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Committee Approval Date:

Orders & Observations project approval May 23, 2019

CIMI project approval May 23, 2019

Publishing Lead:

Nathan Davis, CIMI

Contributing or Reviewing Work Groups:


FHIR Development Project Insight ID:

Vital Signs PSS ID 1541

Scope of coverage:

To create the terminology content, logical models, FHIR profiles and implementation guides for all of vital signs including all qualifying observations (patient position, body location, device, method, etc.) and coded value sets, building on the FHIR Vital Signs profile currently in place.

Content location:      Github repository for the IG     Landing page for the IG

Proposed IG realm and code:

Realm: US

Code: us/vitals

Maintenance Plan:

All logical models, FHIR profiles, and the IG will be maintained by CIMI.  Terminology bindings and links will be reviewed and updated with each release.

Short Description:

US Realm Implementation Guide for Vital Signs observations with extensions for qualifying data.

Long Description:

Vital signs are collected on nearly every patient encounter. Oftentimes, the clinician needs to know the patient position, device, body location or method by which the measures were taken. This implementation guide provides further definition of the relevant value sets and extensions for qualifying data to document vital signs in the US based on the FHIR Core Vital Signs profile.

Examples include capturing cuff size, body position, clothing worn during measure, body location (more extensive than BodySite), exertion phase, etc.

Involved parties:



Intermountain Healthcare

American Medical Association

University of Utah

Veteran's Administration

Expected implementations:

Intermountain Healthcare

American Medical Association

University of Utah


Content sources:

Federal Health Information Model

Intermountain Healthcare Clinical Element Models


Example Scenarios:

Respiratory rate taken with patient sleeping in a supine position.

Heart rate measured using radial artery palpation.

Rectal Temperature

Orthostatic Blood Pressure (sitting/standing/lying)

IG Relationships:

Proper constraints on both FHIR Core Vital Signs & US Core IG


  1. Develop the logical model (complete)
  2. Curate the needed terminology content with LOINC and SNOMED CT (complete).
  3. Develop the FHIR profiles (first draft complete, second draft 1/31/2020)
  4. QA the FHIR profile with CIMI
  5. Develop the IG. (first draft complete, second draft 1/31/2020)
  6. Connectathon (currently being planned 1/6/2020 using HSPC sandbox)
  7. Ballot May 2020

FMG Notes