# US Core Average Blood Pressure Profile - US Core Implementation Guide v9.0.0

* [**Table of Contents**](toc.md)
* [**Artifacts Summary**](artifacts.md)
* **US Core Average Blood Pressure Profile**

## Resource Profile: US Core Average Blood Pressure Profile 

| | | |
| :--- | :--- | :--- |
| *Official URL*:http://hl7.org/fhir/us/core/StructureDefinition/us-core-average-blood-pressure | *Version*:9.0.0 | |
| * Standards status: *[Trial-use](http://hl7.org/fhir/R4/versions.html#std-process) | [Maturity Level](changes-between-versions.md#us-core-maturity-levels): 2 | *Computable Name*:USCoreAverageBloodPressureProfile |
| *Other Identifiers:*OID:2.16.840.1.113883.4.642.40.2.42.7 | | |

 
The US Core Average Blood Pressure Profile inherits from the [Observation](https://hl7.org/fhir/R4/observation.html) resource; refer to it for scope and usage definitions. This profile sets minimum expectations for recording, searching, and fetching average diastolic and systolic blood pressure observations with standard LOINC codes and UCUM units of measure. It specifies which core elements, extensions, vocabularies, and value sets **SHALL** be present in the resource and constrains how the elements are used. Providing the floor for standards development for specific use cases promotes interoperability and adoption. 

**Example Usage Scenarios:**

The following are example usage scenarios for this profile:

* Query for average blood pressure observations belonging to a patient
* [Record or update](us-core-roadmap.md#future-candidate-requirements-under-consideration) average blood pressure observations belonging to a patient

### Mandatory and Must Support Data Elements

The following data elements must always be present ([Mandatory](must-support.md) definition) or must be supported if the data is present in the sending system ([Must Support](must-support.md) definition). They are presented below in a simple human-readable explanation. Profile specific guidance and examples are provided as well. The [Formal Views](#profile) below provides the formal summary, definitions, and terminology requirements.

**Each Observation Must Have:**

1. a status
1. a category code of "vital-signs"
1. a fixed code for average systolic and diastolic blood pressure panel
1. a fixed**component**code for average systolic blood pressure
1. a fixed**component**code for average diastolic blood pressure
1. a patient
1. clinically relevant time-period for the average of blood pressure readings

**Each Observation Must Support:**

1. a performer1
1. a result value for the average systolic blood pressure
1. a result value for the average diastolic blood pressure
1. a reason if the value is absent2

1,2 see guidance below

### Profile Specific Implementation Guidance

This section provides detailed implementation guidance for the US Core Profile to support implementation and certification.

* The category "vital-signs" aligns with the USCDI Data Class and Elements and provides a convenient and consistent grouping of the clinical concepts. Implementers can group them differently based on their clinical needs.
* A code system value **SHOULD** be supplied for each additional code.[§](requirements.md#CONF-0420)

* 1The profile elements `Observation.performer and Observation.device` communicate the [individual level provenance](basic-provenance.md#individual-level-provenance) author data corresponding to the U.S. Core Data for Interoperability (USCDI) Provenance Author Data Elements.
* 2Because the blood pressure values are communicated in the **mandatory** systolic and diastolic components: 
* the `Observation.value[x]` element **SHALL** be omitted.[§](requirements.md#CONF-0421)
* An Observation without a systolic or diastolic result value **SHALL** include a reason why the data is absent in `Observation.component.dataAbsentReason`
* **All Server systems** - including those that never provide a component observation without a value - **SHALL** support `Observation.component.dataAbsentReason` for the components.
 
* This Profile is not dependent on any specific protocol. Information about the protocol used **SHOULD** be supplied in either: 
* `Observation.note.text` (for example, "Average blood pressure is calculated from 12 measurements taken by the patient over three days.")
* The standard FHIR extension [http://hl7.org/fhir/StructureDefinition/workflow-adheresTo](http://hl7.org/fhir/StructureDefinition/workflow-adheresTo)
 
* Information about the number of measurements used to determine the average **SHOULD** be supplied as an `Observation.component` using the SNOMED CT code "246432004 | Number of occurrences (qualifier value)". The example shows how this component can be used.
* The observation **MAY** use an [extension](http://hl7.org/fhir/R4/extensibility.html) defined by other profiles such as [Vital Signs with Qualifying Elements: Average Blood Pressure Profile](https://hl7.org/fhir/us/vitals/STU1/StructureDefinition-average-blood-pressure.html).

**Usages:**

* Examples for this Profile: [Observation/average-blood-pressure](Observation-average-blood-pressure.md)
* CapabilityStatements using this Profile: [US Core Client CapabilityStatement](CapabilityStatement-us-core-client.md) and [US Core Server CapabilityStatement](CapabilityStatement-us-core-server.md)

You can also check for [usages in the FHIR IG Statistics](https://packages2.fhir.org/xig/resource/hl7.fhir.us.core|current/StructureDefinition/StructureDefinition-us-core-average-blood-pressure.json)

**Changes since version 8.0.1:**

* The resource metadata has changed (description, copyright)

### Formal Views of Profile Content

 [Description of Profiles, Differentials, Snapshots and how the different presentations work](http://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#structure-definitions). 

 

Other representations of profile: [CSV](StructureDefinition-us-core-average-blood-pressure.csv), [Excel](StructureDefinition-us-core-average-blood-pressure.xlsx), [Schematron](StructureDefinition-us-core-average-blood-pressure.sch) 

### Notes:

-------

**Quick Start**  

-------

Below is an overview of the required Server RESTful FHIR interactions for this profile - for example, search and read operations - when supporting the US Core interactions to access this profile's information (Profile Support + Interaction Support). Note that systems that support only US Core Profiles (Profile Only Support) are not required to support these interactions. See the [US Core Server CapabilityStatement](CapabilityStatement-us-core-server.md) for a complete list of supported RESTful interactions for this IG.

* See the [Scopes Format](scopes.md#scopes-format) section for a description of the SMART scopes syntax.
* See the [Search Syntax](general-guidance.md#search-syntax) section for a description of the US Core search syntax.
* See the [General Requirements](general-requirements.md) section for additional rules and expectations when a Server requires status parameters.
* See the [General Guidance](general-guidance.md) section for additional guidance on searching for multiple patients.

#### US Core Scopes

Servers providing access to vital signs data **SHALL** support these [US Core SMART Scopes](scopes.md#smart-scopes):

* [resource level scopes](http://hl7.org/fhir/smart-app-launch/STU2.2/scopes-and-launch-context.html#scopes-for-requesting-clinical-data): `<patient|user|system>/Observation.rs` [§](requirements.md#CONF-0145)
* [granular scopes](http://hl7.org/fhir/smart-app-launch/STU2.2/scopes-and-launch-context.html#finer-grained-resource-constraints-using-search-parameters): `<patient|user|system>/Observation.rs?category=http://terminology.hl7.org/CodeSystem/observation-category|vital-signs` [§](requirements.md#CONF-0165)

-------

#### Mandatory Search Parameters:

The following search parameters and search parameter combinations **SHALL** be supported:

1. **SHALL** support searching for all Observations using the combination of the [patient](SearchParameter-us-core-observation-patient.md) and [category](SearchParameter-us-core-observation-category.md) search parameters`GET [base]/Observation?patient={Patient/}[id]&category={system|}[search_code]`Example:
> 
1. GET [base]/Observation?patient=Patient/1137192&category=http://terminology.hl7.org/CodeSystem/observation-category|vital-signs

**Implementation Notes**: Fetches a bundle of all US Core Average Blood Pressure Profile resources for the specified patient and a category code = "vital-signs" ( see [how to search by reference](http://hl7.org/fhir/R4/search.html#reference) and [how to search by token](http://hl7.org/fhir/R4/search.html#token)).
1. **SHALL** support searching for all Observations by code using the combination of the [patient](SearchParameter-us-core-observation-patient.md) and [code](SearchParameter-us-core-observation-code.md) search parameters
* Including optional support **OR** search on `code` (e.g.`code={system|}[code],{system|}[code],...`)
`GET [base]/Observation?patient={Patient/}[id]&code={system|}[search_code]{,{system|}[code],...}`Examples:
> 
1. GET [base]/Observation?patient=Patient/1137192&code=http://loinc.org|96607-7
1. GET [base]/Observation?patient=Patient/1137192&code=http://loinc.org|96607-7,http://loinc.org|9279-1,http://loinc.org|8867-4

**Implementation Notes**: Fetches a bundle of all US Core Average Blood Pressure Profile resources for the specified patient and observation code(s). SHOULD support search by multiple codes. The US Core Average Blood Pressure Profile "code" parameter searches only `.code` and not `component.code`. ( see [how to search by reference](http://hl7.org/fhir/R4/search.html#reference) and [how to search by token](http://hl7.org/fhir/R4/search.html#token)).
1. **SHALL** support searching for all Observations by date (for example, results after 2018) using the combination of the [patient](SearchParameter-us-core-observation-patient.md) and [category](SearchParameter-us-core-observation-category.md) and [date](SearchParameter-us-core-observation-date.md) search parameters
* Including optional support for **AND** search on `date` (e.g.`date=[date]&date=[date]&...`)
* Including support for these `date` comparators: "gt", "lt", "ge", "le"
`GET [base]/Observation?patient={Patient/}[id]&category={system|}[search_code]&date={gt|lt|ge|le}[dateTime]{&date={gt|lt|ge|le}[dateTime]&...}`Example:
> 
1. GET [base]/Observation?patient=Patient/1137192&category=http://terminology.hl7.org/CodeSystem/observation-category|vital-signs&date=ge2018-03-14T00:00:00Z

**Implementation Notes**: Fetches a bundle of all US Core Average Blood Pressure Profile resources for the specified patient and date and a category code = "vital-signs" ( see [how to search by reference](http://hl7.org/fhir/R4/search.html#reference) and [how to search by token](http://hl7.org/fhir/R4/search.html#token) and [how to search by date](http://hl7.org/fhir/R4/search.html#date)).

#### Optional Search Parameters:

The following search parameters and search parameter combinations **SHOULD** be supported

1. **SHOULD** support searching for all Observations for a patient for a given status (for example all observations marked as final) using the combination of the [patient](SearchParameter-us-core-observation-patient.md) and [category](SearchParameter-us-core-observation-category.md) and [status](SearchParameter-us-core-observation-status.md) search parameters
* Including support **OR** search on `status` (e.g.`status={system|}[code],{system|}[code],...`)
`GET [base]/Observation?patient={Patient/}[id]&category={system|}[search_code]&status={system|}[search_code]{,{system|}[code],...}`Example:
> 
1. GET [base]/Observation?patient=Patient/1137192&category=http://terminology.hl7.org/CodeSystem/observation-category|vital-signs&status=final

**Implementation Notes**: Fetches a bundle of all US Core Average Blood Pressure Profile resources for the specified patient and category = "vital-signs" and status ( see [how to search by reference](http://hl7.org/fhir/R4/search.html#reference) and [how to search by token](http://hl7.org/fhir/R4/search.html#token)).
1. **SHOULD** support searching using the combination of the [patient](SearchParameter-us-core-observation-patient.md) and [category](SearchParameter-us-core-observation-category.md) and [_lastUpdated](SearchParameter-us-core-observation-lastupdated.md) search parameters
* Including optional support for **AND** search on `_lastUpdated` (e.g.`_lastUpdated=[date]&_lastUpdated=[date]&...`)
* Including support for these `_lastUpdated` comparators: "gt", "lt", "ge", "le"
`GET [base]/Observation?patient={Patient/}[id]&category={system|}[search_code]&_lastUpdated=[dateTime]`Example:
> 
1. GET [base]/Observation?patient=Patient/1137192&category=http://terminology.hl7.org/CodeSystem/observation-category|vital-signs&_lastUpdated=ge2024-01-01T00:00:00Z

**Implementation Notes**: Fetches a bundle of all US Core Average Blood Pressure Profile resources for the specified patient and category code = "vital-signs" and _lastUpdated. See the US Core General Guidance page for [Searching Using lastUpdated](general-guidance.md#searching-using-lastupdated). ( see [how to search by reference](http://hl7.org/fhir/R4/search.html#reference) and [how to search by token](http://hl7.org/fhir/R4/search.html#token) and [how to search by date](http://hl7.org/fhir/R4/search.html#date)).
1. **SHOULD** support searching Observations by code and date using the combination of the [patient](SearchParameter-us-core-observation-patient.md) and [code](SearchParameter-us-core-observation-code.md) and [date](SearchParameter-us-core-observation-date.md) search parameters
* Including optional support **OR** search on `code` (e.g.`code={system|}[code],{system|}[code],...`)
* Including optional support for **AND** search on `date` (e.g.`date=[date]&date=[date]&...`)
* Including support for these `date` comparators: "gt", "lt", "ge", "le"
`GET [base]/Observation?patient={Patient/}[id]&code={system|}[search_code]{,{system|}[code],...}&date={gt|lt|ge|le}[dateTime]{&date={gt|lt|ge|le}[dateTime]&...}`Example:
> 
1. GET [base]/Observation?patient=Patient/1137192&code=http://loinc.org|96607-7&date=ge2019-01-01T00:00:00Z

**Implementation Notes**: Fetches a bundle of all US Core Average Blood Pressure Profile resources for the specified patient and date and code(s). SHOULD support search by multiple codes. ( see [how to search by reference](http://hl7.org/fhir/R4/search.html#reference) and [how to search by token](http://hl7.org/fhir/R4/search.html#token) and [how to search by date](http://hl7.org/fhir/R4/search.html#date)).



## Resource Content

```json
{
  "resourceType" : "StructureDefinition",
  "id" : "us-core-average-blood-pressure",
  "extension" : [{
    "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm",
    "valueInteger" : 2
  },
  {
    "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg",
    "valueCode" : "cgp"
  },
  {
    "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
    "valueCode" : "trial-use",
    "_valueCode" : {
      "extension" : [{
        "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom",
        "valueCanonical" : "http://hl7.org/fhir/us/core/ImplementationGuide/hl7.fhir.us.core"
      }]
    }
  }],
  "url" : "http://hl7.org/fhir/us/core/StructureDefinition/us-core-average-blood-pressure",
  "identifier" : [{
    "system" : "urn:ietf:rfc:3986",
    "value" : "urn:oid:2.16.840.1.113883.4.642.40.2.42.7"
  }],
  "version" : "9.0.0",
  "name" : "USCoreAverageBloodPressureProfile",
  "title" : "US Core Average Blood Pressure Profile",
  "status" : "active",
  "experimental" : false,
  "date" : "2024-03-25",
  "publisher" : "HL7 International / Cross-Group Projects",
  "contact" : [{
    "name" : "HL7 International / Cross-Group Projects",
    "telecom" : [{
      "system" : "url",
      "value" : "http://www.hl7.org/Special/committees/cgp"
    },
    {
      "system" : "email",
      "value" : "cgp@lists.HL7.org"
    }]
  }],
  "description" : "The US Core Average Blood Pressure Profile inherits from the [Observation](https://hl7.org/fhir/R4/observation.html) resource; refer to it for scope and usage definitions. This profile sets minimum expectations for recording, searching, and fetching average diastolic and systolic blood pressure observations with standard LOINC codes and UCUM units of measure. It specifies which core elements, extensions, vocabularies, and value sets **SHALL** be present in the resource and constrains how the elements are used. Providing the floor for standards development for specific use cases promotes interoperability and adoption.",
  "jurisdiction" : [{
    "coding" : [{
      "system" : "urn:iso:std:iso:3166",
      "code" : "US"
    }]
  }],
  "fhirVersion" : "4.0.1",
  "mapping" : [{
    "identity" : "workflow",
    "uri" : "http://hl7.org/fhir/workflow",
    "name" : "Workflow Pattern"
  },
  {
    "identity" : "sct-concept",
    "uri" : "http://snomed.info/conceptdomain",
    "name" : "SNOMED CT Concept Domain Binding"
  },
  {
    "identity" : "v2",
    "uri" : "http://hl7.org/v2",
    "name" : "HL7 v2 Mapping"
  },
  {
    "identity" : "rim",
    "uri" : "http://hl7.org/v3",
    "name" : "RIM Mapping"
  },
  {
    "identity" : "w5",
    "uri" : "http://hl7.org/fhir/fivews",
    "name" : "FiveWs Pattern Mapping"
  },
  {
    "identity" : "sct-attr",
    "uri" : "http://snomed.org/attributebinding",
    "name" : "SNOMED CT Attribute Binding"
  }],
  "kind" : "resource",
  "abstract" : false,
  "type" : "Observation",
  "baseDefinition" : "http://hl7.org/fhir/StructureDefinition/Observation",
  "derivation" : "constraint",
  "differential" : {
    "element" : [{
      "id" : "Observation",
      "path" : "Observation",
      "short" : "US Core Average Blood Pressure Profile"
    },
    {
      "id" : "Observation.status",
      "path" : "Observation.status",
      "mustSupport" : true
    },
    {
      "id" : "Observation.category",
      "path" : "Observation.category",
      "slicing" : {
        "discriminator" : [{
          "type" : "value",
          "path" : "coding.code"
        },
        {
          "type" : "value",
          "path" : "coding.system"
        }],
        "ordered" : false,
        "rules" : "open"
      },
      "min" : 1,
      "max" : "*",
      "type" : [{
        "code" : "CodeableConcept"
      }],
      "mustSupport" : true
    },
    {
      "id" : "Observation.category:VSCat",
      "path" : "Observation.category",
      "sliceName" : "VSCat",
      "min" : 1,
      "max" : "1",
      "type" : [{
        "code" : "CodeableConcept"
      }],
      "mustSupport" : true
    },
    {
      "id" : "Observation.category:VSCat.coding",
      "path" : "Observation.category.coding",
      "min" : 1,
      "max" : "*",
      "type" : [{
        "code" : "Coding"
      }],
      "mustSupport" : true
    },
    {
      "id" : "Observation.category:VSCat.coding.system",
      "path" : "Observation.category.coding.system",
      "short" : "Identity of the terminology system",
      "min" : 1,
      "max" : "1",
      "type" : [{
        "code" : "uri"
      }],
      "fixedUri" : "http://terminology.hl7.org/CodeSystem/observation-category"
    },
    {
      "id" : "Observation.category:VSCat.coding.code",
      "path" : "Observation.category.coding.code",
      "short" : "Symbol in syntax defined by the system",
      "min" : 1,
      "max" : "1",
      "type" : [{
        "code" : "code"
      }],
      "fixedCode" : "vital-signs"
    },
    {
      "id" : "Observation.code",
      "path" : "Observation.code",
      "short" : "Blood Pressure",
      "type" : [{
        "code" : "CodeableConcept"
      }],
      "patternCodeableConcept" : {
        "coding" : [{
          "system" : "http://loinc.org",
          "code" : "96607-7"
        }]
      },
      "mustSupport" : true
    },
    {
      "id" : "Observation.subject",
      "path" : "Observation.subject",
      "min" : 1,
      "type" : [{
        "code" : "Reference",
        "targetProfile" : ["http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient"]
      }],
      "mustSupport" : true
    },
    {
      "id" : "Observation.effective[x]",
      "path" : "Observation.effective[x]",
      "short" : "clinically relevant time-period for the average of blood pressure (BP) readings",
      "min" : 1,
      "type" : [{
        "code" : "dateTime"
      },
      {
        "extension" : [{
          "url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-type-must-support",
          "valueBoolean" : true
        }],
        "code" : "Period"
      }],
      "mustSupport" : true
    },
    {
      "id" : "Observation.performer",
      "path" : "Observation.performer",
      "type" : [{
        "code" : "Reference",
        "targetProfile" : ["http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitioner",
        "http://hl7.org/fhir/us/core/StructureDefinition/us-core-organization",
        "http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient",
        "http://hl7.org/fhir/StructureDefinition/PractitionerRole",
        "http://hl7.org/fhir/us/core/StructureDefinition/us-core-careteam",
        "http://hl7.org/fhir/us/core/StructureDefinition/us-core-relatedperson"],
        "_targetProfile" : [{
          "extension" : [{
            "url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-type-must-support",
            "valueBoolean" : false
          }]
        },
        {
          "extension" : [{
            "url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-type-must-support",
            "valueBoolean" : false
          }]
        },
        {
          "extension" : [{
            "url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-type-must-support",
            "valueBoolean" : false
          }]
        },
        {
          "extension" : [{
            "url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-type-must-support",
            "valueBoolean" : false
          }]
        },
        {
          "extension" : [{
            "url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-type-must-support",
            "valueBoolean" : false
          }]
        },
        {
          "extension" : [{
            "url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-type-must-support",
            "valueBoolean" : false
          }]
        }]
      }],
      "mustSupport" : true
    },
    {
      "id" : "Observation.value[x]",
      "path" : "Observation.value[x]",
      "max" : "0"
    },
    {
      "id" : "Observation.component",
      "path" : "Observation.component",
      "slicing" : {
        "discriminator" : [{
          "type" : "value",
          "path" : "code"
        }],
        "ordered" : false,
        "rules" : "open"
      },
      "short" : "Average systolic and diastolic blood pressure and other qualifiers.",
      "min" : 2,
      "max" : "*",
      "constraint" : [{
        "key" : "us-core-26",
        "severity" : "error",
        "human" : "If there is no value a data absent reason must be present",
        "expression" : "value.exists() or dataAbsentReason.exists()"
      }],
      "mustSupport" : true
    },
    {
      "id" : "Observation.component.value[x]",
      "path" : "Observation.component.value[x]",
      "short" : "Vital Sign Component Value",
      "definition" : "Vital Signs value are typically recorded using the Quantity data type. For supporting observations such as cuff size could use other datatypes such as CodeableConcept.",
      "type" : [{
        "extension" : [{
          "url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-type-must-support",
          "valueBoolean" : true
        }],
        "code" : "Quantity"
      },
      {
        "code" : "CodeableConcept"
      },
      {
        "code" : "string"
      },
      {
        "code" : "boolean"
      },
      {
        "code" : "integer"
      },
      {
        "code" : "Range"
      },
      {
        "code" : "Ratio"
      },
      {
        "code" : "SampledData"
      },
      {
        "code" : "time"
      },
      {
        "code" : "dateTime"
      },
      {
        "code" : "Period"
      }],
      "mustSupport" : true
    },
    {
      "id" : "Observation.component.dataAbsentReason",
      "path" : "Observation.component.dataAbsentReason",
      "condition" : ["us-core-26"],
      "mustSupport" : true
    },
    {
      "id" : "Observation.component:systolic",
      "path" : "Observation.component",
      "sliceName" : "systolic",
      "short" : "Systolic Average Blood Pressure",
      "min" : 1,
      "max" : "1",
      "mustSupport" : true
    },
    {
      "id" : "Observation.component:systolic.code",
      "path" : "Observation.component.code",
      "short" : "Systolic Average Blood Pressure Code",
      "min" : 1,
      "max" : "1",
      "patternCodeableConcept" : {
        "coding" : [{
          "system" : "http://loinc.org",
          "code" : "96608-5"
        }]
      },
      "mustSupport" : true
    },
    {
      "id" : "Observation.component:systolic.valueQuantity",
      "path" : "Observation.component.valueQuantity",
      "short" : "Systolic Average Blood Pressure Value",
      "type" : [{
        "code" : "Quantity"
      }],
      "condition" : ["us-core-26"],
      "mustSupport" : true
    },
    {
      "id" : "Observation.component:systolic.valueQuantity.value",
      "path" : "Observation.component.valueQuantity.value",
      "min" : 1,
      "max" : "1",
      "type" : [{
        "code" : "decimal"
      }]
    },
    {
      "id" : "Observation.component:systolic.valueQuantity.unit",
      "path" : "Observation.component.valueQuantity.unit",
      "min" : 1,
      "max" : "1",
      "type" : [{
        "code" : "string"
      }]
    },
    {
      "id" : "Observation.component:systolic.valueQuantity.system",
      "path" : "Observation.component.valueQuantity.system",
      "min" : 1,
      "max" : "1",
      "type" : [{
        "code" : "uri"
      }],
      "fixedUri" : "http://unitsofmeasure.org"
    },
    {
      "id" : "Observation.component:systolic.valueQuantity.code",
      "path" : "Observation.component.valueQuantity.code",
      "min" : 1,
      "max" : "1",
      "type" : [{
        "code" : "code"
      }],
      "fixedCode" : "mm[Hg]"
    },
    {
      "id" : "Observation.component:diastolic",
      "path" : "Observation.component",
      "sliceName" : "diastolic",
      "short" : "Diastolic Average Blood Pressure",
      "min" : 1,
      "max" : "1",
      "mustSupport" : true
    },
    {
      "id" : "Observation.component:diastolic.code",
      "path" : "Observation.component.code",
      "short" : "Diastolic Average Blood Pressure Code",
      "min" : 1,
      "max" : "1",
      "patternCodeableConcept" : {
        "coding" : [{
          "system" : "http://loinc.org",
          "code" : "96609-3"
        }]
      },
      "mustSupport" : true
    },
    {
      "id" : "Observation.component:diastolic.valueQuantity",
      "path" : "Observation.component.valueQuantity",
      "short" : "Diastolic Average Blood Pressure Value",
      "type" : [{
        "code" : "Quantity"
      }],
      "condition" : ["us-core-26"],
      "mustSupport" : true
    },
    {
      "id" : "Observation.component:diastolic.valueQuantity.value",
      "path" : "Observation.component.valueQuantity.value",
      "min" : 1,
      "max" : "1",
      "type" : [{
        "code" : "decimal"
      }]
    },
    {
      "id" : "Observation.component:diastolic.valueQuantity.unit",
      "path" : "Observation.component.valueQuantity.unit",
      "min" : 1,
      "max" : "1",
      "type" : [{
        "code" : "string"
      }]
    },
    {
      "id" : "Observation.component:diastolic.valueQuantity.system",
      "path" : "Observation.component.valueQuantity.system",
      "min" : 1,
      "max" : "1",
      "type" : [{
        "code" : "uri"
      }],
      "fixedUri" : "http://unitsofmeasure.org"
    },
    {
      "id" : "Observation.component:diastolic.valueQuantity.code",
      "path" : "Observation.component.valueQuantity.code",
      "min" : 1,
      "max" : "1",
      "type" : [{
        "code" : "code"
      }],
      "fixedCode" : "mm[Hg]"
    }]
  }
}

```
