where(system='http://loinc.org').where(code='9274-2').exists()"
}, {
"key": "zib-apgarscore-4",
"human": "Components for 10 minute Apgar score are only allowed when Observation.code indicates 10 minute Apgar score",
"severity": "error",
"expression": "component.code.coding.where(system='http://loinc.org').where(code='32405-3' or code='32401-2' or code='32402-0' or code='32404-6' or code='32403-8').exists() implies code.coding.where(system='http://loinc.org').where(code='9271-8').exists()"
} ]
}, {
"id": "Observation.code",
"path": "Observation.code",
"example": [ {
"label": "Example of 1 Minute ApgarScore",
"valueCodeableConcept": {
"coding": [ {
"code": "9272-6",
"system": "http://loinc.org",
"display": "1 minute Apgar Score"
} ]
}
} ]
}, {
"id": "Observation.code.coding",
"min": 1,
"path": "Observation.code.coding",
"slicing": {
"rules": "open",
"discriminator": [ {
"path": "system",
"type": "value"
}, {
"path": "code",
"type": "value"
} ]
}
}, {
"id": "Observation.code.coding:1MinuteApgarScore",
"max": "1",
"path": "Observation.code.coding",
"sliceName": "1MinuteApgarScore"
}, {
"id": "Observation.code.coding:1MinuteApgarScore.system",
"min": 1,
"path": "Observation.code.coding.system",
"fixedUri": "http://loinc.org"
}, {
"id": "Observation.code.coding:1MinuteApgarScore.code",
"min": 1,
"path": "Observation.code.coding.code",
"fixedCode": "9272-6"
}, {
"id": "Observation.code.coding:1MinuteApgarScore.display",
"path": "Observation.code.coding.display",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
"valueBoolean": true
} ],
"defaultValueString": "1 minute Apgar Score"
}, {
"id": "Observation.code.coding:5MinuteApgarScore",
"max": "1",
"path": "Observation.code.coding",
"sliceName": "5MinuteApgarScore"
}, {
"id": "Observation.code.coding:5MinuteApgarScore.system",
"min": 1,
"path": "Observation.code.coding.system",
"fixedUri": "http://loinc.org"
}, {
"id": "Observation.code.coding:5MinuteApgarScore.code",
"min": 1,
"path": "Observation.code.coding.code",
"fixedCode": "9274-2"
}, {
"id": "Observation.code.coding:5MinuteApgarScore.display",
"path": "Observation.code.coding.display",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
"valueBoolean": true
} ],
"defaultValueString": "5 minute Apgar Score"
}, {
"id": "Observation.code.coding:10MinuteApgarScore",
"max": "1",
"path": "Observation.code.coding",
"sliceName": "10MinuteApgarScore"
}, {
"id": "Observation.code.coding:10MinuteApgarScore.system",
"min": 1,
"path": "Observation.code.coding.system",
"fixedUri": "http://loinc.org"
}, {
"id": "Observation.code.coding:10MinuteApgarScore.code",
"min": 1,
"path": "Observation.code.coding.code",
"fixedCode": "9271-8"
}, {
"id": "Observation.code.coding:10MinuteApgarScore.display",
"path": "Observation.code.coding.display",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
"valueBoolean": true
} ],
"defaultValueString": "10 minute Apgar Score"
}, {
"path": "Observation.effectiveDateTime",
"min": 1,
"definition": "The day and time at which the Apgar score is registered.",
"short": "ApgarScoreDateTime",
"mapping": [ {
"map": "NL-CM:12.16.3",
"comment": "ApgarScoreDateTime",
"identity": "hcim-apgarscore-v1.0-2017EN"
} ],
"type": [ {
"code": "dateTime"
} ],
"sliceName": "effectiveDateTime",
"alias": [ "ApgarScoreDatumTijd" ],
"id": "Observation.effective[x]:effectiveDateTime"
}, {
"path": "Observation.value[x]",
"min": 1,
"definition": "Total of the Apgar score.",
"short": "ApgarScoreTotal",
"mapping": [ {
"map": "NL-CM:12.16.2",
"comment": "ApgarScoreTotal",
"identity": "hcim-apgarscore-v1.0-2017EN"
} ],
"type": [ {
"code": "Quantity"
} ],
"sliceName": "valueQuantity",
"alias": [ "ApgarScoreTotaal" ],
"id": "Observation.value[x]:valueQuantity"
}, {
"id": "Observation.value[x]:valueQuantity.value",
"path": "Observation.value[x].value",
"maxValueDecimal": 10,
"minValueDecimal": 0
}, {
"id": "Observation.comment",
"path": "Observation.comment",
"alias": [ "Toelichting" ],
"short": "Comment",
"mapping": [ {
"map": "NL-CM:12.16.9",
"comment": "Comment",
"identity": "hcim-apgarscore-v1.0-2017EN"
} ],
"definition": "Comment on the Apgar score."
}, {
"id": "Observation.component",
"path": "Observation.component",
"slicing": {
"rules": "open",
"discriminator": [ {
"path": "code",
"type": "pattern"
} ]
}
}, {
"id": "Observation.component:1MinuteRespiratoryScore",
"max": "1",
"path": "Observation.component",
"sliceName": "1MinuteRespiratoryScore"
}, {
"id": "Observation.component:1MinuteRespiratoryScore.code",
"path": "Observation.component.code",
"patternCodeableConcept": {
"coding": [ {
"code": "32410-3",
"system": "http://loinc.org"
} ]
}
}, {
"path": "Observation.component.valueCodeableConcept",
"definition": "The Apgar subscore for respiration.",
"short": "RespiratoryScore",
"mapping": [ {
"map": "NL-CM:12.16.4",
"comment": "RespiratoryScore",
"identity": "hcim-apgarscore-v1.0-2017EN"
} ],
"type": [ {
"code": "CodeableConcept"
} ],
"sliceName": "valueCodeableConcept",
"binding": {
"strength": "extensible",
"description": "AdemhalingScoreCodelijst",
"valueSetReference": {
"reference": "http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.12.16.1--20171231000000"
}
},
"alias": [ "AdemhalingScore" ],
"id": "Observation.component:1MinuteRespiratoryScore.value[x]:valueCodeableConcept"
}, {
"id": "Observation.component:5MinuteRespiratoryScore",
"max": "1",
"path": "Observation.component",
"sliceName": "5MinuteRespiratoryScore"
}, {
"id": "Observation.component:5MinuteRespiratoryScore.code",
"path": "Observation.component.code",
"patternCodeableConcept": {
"coding": [ {
"code": "32415-2",
"system": "http://loinc.org"
} ]
}
}, {
"path": "Observation.component.valueCodeableConcept",
"definition": "The Apgar subscore for respiration.",
"short": "RespiratoryScore",
"mapping": [ {
"map": "NL-CM:12.16.4",
"comment": "RespiratoryScore",
"identity": "hcim-apgarscore-v1.0-2017EN"
} ],
"type": [ {
"code": "CodeableConcept"
} ],
"sliceName": "valueCodeableConcept",
"binding": {
"strength": "extensible",
"description": "AdemhalingScoreCodelijst",
"valueSetReference": {
"reference": "http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.12.16.1--20171231000000"
}
},
"alias": [ "AdemhalingScore" ],
"id": "Observation.component:5MinuteRespiratoryScore.value[x]:valueCodeableConcept"
}, {
"id": "Observation.component:10MinuteRespiratoryScore",
"max": "1",
"path": "Observation.component",
"sliceName": "10MinuteRespiratoryScore"
}, {
"id": "Observation.component:10MinuteRespiratoryScore.code",
"path": "Observation.component.code",
"patternCodeableConcept": {
"coding": [ {
"code": "32405-3",
"system": "http://loinc.org"
} ]
}
}, {
"path": "Observation.component.valueCodeableConcept",
"definition": "The Apgar subscore for respiration.",
"short": "RespiratoryScore",
"mapping": [ {
"map": "NL-CM:12.16.4",
"comment": "RespiratoryScore",
"identity": "hcim-apgarscore-v1.0-2017EN"
} ],
"type": [ {
"code": "CodeableConcept"
} ],
"sliceName": "valueCodeableConcept",
"binding": {
"strength": "extensible",
"description": "AdemhalingScoreCodelijst",
"valueSetReference": {
"reference": "http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.12.16.1--20171231000000"
}
},
"alias": [ "AdemhalingScore" ],
"id": "Observation.component:10MinuteRespiratoryScore.value[x]:valueCodeableConcept"
}, {
"id": "Observation.component:1MinuteAppearanceScore",
"max": "1",
"path": "Observation.component",
"sliceName": "1MinuteAppearanceScore"
}, {
"id": "Observation.component:1MinuteAppearanceScore.code",
"path": "Observation.component.code",
"patternCodeableConcept": {
"coding": [ {
"code": "32406-1",
"system": "http://loinc.org"
} ]
}
}, {
"path": "Observation.component.valueCodeableConcept",
"definition": "The Apgar subscore for skin color/appearance.",
"short": "AppearanceScore",
"mapping": [ {
"map": "NL-CM:12.16.7",
"comment": "AppearanceScore",
"identity": "hcim-apgarscore-v1.0-2017EN"
} ],
"type": [ {
"code": "CodeableConcept"
} ],
"sliceName": "valueCodeableConcept",
"binding": {
"strength": "extensible",
"description": "HuidskleurScoreCodelijst",
"valueSetReference": {
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}
},
"alias": [ "HuidskleurScore" ],
"id": "Observation.component:1MinuteAppearanceScore.value[x]:valueCodeableConcept"
}, {
"id": "Observation.component:5MinuteAppearanceScore",
"max": "1",
"path": "Observation.component",
"sliceName": "5MinuteAppearanceScore"
}, {
"id": "Observation.component:5MinuteAppearanceScore.code",
"path": "Observation.component.code",
"patternCodeableConcept": {
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"code": "32411-1",
"system": "http://loinc.org"
} ]
}
}, {
"path": "Observation.component.valueCodeableConcept",
"definition": "The Apgar subscore for skin color/appearance.",
"short": "AppearanceScore",
"mapping": [ {
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"comment": "AppearanceScore",
"identity": "hcim-apgarscore-v1.0-2017EN"
} ],
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"sliceName": "valueCodeableConcept",
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}
},
"alias": [ "HuidskleurScore" ],
"id": "Observation.component:5MinuteAppearanceScore.value[x]:valueCodeableConcept"
}, {
"id": "Observation.component:10MinuteAppearanceScore",
"max": "1",
"path": "Observation.component",
"sliceName": "10MinuteAppearanceScore"
}, {
"id": "Observation.component:10MinuteAppearanceScore.code",
"path": "Observation.component.code",
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"system": "http://loinc.org"
} ]
}
}, {
"path": "Observation.component.valueCodeableConcept",
"definition": "The Apgar subscore for skin color/appearance.",
"short": "AppearanceScore",
"mapping": [ {
"map": "NL-CM:12.16.7",
"comment": "AppearanceScore",
"identity": "hcim-apgarscore-v1.0-2017EN"
} ],
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"code": "CodeableConcept"
} ],
"sliceName": "valueCodeableConcept",
"binding": {
"strength": "extensible",
"description": "HuidskleurScoreCodelijst",
"valueSetReference": {
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}
},
"alias": [ "HuidskleurScore" ],
"id": "Observation.component:10MinuteAppearanceScore.value[x]:valueCodeableConcept"
}, {
"id": "Observation.component:1MinutePulseScore",
"max": "1",
"path": "Observation.component",
"sliceName": "1MinutePulseScore"
}, {
"id": "Observation.component:1MinutePulseScore.code",
"path": "Observation.component.code",
"patternCodeableConcept": {
"coding": [ {
"code": "32407-9",
"system": "http://loinc.org"
} ]
}
}, {
"path": "Observation.component.valueCodeableConcept",
"definition": "The Apgar subscore for pulse.",
"short": "PulseScore",
"mapping": [ {
"map": "NL-CM:12.16.5",
"comment": "PulseScore",
"identity": "hcim-apgarscore-v1.0-2017EN"
} ],
"type": [ {
"code": "CodeableConcept"
} ],
"sliceName": "valueCodeableConcept",
"binding": {
"strength": "extensible",
"description": "HartslagScoreCodelijst",
"valueSetReference": {
"reference": "http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.12.16.2--20171231000000"
}
},
"alias": [ "HartslagScore" ],
"id": "Observation.component:1MinutePulseScore.value[x]:valueCodeableConcept"
}, {
"id": "Observation.component:5MinutePulseScore",
"max": "1",
"path": "Observation.component",
"sliceName": "5MinutePulseScore"
}, {
"id": "Observation.component:5MinutePulseScore.code",
"path": "Observation.component.code",
"patternCodeableConcept": {
"coding": [ {
"code": "32412-9",
"system": "http://loinc.org"
} ]
}
}, {
"path": "Observation.component.valueCodeableConcept",
"definition": "The Apgar subscore for pulse.",
"short": "PulseScore",
"mapping": [ {
"map": "NL-CM:12.16.5",
"comment": "PulseScore",
"identity": "hcim-apgarscore-v1.0-2017EN"
} ],
"type": [ {
"code": "CodeableConcept"
} ],
"sliceName": "valueCodeableConcept",
"binding": {
"strength": "extensible",
"description": "HartslagScoreCodelijst",
"valueSetReference": {
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}
},
"alias": [ "HartslagScore" ],
"id": "Observation.component:5MinutePulseScore.value[x]:valueCodeableConcept"
}, {
"id": "Observation.component:10MinutePulseScore",
"max": "1",
"path": "Observation.component",
"sliceName": "10MinutePulseScore"
}, {
"id": "Observation.component:10MinutePulseScore.code",
"path": "Observation.component.code",
"patternCodeableConcept": {
"coding": [ {
"code": "32402-0",
"system": "http://loinc.org"
} ]
}
}, {
"path": "Observation.component.valueCodeableConcept",
"definition": "The Apgar subscore for pulse.",
"short": "PulseScore",
"mapping": [ {
"map": "NL-CM:12.16.5",
"comment": "PulseScore",
"identity": "hcim-apgarscore-v1.0-2017EN"
} ],
"type": [ {
"code": "CodeableConcept"
} ],
"sliceName": "valueCodeableConcept",
"binding": {
"strength": "extensible",
"description": "HartslagScoreCodelijst",
"valueSetReference": {
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}
},
"alias": [ "HartslagScore" ],
"id": "Observation.component:10MinutePulseScore.value[x]:valueCodeableConcept"
}, {
"id": "Observation.component:1MinuteGrimaceScore",
"max": "1",
"path": "Observation.component",
"sliceName": "1MinuteGrimaceScore"
}, {
"id": "Observation.component:1MinuteGrimaceScore.code",
"path": "Observation.component.code",
"patternCodeableConcept": {
"coding": [ {
"code": "32409-5",
"system": "http://loinc.org"
} ]
}
}, {
"path": "Observation.component.valueCodeableConcept",
"definition": "The Apgar subscore for grimace.",
"short": "GrimaceScore",
"mapping": [ {
"map": "NL-CM:12.16.8",
"comment": "GrimaceScore",
"identity": "hcim-apgarscore-v1.0-2017EN"
} ],
"type": [ {
"code": "CodeableConcept"
} ],
"sliceName": "valueCodeableConcept",
"binding": {
"strength": "extensible",
"description": "ReflexenScoreCodelijst",
"valueSetReference": {
"reference": "http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.12.16.5--20171231000000"
}
},
"alias": [ "ReflexenScore" ],
"id": "Observation.component:1MinuteGrimaceScore.value[x]:valueCodeableConcept"
}, {
"id": "Observation.component:5MinuteGrimaceScore",
"max": "1",
"path": "Observation.component",
"sliceName": "5MinuteGrimaceScore"
}, {
"id": "Observation.component:5MinuteGrimaceScore.code",
"path": "Observation.component.code",
"patternCodeableConcept": {
"coding": [ {
"code": "32414-5",
"system": "http://loinc.org"
} ]
}
}, {
"path": "Observation.component.valueCodeableConcept",
"definition": "The Apgar subscore for grimace.",
"short": "GrimaceScore",
"mapping": [ {
"map": "NL-CM:12.16.8",
"comment": "GrimaceScore",
"identity": "hcim-apgarscore-v1.0-2017EN"
} ],
"type": [ {
"code": "CodeableConcept"
} ],
"sliceName": "valueCodeableConcept",
"binding": {
"strength": "extensible",
"description": "ReflexenScoreCodelijst",
"valueSetReference": {
"reference": "http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.12.16.5--20171231000000"
}
},
"alias": [ "ReflexenScore" ],
"id": "Observation.component:5MinuteGrimaceScore.value[x]:valueCodeableConcept"
}, {
"id": "Observation.component:10MinuteGrimaceScore",
"max": "1",
"path": "Observation.component",
"sliceName": "10MinuteGrimaceScore"
}, {
"id": "Observation.component:10MinuteGrimaceScore.code",
"path": "Observation.component.code",
"patternCodeableConcept": {
"coding": [ {
"code": "32404-6",
"system": "http://loinc.org"
} ]
}
}, {
"path": "Observation.component.valueCodeableConcept",
"definition": "The Apgar subscore for grimace.",
"short": "GrimaceScore",
"mapping": [ {
"map": "NL-CM:12.16.8",
"comment": "GrimaceScore",
"identity": "hcim-apgarscore-v1.0-2017EN"
} ],
"type": [ {
"code": "CodeableConcept"
} ],
"sliceName": "valueCodeableConcept",
"binding": {
"strength": "extensible",
"description": "ReflexenScoreCodelijst",
"valueSetReference": {
"reference": "http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.12.16.5--20171231000000"
}
},
"alias": [ "ReflexenScore" ],
"id": "Observation.component:10MinuteGrimaceScore.value[x]:valueCodeableConcept"
}, {
"id": "Observation.component:1MinuteMuscleToneScore",
"max": "1",
"path": "Observation.component",
"sliceName": "1MinuteMuscleToneScore"
}, {
"id": "Observation.component:1MinuteMuscleToneScore.code",
"path": "Observation.component.code",
"patternCodeableConcept": {
"coding": [ {
"code": "32408-7",
"system": "http://loinc.org"
} ]
}
}, {
"path": "Observation.component.valueCodeableConcept",
"definition": "The Apgar subscore for activity/muscle tone.",
"short": "MusleToneScore",
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