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10.3.14.3 7.18.5 StructureDefinition: DiagnosticReport-Genetics Other HL7 Standards

 

Orders and Observations FHIR Infrastructure Work Group

Maturity Level : 1 N/A

Trial Use Standards Status : Informative Use Context : Any

The official URL for this profile is: http://hl7.org/fhir/StructureDefinition/diagnosticreport-genetics Describes how the DiagnosticReport resource is used to report structured genetic test results This profile was published on Fri, Oct 9, 2015 00:00+1100 HL7 has produced a number of other standards that don't overlap with FHIR as closely as those listed above, primarily because they aren't focused solely on information exchange. However, they deserve a draft by Health Level Seven International (Clinical Genomics). brief mention:

7.18.5.1 10.3.14.3.1 Formal Views of Profile Content EHR Functional Model (EHR-FM) Description of Profiles, Differentials, Snapshots, and how the XML and JSON presentations work . Text Summary Differential Table Snapshot Table XML Template JSON Template All

This structure specification defines a number of functional behaviors for Electronic Health Record systems. FHIR is derived from DiagnosticReport . Summary Prohibited: 1 element Extensions This structure refers a healthcare information exchange standard that can be used to satisfy some of these extensions: http://hl7.org/fhir/StructureDefinition/DiagnosticReport-geneticsAssessedCondition http://hl7.org/fhir/StructureDefinition/DiagnosticReport-geneticsFamilyMemberHistory http://hl7.org/fhir/StructureDefinition/DiagnosticReport-geneticsAnalysis http://hl7.org/fhir/StructureDefinition/DiagnosticReport-geneticsReferences functional behaviors. Details on how FHIR fits into the EHR-FM can be found here This structure is derived from DiagnosticReport .

Name Flags Card. Type Description & Constraints DiagnosticReport 0..* DiagnosticReport-geneticsAssessedCondition 0..* Reference ( Condition ) AssessedCondition URL: http://hl7.org/fhir/StructureDefinition/DiagnosticReport-geneticsAssessedCondition DiagnosticReport-geneticsFamilyMemberHistory 0..* Reference ( FamilyMemberHistory ) FamilyHistory URL: http://hl7.org/fhir/StructureDefinition/DiagnosticReport-geneticsFamilyMemberHistory DiagnosticReport-geneticsAnalysis 0..* (Complex) Analysis URL: http://hl7.org/fhir/StructureDefinition/DiagnosticReport-geneticsAnalysis DiagnosticReport-geneticsReferences

7.18.5.2 0..* (Complex) References URL: Context Management Specifications (CCOW) http://hl7.org/fhir/StructureDefinition/DiagnosticReport-geneticsReferences 0 .. 0 Documentation

CCOW is a standard for this format Name Flags Card. Type Description & Constraints DiagnosticReport I 0..* A Diagnostic report - allowing independent systems to synchronize context on a combination of request information, atomic results, images, interpretation, as well as formatted reports id Σ 0..1 string Logical id of this artifact meta Σ I 0..1 Meta Metadata about single workstation, providing a seamless interface for the resource implicitRules ?! Σ I 0..1 uri A set user of rules under which this content was created language I 0..1 code Language that workstation (e.g. ensuring consistent user authentication, display of the resource content Binding: Common Languages ( preferred ) Max Binding: All Languages text I 0..1 Narrative Text summary same patient, display of the resource, for human interpretation contained 0..* Resource Contained, inline Resources extension I 0..* Extension Extension Slice: Unordered, Open by value:url DiagnosticReport-geneticsAssessedCondition I 0..* Reference ( Condition ) AssessedCondition URL: http://hl7.org/fhir/StructureDefinition/DiagnosticReport-geneticsAssessedCondition DiagnosticReport-geneticsFamilyMemberHistory I 0..* Reference ( FamilyMemberHistory ) FamilyHistory URL: http://hl7.org/fhir/StructureDefinition/DiagnosticReport-geneticsFamilyMemberHistory DiagnosticReport-geneticsAnalysis I 0..* (Complex) Analysis URL: http://hl7.org/fhir/StructureDefinition/DiagnosticReport-geneticsAnalysis DiagnosticReport-geneticsReferences I 0..* (Complex) References URL: http://hl7.org/fhir/StructureDefinition/DiagnosticReport-geneticsReferences modifierExtension ?! I 0..* Extension Extensions that cannot same order, etc.) In theory, FHIR resources could be ignored identifier Σ I 0..* Identifier Business identifier for report basedOn I 0..* Reference ( CarePlan | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest ) What was requested status ?! Σ I 1..1 code registered | partial | preliminary | final + Binding: DiagnosticReportStatus ( required ) category Σ I 0..* CodeableConcept Service category Binding: Diagnostic Service Section Codes ( example ) code Σ I 1..1 CodeableConcept Name/Code for this diagnostic report Binding: LOINC Diagnostic Report Codes ( preferred ) subject Σ I 0..1 Reference ( Patient | Group | Device | Location ) The subject of the report - usually, but not always, used as an alternative CCOW implementation technology, however the patient encounter Σ I 0..1 Reference ( Encounter ) Health care event when test ordered effective[x] Σ I 0..1 Clinically relevant time/time-period business case for report effectiveDateTime dateTime effectivePeriod Period issued Σ I 0..1 instant DateTime this version was made performer Σ I 0..* Reference ( Practitioner | PractitionerRole | Organization | CareTeam ) Responsible Diagnostic Service resultsInterpreter Σ I 0..* Reference ( Practitioner | PractitionerRole | Organization | CareTeam ) Primary result interpreter specimen I 0..* Reference ( Specimen ) Specimens doing this report is based on result I 0..* Reference ( Observation ) Observations imagingStudy I 0..* Reference ( ImagingStudy ) Reference to full details of imaging associated with the diagnostic report media Σ I 0..* BackboneElement Key images associated with this report id 0..1 string Unique id for inter-element referencing extension I 0..* Extension Additional content defined by implementations modifierExtension ?! Σ I 0..* not clear. CCOW profiles include HL7 V2 Extension Extensions that cannot mappings. These mappings can be ignored even if unrecognized comment I 0..1 string Comment about the image (e.g. explanation) link Σ I 1..1 Reference ( Media ) Reference used to help identify the image source conclusion I 0..1 string Clinical conclusion (interpretation) of test results presentedForm I 0..* Attachment Entire report as issued Documentation for this format <!-- DiagnosticReport-Genetics --> < xmlns="http://hl7.org/fhir" > <!-- from Element: --> <</id> <</meta> < < < Text summary of the resource, for human interpretation</text> < Contained, inline Resources</contained> <<a href="diagnosticreport-genetics-definitions.html#DiagnosticReport.modifierExtension" title="May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself) (this element modifies the meaning of other elements)" class="dict"></modifierExtension> < Business identifier for report</identifier> <</basedOn> < <</category> <</code> < The subject of the report - usually, but not always, the patient</subject> < Health care event when test ordered</encounter> < Clinically relevant time/time-period for report</effective[x]> < < Responsible Diagnostic Service</performer> < Primary result interpreter</resultsInterpreter> < Specimens this report is based on</specimen> <</result> < Reference to full details of imaging associated with the diagnostic report</imagingStudy> < <<a href="diagnosticreport-genetics-definitions.html#DiagnosticReport.media.modifierExtension" title="May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself) (this element modifies the meaning of other elements)" class="dict"></modifierExtension> < < Reference to the image source</link> </media> < <</conclusionCode> < Entire report as issued</presentedForm> </DiagnosticReport> { // // from Element: " " " " " " { // // from Element: }, { // // from Element: }, { // // from Element: }, { // // from Element: } ], "<a href="diagnosticreport-genetics-definitions.html#DiagnosticReport.modifierExtension" title="May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself) (this element modifies the meaning of other elements)" class="dict"> " " " " " " " " " " " " " " " " " " } This structure is derived from DiagnosticReport . Summary Prohibited: 1 element Extensions This structure refers to these extensions: http://hl7.org/fhir/StructureDefinition/DiagnosticReport-geneticsAssessedCondition http://hl7.org/fhir/StructureDefinition/DiagnosticReport-geneticsFamilyMemberHistory http://hl7.org/fhir/StructureDefinition/DiagnosticReport-geneticsAnalysis http://hl7.org/fhir/StructureDefinition/DiagnosticReport-geneticsReferences Differential View This structure is derived from DiagnosticReport . equivalent FHIR data elements when establishing CCOW linkages in FHIR-based systems.

Name Flags Card. Type Description & Constraints DiagnosticReport 0..* DiagnosticReport-geneticsAssessedCondition 0..* Reference ( Condition ) AssessedCondition URL: http://hl7.org/fhir/StructureDefinition/DiagnosticReport-geneticsAssessedCondition DiagnosticReport-geneticsFamilyMemberHistory 0..* Reference ( FamilyMemberHistory ) FamilyHistory URL: http://hl7.org/fhir/StructureDefinition/DiagnosticReport-geneticsFamilyMemberHistory DiagnosticReport-geneticsAnalysis 0..* (Complex) Analysis URL: http://hl7.org/fhir/StructureDefinition/DiagnosticReport-geneticsAnalysis DiagnosticReport-geneticsReferences 0..* (Complex) References URL: http://hl7.org/fhir/StructureDefinition/DiagnosticReport-geneticsReferences conclusionCode

7.18.5.3 0 Arden Syntax .. 0 Documentation for this format

Snapshot View Name Flags Card. Type Description & Constraints DiagnosticReport I 0..* A Diagnostic report - Arden Syntax is a combination of request information, atomic results, images, interpretation, as well as formatted reports id Σ 0..1 string Logical id of this artifact meta Σ I 0..1 Meta Metadata about the resource implicitRules ?! Σ I 0..1 uri A set of rules under which this content was created language I 0..1 code Language of the resource content Binding: Common Languages ( preferred ) Max Binding: All Languages text I 0..1 Narrative Text summary of the resource, for human interpretation contained 0..* Resource Contained, inline Resources extension I 0..* Extension Extension Slice: Unordered, Open by value:url DiagnosticReport-geneticsAssessedCondition I 0..* Reference ( Condition ) AssessedCondition URL: http://hl7.org/fhir/StructureDefinition/DiagnosticReport-geneticsAssessedCondition DiagnosticReport-geneticsFamilyMemberHistory I 0..* Reference ( FamilyMemberHistory ) FamilyHistory URL: http://hl7.org/fhir/StructureDefinition/DiagnosticReport-geneticsFamilyMemberHistory DiagnosticReport-geneticsAnalysis I 0..* (Complex) Analysis URL: http://hl7.org/fhir/StructureDefinition/DiagnosticReport-geneticsAnalysis DiagnosticReport-geneticsReferences I 0..* (Complex) References URL: http://hl7.org/fhir/StructureDefinition/DiagnosticReport-geneticsReferences modifierExtension ?! I 0..* Extension Extensions defining decision support rules. These rules reference data elements that cannot be ignored identifier Σ I 0..* Identifier Business identifier for report basedOn I 0..* Reference ( CarePlan | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest ) What was requested status ?! Σ I 1..1 code registered | partial | preliminary | final + Binding: DiagnosticReportStatus ( required ) category Σ I 0..* CodeableConcept Service category Binding: Diagnostic Service Section Codes ( example ) code Σ I 1..1 CodeableConcept Name/Code for this diagnostic report Binding: LOINC Diagnostic Report Codes ( preferred ) subject Σ I 0..1 Reference ( Patient | Group | Device | Location ) The subject are used as part of the report - usually, but decision making process. However, the specification does not always, define how these data elements are identified. FHIR element and extension identifiers would provide one mechanism for identifying the patient encounter Σ I 0..1 Reference ( Encounter ) Health care event when test ordered effective[x] Σ I 0..1 Clinically relevant time/time-period for report effectiveDateTime dateTime effectivePeriod Period issued Σ I 0..1 instant DateTime this version was made performer Σ I 0..* Reference ( Practitioner | PractitionerRole | Organization | CareTeam ) Responsible Diagnostic Service resultsInterpreter Σ I 0..* Reference ( Practitioner | PractitionerRole | Organization | CareTeam ) Primary result interpreter specimen data elements.

7.18.5.4 I Virtual Medical Record Reference ( Specimen ) Specimens this report

The Virtual Medical Record is based on result I 0..* Reference ( Observation ) Observations imagingStudy I 0..* Reference ( ImagingStudy ) Reference to full details of imaging associated with the diagnostic report media Σ I 0..* BackboneElement Key images associated with this report id 0..1 string Unique id for inter-element referencing extension I 0..* Extension Additional content defined a draft specification under development by implementations modifierExtension ?! Σ I 0..* Extension Extensions HL7 that cannot also serves the decision support space. It defines a logical medical record that decision support rules can be ignored even if unrecognized comment I 0..1 string Comment about constructed against. At present, this model is a custom model created specifically for VMR. However, the image (e.g. explanation) link Σ I 1..1 Reference ( Media ) Reference to Decision Support work group is evaluating the image source conclusion I 0..1 string Clinical conclusion (interpretation) possibility of test results presentedForm I 0..* Attachment Entire report using FHIR as issued Documentation a structure for this format XML Template <!-- DiagnosticReport-Genetics --> < xmlns="http://hl7.org/fhir" > <!-- from Element: --> <</id> <</meta> < < < Text summary of the resource, for human interpretation</text> < Contained, inline Resources</contained> <<a href="diagnosticreport-genetics-definitions.html#DiagnosticReport.modifierExtension" title="May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself) (this element modifies the meaning of other elements)" class="dict"></modifierExtension> < Business identifier for report</identifier> <</basedOn> < <</category> <</code> < The subject of the report - usually, but not always, the patient</subject> < Health care event when test ordered</encounter> < Clinically relevant time/time-period for report</effective[x]> < < Responsible Diagnostic Service</performer> < Primary result interpreter</resultsInterpreter> < Specimens this report is based on</specimen> <</result> < Reference to full details of imaging associated with the diagnostic report</imagingStudy> < <<a href="diagnosticreport-genetics-definitions.html#DiagnosticReport.media.modifierExtension" title="May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself) (this element modifies the meaning of other elements)" class="dict"></modifierExtension> < < Reference to the image source</link> </media> < <</conclusionCode> < Entire report as issued</presentedForm> </DiagnosticReport> JSON Template future versions of the specification.

{ // // from Element: " " " " " " { // // from Element: }, { // // from Element: }, { // // from Element: }, { // // from Element: } ], "<a href="diagnosticreport-genetics-definitions.html#DiagnosticReport.modifierExtension" title="May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself) (this element modifies the meaning of other elements)" class="dict"> " " " " " " " " " " " " " " " " " " }   Alternate definitions: Master Definition ( XML , JSON ), Schematron 10.3.14.3.2 Terminology Bindings Path Name Conformance ValueSet DiagnosticReport.language Common Languages preferred Common Languages DiagnosticReport.status DiagnosticReportStatus required DiagnosticReportStatus DiagnosticReport.category Diagnostic Service Section Codes example Diagnostic Service Section Codes DiagnosticReport.code LOINC Diagnostic Report Codes preferred LOINC Diagnostic Report Codes .