Observation
Measurements and simple assertions made about a patient, device or other subject.
Canvas supports the following US Core Profiles for Observations:
- US Core Laboratory Result Observation Profile
- US Core Pediatric BMI for Age Observation Profile
- US Core Pediatric Head Occipital-frontal Circumference Percentile Profile
- US Core Pediatric Weight for Height Observation Profile
- US Core Smoking Status Observation Profile
- US Core Pulse Oximetry Profile
The following USCDI data elements are retrievable from this endpoint:
- Laboratory Tests
- Laboratory Values/Results
- Smoking Status
Here are some Canvas specific workflows where observations will be created:
- Documenting Vitals via our Vital Command (category coding will be
vital-signs) - Submitting a Questionnaire, Review Of System (ROS), Structured Assessment (SA), or a Physical Exam will result in an observation for each question answered if the question’s code system is LOINC or SNOMED (category coding will be
social-history). - There is a specific Physical Exam to capture Pediatric Vitals. Upon submission of the Exam, associated observations for Body Length, Head Circumference, and Head Occipital-Frontal Circumference Percentile (category coding will be
vital-signs) will be created along with the observations for the answers of the exam (category coding will besocial-history). Please contact Customer Support for help loading this Exam into your instance if you want to utilize it. - Once weight and either height or pediatric body length is entered on a patients chart, the vital observations of BMI for Age Percentile (for patients 2 years or older) and Weight-for-Length Percentile will be calculated (category coding will be
vital-signs). - Submitting a Questionnaire that has custom scoring defined will result in an observation containing the scored value (category coding will be
survey). - When a lab report is created in Canvas through DI, API, integration with HG, or POC Lab Test Command, there will be resulting Observations made (category coding will be
laboratory).
Observation create
Although the observation endpoint houses many different Canvas models, currently, only vital signs and panels can be created through this endpoint.
Vital signs and Vital Sign Panels
See this helpful guide to walk you through creating a vital panel via FHIR.
- Vital sign panels and vital signs are both observations.
- Vital sign panels are the parent that “contain” the vital sign observations. The
hasMembersattribute contains references to the child observations - Each vital sign that is part of the panel links back to the parent Observation via the
derivedFromattribute. - If a
derivedFromvalue is not included for a vital sign observation, then a new vital sign panel observation is created and will autofill thederivedFromattribute field.
- Vital sign panels are the parent that “contain” the vital sign observations. The
- Vital signs and their parent panel feed into our Vitals command.
Note types
Most our FHIR endpoints insert commands into a Data Import Note type on the patient’s timeline. With the release of configurable note types, if you create a new Note Type in Settings with system = Canvas and code = VitalsImport, then the Observation Create endpoint will always import into that note type instead.
Supported vital sign codes used in create
| vital sign | LOINC code | default unit | additional accepted units |
|---|---|---|---|
| vital sign panel | 85353-1 | ||
| blood pressure | 85354-9 | mmHg | |
| weight | 29463-7 | oz | lb, kg |
| height | 8302-2 | in | cm |
| pulse rate | 8867-4 | bpm | |
| body temperature | 8310-5 | °F | |
| oxygen saturation (arterial)* | 2708-6 | % | |
| oxygen saturation* | 59408-5 | % | |
| respiration rate | 9279-1 | bpm | |
| waist circumference | 56086-2 | cm | in |
| note | 80339-5 | ||
| pulse rhythm | 8884-9 |
*If an oxygen saturation vital sign is created, an oxygen saturation (arterial) vital sign code is also automatically generated.
Additional examples
Attributes
The FHIR Resource name.
The status of the result value. In Canvas only final committed vitals can be created.
Describes what was observed.
For create interactions, only vital sign LOINC codes are supported.
Code defined by a terminology system.
The system url of the coding.
The code of the observation.
The display name of the coding.
Canvas Patient reference the Observation is for.
The reference string of the subject in the format of "Patient/a39cafb9d1b445be95a2e2548e12a787".
Type the reference refers to (e.g. “Patient”).
Clinically relevant time/time-period for observation.
For an individual vital sign, if the effectiveDateTime differs from the panel time, it will be reflected in a read/search; however, you will not see the individual date in the UI, only the panel’s datetime.
If omitted from create, Canvas will save a default value of the current datetime.
Actual result.
This is used for vital observation that correspond with a numeric value. If this field is not provided or specifically the value attribute in the json is omitted, Canvas will interpret that as an empty value. A Read/Search of this observation will display the dataAbsentReason attribute.
Currently supported numeric values are
- height
- weight
- waist circumference
- body temperature
- pulse rate
- oxygen saturation
- respiration rate
Numerical value (with implicit precision).
Unit representation. If omitted, it will default to the values in the table defined above. For the submitted code, only units from the table above can be sent. Sending a different unit will result in a 422 error.
Actual result.
This is used for vital observation that correspond with a string value. If this field is not provided or specifically the value attribute in the json is omitted, Canvas will interpret that as an empty value. A Read/Search of this observation will display the dataAbsentReason attribute.
Currently supported string values are
- note - this is a free text comment field in the Canvas Vital Command
- pulse rhythm - This is an enum in the Canvas Vital command. Values supported are Regular, Irregularly Irregular, Regulary Irregular. If one of these values is not provided, a 422 error will occur.
- blood pressure - This is a string reprentation of the systolic and diastolic combined in the format "100/80". If this valueString is not given, it will not appear correctly in the Canvas Vital Command.
Related Observation reference(s) that belongs to the Observation group/panel.
Only need to supply this attribute in a Vital Sign Panel to specify specific child observations that are a part of the panel. In Canvas these will form the Vitals Command. This observation IDs can be found using the Observation Search.
If a new vital sign panel is created and links pre-existing vital signs via the hasMember attribute, those linked observations will update their derivedFrom attribute to be set to the newly created vital sign panel.
The reference string of the child observation in the format of "Observation/920807d3-034b-4423-a65b-980068cb4bd1".
Type the reference refers to (e.g. “Observation”).
The coding display of the reference.
Related Observation resource that the Observation is made from.
This attribute should only be used to link a vital sign to an existing “parent” vital sign panel. It ingests a reference to the vital sign panel’s observation. This observation ID can be found using the Observation Search.
If this field is omitted on a vital sign observation, a vital sign panel will automatically be created.
It is important to note that each vital sign panel can only contain a single vital sign of each type. Adding a duplicate of a vital sign will result in a 422 error: “Vital sign reading already exists for the given reading”.
The reference string of the child observation in the format of "Observation/920807d3-034b-4423-a65b-980068cb4bd1" or "QuestionnaireResponse/0e34b12d-0494-4ade-9a51-aa12225dd959".
Type the reference refers to (e.g. “Observation”, “QuestionnaireResponse”).
Component results
This attribute is only used for blood pressure, as it has two components (systolic and diastolic).
- These components are added to a vital sign observation by including their
codeandvalueQuantity. - The components are what will be stored in the database; however, they will not display on the UI. The
Observation.valueStringwill be the attribute that displays on the UI. - The
valueQuantityfor the systolic component should match the first number in the blood pressure vital signvalueQuantity, where thevalueQuantityof the diastole component should match the second number.
Type of component observation (code / type).
Code defined by a terminology system.
The system url of the coding.
The code of the observation.
The display name of the coding.
Actual component result. Since this endpoint only supports blood pressure systolic/diastolic components, the units are already defaulted to mmHg.
Numerical value (with implicit precision).
Responses
Canvas returns the created resource's id as a UUID within the
location header and a null response body.Errors
Observation read
Path Parameters
Response Payload Attributes
The FHIR Resource name.
The Canvas identifier of the observation
The status of the result value.
Classifies the general type of observation being made.
Code defined by a terminology system.
The system url of the coding.
The code of the observation.
The display name of the coding.
Describes what was observed.
For observations that do not have an associated code (e.g Laboratory Observations), an extension will be displayed to denote an absent of a coding.
Reference that defines the content of this object.
The reason the Observation.coding attribute is missing.
Code defined by a terminology system.
The system url of the coding.
The code of the observation.
The display name of the coding.
Canvas Patient reference the Observation is for.
The reference string of the subject in the format of "Patient/a39cafb9d1b445be95a2e2548e12a787".
Type the reference refers to (e.g. “Patient”).
Clinically relevant time/time-period for observation.
Date/Time this version was made available. It is the timestamp in Canvas when the observation was ingested.
Actual result.
Used for observations with numeric values like vitals, lab report values, any questionnaire result scoring programed in Canvas.
Numerical value (with implicit precision).
Unit representation.
System that defines coded unit form.
Coded form of the unit may be shown.
Actual result.
Used for observations containing text values like vitals that are strings (e.g Blood Pressure, notes, and pulse rhythm) and free text lab result values.
Actual result.
Used for observations with a selected coding like Questionnaire Responses showing the answer to a specific question. This comes from Questionnaires, Structured Assessment, Physical Exam, and Review of Systems in Canvas.
Code defined by a terminology system. Codings are used when the Observation comes from a QuestionnaireResponse.
The system url of the coding.
The code of the observation.
The display name of the coding.
Why the result is missing (if there is no value[x] section)
Code defined by a terminology system.
The system url of the coding.
The code of the observation.
The display name of the coding.
Related Observation reference(s) that belongs to the Observation group/panel.
In Canvas, all the vital signs taken in a Vitals Command will be listed in this hasMember attribute.
The reference string of the child observation in the format of "Observation/920807d3-034b-4423-a65b-980068cb4bd1".
Type the reference refers to (e.g. “Observation”).
The coding display of the reference.
Related resource that the Observation is made from.
For vital signs, the derivedFrom reference would be the observation that corresponds to the “parent” vital sign panel this observation is part of.
For observations originating from a custom scoring of a Questionnaire or from answers filled out in Questionnaires, ROS, SA, or Physical Exams the derivedFrom attribute will be a reference to the associated QuestionnaireResponse record.
The reference string of the child observation in the format of "Observation/920807d3-034b-4423-a65b-980068cb4bd1" or "QuestionnaireResponse/0e34b12d-0494-4ade-9a51-aa12225dd959".
Type the reference refers to (e.g. “Observation”, “QuestionnaireResponse”).
Component results.
Currently only used for blood pressure observations to display the systolic and diastolic components.
Type of component observation (code / type).
Code defined by a terminology system.
The system url of the coding.
The code of the observation.
The display name of the coding.
Actual component result.
Numerical value (with implicit precision).
Unit representation.
System that defines coded unit form.
Coded form of the unit
Why the result is missing (if there is no Component[x].value[y] section)
Code defined by a terminology system.
The system url of the coding.
The code of the observation.
The display name of the coding.
Responses
Errors
Observation search
Query Parameters
The Canvas resource id for the Observation
Classification of the type of observation. Filters by the code and/or system under category.coding attribute. You can search by just the code value or you can search by the system and code in the format system|code (e.g http://terminology.hl7.org/CodeSystem/observation-category|vital-signs).
The code of the observation type. Filters by the code and/or system under code.coding attribute. You can search by just the code value or you can search by the system and code in the format system|code (e.g http://loinc.org|85353-1).
A reference to a related measurement the observation is made from.
Use this search parameter to find all observations of a specific vital panel or questionnaire response observations from the same interview.
The patient reference associated to the observation in the format Patient/a39cafb9d1b445be95a2e2548e12a787.
Response Payload Attributes
The FHIR Resource name.
This element and value designate that the bundle is a search response. Search result bundles will always have the Bundle.type of searchset .
The number of resources that match the search parameter.
Attributes relevant to pagination, see our Pagination page for more detail.
The relation of the page search
The search url for the specific relation
The results bundle that lists out each object returned in the search
The attributes specific to the resource type, see the Attributes section below
Attributes
The FHIR Resource name.
The Canvas identifier of the observation
The status of the result value.
Classifies the general type of observation being made.
Code defined by a terminology system.
The system url of the coding.
The code of the observation.
The display name of the coding.
Describes what was observed.
For observations that do not have an associated code (e.g Laboratory Observations), an extension will be displayed to denote an absent of a coding.
Reference that defines the content of this object.
The reason the Observation.coding attribute is missing.
Code defined by a terminology system.
The system url of the coding.
The code of the observation.
The display name of the coding.
Canvas Patient reference the Observation is for.
The reference string of the subject in the format of "Patient/a39cafb9d1b445be95a2e2548e12a787".
Type the reference refers to (e.g. “Patient”).
Clinically relevant time/time-period for observation.
Date/Time this version was made available. It is the timestamp in Canvas when the observation was ingested.
Actual result.
Used for observations with numeric values like vitals, lab report values, any questionnaire result scoring programed in Canvas.
Numerical value (with implicit precision).
Unit representation.
System that defines coded unit form.
Coded form of the unit may be shown.
Actual result.
Used for observations containing text values like vitals that are strings (e.g Blood Pressure, notes, and pulse rhythm) and free text lab result values.
Actual result.
Used for observations with a selected coding like Questionnaire Responses showing the answer to a specific question. This comes from Questionnaires, Structured Assessment, Physical Exam, and Review of Systems in Canvas.
Code defined by a terminology system. Codings are used when the Observation comes from a QuestionnaireResponse.
The system url of the coding.
The code of the observation.
The display name of the coding.
Why the result is missing (if there is no value[x] section)
Code defined by a terminology system.
The system url of the coding.
The code of the observation.
The display name of the coding.
Related Observation reference(s) that belongs to the Observation group/panel.
In Canvas, all the vital signs taken in a Vitals Command will be listed in this hasMember attribute.
The reference string of the child observation in the format of "Observation/920807d3-034b-4423-a65b-980068cb4bd1".
Type the reference refers to (e.g. “Observation”).
The coding display of the reference.
Related resource that the Observation is made from.
For vital signs, the derivedFrom reference would be the observation that corresponds to the “parent” vital sign panel this observation is part of.
For observations originating from a custom scoring of a Questionnaire or from answers filled out in Questionnaires, ROS, SA, or Physical Exams the derivedFrom attribute will be a reference to the associated QuestionnaireResponse record.
The reference string of the child observation in the format of "Observation/920807d3-034b-4423-a65b-980068cb4bd1" or "QuestionnaireResponse/0e34b12d-0494-4ade-9a51-aa12225dd959".
Type the reference refers to (e.g. “Observation”, “QuestionnaireResponse”).
Component results.
Currently only used for blood pressure observations to display the systolic and diastolic components.
Type of component observation (code / type).
Code defined by a terminology system.
The system url of the coding.
The code of the observation.
The display name of the coding.
Actual component result.
Numerical value (with implicit precision).
Unit representation.
System that defines coded unit form.
Coded form of the unit
Why the result is missing (if there is no Component[x].value[y] section)
Code defined by a terminology system.
The system url of the coding.
The code of the observation.
The display name of the coding.
Responses
Errors
curl --request POST \ --url 'https://fumage-example.canvasmedical.com/Observation' \ --header 'Authorization: Bearer <token>' \ --header 'accept: application/json' \ --header 'content-type: application/json' \ --data ' { "resourceType": "Observation", "status": "final", "code": { "coding": [ { "system": "http://loinc.org", "code": "29463-7", "display": "Weight" } ] }, "subject": { "reference": "Patient/ee8672f3497e4a83937b9e71d0a704a5" }, "effectiveDateTime": "2022-07-29T08:50:24.883809+00:00", "valueQuantity": { "value": "50", "unit": "kg" }, "derivedFrom": [ { "reference": "Observation/6173fbe8-110e-4a4a-9647-e949f7b1c35e", "type": "Observation" } ] } 'import requests url = "https://fumage-example.canvasmedical.com/Observation" payload = { "resourceType": "Observation", "status": "final", "code": { "coding": [ { "system": "http://loinc.org", "code": "29463-7", "display": "Weight" } ] }, "subject": { "reference": "Patient/ee8672f3497e4a83937b9e71d0a704a5" }, "effectiveDateTime": "2022-07-29T08:50:24.883809+00:00", "valueQuantity": { "value": "50", "unit": "lb" }, "derivedFrom": [{ "reference": "Observation/6173fbe8-110e-4a4a-9647-e949f7b1c35e" }] } headers = { "accept": "application/json", "Authorization": "Bearer <token>", "content-type": "application/json" } response = requests.post(url, json=payload, headers=headers) print(response.text)
null{ "resourceType": "OperationOutcome", "issue": [ { "severity": "error", "code": "invalid", "details": { "text": "Bad request" } } ] }{ "resourceType": "OperationOutcome", "issue": [ { "severity": "error", "code": "unknown", "details": { "text": "Authentication failed" } } ] }{ "resourceType": "OperationOutcome", "issue": [ { "severity": "error", "code": "forbidden", "details": { "text": "Authorization failed" } } ] }{ "resourceType": "OperationOutcome", "issue": [ { "severity": "error", "code": "not-supported", "details": { "text": "Operation is not supported" } } ] }{ "resourceType": "OperationOutcome", "issue": [ { "severity": "error", "code": "business-rule", "details": { "text": "Unprocessable entity" } } ] }
curl --request GET \ --url 'https://fumage-example.canvasmedical.com/Observation/<id>' \ --header 'Authorization: Bearer <token>' \ --header 'accept: application/json'import requests url = "https://fumage-example.canvasmedical.com/Observation/<id>" headers = { "accept": "application/json", "Authorization": "Bearer <token>" } response = requests.get(url, headers=headers) print(response.text)
{ "resourceType": "Observation", "id": "43b74793-5de6-435a-871d-8ae2232f3aa0", "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": "85353-1" } ] }, "subject": { "reference": "Patient/a1197fa9e65b4a5195af15e0234f61c2", "type": "Patient" }, "effectiveDateTime": "2022-06-28T20:18:54.141759+00:00", "issued": "2022-06-28T20:43:10.465819+00:00", "dataAbsentReason": { "coding": [ { "system": "http://terminology.hl7.org/CodeSystem/data-absent-reason", "code": "not-performed", "display": "Not Performed" } ] }, "hasMember": [ { "reference": "Observation/dd7f25f3-0fa6-4f15-9b8c-c61c24f139d8", "type": "Observation", "display": "Weight" }, { "reference": "Observation/3b96ab8b-aef6-4cbe-8ec5-b88c8e120e19", "type": "Observation", "display": "Body Temperature" }, { "reference": "Observation/201d4404-60c0-4f07-88c1-534456271a74", "type": "Observation", "display": "Blood Pressure" }, { "reference": "Observation/841187ae-0c35-4db7-8852-b5370e4a5c51", "type": "Observation", "display": "Pulse Rhythm" }, { "reference": "Observation/60e563bd-7848-487d-8852-c0db383dc115", "type": "Observation", "display": "Oxygen Saturation Arterial" }, { "reference": "Observation/cb8bca44-d0de-48b0-8786-6887a4b649ec", "type": "Observation", "display": "Height" }, { "reference": "Observation/b96e8bd4-1db9-46db-b292-e9a474bdca44", "type": "Observation", "display": "Waist Circumference" }, { "reference": "Observation/1e8b6774-82c3-4f0b-9b28-fca5fc17e8c9", "type": "Observation", "display": "Pulse" }, { "reference": "Observation/8642e444-53a6-4db8-a15f-17fdb2e01247", "type": "Observation", "display": "Respiration Rate" }, { "reference": "Observation/d0996ff1-643a-4711-88f8-2e303d208663", "type": "Observation", "display": "Note" } ] }{ "resourceType": "OperationOutcome", "issue": [ { "severity": "error", "code": "unknown", "details": { "text": "Authentication failed" } } ] }{ "resourceType": "OperationOutcome", "issue": [ { "severity": "error", "code": "forbidden", "details": { "text": "Authorization failed" } } ] }{ "resourceType": "OperationOutcome", "issue": [ { "severity": "error", "code": "not-found", "details": { "text": "Unknown coverage resource 'a47c7b0ebbb442cdbc4adf259d148ea1'" } } ] }
curl --request GET \ --url 'https://fumage-example.canvasmedical.com/Observation?category=vital-signs&patient=Patient/b60b818fad134c3095b34dd392be9533' \ --header 'Authorization: Bearer <token>' \ --header 'accept: application/json'import requests url = "https://fumage-example.canvasmedical.com/Observation?category=vital-signs&patient=Patient/b60b818fad134c3095b34dd392be9533" headers = { "accept": "application/json", "Authorization": "Bearer <token>" } response = requests.get(url, headers=headers) print(response.text)
{ "resourceType": "Bundle", "type": "searchset", "total": 19, "link": [ { "relation": "self", "url": "/Observation?patient=Patient%2Fb60b818fad134c3095b34dd392be9533&_count=20&_offset=0" }, { "relation": "first", "url": "/Observation?patient=Patient%2Fb60b818fad134c3095b34dd392be9533&_count=20&_offset=0" }, { "relation": "last", "url": "/Observation?patient=Patient%2Fb60b818fad134c3095b34dd392be9533&_count=20&_offset=0" } ], "entry": [ { "resource": { "resourceType": "Observation", "id": "378d88eb-cbfc-4668-a96e-c1e011f9f015", "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": "85353-1", "display": "Vital Signs Panel" } ] }, "subject": { "reference": "Patient/b60b818fad134c3095b34dd392be9533", "type": "Patient" }, "effectiveDateTime": "2024-04-09T18:35:35.633932+00:00", "issued": "2024-04-09T18:35:35.651181+00:00", "dataAbsentReason": { "coding": [ { "system": "http://terminology.hl7.org/CodeSystem/data-absent-reason", "code": "not-performed", "display": "Not Performed" } ] }, "hasMember": [ { "reference": "Observation/201d4404-60c0-4f07-88c1-534456271a74", "type": "Observation", "display": "Blood Pressure" }, { "reference": "Observation/60e563bd-7848-487d-8852-c0db383dc115", "type": "Observation", "display": "Oxygen Saturation Arterial" }, { "reference": "Observation/cb8bca44-d0de-48b0-8786-6887a4b649ec", "type": "Observation", "display": "Height" }, { "reference": "Observation/841187ae-0c35-4db7-8852-b5370e4a5c51", "type": "Observation", "display": "Pulse Rhythm" } ] } }, { "resource": { "resourceType": "Observation", "id": "cb8bca44-d0de-48b0-8786-6887a4b649ec", "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": "8302-2", "display": "Height" } ] }, "subject": { "reference": "Patient/b60b818fad134c3095b34dd392be9533", "type": "Patient" }, "effectiveDateTime": "2024-04-09T18:35:35.754424+00:00", "issued": "2024-04-09T18:35:35.756630+00:00", "valueQuantity": { "value": 69.0, "unit": "in", "system": "http://unitsofmeasure.org", "code": "[in_i]" }, "derivedFrom": [ { "reference": "Observation/378d88eb-cbfc-4668-a96e-c1e011f9f015", "type": "Observation" } ] } }, { "resource": { "resourceType": "Observation", "id": "60e563bd-7848-487d-8852-c0db383dc115", "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": "2708-6", "display": "Oxygen Saturation Arterial" }, { "system": "http://loinc.org", "code": "59408-5", "display": "Oxygen Saturation" } ] }, "subject": { "reference": 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