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PHMR: Vital Sign Data Template Summary
The table below forms the summary of the WebEx discussion held on Thursday 28h June 2012. Prior to this meeting feedback had been gathered on which vital signs the Personal Health Messaging Report should carry. This meeting aimed to reach agreement on the units used for each vital sign, for example Degrees Celsius for temperature, and how many decimal places are carried.
There were some questions asked about are the units international measures, for example is height always measured in metres. The units for measurements were taken from a number of sources, including NHS and the Unified Code for Units of Measure (UCUM).
In addition the message stipulates the units to be used for each vital sign. Creating systems cannot stipulate what they are sending, for example, weight, in pounds. It must first be converted to Kilograms. This approach has a number of advantages.
- Message conformance. It is much easier to check that a message has been correctly implemented if the template against which it is created is as tight as possible.
- By stipulating the vital sign units in the message,the sending and receiving systems are then responsible for translating readings to and from the message units.
We are open to further comments on the vital signs, units of measure and number of decimal places used. However as development work progresses making changes, in this version of the message, will get harder. Any requested changes that cannot be included in this version will be held for consideration in the next.No. / Template Name / Status / Notes
1 / Allergic or Adverse Reaction Event / Retired / Removed
2 / Allergy Propensity / Retired / Removed
3 / Device Definition / No Change / No change (constrained by HL7 definitions.)
4 / Blood Pressure / Update / mmHg, integers only
Include Cuff size, position, laterality and site as optional fields.
5 / Device Read Body Mass Index / No Change / 1 Decimal Point
6 / Device Read Body Temperature / No Change / Degrees Celsius , 1 decimal point
7 / Device Read Height / No Change / Meters, 2 decimal points
8 / Device Read Mean Blood Pressure / No Change / mmHg, integers only
9 / Device Read Pulse / No Change / Beats per Minute, BPM
10 / Device Read Test Result / Retired and replaced 23-33 / Removed
11 / Device Read Weight / No Change / Kilograms, Kg, 2 decimal places
12 / Diagnosis / Retired / Removed
13 / Finding / Retired / Removed
14 / Medication Administration Course / Retired / Removed
15 / Medication Administration Dose / Retired / Removed
16 / Medication Discontinuation / Retired / Removed
17 / Plan Medication Administration / Retired / Removed
18 / Problem / Retired / Removed
19 / Request Medication Administration / Retired / Removed
20 / Supply Medication / Retired / Removed
21 / Threshold / Update / Split into separate templates for each reading. This will ease implementation.
Add capability to specify targets and importance.
22 / Waveform Series Observations / Update / Create a template to carry an image and that can have external reference as a sub template to point to higher quality image if required.
23 / Oxygen Saturation / NEW (replaces 10) / Percentage, %, Integer
24 / Blood Glucose / NEW (replaces 10) / Millimoles per litre,Mmol/L, 1 Decimal Place
Flag for fasting deferred to subsequent message version
25 / Blood Coagulation / NEW (replaces 10) / Seconds, ‘s‘ to 1dp
26 / Peak Flow / NEW (replaces 10) / Litres per minute, L/min, integer value
27 / Forced Expiratory Volume in the 1st Second / NEW (replaces 10) / Litres, L, to 2 decimal points
28 / Forced Vital Capacity / NEW (replaces 10) / Litres, L, to 2 decimal points
29 / Cholesterol / NEW (replaces 10) / Millimoles per litre of blood, mmol/L, to 0dp
Fasting flag deferred for subsequent message type
30 / Triglycerides / NEW (replaces 10) / mg/dL, integer to 0dp
31 / Smoking (Carbon Monoxide) / NEW (replaces 10) / Parts per Million, ppm, integer to 0dp
32 / AF Detection / NEW (replaces 10) / Deferred to subsequent message version. Uncertain clinical value and current informal monitoring devices may report noise as AF.
33 / Attachments / NEW (replaces 10) / No change
34 / Encompassing encounter (carries Location etc.) / NEW / The encounter address format is controlled by the template.
This template suggestion has been deferred for consideration in a subsequent message version. It was suggested that a template be included for alcohol measurement. No one on the call indicated that alcohol is currently measured in the informal care setting; i.e. at home.
Creating a template to carry symptomatic data has been deferred to a subsequent message version. Today this information can either be carried as an attachment or inside the free text field of the message.
The Continua Health Alliance is carrying out work in this area. The recommendation is to review this when published for inclusion in a subsequent message version.