Submit a Full Vital Panel through Canvas FHIR API

Inside of the Canvas’ Vital Command there are many vital signs supported to document.

Protocol framework

The Canvas FHIR Observation Create endpoint supports writing some of the vital signs in the command. This guide will show you all the vitals that can be documented in the Create interaction.


What you’ll learn #

In this guide, you will learn how to do the following:

  1. Create a vital panel via FHIR
  2. Submit various vital signs into the same panel via FHIR
  3. Perform a FHIR Observation Search to view the completed panel

1. Setup and Authentication #

This guide will demonstrate many FHIR API calls into Canvas. Before we can make a FHIR request, we need to setup some imports, reusable variables, and authenticate into the instance we want to work with.

Here is your starting point:

import requests
url = "https://fumage-example.canvasmedical.com/Observation"
headers = {
    "accept": "application/json",
    "Authorization": "Bearer <token>",
    "content-type": "application/json"
}

But there are two places above to update:

  1. The url will show https://fumage-example.canvasmedical.com/Observation. You will need to replace example with the name of the Canvas instance you are using.

  2. One of the header elements will be 'Authorization': 'Bearer <token>'. You will need to create this <token> following our steps laid out in Customer Authentication

2. Understanding our Observation Payload #

Before we start creating the vital panel and the associated vital signs, take some time to familiarize yourself with the FHIR Observation Create endpoint. Each payload to create an observation requires status, code, and subject.

In this guide the status will always be final and the subject will always appear as:
"subject": { "reference": "Patient/$patient_id" }.
When completing these steps yourself, you will want to change the {patient_id} to match a patient in the instance you are using (e.g "Patient/ee8672f3497e4a83937b9e71d0a704a5").

The code attribute is the real magic that tells Canvas which vital you are creating. The coding will always be a LOINC code.

Another thing to note is an optional effectiveDateTime attribute. This allows you to specify the time the vital was taken. But if omitted, it will default to the time of creation.

3. Create a Vital Panel #

First we will need to create the panel object to be able to save all the individual vital signs to. The important attribute is the code.coding[0][code] being 85353-1 to represent a vital panel.

Here is the payload for how to create a Vital Panel (remember to set the patient_id and also update the effectiveDateTime):

payload = {
    "resourceType": "Observation",
    "status": "final",
    "code": {
        "coding": [
            {
                "system": "http://loinc.org",
                "code": "85353-1",
                "display": "Vital Panel"
            }
        ]
    },
    "subject": {
        "reference": f"Patient/{patient_id}"
    },
    "effectiveDateTime": "2024-03-29T08:50:24.883809+00:00"
}

response = requests.post(url, json=payload, headers=headers)

On a successful create, when the response.status_code equal 201. We can fetch the ID of the newly created observation in the response.headers['location'] attribute. The value will always be in the format {url}/{id}/_history/1. We need to extract the id from the value.

However, if the request failed it will throw an error to see what went wrong. It will also display the Correlation ID that can be given to Customer Support for help with further debugging.

if response.status_code == 201:
    panel_id = response.headers['location'].replace(f"{url.replace('https', 'http')}/", '').replace('/_history/1', '')
else:
    raise Exception(f"Failed to perform {response.url}. \n Correlation ID: {response.headers['fumage-correlation-id']} \n {response.text}")

Looking in the Canvas UI, there will now be a Data Import note placed on that patient’s timeline based on the date passed in the effectiveDateTime attribute with an empty Vitals Command:

Protocol framework

4. Creating Individual Vital Signs #

Now that we have created a Vital Panel, we will be able to use this panel_id when creating the individual vital signs to be associated with the same command by passing the derivedFrom attribute in the payload:

    "derivedFrom": [
        {
            "reference": f"Observation/{panel_id}",
            "type": "Observation"
        }
    ]

Now we are ready to create the following vital signs in the panel that are supported via FHIR Observation Create:

  • Height
  • Weight
  • Waist Circumference
  • Body Temperature
  • Blood Pressure
  • Pulse Rhythm
  • Pulse Rate
  • Respiration Rate
  • Oxygen Saturation
  • Notes

Add Height #

Height is denoted by the LOINC code 8302-2. Since its value is numeric, we will be able to pass the value and units through the valueQuantity attribute. By default if no valueQuantity.unit is specified, it will default to using inches, but cm is also supported, it will just convert it to inches on the UI and when a Read/Search is performed.

Here is a payload to create a height of 69.0 inches:

payload = {
    "resourceType": "Observation",
    "status": "final",
    "code": {
        "coding": [
            {
                "system": "http://loinc.org",
                "code": "8302-2",
                "display": "Height"
            }
        ]
    },
    "subject": {
        "reference": f"Patient/{patient_id}"
    },
    "effectiveDateTime": "2024-03-29T08:50:24.883809+00:00",
    "valueQuantity": {
        "value": 69.0,
        "unit": "in",
    },
    "derivedFrom": [
        {
            "reference": f"Observation/{panel_id}",
            "type": "Observation"
        }
    ]
}

response = requests.post(url, json=payload, headers=headers)
if response.status_code == 201:
    print(f"Height observation id = {response.headers['location'].replace(f'{url}/', '').replace('/_history/1', '')}")
else:
    raise Exception(f"Failed to perform {response.url}. \n Fumage Correlation ID: {response.headers['fumage-correlation-id']} \n {response.text}")

Looking in the Canvas UI, there will now be height of 69.0 in added in that Vitals Command:

Protocol framework

Add Weight #

Weight is denoted by the LOINC code 29463-7. Since its value is numeric, we will be able to pass the value and units through the valueQuantity attribute. By default if no valueQuantity.unit is specified, it will default to using ounces, but lb or kg is also supported, it will just convert it to oz when a Read/Search is performed. The UI will display it in lbs and leftover oz.

Here is a payload to create a weight of 176.4 lbs:

payload = {
    "resourceType": "Observation",
    "status": "final",
    "code": {
        "coding": [
            {
                "system": "http://loinc.org",
                "code": "29463-7",
                "display": "Weight"
            }
        ]
    },
    "subject": {
        "reference": f"Patient/{patient_id}"
    },
    "effectiveDateTime": "2024-03-29T08:50:24.883809+00:00",
    "valueQuantity": {
        "value": 176.4,
        "unit": "lb",
    },
    "derivedFrom": [
        {
            "reference": f"Observation/{panel_id}",
            "type": "Observation"
        }
    ]
}

response = requests.post(url, json=payload, headers=headers)
if response.status_code == 201:
    print(f"Weight observation id = {response.headers['location'].replace(f'{url}/', '').replace('/_history/1', '')}")
else:
    raise Exception(f"Failed to perform {response.url}. \n Fumage Correlation ID: {response.headers['fumage-correlation-id']} \n {response.text}")

Looking in the Canvas UI, there will now be weight of 176 lbs 6.4 oz added in that Vitals Command:

Protocol framework

Add Waist Circumference #

Waist Circumference is denoted by the LOINC code 29463-7. Since its value is numeric, we will be able to pass the value and units through the valueQuantity attribute. By default if no valueQuantity.unit is specified, it will default to using centimeters, but in is also supported, it will just convert it to cm on the UI or when a Read/Search is performed.

Here is a payload to create a waist circumference of 98.2 cm:

payload = {
    "resourceType": "Observation",
    "status": "final",
    "code": {
        "coding": [
            {
                "system": "http://loinc.org",
                "code": "56086-2",
                "display": "Waist Circumference"
            }
        ]
    },
    "subject": {
        "reference": f"Patient/{patient_id}"
    },
    "effectiveDateTime": "2024-03-29T08:50:24.883809+00:00",
    "valueQuantity": {
        "value": 98.2,
        "unit": "cm",
    },
    "derivedFrom": [
        {
            "reference": f"Observation/{panel_id}",
            "type": "Observation"
        }
    ]
}

response = requests.post(url, json=payload, headers=headers)
if response.status_code == 201:
    print(f"Waist Circumference observation id = {response.headers['location'].replace(f'{url}/', '').replace('/_history/1', '')}")
else:
    raise Exception(f"Failed to perform {response.url}. \n Fumage Correlation ID: {response.headers['fumage-correlation-id']} \n {response.text}")

Looking in the Canvas UI, there will now be waist circumference of 98.2 cm added in that Vitals Command:

Protocol framework

Add Body Temperature #

Body Temperature is denoted by the LOINC code 8310-5. Since its value is numeric, we will be able to pass the value and units through the valueQuantity attribute. The only unit accepted for body temperature is °F and if omitted it will be default.

Here is a payload to create a temperature of 98.4 °F:

payload = {
    "resourceType": "Observation",
    "status": "final",
    "code": {
        "coding": [
            {
                "system": "http://loinc.org",
                "code": "8310-5",
                "display": "Body Temperature"
            }
        ]
    },
    "subject": {
        "reference": f"Patient/{patient_id}"
    },
    "effectiveDateTime": "2024-03-29T08:50:24.883809+00:00",
    "valueQuantity": {
        "value": 98.4,
        "unit": "°F",
    },
    "derivedFrom": [
        {
            "reference": f"Observation/{panel_id}",
            "type": "Observation"
        }
    ]
}

response = requests.post(url, json=payload, headers=headers)
if response.status_code == 201:
    print(f"Body Temperature observation id = {response.headers['location'].replace(f'{url}/', '').replace('/_history/1', '')}")
else:
    raise Exception(f"Failed to perform {response.url}. \n Fumage Correlation ID: {response.headers['fumage-correlation-id']} \n {response.text}")

Looking in the Canvas UI, there will now be temperature of 98.4 °F added in that Vitals Command:

Protocol framework

Add Blood Pressure #

Blood Pressure is denoted by the LOINC code 85354-9. In the Vital’s command blood pressure is a string value that combines the systolic and diastolic components with a /. So the payload will pass the valueString component in order for the blood pressure to appear correctly in the Vitals Command.

Since blood pressure is made up of two values, the payload will also define a component attribute list to pass the systolic (LOINC code 8480-6) and diastolic (LOINC code 8462-4) values. These two values are numeric, so they will have the valueQuantity attributes where the unit will be mmHg

Here is a payload to create a Blood Pressure of 122/68:

payload = {
    "resourceType": "Observation",
    "status": "final",
    "code": {
        "coding": [
            {
                "system": "http://loinc.org",
                "code": "85354-9",
                "display": "Blood Pressure"
            }
        ]
    },
    "subject": {
        "reference": f"Patient/{patient_id}"
    },
    "effectiveDateTime": "2024-03-29T08:50:24.883809+00:00",
    "valueString": "122/68",
    "component": [
        {
            "code": {
                "coding": [
                    {
                        "system": "http://loinc.org",
                        "code": "8480-6",
                        "display": "Systolic blood pressure"
                    }
                ]
            },
            "valueQuantity": {
                "value": 122,
                "unit": "mmHg"
            }
        },
        {
            "code": {
                "coding": [
                    {
                        "system": "http://loinc.org",
                        "code": "8462-4",
                        "display": "Diastolic blood pressure"
                    }
                ]
            },
            "valueQuantity": {
                "value": 68,
                "unit": "mmHg"
            }
        }
    ],
    "derivedFrom": [
        {
            "reference": f"Observation/{panel_id}",
            "type": "Observation"
        }
    ]
}

response = requests.post(url, json=payload, headers=headers)
if response.status_code == 201:
    print(f"Blood Pressure observation id = {response.headers['location'].replace(f'{url}/', '').replace('/_history/1', '')}")
else:
    raise Exception(f"Failed to perform {response.url}. \n Fumage Correlation ID: {response.headers['fumage-correlation-id']} \n {response.text}")

Looking in the Canvas UI, there will now be blood pressure of 122/68 added in that Vitals Command:

Protocol framework

Add Pulse Rate #

Pulse Rate is denoted by the LOINC code 8867-4. Since its value is numeric, we will be able to pass the value and units through the valueQuantity attribute. The only unit accepted for pulse rate is bpm and if omitted it will be default.

Here is a payload to create a pulse rate of 115 bpm:

payload = {
    "resourceType": "Observation",
    "status": "final",
    "code": {
        "coding": [
            {
                "system": "http://loinc.org",
                "code": "8867-4",
                "display": "Pulse"
            }
        ]
    },
    "subject": {
        "reference": f"Patient/{patient_id}"
    },
    "effectiveDateTime": "2024-03-29T08:50:24.883809+00:00",
    "valueQuantity": {
        "value": 115,
        "unit": "bpm",
    },
    "derivedFrom": [
        {
            "reference": f"Observation/{panel_id}",
            "type": "Observation"
        }
    ]
}

response = requests.post(url, json=payload, headers=headers)
if response.status_code == 201:
    print(f"Pulse Rate observation id = {response.headers['location'].replace(f'{url}/', '').replace('/_history/1', '')}")
else:
    raise Exception(f"Failed to perform {response.url}. \n Fumage Correlation ID: {response.headers['fumage-correlation-id']} \n {response.text}")

Looking in the Canvas UI, there will now be pulse rate of 115 bpm added in that Vitals Command:

Protocol framework

Add Pulse Rhythm #

Pulse Rhythm is denoted by the LOINC code 8884-9. Canvas accepts only three different string values for pulse rhythm: Regular, Irregularly Irregular, or Regulary Irregular. This value will be passed in the valueString attribute.

Here is a payload to create a pulse rhythm of Regular:

payload = {
    "resourceType": "Observation",
    "status": "final",
    "code": {
        "coding": [
            {
                "system": "http://loinc.org",
                "code": "8884-9",
                "display": "Pulse Rhythm"
            }
        ]
    },
    "subject": {
        "reference": f"Patient/{patient_id}"
    },
    "effectiveDateTime": "2024-03-29T08:50:24.883809+00:00",
    "valueString": "Regular",
    "derivedFrom": [
        {
            "reference": f"Observation/{panel_id}",
            "type": "Observation"
        }
    ]
}

response = requests.post(url, json=payload, headers=headers)
if response.status_code == 201:
    print(f"Pulse rhythm observation id = {response.headers['location'].replace(f'{url}/', '').replace('/_history/1', '')}")
else:
    raise Exception(f"Failed to perform {response.url}. \n Fumage Correlation ID: {response.headers['fumage-correlation-id']} \n {response.text}")

Looking in the Canvas UI, there will now be pulse rhythm of Regular added in that Vitals Command:

Protocol framework

Add Respiration Rate #

Respiration Rate is denoted by the LOINC code 9279-1. Since its value is numeric, we will be able to pass the value and units through the valueQuantity attribute. The only unit accepted for respiration rate is bpm and if omitted it will be default.

Here is a payload to create a respiration rate of 15 bpm:

payload = {
    "resourceType": "Observation",
    "status": "final",
    "code": {
        "coding": [
            {
                "system": "http://loinc.org",
                "code": "9279-1",
                "display": "Respiration Rate"
            }
        ]
    },
    "subject": {
        "reference": f"Patient/{patient_id}"
    },
    "effectiveDateTime": "2024-03-29T08:50:24.883809+00:00",
    "valueQuantity": {
        "value": 15,
        "unit": "bpm",
    },
    "derivedFrom": [
        {
            "reference": f"Observation/{panel_id}",
            "type": "Observation"
        }
    ]
}

response = requests.post(url, json=payload, headers=headers)
if response.status_code == 201:
    print(f"Respiration Rate observation id = {response.headers['location'].replace(f'{url}/', '').replace('/_history/1', '')}")
else:
    raise Exception(f"Failed to perform {response.url}. \n Fumage Correlation ID: {response.headers['fumage-correlation-id']} \n {response.text}")

Looking in the Canvas UI, there will now be respiration rate of 15 bpm added in that Vitals Command:

Protocol framework

Add Oxygen Saturation #

Oxygen Saturation is denoted by either LOINC code 2708-6 or 59408-5. Canvas saves the oxygen saturation with both codings. Since its value is numeric, we will be able to pass the value and units through the valueQuantity attribute. The only unit accepted for Oxygen Saturation is % and if omitted it will be default.

Here is a payload to create a Oxygen Saturation of 98%:

payload = {
    "resourceType": "Observation",
    "status": "final",
    "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": f"Patient/{patient_id}"
    },
    "effectiveDateTime": "2024-03-29T08:50:24.883809+00:00",
    "valueQuantity": {
        "value": 98,
        "unit": "%",
    },
    "derivedFrom": [
        {
            "reference": f"Observation/{panel_id}",
            "type": "Observation"
        }
    ]
}

response = requests.post(url, json=payload, headers=headers)
if response.status_code == 201:
    print(f"Oxygen Saturation observation id = {response.headers['location'].replace(f'{url}/', '').replace('/_history/1', '')}")
else:
    raise Exception(f"Failed to perform {response.url}. \n Fumage Correlation ID: {response.headers['fumage-correlation-id']} \n {response.text}")

Looking in the Canvas UI, there will now be Oxygen Saturation of 98% added in that Vitals Command:

Protocol framework

Add Notes #

Adding a Note is denoted by the LOINC code 80339-5. Since this value is free text, a valueString attribute can be used.

Here is a payload to create an internal Note:

payload = {
    "resourceType": "Observation",
    "status": "final",
    "code": {
        "coding": [
            {
                "system": "http://loinc.org",
                "code": "80339-5",
                "display": "Note"
            }
        ]
    },
    "subject": {
        "reference": f"Patient/{patient_id}"
    },
    "effectiveDateTime": "2024-03-29T08:50:24.883809+00:00",
    "valueString": "Last Blood sugar was 78",
    "derivedFrom": [
        {
            "reference": f"Observation/{panel_id}",
            "type": "Observation"
        }
    ]
}

response = requests.post(url, json=payload, headers=headers)
if response.status_code == 201:
    print(f"Oxygen Saturation observation id = {response.headers['location'].replace(f'{url}/', '').replace('/_history/1', '')}")
else:
    raise Exception(f"Failed to perform {response.url}. \n Fumage Correlation ID: {response.headers['fumage-correlation-id']} \n {response.text}")

Looking in the Canvas UI, there will now will be a Note added in that Vitals Command:

Protocol framework

5. Perform FHIR Observation Read and Search #

A full Vital Panel has been completed! Let’s now perform a FHIR Observation Read using the panel_id to see all the observation members of this panel now:

from pprint import pprint
response = requests.get(f"{url}/{panel_id}", headers=headers)
if response.status_code == 200:
    pprint(response.json())
else:
    raise Exception(f"Failed to perform {response.url}. \n Fumage Correlation ID: {response.headers['fumage-correlation-id']} \n {response.text}")

The output will look like:

{
    "resourceType": "Observation",
    "id": "64ef9722-87c9-4b51-96d5-5812f15654d2",
    "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/b23295011ddf4df799976866c84d79d3",
        "type": "Patient"
    },
    "effectiveDateTime": "2024-03-29T08:50:24.883809+00:00",
    "issued": "2024-04-19T18:13:03.574074+00:00",
    "dataAbsentReason": {
        "coding": [
            {
                "system": "http://terminology.hl7.org/CodeSystem/data-absent-reason",
                "code": "not-performed",
                "display": "Not Performed"
            }
        ]
    },
    "hasMember": [
        {
            "reference": "Observation/a21ee97f-dd35-4266-afaf-3e1b0a537668",
            "type": "Observation",
            "display": "Height"
        },
        {
            "reference": "Observation/c9898fa2-e78e-48b0-8c7b-7ab8c99f0d30",
            "type": "Observation",
            "display": "Weight"
        },
        {
            "reference": "Observation/a70a2979-d820-42e4-a0c6-cdbd80d7468f",
            "type": "Observation",
            "display": "Waist Circumference"
        },
        {
            "reference": "Observation/794c1f41-a564-4f4c-b56e-6ab5ee40ad0e",
            "type": "Observation",
            "display": "Body Temperature"
        },
        {
            "reference": "Observation/4fe8ba77-14aa-4d4a-b7eb-eaa0020a741f",
            "type": "Observation",
            "display": "Blood Pressure"
        },
        {
            "reference": "Observation/8a7c9a2b-3b06-4ede-bb98-620788cf2071",
            "type": "Observation",
            "display": "Pulse"
        },
        {
            "reference": "Observation/53a6e624-d7a6-4eef-8e05-9d98c889d820",
            "type": "Observation",
            "display": "Pulse Rhythm"
        },
        {
            "reference": "Observation/3ef9d6d0-68db-46ce-b30d-ca7081da14b7",
            "type": "Observation",
            "display": "Respiration Rate"
        },
        {
            "reference": "Observation/e08993a5-1d62-4bb2-ae00-c30bcd8e66bf",
            "type": "Observation",
            "display": "Oxygen Saturation Arterial"
        },
        {
            "reference": "Observation/49c4871d-ce6c-4281-86aa-27a8dd03ccf8",
            "type": "Observation",
            "display": "Note"
        }
    ]
}

And finally let’s perform a FHIR Observation Search to see all the vital signs that are for that patient using the derived from search parameter:

from pprint import pprint
response = requests.get(f"{url}?patient=Patient/{patient_id}&category=http://terminology.hl7.org/CodeSystem/observation-category|vital-signs&derived-from=Observation/{panel_id}&_count=20", headers=headers)
if response.status_code == 200:
    pprint(response.json())
else:
    raise Exception(f"Failed to perform {response.url}. \n Fumage Correlation ID: {response.headers['fumage-correlation-id']} \n {response.text}")

The response will look like:

{
    "resourceType": "Bundle",
    "type": "searchset",
    "total": 10,
    "link": [
        {
            "relation": "self",
            "url": "/Observation?category=vital-signs&derived-from=Observation%2F64ef9722-87c9-4b51-96d5-5812f15654d2&patient=Patient%2Fb23295011ddf4df799976866c84d79d3&_count=50&_offset=0"
        },
        {
            "relation": "first",
            "url": "/Observation?category=vital-signs&derived-from=Observation%2F64ef9722-87c9-4b51-96d5-5812f15654d2&patient=Patient%2Fb23295011ddf4df799976866c84d79d3&_count=50&_offset=0"
        },
        {
            "relation": "last",
            "url": "/Observation?category=vital-signs&derived-from=Observation%2F64ef9722-87c9-4b51-96d5-5812f15654d2&patient=Patient%2Fb23295011ddf4df799976866c84d79d3&_count=50&_offset=0"
        }
    ],
    "entry": [
        {
            "resource": {
                "resourceType": "Observation",
                "id": "a21ee97f-dd35-4266-afaf-3e1b0a537668",
                "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": {
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