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The terms reference range and measurement range are used interchangeably even though, for a clinician, the reference range has particular meaning and use. The latter is meant as an abstraction of all sorts of ranges on measurements, including reference ranges and therapeutic ranges.

Measurement ranges are defined in the following, different resources:

  • ActivityDefinition, in the extension ActivityDefinition.ehealth-referenceRange . These are generic, that is, non-patient specific ranges applicable for the particular activity, say, a measurement of oxygen saturation.

  • ProcedureRequest, in the extension ProcedureRequest.ehealth-referenceRange. These are patient-specific ranges applicable to the particular activity in the particular CarePlan referencing the ProcedureRequest. A Patient can have multiple CarePlan with multiple ProcedureRequest and therefore, possibly differing measurement ranges even for the same activity type, say, measurement of oxygen saturation.

  • Observation, in the element Observation.referenceRange

As is reflected in the cardinality, multiple reference ranges can be defined simultaneously. Upon submission of an Observation, the reference ranges defined in the referenced ProcedureRequest are copied to the Observation by the service. This way, the set of measurement ranges in effect at the time of submission are captured in the Observation, regardless of how they Patient-specific reference ranges in ProcedureRequest are maintained and altered.

The structure used in the extension ehealth-referenceRange contains the following subset of elements defined in Observation.referenceRange:

  • low - the lower end of the range

  • high - the higher end of the range

  • type - the type of measurement range

Certain consideration should be made when maintaining measurement ranges in the eHealth Infrastructure. For the current list of allowed measurement range types, some can overlap and some typically should not, or at least only at their low or high bounds.

Under construction: Figure showing multiple REL and GAL type of measurement ranges.

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