I am attempting to create or update a Blood Pressure Observation resource in Oracle Cerner R4 FHIR, but the request is consistently failing with an OperationOutcome response indicating an Invalid request.
Request Payload
{
"resourceType": "Observation",
"id": "BP-208846163-208846165",
"identifier": [
{
"system": "https://fhir.cerner.com/ceuuid",
"value": "CE87caf4b7-9397-4667-9897-702218017c9e-208846163-2025060618254200"
},
{
"system": "https://fhir.cerner.com/ceuuid",
"value": "CE87caf4b7-9397-4667-9897-702218017c9e-208846165-2025060618261400"
}
],
"category": [
{
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital Signs"
}
],
"text": "Vital Signs"
}
],
"subject": {
"reference": "Patient/12724066"
},
"status": "amended",
"code": {
"coding": [
{
"system": "http://loinc.org",
"code": "85354-9",
"display": "Blood pressure panel with all children optional"
}
],
"text": "Blood pressure"
},
"component": [
{
"code": {
"coding": [
{
"system": "http://loinc.org",
"code": "8480-6"
}
],
"text": "Systolic Blood Pressure Sitting"
},
"valueQuantity": {
"value": 99,
"unit": "mmHg",
"system": "http://unitsofmeasure.org",
"code": "mm[Hg]"
}
},
{
"code": {
"coding": [
{
"system": "http://loinc.org",
"code": "8462-4"
}
],
"text": "Diastolic Blood Pressure Sitting"
},
"valueQuantity": {
"value": 35,
"unit": "mmHg",
"system": "http://unitsofmeasure.org",
"code": "mm[Hg]"
}
}
],
"effectiveDateTime": "2025-06-06T23:06:55.000Z",
"encounter": {
"reference": "Encounter/97953477"
},
"performer": [
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/event-performerFunction",
"valueCodeableConcept": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/v3-ParticipationType",
"code": "LA",
"display": "legal authenticator"
}
],
"text": "legal authenticator"
}
}
],
"reference": "Practitioner/12742069"
}
],
"issued": "2025-06-06T23:06:55.000Z"
}
Response Received
{
"resourceType": "OperationOutcome",
"issue": [
{
"severity": "error",
"code": "invalid",
"details": {
"text": "Invalid request"
}
}
]
}
Response Headers
- x-request-id:
/B25A9D5D0E771966FB0C99F624C0FB13+F8w3_FsSi
- opc-request-id:
/B25A9D5D0E771966FB0C99F624C0FB13/9DEE4FBA972E4AEFDC37530E9EAFF892
Questions
- Are there any restrictions on using
**status = amended** when creating or updating an Observation in Cerner?
- Is it valid to send multiple
**identifier** entries with the same system (https://fhir.cerner.com/ceuuid)?
- Does Cerner restrict client-supplied Observation IDs, or must the ID always be server-generated?
- Are there any mandatory fields or Cerner-specific constraints for Blood Pressure Observations that may cause this request to be rejected?
Any guidance or clarification would be greatly appreciated.