StructureDefinition
for
diagnosticreport
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DiagnosticReport : The findings and interpretation of diagnostic tests performed on patients,
groups of patients, devices, and locations, and/or specimens derived from these. The report
includes clinical context such as requesting and provider information, and some mix of
atomic results, images, textual and coded interpretations, and formatted representation
of diagnostic reports.
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padding:0px 4px 0px 4px
padding-left: 3px; padding-right: 3px; border: 1px grey solid; font-weight: bold; color:
black; background-color: #fff5e6
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padding:0px 4px 0px 4px
vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
padding:0px 4px 0px 4pxA Diagnostic report - a combination of request information, atomic results, images, interpretation,
as well as formatted reports
Elements defined in Ancestors:
The logical id of the resource, as used in the URL for the resource. Once assigned, this
value never changes.,
The metadata about the resource. This is content that is maintained by the infrastructure.
Changes to the content might not always be associated with version changes to the resource.,
A reference to a set of rules that were followed when the resource was constructed, and
which must be understood when processing the content. Often, this is a reference to an
implementation guide that defines the special rules along with other profiles etc.,
,
A human-readable narrative that contains a summary of the resource and can be used to
represent the content of the resource to a human. The narrative need not encode all the
structured data, but is required to contain sufficient detail to make it "clinically
safe" for a human to just read the narrative. Resource definitions may define what
content should be represented in the narrative to ensure clinical safety.,
These resources do not have an independent existence apart from the resource that contains
them - they cannot be identified independently, and nor can they have their own independent
transaction scope.,
May be used to represent additional information that is not part of the basic definition
of the resource. 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.,
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).
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DiagnosticReport.identifier : Identifiers assigned to this report by the performer or
other systems.
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(
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padding:0px 4px 0px 4pxWhat was requested
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solid; padding:0px 4px 0px 4pxregistered | partial | preliminary | final +
(
)
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DiagnosticReport.category : A code that classifies the clinical discipline, department
or diagnostic service that created the report (e.g. cardiology, biochemistry, hematology,
MRI). This is used for searching, sorting and display purposes.
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padding:0px 4px 0px 4pxService category
(
Instances are not expected or even encouraged to draw from the specified value set. The
value set merely provides examples of the types of concepts intended to be included.)
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solid; padding:0px 4px 0px 4pxName/Code for this diagnostic report
(
Instances are encouraged to draw from the specified codes for interoperability purposes
but are not required to do so to be considered conformant.)
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DiagnosticReport.subject : The subject of the report. Usually, but not always, this is
a patient. However, diagnostic services also perform analyses on specimens collected from
a variety of other sources.
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DiagnosticReport.encounter : The healthcare event (e.g. a patient and healthcare provider
interaction) which this DiagnosticReport is about.
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DiagnosticReport.effective[x] : The time or time-period the observed values are related
to. When the subject of the report is a patient, this is usually either the time of the
procedure or of specimen collection(s), but very often the source of the date/time is
not known, only the date/time itself.
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A date, date-time or partial date (e.g. just year or year + month). If hours and minutes
are specified, a time zone SHALL be populated. The format is a union of the schema types
gYear, gYearMonth, date and dateTime. Seconds must be provided due to schema type constraints
but may be zero-filled and may be ignored. Dates SHALL be valid dates.
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DiagnosticReport.issued : The date and time that this version of the report was made available
to providers, typically after the report was reviewed and verified.
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DiagnosticReport.performer : The diagnostic service that is responsible for issuing the
report.
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padding:0px 4px 0px 4pxResponsible Diagnostic Service
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DiagnosticReport.resultsInterpreter : The practitioner or organization that is responsible
for the report's conclusions and interpretations.
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solid; padding:0px 4px 0px 4pxPrimary result interpreter
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DiagnosticReport.specimen : Details about the specimens on which this diagnostic report
is based.
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DiagnosticReport.result : [Observations](observation.html) that are part of this diagnostic
report.
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DiagnosticReport.imagingStudy : One or more links to full details of any imaging performed
during the diagnostic investigation. Typically, this is imaging performed by DICOM enabled
modalities, but this is not required. A fully enabled PACS viewer can use this information
to provide views of the source images.
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DiagnosticReport.media : A list of key images associated with this report. The images
are generally created during the diagnostic process, and may be directly of the patient,
or of treated specimens (i.e. slides of interest).
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DiagnosticReport.media.comment : A comment about the image. Typically, this is used to
provide an explanation for why the image is included, or to draw the viewer's attention
to important features.
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DiagnosticReport.conclusion : Concise and clinically contextualized summary conclusion
(interpretation/impression) of the diagnostic report.
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DiagnosticReport.conclusionCode : One or more codes that represent the summary conclusion
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solid; padding:0px 4px 0px 4px
vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0
solid; padding:0px 4px 0px 4px
vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0
solid; padding:0px 4px 0px 4pxCodes for the clinical conclusion of test results
(
Instances are not expected or even encouraged to draw from the specified value set. The
value set merely provides examples of the types of concepts intended to be included.)
vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data:image/png;base64,iVBORw0KGg
oAAAANSUhEUgAAAyAAAAACCAYAAACg/LjIAAAAI0lEQVR42u3QIQEAAAACIL/6/4MvTAQOkLYBAAB4kAAAANwMad9AqkRjgNAAAAA
ASUVORK5CYII=)
data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB3
RJTUUH3wYeFzIs1vtcMQAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAE0lEQVQI12P4//8/AxMDAwN
dCABMPwMo2ctnoQAAAABJRU5ErkJggg==
data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB3
RJTUUH3wYeFzME+lXFigAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAANklEQVQ4y+3OsRUAIAjEUOL
+O8cJABttJM11/x1qZAGqRBEVcNIqdWj1efDqQbb3HwwwwEfABmQUHSPM9dtDAAAAAElFTkSuQmCC
data:image/png;base64,R0lGODlhEAAQAPZ/APrkusOiYvvfqbiXWaV2G+jGhdq1b8GgYf3v1frw3vTUlsWkZNewbcSjY/DQka
d4Hb6dXv3u0f3v1ObEgfPTlerJiP3w1v79+e7OkPrfrfnjuNOtZPrpydaxa+/YrvvdpP779ZxvFPvnwKKBQaFyF/369M2vdaqHRPz
58/HNh/vowufFhfroxO3OkPrluv779tK0e6JzGProwvrow9m4eOnIifPTlPDPkP78+Naxaf3v0/zowfXRi+bFhLWUVv379/rnwPvs
zv3rye3LiPvnv+3MjPDasKiIS/789/3x2f747eXDg+7Mifvu0tu7f+/QkfDTnPXWmPrjsvrjtPbPgrqZW+/QlPz48K2EMv36866OU
Pvowat8Ivvgq/Pbrvzgq/PguvrgrqN0Gda2evfYm9+7d/rpw9q6e/LSku/Rl/XVl/LSlfrkt+zVqe7Wqv3x1/bNffbOf59wFdS6if
3u0vrqyP3owPvepfXQivDQkO/PkKh9K7STVf779P///wD/ACH5BAEKAH8ALAAAAAAQABAAAAemgH+CgxeFF4OIhBdKGwFChYl/hYw
bdkoBPnaQkosbG3d3VEpSUlonUoY1Gzo6QkI8SrGxWBOFG4uySgY5ZWR3PFy2hnaWZXC/PHcPwkpJk1ShoHcxhQEXSUmtFy6+0iSF
VResrjoTPDzdcoU+F65CduVU6KAhhQa3F8Tx8nchBoYuqoTLZoAKFRIhqGwqJAULFx0GYpBQeChRIR4TJm6KJMhQRUSBAAA7
DiagnosticReport.presentedForm : Rich text representation of the entire result as issued
by the diagnostic service. Multiple formats are allowed but they SHALL be semantically
equivalent.
vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
padding:0px 4px 0px 4px
vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
padding:0px 4px 0px 4px
vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
padding:0px 4px 0px 4px
vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
padding:0px 4px 0px 4pxEntire report as issued
Documentation for this format
The findings and interpretation of diagnostic tests performed on patients, groups of
patients, devices, and locations, and/or specimens derived from these. The report includes
clinical context such as requesting and provider information, and some mix of atomic results,
images, textual and coded interpretations, and formatted representation of diagnostic
reports.
A Diagnostic report - a combination of request information, atomic results, images, interpretation,
as well as formatted reports
The findings and interpretation of diagnostic tests performed on patients, groups of
patients, devices, and locations, and/or specimens derived from these. The report includes
clinical context such as requesting and provider information, and some mix of atomic results,
images, textual and coded interpretations, and formatted representation of diagnostic
reports.
This is intended to capture a single report and is not suitable for use in displaying
summary information that covers multiple reports. For example, this resource has not
been designed for laboratory cumulative reporting formats nor detailed structured reports
for sequencing.
If the resource is contained in another resource, it SHALL be referred to from elsewhere
in the resource or SHALL refer to the containing resource
contained.where(((id.exists() and ('#'+id in (%resource.descendants().reference | %resource.descenda
nts().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))))
or descendants().where(reference = '#').exists() or descendants().where(as(canonical)
= '#').exists() or descendants().where(as(uri) = '#').exists()).not()).trace('unmatched',
id).empty()
not(exists(for $contained in f:contained return $contained[not(exists(parent::*/descendant::f:refere
nce/@value=concat('#', $contained/*/f:id/@value)) or exists(descendant::f:reference[@value='#']))]))
If a resource is contained in another resource, it SHALL NOT have a meta.versionId or
a meta.lastUpdated
When a resource has no narrative, only systems that fully understand the data can display
the resource to a human safely. Including a human readable representation in the resource
makes for a much more robust eco-system and cheaper handling of resources by intermediary
systems. Some ecosystems restrict distribution of resources to only those systems that
do fully understand the resources, and as a consequence implementers may believe that
the narrative is superfluous. However experience shows that such eco-systems often open
up to new participants over time.
The logical id of the resource, as used in the URL for the resource. Once assigned, this
value never changes.
The only time that a resource does not have an id is when it is being submitted to the
server using a create operation.
The metadata about the resource. This is content that is maintained by the infrastructure.
Changes to the content might not always be associated with version changes to the resource.
A reference to a set of rules that were followed when the resource was constructed, and
which must be understood when processing the content. Often, this is a reference to an
implementation guide that defines the special rules along with other profiles etc.
Asserting this rule set restricts the content to be only understood by a limited set of
trading partners. This inherently limits the usefulness of the data in the long term.
However, the existing health eco-system is highly fractured, and not yet ready to define,
collect, and exchange data in a generally computable sense. Wherever possible, implementers
and/or specification writers should avoid using this element. Often, when used, the URL
is a reference to an implementation guide that defines these special rules as part of
it's narrative along with other profiles, value sets, etc.
This element is labeled as a modifier because the implicit rules may provide additional
knowledge about the resource that modifies it's meaning or interpretation
Language is provided to support indexing and accessibility (typically, services such as
text to speech use the language tag). The html language tag in the narrative applies
to the narrative. The language tag on the resource may be used to specify the language
of other presentations generated from the data in the resource. Not all the content has
to be in the base language. The Resource.language should not be assumed to apply to the
narrative automatically. If a language is specified, it should it also be specified on
the div element in the html (see rules in HTML5 for information about the relationship
between xml:lang and the html lang attribute).
A human-readable narrative that contains a summary of the resource and can be used to
represent the content of the resource to a human. The narrative need not encode all the
structured data, but is required to contain sufficient detail to make it "clinically
safe" for a human to just read the narrative. Resource definitions may define what
content should be represented in the narrative to ensure clinical safety.
Contained resources do not have narrative. Resources that are not contained SHOULD have
a narrative. In some cases, a resource may only have text with little or no additional
discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary
for data from legacy systems where information is captured as a "text blob"
or where text is additionally entered raw or narrated and encoded information is added
later.
These resources do not have an independent existence apart from the resource that contains
them - they cannot be identified independently, and nor can they have their own independent
transaction scope.
This should never be done when the content can be identified properly, as once identification
is lost, it is extremely difficult (and context dependent) to restore it again. Contained
resources may have profiles and tags In their meta elements, but SHALL NOT have security
labels.
Containing new R4B resources within R4 resources may cause interoperability issues if
instances are shared with R4 systems
($this is Citation or $this is Evidence or $this is EvidenceReport or $this is EvidenceVariable
or $this is MedicinalProductDefinition or $this is PackagedProductDefinition or $this
is AdministrableProductDefinition or $this is Ingredient or $this is ClinicalUseDefinition
or $this is RegulatedAuthorization or $this is SubstanceDefinition or $this is SubscriptionStatus
or $this is SubscriptionTopic) implies (%resource is Citation or %resource is Evidence
or %resource is EvidenceReport or %resource is EvidenceVariable or %resource is MedicinalProductDefi
nition or %resource is PackagedProductDefinition or %resource is AdministrableProductDefinition
or %resource is Ingredient or %resource is ClinicalUseDefinition or %resource is RegulatedAuthorizat
ion or %resource is SubstanceDefinition or %resource is SubscriptionStatus or %resource
is SubscriptionTopic)
not(f:Citation|f:Evidence|f:EvidenceReport|f:EvidenceVariable|f:MedicinalProductDefinition|f:Package
dProductDefinition|f:AdministrableProductDefinition|f:Ingredient|f:ClinicalUseDefinition|f:RegulatedA
uthorization|f:SubstanceDefinition|f:SubscriptionStatus|f:SubscriptionTopic) or not(parent::f:Citatio
n|parent::f:Evidence|parent::f:EvidenceReport|parent::f:EvidenceVariable|parent::f:MedicinalProductDe
finition|parent::f:PackagedProductDefinition|parent::f:AdministrableProductDefinition|parent::f:Ingre
dient|parent::f:ClinicalUseDefinition|parent::f:RegulatedAuthorization|parent::f:SubstanceDefinition|
f:SubscriptionStatus|f:SubscriptionTopic)
May be used to represent additional information that is not part of the basic definition
of the resource. 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.
There can be no stigma associated with the use of extensions by any application, project,
or standard - regardless of the institution or jurisdiction that uses or defines the extensions.
The use of extensions is what allows the FHIR specification to retain a core level of
simplicity for everyone.
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).
There can be no stigma associated with the use of extensions by any application, project,
or standard - regardless of the institution or jurisdiction that uses or defines the extensions.
The use of extensions is what allows the FHIR specification to retain a core level of
simplicity for everyone.
Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly
distinguished from the vast majority of extensions which can be safely ignored. This
promotes interoperability by eliminating the need for implementers to prohibit the presence
of extensions. For further information, see the [definition of modifier extensions](extensibility.ht
ml#modifierExtension).
Modifier extensions are expected to modify the meaning or interpretation of the resource
that contains them
Usually assigned by the Information System of the diagnostic service provider (filler
id).
Need to know what identifier to use when making queries about this report from the source
laboratory, and for linking to the report outside FHIR context.
OBR-51/ for globally unique filler ID - OBR-3 , For non-globally unique filler-id the
flller/placer number must be combined with the universal service Id - OBR-2(if present)+OBR-3+OBR-4
Note: Usually there is one test request for each result, however in some circumstances
multiple test requests may be represented using a single test result resource. Note that
there are also cases where one request leads to multiple reports.
This allows tracing of authorization for the report and tracking whether proposals/recommendations
were acted upon.
Diagnostic services routinely issue provisional/incomplete reports, and sometimes withdraw
previously released reports.
This element is labeled as a modifier because it is a status element that contains status
entered-in-error which means that the resource should not be treated as valid
statusCode Note: final and amended are distinguished by whether observation is the subject
of a ControlAct event of type "revise"
A code that classifies the clinical discipline, department or diagnostic service that
created the report (e.g. cardiology, biochemistry, hematology, MRI). This is used for
searching, sorting and display purposes.
Multiple categories are allowed using various categorization schemes. The level of granularity
is defined by the category concepts in the value set. More fine-grained filtering can
be performed using the metadata and/or terminology hierarchy in DiagnosticReport.code.
OBR-4 (HL7 v2 doesn't provide an easy way to indicate both the ordered test and the performed
panel)
The subject of the report. Usually, but not always, this is a patient. However, diagnostic
services also perform analyses on specimens collected from a variety of other sources.
The healthcare event (e.g. a patient and healthcare provider interaction) which this
DiagnosticReport is about.
This will typically be the encounter the event occurred within, but some events may be
initiated prior to or after the official completion of an encounter but still be tied
to the context of the encounter (e.g. pre-admission laboratory tests).
The time or time-period the observed values are related to. When the subject of the report
is a patient, this is usually either the time of the procedure or of specimen collection(s),
but very often the source of the date/time is not known, only the date/time itself.
If the diagnostic procedure was performed on the patient, this is the time it was performed.
If there are specimens, the diagnostically relevant time can be derived from the specimen
collection times, but the specimen information is not always available, and the exact
relationship between the specimens and the diagnostically relevant time is not always
automatic.
The date and time that this version of the report was made available to providers, typically
after the report was reviewed and verified.
May be different from the update time of the resource itself, because that is the status
of the record (potentially a secondary copy), not the actual release time of the report.
This is not necessarily the source of the atomic data items or the entity that interpreted
the results. It is the entity that takes responsibility for the clinical report.
Need to know whom to contact if there are queries about the results. Also may need to
track the source of reports for secondary data analysis.
The practitioner or organization that is responsible for the report's conclusions and
interpretations.
Need to know whom to contact if there are queries about the results. Also may need to
track the source of reports for secondary data analysis.
If the specimen is sufficiently specified with a code in the test result name, then this
additional data may be redundant. If there are multiple specimens, these may be represented
per observation or group.
Need to be able to report information about the collected specimens on which the report
is based.
Need to support individual results, or groups of results, where the result grouping is
arbitrary, but meaningful.
One or more links to full details of any imaging performed during the diagnostic investigation.
Typically, this is imaging performed by DICOM enabled modalities, but this is not required.
A fully enabled PACS viewer can use this information to provide views of the source images.
ImagingStudy and the image element are somewhat overlapping - typically, the list of image
references in the image element will also be found in one of the imaging study resources.
However, each caters to different types of displays for different types of purposes. Neither,
either, or both may be provided.
A list of key images associated with this report. The images are generally created during
the diagnostic process, and may be directly of the patient, or of treated specimens (i.e.
slides of interest).
Unique id for the element within a resource (for internal references). This may be any
string value that does not contain spaces.
May be used to represent additional information that is not part of the basic definition
of the element. 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.
There can be no stigma associated with the use of extensions by any application, project,
or standard - regardless of the institution or jurisdiction that uses or defines the extensions.
The use of extensions is what allows the FHIR specification to retain a core level of
simplicity for everyone.
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).
There can be no stigma associated with the use of extensions by any application, project,
or standard - regardless of the institution or jurisdiction that uses or defines the extensions.
The use of extensions is what allows the FHIR specification to retain a core level of
simplicity for everyone.
Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly
distinguished from the vast majority of extensions which can be safely ignored. This
promotes interoperability by eliminating the need for implementers to prohibit the presence
of extensions. For further information, see the [definition of modifier extensions](extensibility.ht
ml#modifierExtension).
Modifier extensions are expected to modify the meaning or interpretation of the element
that contains them
A comment about the image. Typically, this is used to provide an explanation for why the
image is included, or to draw the viewer's attention to important features.
The comment should be displayed with the image. It would be common for the report to include
additional discussion of the image contents in other sections such as the conclusion.
.inboundRelationship[typeCode=COMP].source[classCode=OBS, moodCode=EVN, code="annotation"]
.value
Concise and clinically contextualized summary conclusion (interpretation/impression) of
the diagnostic report.
inboundRelationship[typeCode="SPRT"].source[classCode=OBS, moodCode=EVN, code=LOINC:48767-
8].value (type=ST)
One or more codes that represent the summary conclusion (interpretation/impression) of
the diagnostic report.
inboundRelationship[typeCode=SPRT].source[classCode=OBS, moodCode=EVN, code=LOINC:54531-9].value
(type=CD)
Rich text representation of the entire result as issued by the diagnostic service. Multiple
formats are allowed but they SHALL be semantically equivalent.
"application/pdf" is recommended as the most reliable and interoperable in this
context.
A Diagnostic report - a combination of request information, atomic results, images, interpretation,
as well as formatted reports
The findings and interpretation of diagnostic tests performed on patients, groups of
patients, devices, and locations, and/or specimens derived from these. The report includes
clinical context such as requesting and provider information, and some mix of atomic results,
images, textual and coded interpretations, and formatted representation of diagnostic
reports.
This is intended to capture a single report and is not suitable for use in displaying
summary information that covers multiple reports. For example, this resource has not
been designed for laboratory cumulative reporting formats nor detailed structured reports
for sequencing.
Usually assigned by the Information System of the diagnostic service provider (filler
id).
Need to know what identifier to use when making queries about this report from the source
laboratory, and for linking to the report outside FHIR context.
OBR-51/ for globally unique filler ID - OBR-3 , For non-globally unique filler-id the
flller/placer number must be combined with the universal service Id - OBR-2(if present)+OBR-3+OBR-4
Note: Usually there is one test request for each result, however in some circumstances
multiple test requests may be represented using a single test result resource. Note that
there are also cases where one request leads to multiple reports.
This allows tracing of authorization for the report and tracking whether proposals/recommendations
were acted upon.
Diagnostic services routinely issue provisional/incomplete reports, and sometimes withdraw
previously released reports.
This element is labeled as a modifier because it is a status element that contains status
entered-in-error which means that the resource should not be treated as valid
statusCode Note: final and amended are distinguished by whether observation is the subject
of a ControlAct event of type "revise"
A code that classifies the clinical discipline, department or diagnostic service that
created the report (e.g. cardiology, biochemistry, hematology, MRI). This is used for
searching, sorting and display purposes.
Multiple categories are allowed using various categorization schemes. The level of granularity
is defined by the category concepts in the value set. More fine-grained filtering can
be performed using the metadata and/or terminology hierarchy in DiagnosticReport.code.
OBR-4 (HL7 v2 doesn't provide an easy way to indicate both the ordered test and the performed
panel)
The subject of the report. Usually, but not always, this is a patient. However, diagnostic
services also perform analyses on specimens collected from a variety of other sources.
The healthcare event (e.g. a patient and healthcare provider interaction) which this
DiagnosticReport is about.
This will typically be the encounter the event occurred within, but some events may be
initiated prior to or after the official completion of an encounter but still be tied
to the context of the encounter (e.g. pre-admission laboratory tests).
The time or time-period the observed values are related to. When the subject of the report
is a patient, this is usually either the time of the procedure or of specimen collection(s),
but very often the source of the date/time is not known, only the date/time itself.
If the diagnostic procedure was performed on the patient, this is the time it was performed.
If there are specimens, the diagnostically relevant time can be derived from the specimen
collection times, but the specimen information is not always available, and the exact
relationship between the specimens and the diagnostically relevant time is not always
automatic.
The date and time that this version of the report was made available to providers, typically
after the report was reviewed and verified.
May be different from the update time of the resource itself, because that is the status
of the record (potentially a secondary copy), not the actual release time of the report.
This is not necessarily the source of the atomic data items or the entity that interpreted
the results. It is the entity that takes responsibility for the clinical report.
Need to know whom to contact if there are queries about the results. Also may need to
track the source of reports for secondary data analysis.
The practitioner or organization that is responsible for the report's conclusions and
interpretations.
Need to know whom to contact if there are queries about the results. Also may need to
track the source of reports for secondary data analysis.
If the specimen is sufficiently specified with a code in the test result name, then this
additional data may be redundant. If there are multiple specimens, these may be represented
per observation or group.
Need to be able to report information about the collected specimens on which the report
is based.
Need to support individual results, or groups of results, where the result grouping is
arbitrary, but meaningful.
One or more links to full details of any imaging performed during the diagnostic investigation.
Typically, this is imaging performed by DICOM enabled modalities, but this is not required.
A fully enabled PACS viewer can use this information to provide views of the source images.
ImagingStudy and the image element are somewhat overlapping - typically, the list of image
references in the image element will also be found in one of the imaging study resources.
However, each caters to different types of displays for different types of purposes. Neither,
either, or both may be provided.
A list of key images associated with this report. The images are generally created during
the diagnostic process, and may be directly of the patient, or of treated specimens (i.e.
slides of interest).
A comment about the image. Typically, this is used to provide an explanation for why the
image is included, or to draw the viewer's attention to important features.
The comment should be displayed with the image. It would be common for the report to include
additional discussion of the image contents in other sections such as the conclusion.
.inboundRelationship[typeCode=COMP].source[classCode=OBS, moodCode=EVN, code="annotation"]
.value
Concise and clinically contextualized summary conclusion (interpretation/impression) of
the diagnostic report.
inboundRelationship[typeCode="SPRT"].source[classCode=OBS, moodCode=EVN, code=LOINC:48767-
8].value (type=ST)
One or more codes that represent the summary conclusion (interpretation/impression) of
the diagnostic report.
inboundRelationship[typeCode=SPRT].source[classCode=OBS, moodCode=EVN, code=LOINC:54531-9].value
(type=CD)
Rich text representation of the entire result as issued by the diagnostic service. Multiple
formats are allowed but they SHALL be semantically equivalent.
"application/pdf" is recommended as the most reliable and interoperable in this
context.
<?xml version="1.0" encoding="UTF-8"?>
<StructureDefinition xmlns="http://hl7.org/fhir"> <id value="DiagnosticReport"/> <meta> <lastUpdated value="2023-03-01T23:03:57.298+11:00"/> </meta> <text> <status value="generated"/> <div xmlns="http://www.w3.org/1999/xhtml"> <table border="0" cellpadding="0" cellspacing="0" style="border: 0px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align:
top;">
<tr style="border: 1px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align:
top">
<th class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
solid; padding:0px 4px 0px 4px">
<a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="The logical name of the element">Name</a> </th> <th class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
solid; padding:0px 4px 0px 4px">
<a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="Information about the use of the element">Flags</a> </th> <th class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
solid; padding:0px 4px 0px 4px">
<a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="Minimum and Maximum # of times the the element can appear in the instance">Card.</a> </th> <th class="hierarchy" style="width: 100px"> <a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="Reference to the type of the element">Type</a> </th> <th class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
solid; padding:0px 4px 0px 4px">
<a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="Additional information about the element">Description & Constraints</a> <span style="float: right"> <a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="Legend for this format"> <img alt="doco" src="help16.png" style="background-color: inherit"/> </a> </span> </th> </tr> <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color:
white">
<td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data:image/png;bas
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<img alt="." class="hierarchy" src="data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpw
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<img alt="." class="hierarchy" src="data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAQCAYAAAAf8/9hAAAACXBIWXMAAAsTAAALEwEAmpw
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<span title="DiagnosticReport : The findings and interpretation of diagnostic tests performed
on patients, groups of patients, products, substances, devices, and locations,
and/or specimens derived from these. The report includes clinical context such
as requesting provider information, and some mix of atomic results, images, textual
and coded interpretations, and formatted representation of diagnostic reports.
The report also includes non-clinical context such as batch analysis and stability
reporting of products and substances.">DiagnosticReport</span>
<a name="DiagnosticReport"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
solid; padding:0px 4px 0px 4px">
<a href="versions.html#std-process" style="padding-left: 3px; padding-right: 3px; border: 1px grey solid; font-weight: bold;
color: black; background-color: #fff5e6" title="Standards Status = Trial Use">TU</a>
</td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
solid; padding:0px 4px 0px 4px"/>
<td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
solid; padding:0px 4px 0px 4px">
<a href="domainresource.html">DomainResource</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
solid; padding:0px 4px 0px 4px">A Diagnostic report - a combination of request information, atomic results, images,
interpretation, as well as formatted reports
<br/> <span style="font-style: italic" title="dgr-1">+ Rule: A resource referenced in a Composition entry must also be included in the
DiagnosticReport result (Observation resources or nested resources via Observation.hasMember)</span>
<br/> <br/> Elements defined in Ancestors: <a href="resource.html#Resource" title="The logical id of the resource, as used in the URL for the resource. Once assigned,
this value never changes.">id</a> ,
<a href="resource.html#Resource" title="The metadata about the resource. This is content that is maintained by the infrastructure.
Changes to the content might not always be associated with version changes to the
resource.">meta</a> ,
<a href="resource.html#Resource" title="A reference to a set of rules that were followed when the resource was constructed,
and which must be understood when processing the content. Often, this is a reference
to an implementation guide that defines the special rules along with other profiles
etc.">implicitRules</a> ,
<a href="resource.html#Resource" title="The base language in which the resource is written.">language</a> , <a href="domainresource.html#DomainResource" title="A human-readable narrative that contains a summary of the resource and can be used
to represent the content of the resource to a human. The narrative need not encode
all the structured data, but is required to contain sufficient detail to make it
"clinically safe" for a human to just read the narrative. Resource definitions
may define what content should be represented in the narrative to ensure clinical
safety.">text</a> ,
<a href="domainresource.html#DomainResource" title="These resources do not have an independent existence apart from the resource that
contains them - they cannot be identified independently, nor can they have their
own independent transaction scope. This is allowed to be a Parameters resource
if and only if it is referenced by a resource that provides context/meaning.">contained</a> ,
<a href="domainresource.html#DomainResource" title="May be used to represent additional information that is not part of the basic definition
of the resource. To make the use of extensions safe and managable, 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.">extension</a> ,
<a href="domainresource.html#DomainResource" 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 managable, 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).">modifierExtension</a>
</td> </tr> <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color:
#F7F7F7">
<td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
#F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image:
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<img alt="." class="hierarchy" src="data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpw
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<img alt="." class="hierarchy" src="data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpw
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<img alt="." class="hierarchy" src="data:image/png;base64,R0lGODlhEAAQAPZ/APrkusOiYvvfqbiXWaV2G+jGhdq1b8GgYf3v1frw3vTUlsWkZNewbcS
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<span title="DiagnosticReport.identifier : Identifiers assigned to this report by the performer
or other systems.">identifier</span>
<a name="DiagnosticReport.identifier"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
#F0F0F0 solid; padding:0px 4px 0px 4px">
<a href="elementdefinition-definitions.html#ElementDefinition.isSummary" style="padding-left: 3px; padding-right: 3px; color: black; null" title="This element is included in summaries">Σ</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
#F0F0F0 solid; padding:0px 4px 0px 4px">0..*</td>
<td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
#F0F0F0 solid; padding:0px 4px 0px 4px">
<a href="datatypes.html#Identifier">Identifier</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
#F0F0F0 solid; padding:0px 4px 0px 4px">Business identifier for report
<br/> <br/> </td> </tr> <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color:
white">
<td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data:image/png;bas
e64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCAYAAACg/LjIAAAALUlEQVR4Xu3IoREAIAwEwfT6/ddA0GBAxO3NrLlKUj
9263wAAAAvrgEAADClAVWFQIBRHMicAAAAAElFTkSuQmCC)">
<img alt="." class="hierarchy" src="data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpw
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<img alt="." class="hierarchy" src="data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpw
YAAAAB3RJTUUH3wYeFzI3XJ6V3QAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAANklEQVQ4y
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<img alt="." class="hierarchy" src="data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAQCAYAAAAf8/9hAAAAAXNSR0IArs4c6QAAAARnQU1
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6TFi6cHULyz8KOjC7OIQKlQpU3uPjAwhX2CCcGsgOAAAAAElFTkSuQmCC" style="background-color: white; background-color: inherit" title="Reference to another Resource"/>
<span title="DiagnosticReport.basedOn : Details concerning a service requested.">basedOn</span> <a name="DiagnosticReport.basedOn"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
solid; padding:0px 4px 0px 4px"/>
<td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
solid; padding:0px 4px 0px 4px">0..*</td>
<td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
solid; padding:0px 4px 0px 4px">
<a href="references.html#Reference">Reference</a> ( <a href="careplan.html">CarePlan</a> | <a href="immunizationrecommendation.html">ImmunizationRecommendation</a> | <a href="medicationrequest.html">MedicationRequest</a> | <a href="nutritionorder.html">NutritionOrder</a> | <a href="servicerequest.html">ServiceRequest</a> ) </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
solid; padding:0px 4px 0px 4px">What was requested
<br/> <br/> </td> </tr> <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color:
#F7F7F7">
<td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
#F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image:
url(data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCAYAAACg/LjIAAAALUlEQVR4Xu3IoREAIAw
EwfT6/ddA0GBAxO3NrLlKUj9263wAAAAvrgEAADClAVWFQIBRHMicAAAAAElFTkSuQmCC)">
<img alt="." class="hierarchy" src="data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpw
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2P4//8/AxMDAwNdCABMPwMo2ctnoQAAAABJRU5ErkJggg==" style="background-color: inherit"/>
<img alt="." class="hierarchy" src="data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpw
YAAAAB3RJTUUH3wYeFzI3XJ6V3QAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAANklEQVQ4y
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<img alt="." class="hierarchy" src="data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAQCAYAAAAf8/9hAAAACXBIWXMAAAsTAAALEwEAmpw
YAAAARklEQVQ4y2P8//8/AyWAhYFCMAgMuHjx4n+KXaCv+I0szW8WpCG8kFO1lGFKW/SIjAUYgxz/MzAwMDC+nqhDUTQyj
uYFBgCNmhP4OvTRgwAAAABJRU5ErkJggg==" style="background-color: #F7F7F7; background-color: inherit" title="Primitive Data Type"/>
<span title="DiagnosticReport.status : The status of the diagnostic report.">status</span> <a name="DiagnosticReport.status"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
#F0F0F0 solid; padding:0px 4px 0px 4px">
<a href="conformance-rules.html#isModifier" style="padding-left: 3px; padding-right: 3px; color: black; null" title="This element is a modifier element">?!</a> <a href="elementdefinition-definitions.html#ElementDefinition.isSummary" style="padding-left: 3px; padding-right: 3px; color: black; null" title="This element is included in summaries">Σ</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
#F0F0F0 solid; padding:0px 4px 0px 4px">1..1</td>
<td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
#F0F0F0 solid; padding:0px 4px 0px 4px">
<a href="datatypes.html#code">code</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
#F0F0F0 solid; padding:0px 4px 0px 4px">registered | partial | preliminary | final +
<br/> Binding: <a href="valueset-diagnostic-report-status.html">Diagnostic Report Status</a> ( <a href="terminologies.html#required" title="To be conformant, the concept in this element SHALL be from the specified value
set.">Required</a> )
<br/> </td> </tr> <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color:
white">
<td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data:image/png;bas
e64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCAYAAACg/LjIAAAALUlEQVR4Xu3IoREAIAwEwfT6/ddA0GBAxO3NrLlKUj
9263wAAAAvrgEAADClAVWFQIBRHMicAAAAAElFTkSuQmCC)">
<img alt="." class="hierarchy" src="data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpw
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<img alt="." class="hierarchy" src="data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpw
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<img alt="." class="hierarchy" src="data:image/png;base64,R0lGODlhEAAQAPZ/APrkusOiYvvfqbiXWaV2G+jGhdq1b8GgYf3v1frw3vTUlsWkZNewbcS
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Ri+bFhLWUVv379/rnwPvszv3rye3LiPvnv+3MjPDasKiIS/789/3x2f747eXDg+7Mifvu0tu7f+/QkfDTnPXWmPrjsvrjt
PbPgrqZW+/QlPz48K2EMv36866OUPvowat8Ivvgq/Pbrvzgq/PguvrgrqN0Gda2evfYm9+7d/rpw9q6e/LSku/Rl/XVl/L
Slfrkt+zVqe7Wqv3x1/bNffbOf59wFdS6if3u0vrqyP3owPvepfXQivDQkO/PkKh9K7STVf779P///wD/ACH5BAEKAH8AL
AAAAAAQABAAAAemgH+CgxeFF4OIhBdKGwFChYl/hYwbdkoBPnaQkosbG3d3VEpSUlonUoY1Gzo6QkI8SrGxWBOFG4uySgY
5ZWR3PFy2hnaWZXC/PHcPwkpJk1ShoHcxhQEXSUmtFy6+0iSFVResrjoTPDzdcoU+F65CduVU6KAhhQa3F8Tx8nchBoYuq
oTLZoAKFRIhqGwqJAULFx0GYpBQeChRIR4TJm6KJMhQRUSBAAA7" style="background-color: white; background-color: inherit" title="Data Type"/>
<span title="DiagnosticReport.category : A code that classifies the clinical discipline, department
or diagnostic service that created the report (e.g. cardiology, biochemistry, hematology,
MRI). This is used for searching, sorting and display purposes.">category</span>
<a name="DiagnosticReport.category"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
solid; padding:0px 4px 0px 4px">
<a href="elementdefinition-definitions.html#ElementDefinition.isSummary" style="padding-left: 3px; padding-right: 3px; color: black; null" title="This element is included in summaries">Σ</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
solid; padding:0px 4px 0px 4px">0..*</td>
<td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
solid; padding:0px 4px 0px 4px">
<a href="datatypes.html#CodeableConcept">CodeableConcept</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
solid; padding:0px 4px 0px 4px">Service category
<br/> Binding: <a href="valueset-diagnostic-service-sections.html">Diagnostic Service Section Codes</a> ( <a href="terminologies.html#example" title="Instances are not expected or even encouraged to draw from the specified value
set. The value set merely provides examples of the types of concepts intended
to be included.">Example</a> )
<br/> <br/> </td> </tr> <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color:
#F7F7F7">
<td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
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<span title="DiagnosticReport.code : A code or name that describes this diagnostic report.">code</span> <a name="DiagnosticReport.code"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
#F0F0F0 solid; padding:0px 4px 0px 4px">
<a href="elementdefinition-definitions.html#ElementDefinition.isSummary" style="padding-left: 3px; padding-right: 3px; color: black; null" title="This element is included in summaries">Σ</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
#F0F0F0 solid; padding:0px 4px 0px 4px">1..1</td>
<td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
#F0F0F0 solid; padding:0px 4px 0px 4px">
<a href="datatypes.html#CodeableConcept">CodeableConcept</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
#F0F0F0 solid; padding:0px 4px 0px 4px">Name/Code for this diagnostic report
<br/> Binding: <a href="valueset-report-codes.html">LOINC Diagnostic Report Codes</a> ( <a href="terminologies.html#preferred" title="Instances are encouraged to draw from the specified codes for interoperability
purposes but are not required to do so to be considered conformant.">Preferred</a> )
<br/> </td> </tr> <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color:
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<span title="DiagnosticReport.subject : The subject of the report. Usually, but not always,
this is a patient. However, diagnostic services also perform analyses on specimens
collected from a variety of other sources.">subject</span>
<a name="DiagnosticReport.subject"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
solid; padding:0px 4px 0px 4px">
<a href="elementdefinition-definitions.html#ElementDefinition.isSummary" style="padding-left: 3px; padding-right: 3px; color: black; null" title="This element is included in summaries">Σ</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
solid; padding:0px 4px 0px 4px">0..1</td>
<td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
solid; padding:0px 4px 0px 4px">
<a href="references.html#Reference">Reference</a> ( <a href="patient.html">Patient</a> | <a href="group.html">Group</a> | <a href="device.html">Device</a> | <a href="location.html">Location</a> | <a href="organization.html">Organization</a> | <a href="practitioner.html">Practitioner</a> | <a href="medication.html">Medication</a> | <a href="substance.html">Substance</a> | <a href="biologicallyderivedproduct.html">BiologicallyDerivedProduct</a> ) </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
solid; padding:0px 4px 0px 4px">The subject of the report - usually, but not always, the patient
<br/> </td> </tr> <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color:
#F7F7F7">
<td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
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<span title="DiagnosticReport.encounter : The healthcare event (e.g. a patient and healthcare
provider interaction) which this DiagnosticReport is about.">encounter</span>
<a name="DiagnosticReport.encounter"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
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<a href="elementdefinition-definitions.html#ElementDefinition.isSummary" style="padding-left: 3px; padding-right: 3px; color: black; null" title="This element is included in summaries">Σ</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
#F0F0F0 solid; padding:0px 4px 0px 4px">0..1</td>
<td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
#F0F0F0 solid; padding:0px 4px 0px 4px">
<a href="references.html#Reference">Reference</a> ( <a href="encounter.html">Encounter</a> ) </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
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<br/> </td> </tr> <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color:
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<td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
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<span title="DiagnosticReport.effective[x] : The time or time-period the observed values are
related to. When the subject of the report is a patient, this is usually either
the time of the procedure or of specimen collection(s), but very often the source
of the date/time is not known, only the date/time itself.">effective[x]</span>
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<a href="elementdefinition-definitions.html#ElementDefinition.isSummary" style="padding-left: 3px; padding-right: 3px; color: black; null" title="This element is included in summaries">Σ</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
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<td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
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<td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
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<br/> </td> </tr> <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color:
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<td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
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<img alt="." class="hierarchy" src="data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpw
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<span title="A date, date-time or partial date (e.g. just year or year + month). If hours and
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due to schema type constraints but may be zero-filled and may be ignored.
Dates SHALL be valid dates.">effectiveDateTime</span>
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<td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
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<td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
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<a href="datatypes.html#dateTime">dateTime</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
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</tr> <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color:
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<span title="DiagnosticReport.issued : The date and time that this version of the report was
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<span title="DiagnosticReport.performer : The diagnostic service that is responsible for issuing
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<a href="elementdefinition-definitions.html#ElementDefinition.isSummary" style="padding-left: 3px; padding-right: 3px; color: black; null" title="This element is included in summaries">Σ</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
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<a href="references.html#Reference">Reference</a> ( <a href="practitioner.html">Practitioner</a> | <a href="practitionerrole.html">PractitionerRole</a> | <a href="organization.html">Organization</a> | <a href="careteam.html">CareTeam</a> ) </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
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<span title="DiagnosticReport.resultsInterpreter : The practitioner or organization that is
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<a href="elementdefinition-definitions.html#ElementDefinition.isSummary" style="padding-left: 3px; padding-right: 3px; color: black; null" title="This element is included in summaries">Σ</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
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<a href="references.html#Reference">Reference</a> ( <a href="practitioner.html">Practitioner</a> | <a href="practitionerrole.html">PractitionerRole</a> | <a href="organization.html">Organization</a> | <a href="careteam.html">CareTeam</a> ) </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
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<span title="DiagnosticReport.specimen : Details about the specimens on which this diagnostic
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<td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
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<a href="references.html#Reference">Reference</a> ( <a href="specimen.html">Specimen</a> ) </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
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<br/> <br/> </td> </tr> <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color:
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<span title="DiagnosticReport.result : [Observations](observation.html) that are part of this
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<a href="references.html#Reference">Reference</a> ( <a href="observation.html">Observation</a> ) </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
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<span title="DiagnosticReport.note : Comments about the diagnostic report.">note</span> <a name="DiagnosticReport.note"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
solid; padding:0px 4px 0px 4px"/>
<td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
solid; padding:0px 4px 0px 4px">0..*</td>
<td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
solid; padding:0px 4px 0px 4px">
<a href="datatypes.html#Annotation">Annotation</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
solid; padding:0px 4px 0px 4px">Comments about the diagnostic report
<br/> <br/> </td> </tr> <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color:
#F7F7F7">
<td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
#F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image:
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<span title="DiagnosticReport.study : One or more links to full details of any study performed
during the diagnostic investigation. An ImagingStudy might comprise a set of radiologic
images obtained via a procedure that are analyzed as a group. Typically, this is
imaging performed by DICOM enabled modalities, but this is not required. A fully
enabled PACS viewer can use this information to provide views of the source images.
A GenomicStudy might comprise one or more analyses, each serving a specific purpose.
These analyses may vary in method (e.g., karyotyping, CNV, or SNV detection), performer,
software, devices used, or regions targeted.">study</span>
<a name="DiagnosticReport.study"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
#F0F0F0 solid; padding:0px 4px 0px 4px"/>
<td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
#F0F0F0 solid; padding:0px 4px 0px 4px">0..*</td>
<td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
#F0F0F0 solid; padding:0px 4px 0px 4px">
<a href="references.html#Reference">Reference</a> ( <a href="genomicstudy.html">GenomicStudy</a> | <a href="imagingstudy.html">ImagingStudy</a> ) </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
#F0F0F0 solid; padding:0px 4px 0px 4px">Reference to full details of an analysis associated with the diagnostic report
<br/> <br/> </td> </tr> <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color:
white">
<td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
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<span title="DiagnosticReport.supportingInfo : This backbone element contains supporting information
that was used in the creation of the report not included in the results already
included in the report.">supportingInfo</span>
<a name="DiagnosticReport.supportingInfo"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
solid; padding:0px 4px 0px 4px"/>
<td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
solid; padding:0px 4px 0px 4px">0..*</td>
<td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
solid; padding:0px 4px 0px 4px">
<a href="types.html#BackBoneElement">BackboneElement</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
solid; padding:0px 4px 0px 4px">Additional information supporting the diagnostic report
<br/> <br/> </td> </tr> <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color:
#F7F7F7">
<td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
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<span title="DiagnosticReport.supportingInfo.type : The code value for the role of the supporting
information in the diagnostic report.">type</span>
<a name="DiagnosticReport.supportingInfo.type"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
#F0F0F0 solid; padding:0px 4px 0px 4px"/>
<td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
#F0F0F0 solid; padding:0px 4px 0px 4px">1..1</td>
<td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
#F0F0F0 solid; padding:0px 4px 0px 4px">
<a href="datatypes.html#CodeableConcept">CodeableConcept</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
#F0F0F0 solid; padding:0px 4px 0px 4px">Supporting information role code
<br/> Binding: <a href="http://terminology.hl7.org/4.0.0/ValueSet-v2-0936.html">hl7VS-VS-observationType</a> ( <a href="terminologies.html#example" title="Instances are not expected or even encouraged to draw from the specified value
set. The value set merely provides examples of the types of concepts intended
to be included.">Example</a> )
<br/> </td> </tr> <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color:
white">
<td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
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<img alt="." class="hierarchy" src="data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpw
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<img alt="." class="hierarchy" src="data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAQCAYAAAAf8/9hAAAAAXNSR0IArs4c6QAAAARnQU1
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<span title="DiagnosticReport.supportingInfo.reference : The reference for the supporting information
in the diagnostic report.">reference</span>
<a name="DiagnosticReport.supportingInfo.reference"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
solid; padding:0px 4px 0px 4px"/>
<td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
solid; padding:0px 4px 0px 4px">1..1</td>
<td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
solid; padding:0px 4px 0px 4px">
<a href="references.html#Reference">Reference</a> ( <a href="procedure.html">Procedure</a> | <a href="observation.html">Observation</a> | <a href="diagnosticreport.html">DiagnosticReport</a> | <a href="citation.html">Citation</a> ) </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
solid; padding:0px 4px 0px 4px">Supporting information reference
<br/> </td> </tr> <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color:
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<td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
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<img alt="." class="hierarchy" src="data:image/png;base64,R0lGODlhEAAQAPQfAOvGUf7ztuvPMf/78/fkl/Pbg+u8Rvjqteu2Pf3zxPz36Pz0z+vTmPz
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<span title="DiagnosticReport.media : A list of key images or data associated with this report.
The images or data are generally created during the diagnostic process, and may
be directly of the patient, or of treated specimens (i.e. slides of interest).">media</span>
<a name="DiagnosticReport.media"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
#F0F0F0 solid; padding:0px 4px 0px 4px">
<a href="elementdefinition-definitions.html#ElementDefinition.isSummary" style="padding-left: 3px; padding-right: 3px; color: black; null" title="This element is included in summaries">Σ</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
#F0F0F0 solid; padding:0px 4px 0px 4px">0..*</td>
<td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
#F0F0F0 solid; padding:0px 4px 0px 4px">
<a href="types.html#BackBoneElement">BackboneElement</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
#F0F0F0 solid; padding:0px 4px 0px 4px">Key images or data associated with this report
<br/> <br/> </td> </tr> <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color:
white">
<td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data:image/png;bas
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<img alt="." class="hierarchy" src="data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAQCAYAAAAf8/9hAAAACXBIWXMAAAsTAAALEwEAmpw
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<span title="DiagnosticReport.media.comment : A comment about the image or data. Typically,
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to draw the viewer's attention to important features.">comment</span>
<a name="DiagnosticReport.media.comment"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
solid; padding:0px 4px 0px 4px"/>
<td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
solid; padding:0px 4px 0px 4px">0..1</td>
<td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
solid; padding:0px 4px 0px 4px">
<a href="datatypes.html#string">string</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
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<br/> </td> </tr> <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color:
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<td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
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<span title="DiagnosticReport.media.link : Reference to the image or data source.">link</span> <a name="DiagnosticReport.media.link"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
#F0F0F0 solid; padding:0px 4px 0px 4px">
<a href="elementdefinition-definitions.html#ElementDefinition.isSummary" style="padding-left: 3px; padding-right: 3px; color: black; null" title="This element is included in summaries">Σ</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
#F0F0F0 solid; padding:0px 4px 0px 4px">1..1</td>
<td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
#F0F0F0 solid; padding:0px 4px 0px 4px">
<a href="references.html#Reference">Reference</a> ( <a href="documentreference.html">DocumentReference</a> ) </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
#F0F0F0 solid; padding:0px 4px 0px 4px">Reference to the image or data source
<br/> </td> </tr> <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color:
white">
<td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data:image/png;bas
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<img alt="." class="hierarchy" src="data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpw
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<img alt="." class="hierarchy" src="data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAQCAYAAAAf8/9hAAAAAXNSR0IArs4c6QAAAARnQU1
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<span title="DiagnosticReport.composition : Reference to a Composition resource instance that
provides structure for organizing the contents of the DiagnosticReport.">composition</span>
<a name="DiagnosticReport.composition"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
solid; padding:0px 4px 0px 4px">
<a href="conformance-rules.html#constraints" style="padding-left: 3px; padding-right: 3px; border: 1px maroon solid; font-weight: bold;
color: #301212; background-color: #fdf4f4;" title="This element has or is affected by some invariants">C</a>
</td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
solid; padding:0px 4px 0px 4px">0..1</td>
<td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
solid; padding:0px 4px 0px 4px">
<a href="references.html#Reference">Reference</a> ( <a href="composition.html">Composition</a> ) </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
solid; padding:0px 4px 0px 4px">Reference to a Composition resource for the DiagnosticReport structure
<br/> </td> </tr> <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color:
#F7F7F7">
<td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
#F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image:
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<img alt="." class="hierarchy" src="data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpw
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<img alt="." class="hierarchy" src="data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAQCAYAAAAf8/9hAAAACXBIWXMAAAsTAAALEwEAmpw
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<span title="DiagnosticReport.conclusion : Concise and clinically contextualized summary conclusion
(interpretation/impression) of the diagnostic report.">conclusion</span>
<a name="DiagnosticReport.conclusion"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
#F0F0F0 solid; padding:0px 4px 0px 4px"/>
<td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
#F0F0F0 solid; padding:0px 4px 0px 4px">0..1</td>
<td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
#F0F0F0 solid; padding:0px 4px 0px 4px">
<a href="datatypes.html#markdown">markdown</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
#F0F0F0 solid; padding:0px 4px 0px 4px">Clinical conclusion (interpretation) of test results
<br/> </td> </tr> <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color:
white">
<td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data:image/png;bas
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<img alt="." class="hierarchy" src="data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpw
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<img alt="." class="hierarchy" src="data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpw
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<img alt="." class="hierarchy" src="data:image/png;base64,R0lGODlhEAAQAPZ/APrkusOiYvvfqbiXWaV2G+jGhdq1b8GgYf3v1frw3vTUlsWkZNewbcS
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<span title="DiagnosticReport.conclusionCode : One or more codes that represent the summary
conclusion (interpretation/impression) of the diagnostic report.">conclusionCode</span>
<a name="DiagnosticReport.conclusionCode"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
solid; padding:0px 4px 0px 4px"/>
<td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
solid; padding:0px 4px 0px 4px">0..*</td>
<td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
solid; padding:0px 4px 0px 4px">
<a href="datatypes.html#CodeableConcept">CodeableConcept</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
solid; padding:0px 4px 0px 4px">Codes for the clinical conclusion of test results
<br/> Binding: <a href="valueset-clinical-findings.html">SNOMED CT Clinical Findings</a> ( <a href="terminologies.html#example" title="Instances are not expected or even encouraged to draw from the specified value
set. The value set merely provides examples of the types of concepts intended
to be included.">Example</a> )
<br/> <br/> </td> </tr> <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color:
#F7F7F7">
<td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
#F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image:
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<img alt="." class="hierarchy" src="data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpw
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<img alt="." class="hierarchy" src="data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpw
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<img alt="." class="hierarchy" src="data:image/png;base64,R0lGODlhEAAQAPZ/APrkusOiYvvfqbiXWaV2G+jGhdq1b8GgYf3v1frw3vTUlsWkZNewbcS
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oTLZoAKFRIhqGwqJAULFx0GYpBQeChRIR4TJm6KJMhQRUSBAAA7" style="background-color: #F7F7F7; background-color: inherit" title="Data Type"/>
<span title="DiagnosticReport.presentedForm : Rich text representation of the entire result
as issued by the diagnostic service. Multiple formats are allowed but they SHALL
be semantically equivalent.">presentedForm</span>
<a name="DiagnosticReport.presentedForm"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
#F0F0F0 solid; padding:0px 4px 0px 4px"/>
<td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
#F0F0F0 solid; padding:0px 4px 0px 4px">0..*</td>
<td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
#F0F0F0 solid; padding:0px 4px 0px 4px">
<a href="datatypes.html#Attachment">Attachment</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
#F0F0F0 solid; padding:0px 4px 0px 4px">Entire report as issued
<br/> <br/> </td> </tr> <tr> <td class="hierarchy" colspan="5"> <br/> <a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="Legend for this format"> <img alt="doco" src="help16.png" style="background-color: inherit"/> Documentation for this format </a> </td> </tr> </table> </div> </text> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-category"> <valueString value="Clinical.Diagnostics"/> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status"> <valueCode value="trial-use"/> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm"> <valueInteger value="3"/> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-security-category"> <valueCode value="patient"/> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-wg"> <valueCode value="oo"/> </extension> <url value="http://hl7.org/fhir/StructureDefinition/DiagnosticReport"/> <version value="5.0.0-draft-final"/> <name value="DiagnosticReport"/> <status value="draft"/> <experimental value="false"/> <date value="2023-03-01T23:03:57+11:00"/> <publisher value="Health Level Seven International (Orders and Observations)"/> <contact> <telecom> <system value="url"/> <value value="http://hl7.org/fhir"/> </telecom> </contact> <contact> <telecom> <system value="url"/> <value value="http://www.hl7.org/Special/committees/orders/index.cfm"/> </telecom> </contact> <description value="The findings and interpretation of diagnostic tests performed on patients, groups
of patients, products, substances, devices, and locations, and/or specimens derived
from these. The report includes clinical context such as requesting provider information,
and some mix of atomic results, images, textual and coded interpretations, and
formatted representation of diagnostic reports. The report also includes non-clinical
context such as batch analysis and stability reporting of products and substances."/>
<jurisdiction> <coding> <system value="http://unstats.un.org/unsd/methods/m49/m49.htm"/> <code value="001"/> <display value="World"/> </coding> </jurisdiction> <purpose value="To support reporting for any diagnostic report into a clinical data repository."/> <fhirVersion value="5.0.0-draft-final"/> <mapping> <identity value="workflow"/> <uri value="http://hl7.org/fhir/workflow"/> <name value="Workflow Pattern"/> </mapping> <mapping> <identity value="v2"/> <uri value="http://hl7.org/v2"/> <name value="HL7 V2 Mapping"/> </mapping> <mapping> <identity value="rim"/> <uri value="http://hl7.org/v3"/> <name value="RIM Mapping"/> </mapping> <mapping> <identity value="w5"/> <uri value="http://hl7.org/fhir/fivews"/> <name value="FiveWs Pattern Mapping"/> </mapping> <kind value="resource"/> <abstract value="false"/> <type value="DiagnosticReport"/> <baseDefinition value="http://hl7.org/fhir/StructureDefinition/DomainResource"/> <derivation value="specialization"/> <snapshot> <element id="DiagnosticReport"> <path value="DiagnosticReport"/> <short value="A Diagnostic report - a combination of request information, atomic results, images,
interpretation, as well as formatted reports"/>
<definition value="The findings and interpretation of diagnostic tests performed on patients, groups
of patients, products, substances, devices, and locations, and/or specimens derived
from these. The report includes clinical context such as requesting provider information,
and some mix of atomic results, images, textual and coded interpretations, and
formatted representation of diagnostic reports. The report also includes non-clinical
context such as batch analysis and stability reporting of products and substances."/>
<comment value="This is intended to capture a single report and is not suitable for use in displaying
summary information that covers multiple reports. For example, this resource has
not been designed for laboratory cumulative reporting formats nor detailed structured
reports for sequencing."/>
<alias value="Report"/> <alias value="Test"/> <alias value="Result"/> <alias value="Results"/> <alias value="Labs"/> <alias value="Laboratory"/> <min value="0"/> <max value="*"/> <base> <path value="DiagnosticReport"/> <min value="0"/> <max value="*"/> </base> <constraint> <key value="dgr-1"/> <severity value="error"/> <human value="A resource referenced in a Composition entry must also be included in the DiagnosticReport
result (Observation resources or nested resources via Observation.hasMember)"/>
<expression value="composition.exists() implies composition.resolve().section.entry.resolve().descendants().wher
e((id in result.resolve().descendants().id).not()).empty()"/>
<source value="http://hl7.org/fhir/StructureDefinition/DiagnosticReport"/> </constraint> <constraint> <key value="dom-2"/> <severity value="error"/> <human value="If the resource is contained in another resource, it SHALL NOT contain nested Resources"/> <expression value="contained.contained.empty()"/> <source value="http://hl7.org/fhir/StructureDefinition/DomainResource"/> </constraint> <constraint> <key value="dom-3"/> <severity value="error"/> <human value="If the resource is contained in another resource, it SHALL be referred to from
elsewhere in the resource or SHALL refer to the containing resource"/>
<expression value="contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().ofTy
pe(canonical) | %resource.descendants().ofType(uri) | %resource.descendants().ofType(url)))
or descendants().where(reference = '#').exists() or descendants().where(ofType(canonical)
= '#').exists() or descendants().where(ofType(canonical) = '#').exists()).not()).trace('unmat
ched', id).empty()"/>
<source value="http://hl7.org/fhir/StructureDefinition/DomainResource"/> </constraint> <constraint> <key value="dom-4"/> <severity value="error"/> <human value="If a resource is contained in another resource, it SHALL NOT have a meta.versionId
or a meta.lastUpdated"/>
<expression value="contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()"/> <source value="http://hl7.org/fhir/StructureDefinition/DomainResource"/> </constraint> <constraint> <key value="dom-5"/> <severity value="error"/> <human value="If a resource is contained in another resource, it SHALL NOT have a security label"/> <expression value="contained.meta.security.empty()"/> <source value="http://hl7.org/fhir/StructureDefinition/DomainResource"/> </constraint> <constraint> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice"> <valueBoolean value="true"/> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice-explanation"> <valueMarkdown value="When a resource has no narrative, only systems that fully understand the data can
display the resource to a human safely. Including a human readable representation
in the resource makes for a much more robust eco-system and cheaper handling of
resources by intermediary systems. Some ecosystems restrict distribution of resources
to only those systems that do fully understand the resources, and as a consequence
implementers may believe that the narrative is superfluous. However experience
shows that such eco-systems often open up to new participants over time."/>
</extension> <key value="dom-6"/> <severity value="warning"/> <human value="A resource should have narrative for robust management"/> <expression value="text.`div`.exists()"/> <source value="http://hl7.org/fhir/StructureDefinition/DomainResource"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="Entity. Role, or Act"/> </mapping> <mapping> <identity value="workflow"/> <map value="Event"/> </mapping> <mapping> <identity value="v2"/> <map value="ORU -> OBR"/> </mapping> <mapping> <identity value="rim"/> <map value="Observation[classCode=OBS, moodCode=EVN]"/> </mapping> <mapping> <identity value="w5"/> <map value="clinical.diagnostics"/> </mapping> </element> <element id="DiagnosticReport.id"> <path value="DiagnosticReport.id"/> <short value="Logical id of this artifact"/> <definition value="The logical id of the resource, as used in the URL for the resource. Once assigned,
this value never changes."/>
<comment value="Within the context of the FHIR RESTful interactions, the resource has an id except
for cases like the create and conditional update. Otherwise, the use of the resouce
id depends on the given use case."/>
<min value="0"/> <max value="1"/> <base> <path value="Resource.id"/> <min value="0"/> <max value="1"/> </base>
<type> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type"> <valueUrl value="id"/> </extension> <code value="http://hl7.org/fhirpath/System.String"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="true"/> </element> <element id="DiagnosticReport.meta"> <path value="DiagnosticReport.meta"/> <short value="Metadata about the resource"/> <definition value="The metadata about the resource. This is content that is maintained by the infrastructure.
Changes to the content might not always be associated with version changes to the
resource."/>
<min value="0"/> <max value="1"/> <base> <path value="Resource.meta"/> <min value="0"/> <max value="1"/> </base> <type> <code value="Meta"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="true"/> </element> <element id="DiagnosticReport.implicitRules"> <path value="DiagnosticReport.implicitRules"/> <short value="A set of rules under which this content was created"/> <definition value="A reference to a set of rules that were followed when the resource was constructed,
and which must be understood when processing the content. Often, this is a reference
to an implementation guide that defines the special rules along with other profiles
etc."/>
<comment value="Asserting this rule set restricts the content to be only understood by a limited
set of trading partners. This inherently limits the usefulness of the data in the
long term. However, the existing health eco-system is highly fractured, and not
yet ready to define, collect, and exchange data in a generally computable sense.
Wherever possible, implementers and/or specification writers should avoid using
this element. Often, when used, the URL is a reference to an implementation guide
that defines these special rules as part of its narrative along with other profiles,
value sets, etc."/>
<min value="0"/> <max value="1"/> <base> <path value="Resource.implicitRules"/> <min value="0"/> <max value="1"/> </base> <type> <code value="uri"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="true"/> <isModifierReason value="This element is labeled as a modifier because the implicit rules may provide additional
knowledge about the resource that modifies its meaning or interpretation"/>
<isSummary value="true"/> </element> <element id="DiagnosticReport.language"> <path value="DiagnosticReport.language"/> <short value="Language of the resource content"/> <definition value="The base language in which the resource is written."/> <comment value="Language is provided to support indexing and accessibility (typically, services
such as text to speech use the language tag). The html language tag in the narrative
applies to the narrative. The language tag on the resource may be used to specify
the language of other presentations generated from the data in the resource. Not
all the content has to be in the base language. The Resource.language should not
be assumed to apply to the narrative automatically. If a language is specified,
it should it also be specified on the div element in the html (see rules in HTML5
for information about the relationship between xml:lang and the html lang attribute)."/>
<min value="0"/> <max value="1"/> <base> <path value="Resource.language"/> <min value="0"/> <max value="1"/> </base> <type> <code value="code"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="Language"/> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding"> <valueBoolean value="true"/> </extension> <strength value="required"/> <description value="IETF language tag for a human language"/> <valueSet value="http://hl7.org/fhir/ValueSet/all-languages|5.0.0-draft-final"/> <additional> <purpose value="starter"/> <valueSet value="http://hl7.org/fhir/ValueSet/languages"/> </additional> </binding> </element> <element id="DiagnosticReport.text"> <path value="DiagnosticReport.text"/> <short value="Text summary of the resource, for human interpretation"/> <definition value="A human-readable narrative that contains a summary of the resource and can be used
to represent the content of the resource to a human. The narrative need not encode
all the structured data, but is required to contain sufficient detail to make it
"clinically safe" for a human to just read the narrative. Resource definitions
may define what content should be represented in the narrative to ensure clinical
safety."/>
<comment value="Contained resources do not have a narrative. Resources that are not contained SHOULD
have a narrative. In some cases, a resource may only have text with little or no
additional discrete data (as long as all minOccurs=1 elements are satisfied).
This may be necessary for data from legacy systems where information is captured
as a "text blob" or where text is additionally entered raw or narrated
and encoded information is added later."/>
<alias value="narrative"/> <alias value="html"/> <alias value="xhtml"/> <alias value="display"/> <min value="0"/> <max value="1"/> <base> <path value="DomainResource.text"/> <min value="0"/> <max value="1"/> </base> <type> <code value="Narrative"/> </type> <condition value="dom-6"/> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="Act.text?"/> </mapping> </element> <element id="DiagnosticReport.contained"> <path value="DiagnosticReport.contained"/> <short value="Contained, inline Resources"/> <definition value="These resources do not have an independent existence apart from the resource that
contains them - they cannot be identified independently, nor can they have their
own independent transaction scope. This is allowed to be a Parameters resource
if and only if it is referenced by a resource that provides context/meaning."/>
<comment value="This should never be done when the content can be identified properly, as once
identification is lost, it is extremely difficult (and context dependent) to restore
it again. Contained resources may have profiles and tags in their meta elements,
but SHALL NOT have security labels."/>
<alias value="inline resources"/> <alias value="anonymous resources"/> <alias value="contained resources"/> <min value="0"/> <max value="*"/> <base> <path value="DomainResource.contained"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Resource"/> </type> <condition value="dom-2"/> <condition value="dom-4"/> <condition value="dom-3"/> <condition value="dom-5"/> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="N/A"/> </mapping> </element> <element id="DiagnosticReport.extension"> <path value="DiagnosticReport.extension"/> <short value="Additional content defined by implementations"/> <definition value="May be used to represent additional information that is not part of the basic definition
of the resource. To make the use of extensions safe and managable, 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."/>
<comment value="There can be no stigma associated with the use of extensions by any application,
project, or standard - regardless of the institution or jurisdiction that uses
or defines the extensions. The use of extensions is what allows the FHIR specification
to retain a core level of simplicity for everyone."/>
<alias value="extensions"/> <alias value="user content"/> <min value="0"/> <max value="*"/> <base> <path value="DomainResource.extension"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Extension"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <constraint> <key value="ext-1"/> <severity value="error"/> <human value="Must have either extensions or value[x], not both"/> <expression value="extension.exists() != value.exists()"/> <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="N/A"/> </mapping> </element> <element id="DiagnosticReport.modifierExtension"> <path value="DiagnosticReport.modifierExtension"/> <short value="Extensions that cannot be ignored"/> <definition value="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 managable, 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)."/>
<comment value="There can be no stigma associated with the use of extensions by any application,
project, or standard - regardless of the institution or jurisdiction that uses
or defines the extensions. The use of extensions is what allows the FHIR specification
to retain a core level of simplicity for everyone."/>
<requirements value="Modifier extensions allow for extensions that *cannot* be safely ignored to be
clearly distinguished from the vast majority of extensions which can be safely
ignored. This promotes interoperability by eliminating the need for implementers
to prohibit the presence of extensions. For further information, see the [definition
of modifier extensions](extensibility.html#modifierExtension)."/>
<alias value="extensions"/> <alias value="user content"/> <min value="0"/> <max value="*"/> <base> <path value="DomainResource.modifierExtension"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Extension"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <constraint> <key value="ext-1"/> <severity value="error"/> <human value="Must have either extensions or value[x], not both"/> <expression value="extension.exists() != value.exists()"/> <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> </constraint> <mustSupport value="false"/> <isModifier value="true"/> <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the
resource that contains them"/>
<isSummary value="true"/> <mapping> <identity value="rim"/> <map value="N/A"/> </mapping> </element> <element id="DiagnosticReport.identifier"> <path value="DiagnosticReport.identifier"/> <short value="Business identifier for report"/> <definition value="Identifiers assigned to this report by the performer or other systems."/> <comment value="Usually assigned by the Information System of the diagnostic service provider (filler
id)."/>
<requirements value="Need to know what identifier to use when making queries about this report from
the source laboratory, and for linking to the report outside FHIR context."/>
<alias value="ReportID"/> <alias value="Filler ID"/> <alias value="Placer ID"/> <min value="0"/> <max value="*"/> <base> <path value="DiagnosticReport.identifier"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Identifier"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="workflow"/> <map value="Event.identifier"/> </mapping> <mapping> <identity value="w5"/> <map value="FiveWs.identifier"/> </mapping> <mapping> <identity value="v2"/> <map value="OBR-51/ for globally unique filler ID - OBR-3 , For non-globally unique filler-id
the flller/placer number must be combined with the universal service Id - OBR-2(if
present)+OBR-3+OBR-4"/>
</mapping> <mapping> <identity value="rim"/> <map value="id"/> </mapping> </element> <element id="DiagnosticReport.basedOn"> <path value="DiagnosticReport.basedOn"/> <short value="What was requested"/> <definition value="Details concerning a service requested."/> <comment value="Note: Usually there is one test request for each result, however in some circumstances
multiple test requests may be represented using a single test result resource.
Note that there are also cases where one request leads to multiple reports."/>
<requirements value="This allows tracing of authorization for the report and tracking whether proposals/recommenda
tions were acted upon."/>
<alias value="Request"/> <min value="0"/> <max value="*"/> <base> <path value="DiagnosticReport.basedOn"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Reference"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/CarePlan"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/ImmunizationRecommendation"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/MedicationRequest"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/NutritionOrder"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/ServiceRequest"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="workflow"/> <map value="Event.basedOn"/> </mapping> <mapping> <identity value="v2"/> <map value="ORC? OBR-2/3?"/> </mapping> <mapping> <identity value="rim"/> <map value="outboundRelationship[typeCode=FLFS].target"/> </mapping> </element> <element id="DiagnosticReport.status"> <path value="DiagnosticReport.status"/> <short value="registered | partial | preliminary | final +"/> <definition value="The status of the diagnostic report."/> <requirements value="Diagnostic services routinely issue provisional/incomplete reports, and sometimes
withdraw previously released reports."/>
<min value="1"/> <max value="1"/> <base> <path value="DiagnosticReport.status"/> <min value="1"/> <max value="1"/> </base> <type> <code value="code"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="true"/> <isModifierReason value="This element is labeled as a modifier because it is a status element that contains
status entered-in-error which means that the resource should not be treated as
valid"/>
<isSummary value="true"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="DiagnosticReportStatus"/> </extension> <strength value="required"/> <description value="The status of the diagnostic report."/> <valueSet value="http://hl7.org/fhir/ValueSet/diagnostic-report-status|5.0.0-draft-final"/> </binding> <mapping> <identity value="workflow"/> <map value="Event.status"/> </mapping> <mapping> <identity value="w5"/> <map value="FiveWs.status"/> </mapping> <mapping> <identity value="v2"/> <map value="OBR-25 (not 1:1 mapping)"/> </mapping> <mapping> <identity value="rim"/> <map value="statusCode Note: final and amended are distinguished by whether observation is
the subject of a ControlAct event of type "revise""/>
</mapping> </element> <element id="DiagnosticReport.category"> <path value="DiagnosticReport.category"/> <short value="Service category"/> <definition value="A code that classifies the clinical discipline, department or diagnostic service
that created the report (e.g. cardiology, biochemistry, hematology, MRI). This
is used for searching, sorting and display purposes."/>
<comment value="Multiple categories are allowed using various categorization schemes. The level
of granularity is defined by the category concepts in the value set. More fine-grained
filtering can be performed using the metadata and/or terminology hierarchy in DiagnosticRepor
t.code."/>
<alias value="Department"/> <alias value="Sub-department"/> <alias value="Service"/> <alias value="Discipline"/> <min value="0"/> <max value="*"/> <base> <path value="DiagnosticReport.category"/> <min value="0"/> <max value="*"/> </base> <type> <code value="CodeableConcept"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="true"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="DiagnosticServiceSection"/> </extension> <strength value="example"/> <description value="HL7 V2 table 0074"/> <valueSet value="http://hl7.org/fhir/ValueSet/diagnostic-service-sections"/> </binding> <mapping> <identity value="w5"/> <map value="FiveWs.class"/> </mapping> <mapping> <identity value="v2"/> <map value="OBR-24"/> </mapping> <mapping> <identity value="rim"/> <map value="inboundRelationship[typeCode=COMP].source[classCode=LIST, moodCode=EVN, code <
LabService].code"/>
</mapping> </element> <element id="DiagnosticReport.code"> <path value="DiagnosticReport.code"/> <short value="Name/Code for this diagnostic report"/> <definition value="A code or name that describes this diagnostic report."/> <alias value="Type"/> <min value="1"/> <max value="1"/> <base> <path value="DiagnosticReport.code"/> <min value="1"/> <max value="1"/> </base> <type> <code value="CodeableConcept"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="true"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="DiagnosticReportCodes"/> </extension> <strength value="preferred"/> <description value="LOINC Codes for Diagnostic Reports"/> <valueSet value="http://hl7.org/fhir/ValueSet/report-codes"/> </binding> <mapping> <identity value="workflow"/> <map value="Event.code"/> </mapping> <mapping> <identity value="w5"/> <map value="FiveWs.what[x]"/> </mapping> <mapping> <identity value="v2"/> <map value="OBR-4 (HL7 V2 doesn't provide an easy way to indicate both the ordered test and
the performed panel)"/>
</mapping> <mapping> <identity value="rim"/> <map value="code"/> </mapping> </element> <element id="DiagnosticReport.subject"> <path value="DiagnosticReport.subject"/> <short value="The subject of the report - usually, but not always, the patient"/> <definition value="The subject of the report. Usually, but not always, this is a patient. However,
diagnostic services also perform analyses on specimens collected from a variety
of other sources."/>
<requirements value="SHALL know the subject context."/> <alias value="Patient"/> <min value="0"/> <max value="1"/> <base> <path value="DiagnosticReport.subject"/> <min value="0"/> <max value="1"/> </base> <type> <code value="Reference"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Patient"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Group"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Device"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Location"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Organization"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Practitioner"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Medication"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Substance"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/BiologicallyDerivedProduct"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="workflow"/> <map value="Event.subject"/> </mapping> <mapping> <identity value="w5"/> <map value="FiveWs.subject[x]"/> </mapping> <mapping> <identity value="v2"/> <map value="PID-3 (no HL7 V2 mapping for Group or Device)"/> </mapping> <mapping> <identity value="rim"/> <map value="participation[typeCode=SBJ]"/> </mapping> <mapping> <identity value="w5"/> <map value="FiveWs.subject"/> </mapping> </element> <element id="DiagnosticReport.encounter"> <path value="DiagnosticReport.encounter"/> <short value="Health care event when test ordered"/> <definition value="The healthcare event (e.g. a patient and healthcare provider interaction) which
this DiagnosticReport is about."/>
<comment value="This will typically be the encounter the event occurred within, but some events
may be initiated prior to or after the official completion of an encounter but
still be tied to the context of the encounter (e.g. pre-admission laboratory tests)."/>
<requirements value="Links the request to the Encounter context."/> <alias value="Context"/> <min value="0"/> <max value="1"/> <base> <path value="DiagnosticReport.encounter"/> <min value="0"/> <max value="1"/> </base> <type> <code value="Reference"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Encounter"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="workflow"/> <map value="Event.encounter"/> </mapping> <mapping> <identity value="w5"/> <map value="FiveWs.context"/> </mapping> <mapping> <identity value="v2"/> <map value="PV1-19"/> </mapping> <mapping> <identity value="rim"/> <map value="inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN]"/> </mapping> </element> <element id="DiagnosticReport.effective[x]"> <path value="DiagnosticReport.effective[x]"/> <short value="Clinically relevant time/time-period for report"/> <definition value="The time or time-period the observed values are related to. When the subject of
the report is a patient, this is usually either the time of the procedure or of
specimen collection(s), but very often the source of the date/time is not known,
only the date/time itself."/>
<comment value="If the diagnostic procedure was performed on the patient, this is the time it was
performed. If there are specimens, the diagnostically relevant time can be derived
from the specimen collection times, but the specimen information is not always
available, and the exact relationship between the specimens and the diagnostically
relevant time is not always automatic."/>
<requirements value="Need to know where in the patient history to file/present this report."/> <alias value="Observation time"/> <alias value="Effective Time"/> <alias value="Occurrence"/> <min value="0"/> <max value="1"/> <base> <path value="DiagnosticReport.effective[x]"/> <min value="0"/> <max value="1"/> </base> <type> <code value="dateTime"/> </type> <type> <code value="Period"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="workflow"/> <map value="Event.occurrence[x]"/> </mapping> <mapping> <identity value="w5"/> <map value="FiveWs.done[x]"/> </mapping> <mapping> <identity value="v2"/> <map value="OBR-7"/> </mapping> <mapping> <identity value="rim"/> <map value="effectiveTime"/> </mapping> </element> <element id="DiagnosticReport.issued"> <path value="DiagnosticReport.issued"/> <short value="DateTime this version was made"/> <definition value="The date and time that this version of the report was made available to providers,
typically after the report was reviewed and verified."/>
<comment value="May be different from the update time of the resource itself, because that is the
status of the record (potentially a secondary copy), not the actual release time
of the report."/>
<requirements value="Clinicians need to be able to check the date that the report was released."/> <alias value="Date published"/> <alias value="Date Issued"/> <alias value="Date Verified"/> <min value="0"/> <max value="1"/> <base> <path value="DiagnosticReport.issued"/> <min value="0"/> <max value="1"/> </base> <type> <code value="instant"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="w5"/> <map value="FiveWs.recorded"/> </mapping> <mapping> <identity value="v2"/> <map value="OBR-22"/> </mapping> <mapping> <identity value="rim"/> <map value="participation[typeCode=VRF or AUT].time"/> </mapping> </element> <element id="DiagnosticReport.performer"> <path value="DiagnosticReport.performer"/> <short value="Responsible Diagnostic Service"/> <definition value="The diagnostic service that is responsible for issuing the report."/> <comment value="This is not necessarily the source of the atomic data items or the entity that
interpreted the results. It is the entity that takes responsibility for the clinical
report."/>
<requirements value="Need to know whom to contact if there are queries about the results. Also may need
to track the source of reports for secondary data analysis."/>
<alias value="Laboratory"/> <alias value="Service"/> <alias value="Practitioner"/> <alias value="Department"/> <alias value="Company"/> <alias value="Authorized by"/> <alias value="Director"/> <min value="0"/> <max value="*"/> <base> <path value="DiagnosticReport.performer"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Reference"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Practitioner"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/PractitionerRole"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Organization"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/CareTeam"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="workflow"/> <map value="Event.performer.actor"/> </mapping> <mapping> <identity value="w5"/> <map value="FiveWs.actor"/> </mapping> <mapping> <identity value="v2"/> <map value="PRT-8 (where this PRT-4-Participation = "PO")"/> </mapping> <mapping> <identity value="rim"/> <map value=".participation[typeCode=PRF]"/> </mapping> </element> <element id="DiagnosticReport.resultsInterpreter"> <path value="DiagnosticReport.resultsInterpreter"/> <short value="Primary result interpreter"/> <definition value="The practitioner or organization that is responsible for the report's conclusions
and interpretations."/>
<comment value="Might not be the same entity that takes responsibility for the clinical report."/> <requirements value="Need to know whom to contact if there are queries about the results. Also may need
to track the source of reports for secondary data analysis."/>
<alias value="Analyzed by"/> <alias value="Reported by"/> <min value="0"/> <max value="*"/> <base> <path value="DiagnosticReport.resultsInterpreter"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Reference"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Practitioner"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/PractitionerRole"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Organization"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/CareTeam"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="workflow"/> <map value="Event.performer.actor"/> </mapping> <mapping> <identity value="w5"/> <map value="FiveWs.actor"/> </mapping> <mapping> <identity value="v2"/> <map value="OBR-32, PRT-8 (where this PRT-4-Participation = "PI")"/> </mapping> <mapping> <identity value="rim"/> <map value=".participation[typeCode=PRF]"/> </mapping> </element> <element id="DiagnosticReport.specimen"> <path value="DiagnosticReport.specimen"/> <short value="Specimens this report is based on"/> <definition value="Details about the specimens on which this diagnostic report is based."/> <comment value="If the specimen is sufficiently specified with a code in the test result name,
then this additional data may be redundant. If there are multiple specimens, these
may be represented per observation or group."/>
<requirements value="Need to be able to report information about the collected specimens on which the
report is based."/>
<min value="0"/> <max value="*"/> <base> <path value="DiagnosticReport.specimen"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Reference"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Specimen"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="v2"/> <map value="SPM"/> </mapping> <mapping> <identity value="rim"/> <map value="participation[typeCode=SBJ]"/> </mapping> </element> <element id="DiagnosticReport.result"> <path value="DiagnosticReport.result"/> <short value="Observations"/> <definition value="[Observations](observation.html) that are part of this diagnostic report."/> <comment value="Observations can contain observations."/> <requirements value="Need to support individual results, or groups of results, where the result grouping
is arbitrary, but meaningful."/>
<alias value="Data"/> <alias value="Atomic Value"/> <alias value="Result"/> <alias value="Atomic result"/> <alias value="Data"/> <alias value="Test"/> <alias value="Analyte"/> <alias value="Battery"/> <alias value="Organizer"/> <min value="0"/> <max value="*"/> <base> <path value="DiagnosticReport.result"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Reference"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Observation"/> </type> <condition value="dgr-1"/> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="v2"/> <map value="OBXs"/> </mapping> <mapping> <identity value="rim"/> <map value="outboundRelationship[typeCode=COMP].target"/> </mapping> </element> <element id="DiagnosticReport.note"> <path value="DiagnosticReport.note"/> <short value="Comments about the diagnostic report"/> <definition value="Comments about the diagnostic report."/> <comment value="May include general statements about the diagnostic report, or statements about
significant, unexpected or unreliable results values contained within the diagnostic
report, or information about its source when relevant to its interpretation."/>
<requirements value="Need to be able to provide free text additional information."/> <min value="0"/> <max value="*"/> <base> <path value="DiagnosticReport.note"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Annotation"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="unknown"/> </mapping> </element> <element id="DiagnosticReport.study"> <path value="DiagnosticReport.study"/> <short value="Reference to full details of an analysis associated with the diagnostic report"/> <definition value="One or more links to full details of any study performed during the diagnostic
investigation. An ImagingStudy might comprise a set of radiologic images obtained
via a procedure that are analyzed as a group. Typically, this is imaging performed
by DICOM enabled modalities, but this is not required. A fully enabled PACS viewer
can use this information to provide views of the source images. A GenomicStudy
might comprise one or more analyses, each serving a specific purpose. These analyses
may vary in method (e.g., karyotyping, CNV, or SNV detection), performer, software,
devices used, or regions targeted."/>
<comment value="For laboratory-type studies like GenomeStudy, type resources will be used for tracking
additional metadata and workflow aspects of complex studies. ImagingStudy and the
media element are somewhat overlapping - typically, the list of image references
in the media element will also be found in one of the imaging study resources.
However, each caters to different types of displays for different types of purposes.
Neither, either, or both may be provided."/>
<min value="0"/> <max value="*"/> <base> <path value="DiagnosticReport.study"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Reference"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/GenomicStudy"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/ImagingStudy"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="DiagnosticReport.supportingInfo"> <path value="DiagnosticReport.supportingInfo"/> <short value="Additional information supporting the diagnostic report"/> <definition value="This backbone element contains supporting information that was used in the creation
of the report not included in the results already included in the report."/>
<min value="0"/> <max value="*"/> <base> <path value="DiagnosticReport.supportingInfo"/> <min value="0"/> <max value="*"/> </base> <type> <code value="BackboneElement"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="DiagnosticReport.supportingInfo.id"> <path value="DiagnosticReport.supportingInfo.id"/> <representation value="xmlAttr"/> <short value="Unique id for inter-element referencing"/> <definition value="Unique id for the element within a resource (for internal references). This may
be any string value that does not contain spaces."/>
<min value="0"/> <max value="1"/> <base> <path value="Element.id"/> <min value="0"/> <max value="1"/> </base>
<type> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type"> <valueUrl value="string"/> </extension> <code value="http://hl7.org/fhirpath/System.String"/> </type> <condition value="ele-1"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element id="DiagnosticReport.supportingInfo.extension"> <path value="DiagnosticReport.supportingInfo.extension"/> <short value="Additional content defined by implementations"/> <definition value="May be used to represent additional information that is not part of the basic definition
of the element. To make the use of extensions safe and managable, 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."/>
<comment value="There can be no stigma associated with the use of extensions by any application,
project, or standard - regardless of the institution or jurisdiction that uses
or defines the extensions. The use of extensions is what allows the FHIR specification
to retain a core level of simplicity for everyone."/>
<alias value="extensions"/> <alias value="user content"/> <min value="0"/> <max value="*"/> <base> <path value="Element.extension"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Extension"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <constraint> <key value="ext-1"/> <severity value="error"/> <human value="Must have either extensions or value[x], not both"/> <expression value="extension.exists() != value.exists()"/> <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> </constraint> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element id="DiagnosticReport.supportingInfo.modifierExtension"> <path value="DiagnosticReport.supportingInfo.modifierExtension"/> <short value="Extensions that cannot be ignored even if unrecognized"/> <definition value="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 managable, 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)."/>
<comment value="There can be no stigma associated with the use of extensions by any application,
project, or standard - regardless of the institution or jurisdiction that uses
or defines the extensions. The use of extensions is what allows the FHIR specification
to retain a core level of simplicity for everyone."/>
<requirements value="Modifier extensions allow for extensions that *cannot* be safely ignored to be
clearly distinguished from the vast majority of extensions which can be safely
ignored. This promotes interoperability by eliminating the need for implementers
to prohibit the presence of extensions. For further information, see the [definition
of modifier extensions](extensibility.html#modifierExtension)."/>
<alias value="extensions"/> <alias value="user content"/> <alias value="modifiers"/> <min value="0"/> <max value="*"/> <base> <path value="BackboneElement.modifierExtension"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Extension"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <constraint> <key value="ext-1"/> <severity value="error"/> <human value="Must have either extensions or value[x], not both"/> <expression value="extension.exists() != value.exists()"/> <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> </constraint> <isModifier value="true"/> <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the
element that contains them"/>
<isSummary value="true"/> <mapping> <identity value="rim"/> <map value="N/A"/> </mapping> </element> <element id="DiagnosticReport.supportingInfo.type"> <path value="DiagnosticReport.supportingInfo.type"/> <short value="Supporting information role code"/> <definition value="The code value for the role of the supporting information in the diagnostic report."/> <min value="1"/> <max value="1"/> <base> <path value="DiagnosticReport.supportingInfo.type"/> <min value="1"/> <max value="1"/> </base> <type> <code value="CodeableConcept"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="DiagnosticReportSupportingInfoType"/> </extension> <strength value="example"/> <description value="The code value for the role of the supporting information in the diagnostic report."/> <valueSet value="http://terminology.hl7.org/ValueSet/v2-0936"/> </binding> </element> <element id="DiagnosticReport.supportingInfo.reference"> <path value="DiagnosticReport.supportingInfo.reference"/> <short value="Supporting information reference"/> <definition value="The reference for the supporting information in the diagnostic report."/> <min value="1"/> <max value="1"/> <base> <path value="DiagnosticReport.supportingInfo.reference"/> <min value="1"/> <max value="1"/> </base> <type> <code value="Reference"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Procedure"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Observation"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/DiagnosticReport"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Citation"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="DiagnosticReport.media"> <path value="DiagnosticReport.media"/> <short value="Key images or data associated with this report"/> <definition value="A list of key images or data associated with this report. The images or data are
generally created during the diagnostic process, and may be directly of the patient,
or of treated specimens (i.e. slides of interest)."/>
<requirements value="Many diagnostic services include images or data in the report as part of their
service."/>
<alias value="DICOM"/> <alias value="Slides"/> <alias value="Scans"/> <min value="0"/> <max value="*"/> <base> <path value="DiagnosticReport.media"/> <min value="0"/> <max value="*"/> </base> <type> <code value="BackboneElement"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="v2"/> <map value="OBX?"/> </mapping> <mapping> <identity value="rim"/> <map value="outboundRelationship[typeCode=COMP].target"/> </mapping> </element> <element id="DiagnosticReport.media.id"> <path value="DiagnosticReport.media.id"/> <representation value="xmlAttr"/> <short value="Unique id for inter-element referencing"/> <definition value="Unique id for the element within a resource (for internal references). This may
be any string value that does not contain spaces."/>
<min value="0"/> <max value="1"/> <base> <path value="Element.id"/> <min value="0"/> <max value="1"/> </base>
<type> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type"> <valueUrl value="string"/> </extension> <code value="http://hl7.org/fhirpath/System.String"/> </type> <condition value="ele-1"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element id="DiagnosticReport.media.extension"> <path value="DiagnosticReport.media.extension"/> <short value="Additional content defined by implementations"/> <definition value="May be used to represent additional information that is not part of the basic definition
of the element. To make the use of extensions safe and managable, 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."/>
<comment value="There can be no stigma associated with the use of extensions by any application,
project, or standard - regardless of the institution or jurisdiction that uses
or defines the extensions. The use of extensions is what allows the FHIR specification
to retain a core level of simplicity for everyone."/>
<alias value="extensions"/> <alias value="user content"/> <min value="0"/> <max value="*"/> <base> <path value="Element.extension"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Extension"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <constraint> <key value="ext-1"/> <severity value="error"/> <human value="Must have either extensions or value[x], not both"/> <expression value="extension.exists() != value.exists()"/> <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> </constraint> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element id="DiagnosticReport.media.modifierExtension"> <path value="DiagnosticReport.media.modifierExtension"/> <short value="Extensions that cannot be ignored even if unrecognized"/> <definition value="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 managable, 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)."/>
<comment value="There can be no stigma associated with the use of extensions by any application,
project, or standard - regardless of the institution or jurisdiction that uses
or defines the extensions. The use of extensions is what allows the FHIR specification
to retain a core level of simplicity for everyone."/>
<requirements value="Modifier extensions allow for extensions that *cannot* be safely ignored to be
clearly distinguished from the vast majority of extensions which can be safely
ignored. This promotes interoperability by eliminating the need for implementers
to prohibit the presence of extensions. For further information, see the [definition
of modifier extensions](extensibility.html#modifierExtension)."/>
<alias value="extensions"/> <alias value="user content"/> <alias value="modifiers"/> <min value="0"/> <max value="*"/> <base> <path value="BackboneElement.modifierExtension"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Extension"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <constraint> <key value="ext-1"/> <severity value="error"/> <human value="Must have either extensions or value[x], not both"/> <expression value="extension.exists() != value.exists()"/> <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> </constraint> <isModifier value="true"/> <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the
element that contains them"/>
<isSummary value="true"/> <mapping> <identity value="rim"/> <map value="N/A"/> </mapping> </element> <element id="DiagnosticReport.media.comment"> <path value="DiagnosticReport.media.comment"/> <short value="Comment about the image or data (e.g. explanation)"/> <definition value="A comment about the image or data. Typically, this is used to provide an explanation
for why the image or data is included, or to draw the viewer's attention to important
features."/>
<comment value="The comment should be displayed with the image or data. It would be common for
the report to include additional discussion of the image or data contents or in
other sections such as the conclusion."/>
<requirements value="The provider of the report should make a comment about each image or data included
in the report."/>
<min value="0"/> <max value="1"/> <base> <path value="DiagnosticReport.media.comment"/> <min value="0"/> <max value="1"/> </base> <type> <code value="string"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value=".inboundRelationship[typeCode=COMP].source[classCode=OBS, moodCode=EVN, code="annotation
"].value"/>
</mapping> </element> <element id="DiagnosticReport.media.link"> <path value="DiagnosticReport.media.link"/> <short value="Reference to the image or data source"/> <definition value="Reference to the image or data source."/> <min value="1"/> <max value="1"/> <base> <path value="DiagnosticReport.media.link"/> <min value="1"/> <max value="1"/> </base> <type> <code value="Reference"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/DocumentReference"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="rim"/> <map value=".value.reference"/> </mapping> </element> <element id="DiagnosticReport.composition"> <path value="DiagnosticReport.composition"/> <short value="Reference to a Composition resource for the DiagnosticReport structure"/> <definition value="Reference to a Composition resource instance that provides structure for organizing
the contents of the DiagnosticReport."/>
<comment value="The Composition provides structure to the content of the DiagnosticReport (and
only contains contents referenced in the DiagnosticReport) - e.g., to order the
sections of an anatomic pathology structured report."/>
<min value="0"/> <max value="1"/> <base> <path value="DiagnosticReport.composition"/> <min value="0"/> <max value="1"/> </base> <type> <code value="Reference"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Composition"/> </type> <condition value="dgr-1"/> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value=".value.reference"/> </mapping> </element> <element id="DiagnosticReport.conclusion"> <path value="DiagnosticReport.conclusion"/> <short value="Clinical conclusion (interpretation) of test results"/> <definition value="Concise and clinically contextualized summary conclusion (interpretation/impression)
of the diagnostic report."/>
<requirements value="Need to be able to provide a conclusion that is not lost among the basic result
data."/>
<alias value="Report"/> <min value="0"/> <max value="1"/> <base> <path value="DiagnosticReport.conclusion"/> <min value="0"/> <max value="1"/> </base> <type> <code value="markdown"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="v2"/> <map value="OBX"/> </mapping> <mapping> <identity value="rim"/> <map value="inboundRelationship[typeCode="SPRT"].source[classCode=OBS, moodCode=EVN,
code=LOINC:48767-8].value (type=ST)"/>
</mapping> </element> <element id="DiagnosticReport.conclusionCode"> <path value="DiagnosticReport.conclusionCode"/> <short value="Codes for the clinical conclusion of test results"/> <definition value="One or more codes that represent the summary conclusion (interpretation/impression)
of the diagnostic report."/>
<min value="0"/> <max value="*"/> <base> <path value="DiagnosticReport.conclusionCode"/> <min value="0"/> <max value="*"/> </base> <type> <code value="CodeableConcept"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="AdjunctDiagnosis"/> </extension> <strength value="example"/> <description value="SNOMED CT Clinical Findings"/> <valueSet value="http://hl7.org/fhir/ValueSet/clinical-findings"/> </binding> <mapping> <identity value="v2"/> <map value="OBX"/> </mapping> <mapping> <identity value="rim"/> <map value="inboundRelationship[typeCode=SPRT].source[classCode=OBS, moodCode=EVN, code=LOINC:54531-9].va
lue (type=CD)"/>
</mapping> </element> <element id="DiagnosticReport.presentedForm"> <path value="DiagnosticReport.presentedForm"/> <short value="Entire report as issued"/> <definition value="Rich text representation of the entire result as issued by the diagnostic service.
Multiple formats are allowed but they SHALL be semantically equivalent."/>
<comment value=""application/pdf" is recommended as the most reliable and interoperable
in this context."/>
<requirements value="Gives laboratory the ability to provide its own fully formatted report for clinical
fidelity."/>
<min value="0"/> <max value="*"/> <base> <path value="DiagnosticReport.presentedForm"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Attachment"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="v2"/> <map value="OBX"/> </mapping> <mapping> <identity value="rim"/> <map value="text (type=ED)"/> </mapping> </element> </snapshot> <differential> <element id="DiagnosticReport"> <path value="DiagnosticReport"/> <short value="A Diagnostic report - a combination of request information, atomic results, images,
interpretation, as well as formatted reports"/>
<definition value="The findings and interpretation of diagnostic tests performed on patients, groups
of patients, products, substances, devices, and locations, and/or specimens derived
from these. The report includes clinical context such as requesting provider information,
and some mix of atomic results, images, textual and coded interpretations, and
formatted representation of diagnostic reports. The report also includes non-clinical
context such as batch analysis and stability reporting of products and substances."/>
<comment value="This is intended to capture a single report and is not suitable for use in displaying
summary information that covers multiple reports. For example, this resource has
not been designed for laboratory cumulative reporting formats nor detailed structured
reports for sequencing."/>
<alias value="Report"/> <alias value="Test"/> <alias value="Result"/> <alias value="Results"/> <alias value="Labs"/> <alias value="Laboratory"/> <min value="0"/> <max value="*"/> <constraint> <key value="dgr-1"/> <severity value="error"/> <human value="A resource referenced in a Composition entry must also be included in the DiagnosticReport
result (Observation resources or nested resources via Observation.hasMember)"/>
<expression value="composition.exists() implies composition.resolve().section.entry.resolve().descendants().wher
e((id in result.resolve().descendants().id).not()).empty()"/>
<source value="http://hl7.org/fhir/StructureDefinition/DiagnosticReport"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <mapping> <identity value="workflow"/> <map value="Event"/> </mapping> <mapping> <identity value="v2"/> <map value="ORU -> OBR"/> </mapping> <mapping> <identity value="rim"/> <map value="Observation[classCode=OBS, moodCode=EVN]"/> </mapping> <mapping> <identity value="w5"/> <map value="clinical.diagnostics"/> </mapping> </element> <element id="DiagnosticReport.identifier"> <path value="DiagnosticReport.identifier"/> <short value="Business identifier for report"/> <definition value="Identifiers assigned to this report by the performer or other systems."/> <comment value="Usually assigned by the Information System of the diagnostic service provider (filler
id)."/>
<requirements value="Need to know what identifier to use when making queries about this report from
the source laboratory, and for linking to the report outside FHIR context."/>
<alias value="ReportID"/> <alias value="Filler ID"/> <alias value="Placer ID"/> <min value="0"/> <max value="*"/> <type> <code value="Identifier"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="workflow"/> <map value="Event.identifier"/> </mapping> <mapping> <identity value="w5"/> <map value="FiveWs.identifier"/> </mapping> <mapping> <identity value="v2"/> <map value="OBR-51/ for globally unique filler ID - OBR-3 , For non-globally unique filler-id
the flller/placer number must be combined with the universal service Id - OBR-2(if
present)+OBR-3+OBR-4"/>
</mapping> <mapping> <identity value="rim"/> <map value="id"/> </mapping> </element> <element id="DiagnosticReport.basedOn"> <path value="DiagnosticReport.basedOn"/> <short value="What was requested"/> <definition value="Details concerning a service requested."/> <comment value="Note: Usually there is one test request for each result, however in some circumstances
multiple test requests may be represented using a single test result resource.
Note that there are also cases where one request leads to multiple reports."/>
<requirements value="This allows tracing of authorization for the report and tracking whether proposals/recommenda
tions were acted upon."/>
<alias value="Request"/> <min value="0"/> <max value="*"/> <type> <code value="Reference"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/CarePlan"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/ImmunizationRecommendation"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/MedicationRequest"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/NutritionOrder"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/ServiceRequest"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="workflow"/> <map value="Event.basedOn"/> </mapping> <mapping> <identity value="v2"/> <map value="ORC? OBR-2/3?"/> </mapping> <mapping> <identity value="rim"/> <map value="outboundRelationship[typeCode=FLFS].target"/> </mapping> </element> <element id="DiagnosticReport.status"> <path value="DiagnosticReport.status"/> <short value="registered | partial | preliminary | final +"/> <definition value="The status of the diagnostic report."/> <requirements value="Diagnostic services routinely issue provisional/incomplete reports, and sometimes
withdraw previously released reports."/>
<min value="1"/> <max value="1"/> <type> <code value="code"/> </type> <mustSupport value="false"/> <isModifier value="true"/> <isModifierReason value="This element is labeled as a modifier because it is a status element that contains
status entered-in-error which means that the resource should not be treated as
valid"/>
<isSummary value="true"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="DiagnosticReportStatus"/> </extension> <strength value="required"/> <description value="The status of the diagnostic report."/> <valueSet value="http://hl7.org/fhir/ValueSet/diagnostic-report-status|5.0.0-draft-final"/> </binding> <mapping> <identity value="workflow"/> <map value="Event.status"/> </mapping> <mapping> <identity value="w5"/> <map value="FiveWs.status"/> </mapping> <mapping> <identity value="v2"/> <map value="OBR-25 (not 1:1 mapping)"/> </mapping> <mapping> <identity value="rim"/> <map value="statusCode Note: final and amended are distinguished by whether observation is
the subject of a ControlAct event of type "revise""/>
</mapping> </element> <element id="DiagnosticReport.category"> <path value="DiagnosticReport.category"/> <short value="Service category"/> <definition value="A code that classifies the clinical discipline, department or diagnostic service
that created the report (e.g. cardiology, biochemistry, hematology, MRI). This
is used for searching, sorting and display purposes."/>
<comment value="Multiple categories are allowed using various categorization schemes. The level
of granularity is defined by the category concepts in the value set. More fine-grained
filtering can be performed using the metadata and/or terminology hierarchy in DiagnosticRepor
t.code."/>
<alias value="Department"/> <alias value="Sub-department"/> <alias value="Service"/> <alias value="Discipline"/> <min value="0"/> <max value="*"/> <type> <code value="CodeableConcept"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="true"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="DiagnosticServiceSection"/> </extension> <strength value="example"/> <description value="HL7 V2 table 0074"/> <valueSet value="http://hl7.org/fhir/ValueSet/diagnostic-service-sections"/> </binding> <mapping> <identity value="w5"/> <map value="FiveWs.class"/> </mapping> <mapping> <identity value="v2"/> <map value="OBR-24"/> </mapping> <mapping> <identity value="rim"/> <map value="inboundRelationship[typeCode=COMP].source[classCode=LIST, moodCode=EVN, code <
LabService].code"/>
</mapping> </element> <element id="DiagnosticReport.code"> <path value="DiagnosticReport.code"/> <short value="Name/Code for this diagnostic report"/> <definition value="A code or name that describes this diagnostic report."/> <alias value="Type"/> <min value="1"/> <max value="1"/> <type> <code value="CodeableConcept"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="true"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="DiagnosticReportCodes"/> </extension> <strength value="preferred"/> <description value="LOINC Codes for Diagnostic Reports"/> <valueSet value="http://hl7.org/fhir/ValueSet/report-codes"/> </binding> <mapping> <identity value="workflow"/> <map value="Event.code"/> </mapping> <mapping> <identity value="w5"/> <map value="FiveWs.what[x]"/> </mapping> <mapping> <identity value="v2"/> <map value="OBR-4 (HL7 V2 doesn't provide an easy way to indicate both the ordered test and
the performed panel)"/>
</mapping> <mapping> <identity value="rim"/> <map value="code"/> </mapping> </element> <element id="DiagnosticReport.subject"> <path value="DiagnosticReport.subject"/> <short value="The subject of the report - usually, but not always, the patient"/> <definition value="The subject of the report. Usually, but not always, this is a patient. However,
diagnostic services also perform analyses on specimens collected from a variety
of other sources."/>
<requirements value="SHALL know the subject context."/> <alias value="Patient"/> <min value="0"/> <max value="1"/> <type> <code value="Reference"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Patient"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Group"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Device"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Location"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Organization"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Practitioner"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Medication"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Substance"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/BiologicallyDerivedProduct"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="workflow"/> <map value="Event.subject"/> </mapping> <mapping> <identity value="w5"/> <map value="FiveWs.subject[x]"/> </mapping> <mapping> <identity value="v2"/> <map value="PID-3 (no HL7 V2 mapping for Group or Device)"/> </mapping> <mapping> <identity value="rim"/> <map value="participation[typeCode=SBJ]"/> </mapping> <mapping> <identity value="w5"/> <map value="FiveWs.subject"/> </mapping> </element> <element id="DiagnosticReport.encounter"> <path value="DiagnosticReport.encounter"/> <short value="Health care event when test ordered"/> <definition value="The healthcare event (e.g. a patient and healthcare provider interaction) which
this DiagnosticReport is about."/>
<comment value="This will typically be the encounter the event occurred within, but some events
may be initiated prior to or after the official completion of an encounter but
still be tied to the context of the encounter (e.g. pre-admission laboratory tests)."/>
<requirements value="Links the request to the Encounter context."/> <alias value="Context"/> <min value="0"/> <max value="1"/> <type> <code value="Reference"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Encounter"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="workflow"/> <map value="Event.encounter"/> </mapping> <mapping> <identity value="w5"/> <map value="FiveWs.context"/> </mapping> <mapping> <identity value="v2"/> <map value="PV1-19"/> </mapping> <mapping> <identity value="rim"/> <map value="inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN]"/> </mapping> </element> <element id="DiagnosticReport.effective[x]"> <path value="DiagnosticReport.effective[x]"/> <short value="Clinically relevant time/time-period for report"/> <definition value="The time or time-period the observed values are related to. When the subject of
the report is a patient, this is usually either the time of the procedure or of
specimen collection(s), but very often the source of the date/time is not known,
only the date/time itself."/>
<comment value="If the diagnostic procedure was performed on the patient, this is the time it was
performed. If there are specimens, the diagnostically relevant time can be derived
from the specimen collection times, but the specimen information is not always
available, and the exact relationship between the specimens and the diagnostically
relevant time is not always automatic."/>
<requirements value="Need to know where in the patient history to file/present this report."/> <alias value="Observation time"/> <alias value="Effective Time"/> <alias value="Occurrence"/> <min value="0"/> <max value="1"/> <type> <code value="dateTime"/> </type> <type> <code value="Period"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="workflow"/> <map value="Event.occurrence[x]"/> </mapping> <mapping> <identity value="w5"/> <map value="FiveWs.done[x]"/> </mapping> <mapping> <identity value="v2"/> <map value="OBR-7"/> </mapping> <mapping> <identity value="rim"/> <map value="effectiveTime"/> </mapping> </element> <element id="DiagnosticReport.issued"> <path value="DiagnosticReport.issued"/> <short value="DateTime this version was made"/> <definition value="The date and time that this version of the report was made available to providers,
typically after the report was reviewed and verified."/>
<comment value="May be different from the update time of the resource itself, because that is the
status of the record (potentially a secondary copy), not the actual release time
of the report."/>
<requirements value="Clinicians need to be able to check the date that the report was released."/> <alias value="Date published"/> <alias value="Date Issued"/> <alias value="Date Verified"/> <min value="0"/> <max value="1"/> <type> <code value="instant"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="w5"/> <map value="FiveWs.recorded"/> </mapping> <mapping> <identity value="v2"/> <map value="OBR-22"/> </mapping> <mapping> <identity value="rim"/> <map value="participation[typeCode=VRF or AUT].time"/> </mapping> </element> <element id="DiagnosticReport.performer"> <path value="DiagnosticReport.performer"/> <short value="Responsible Diagnostic Service"/> <definition value="The diagnostic service that is responsible for issuing the report."/> <comment value="This is not necessarily the source of the atomic data items or the entity that
interpreted the results. It is the entity that takes responsibility for the clinical
report."/>
<requirements value="Need to know whom to contact if there are queries about the results. Also may need
to track the source of reports for secondary data analysis."/>
<alias value="Laboratory"/> <alias value="Service"/> <alias value="Practitioner"/> <alias value="Department"/> <alias value="Company"/> <alias value="Authorized by"/> <alias value="Director"/> <min value="0"/> <max value="*"/> <type> <code value="Reference"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Practitioner"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/PractitionerRole"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Organization"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/CareTeam"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="workflow"/> <map value="Event.performer.actor"/> </mapping> <mapping> <identity value="w5"/> <map value="FiveWs.actor"/> </mapping> <mapping> <identity value="v2"/> <map value="PRT-8 (where this PRT-4-Participation = "PO")"/> </mapping> <mapping> <identity value="rim"/> <map value=".participation[typeCode=PRF]"/> </mapping> </element> <element id="DiagnosticReport.resultsInterpreter"> <path value="DiagnosticReport.resultsInterpreter"/> <short value="Primary result interpreter"/> <definition value="The practitioner or organization that is responsible for the report's conclusions
and interpretations."/>
<comment value="Might not be the same entity that takes responsibility for the clinical report."/> <requirements value="Need to know whom to contact if there are queries about the results. Also may need
to track the source of reports for secondary data analysis."/>
<alias value="Analyzed by"/> <alias value="Reported by"/> <min value="0"/> <max value="*"/> <type> <code value="Reference"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Practitioner"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/PractitionerRole"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Organization"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/CareTeam"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="workflow"/> <map value="Event.performer.actor"/> </mapping> <mapping> <identity value="w5"/> <map value="FiveWs.actor"/> </mapping> <mapping> <identity value="v2"/> <map value="OBR-32, PRT-8 (where this PRT-4-Participation = "PI")"/> </mapping> <mapping> <identity value="rim"/> <map value=".participation[typeCode=PRF]"/> </mapping> </element> <element id="DiagnosticReport.specimen"> <path value="DiagnosticReport.specimen"/> <short value="Specimens this report is based on"/> <definition value="Details about the specimens on which this diagnostic report is based."/> <comment value="If the specimen is sufficiently specified with a code in the test result name,
then this additional data may be redundant. If there are multiple specimens, these
may be represented per observation or group."/>
<requirements value="Need to be able to report information about the collected specimens on which the
report is based."/>
<min value="0"/> <max value="*"/> <type> <code value="Reference"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Specimen"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="v2"/> <map value="SPM"/> </mapping> <mapping> <identity value="rim"/> <map value="participation[typeCode=SBJ]"/> </mapping> </element> <element id="DiagnosticReport.result"> <path value="DiagnosticReport.result"/> <short value="Observations"/> <definition value="[Observations](observation.html) that are part of this diagnostic report."/> <comment value="Observations can contain observations."/> <requirements value="Need to support individual results, or groups of results, where the result grouping
is arbitrary, but meaningful."/>
<alias value="Data"/> <alias value="Atomic Value"/> <alias value="Result"/> <alias value="Atomic result"/> <alias value="Data"/> <alias value="Test"/> <alias value="Analyte"/> <alias value="Battery"/> <alias value="Organizer"/> <min value="0"/> <max value="*"/> <type> <code value="Reference"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Observation"/> </type> <condition value="dgr-1"/> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="v2"/> <map value="OBXs"/> </mapping> <mapping> <identity value="rim"/> <map value="outboundRelationship[typeCode=COMP].target"/> </mapping> </element> <element id="DiagnosticReport.note"> <path value="DiagnosticReport.note"/> <short value="Comments about the diagnostic report"/> <definition value="Comments about the diagnostic report."/> <comment value="May include general statements about the diagnostic report, or statements about
significant, unexpected or unreliable results values contained within the diagnostic
report, or information about its source when relevant to its interpretation."/>
<requirements value="Need to be able to provide free text additional information."/> <min value="0"/> <max value="*"/> <type> <code value="Annotation"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="unknown"/> </mapping> </element> <element id="DiagnosticReport.study"> <path value="DiagnosticReport.study"/> <short value="Reference to full details of an analysis associated with the diagnostic report"/> <definition value="One or more links to full details of any study performed during the diagnostic
investigation. An ImagingStudy might comprise a set of radiologic images obtained
via a procedure that are analyzed as a group. Typically, this is imaging performed
by DICOM enabled modalities, but this is not required. A fully enabled PACS viewer
can use this information to provide views of the source images. A GenomicStudy
might comprise one or more analyses, each serving a specific purpose. These analyses
may vary in method (e.g., karyotyping, CNV, or SNV detection), performer, software,
devices used, or regions targeted."/>
<comment value="For laboratory-type studies like GenomeStudy, type resources will be used for tracking
additional metadata and workflow aspects of complex studies. ImagingStudy and the
media element are somewhat overlapping - typically, the list of image references
in the media element will also be found in one of the imaging study resources.
However, each caters to different types of displays for different types of purposes.
Neither, either, or both may be provided."/>
<min value="0"/> <max value="*"/> <type> <code value="Reference"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/GenomicStudy"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/ImagingStudy"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="DiagnosticReport.supportingInfo"> <path value="DiagnosticReport.supportingInfo"/> <short value="Additional information supporting the diagnostic report"/> <definition value="This backbone element contains supporting information that was used in the creation
of the report not included in the results already included in the report."/>
<min value="0"/> <max value="*"/> <type> <code value="BackboneElement"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="DiagnosticReport.supportingInfo.type"> <path value="DiagnosticReport.supportingInfo.type"/> <short value="Supporting information role code"/> <definition value="The code value for the role of the supporting information in the diagnostic report."/> <min value="1"/> <max value="1"/> <type> <code value="CodeableConcept"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="DiagnosticReportSupportingInfoType"/> </extension> <strength value="example"/> <description value="The code value for the role of the supporting information in the diagnostic report."/> <valueSet value="http://terminology.hl7.org/ValueSet/v2-0936"/> </binding> </element> <element id="DiagnosticReport.supportingInfo.reference"> <path value="DiagnosticReport.supportingInfo.reference"/> <short value="Supporting information reference"/> <definition value="The reference for the supporting information in the diagnostic report."/> <min value="1"/> <max value="1"/> <type> <code value="Reference"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Procedure"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Observation"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/DiagnosticReport"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Citation"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="DiagnosticReport.media"> <path value="DiagnosticReport.media"/> <short value="Key images or data associated with this report"/> <definition value="A list of key images or data associated with this report. The images or data are
generally created during the diagnostic process, and may be directly of the patient,
or of treated specimens (i.e. slides of interest)."/>
<requirements value="Many diagnostic services include images or data in the report as part of their
service."/>
<alias value="DICOM"/> <alias value="Slides"/> <alias value="Scans"/> <min value="0"/> <max value="*"/> <type> <code value="BackboneElement"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="v2"/> <map value="OBX?"/> </mapping> <mapping> <identity value="rim"/> <map value="outboundRelationship[typeCode=COMP].target"/> </mapping> </element> <element id="DiagnosticReport.media.comment"> <path value="DiagnosticReport.media.comment"/> <short value="Comment about the image or data (e.g. explanation)"/> <definition value="A comment about the image or data. Typically, this is used to provide an explanation
for why the image or data is included, or to draw the viewer's attention to important
features."/>
<comment value="The comment should be displayed with the image or data. It would be common for
the report to include additional discussion of the image or data contents or in
other sections such as the conclusion."/>
<requirements value="The provider of the report should make a comment about each image or data included
in the report."/>
<min value="0"/> <max value="1"/> <type> <code value="string"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value=".inboundRelationship[typeCode=COMP].source[classCode=OBS, moodCode=EVN, code="annotation
"].value"/>
</mapping> </element> <element id="DiagnosticReport.media.link"> <path value="DiagnosticReport.media.link"/> <short value="Reference to the image or data source"/> <definition value="Reference to the image or data source."/> <min value="1"/> <max value="1"/> <type> <code value="Reference"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/DocumentReference"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="rim"/> <map value=".value.reference"/> </mapping> </element> <element id="DiagnosticReport.composition"> <path value="DiagnosticReport.composition"/> <short value="Reference to a Composition resource for the DiagnosticReport structure"/> <definition value="Reference to a Composition resource instance that provides structure for organizing
the contents of the DiagnosticReport."/>
<comment value="The Composition provides structure to the content of the DiagnosticReport (and
only contains contents referenced in the DiagnosticReport) - e.g., to order the
sections of an anatomic pathology structured report."/>
<min value="0"/> <max value="1"/> <type> <code value="Reference"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Composition"/> </type> <condition value="dgr-1"/> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value=".value.reference"/> </mapping> </element> <element id="DiagnosticReport.conclusion"> <path value="DiagnosticReport.conclusion"/> <short value="Clinical conclusion (interpretation) of test results"/> <definition value="Concise and clinically contextualized summary conclusion (interpretation/impression)
of the diagnostic report."/>
<requirements value="Need to be able to provide a conclusion that is not lost among the basic result
data."/>
<alias value="Report"/> <min value="0"/> <max value="1"/> <type> <code value="markdown"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="v2"/> <map value="OBX"/> </mapping> <mapping> <identity value="rim"/> <map value="inboundRelationship[typeCode="SPRT"].source[classCode=OBS, moodCode=EVN,
code=LOINC:48767-8].value (type=ST)"/>
</mapping> </element> <element id="DiagnosticReport.conclusionCode"> <path value="DiagnosticReport.conclusionCode"/> <short value="Codes for the clinical conclusion of test results"/> <definition value="One or more codes that represent the summary conclusion (interpretation/impression)
of the diagnostic report."/>
<min value="0"/> <max value="*"/> <type> <code value="CodeableConcept"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="AdjunctDiagnosis"/> </extension> <strength value="example"/> <description value="SNOMED CT Clinical Findings"/> <valueSet value="http://hl7.org/fhir/ValueSet/clinical-findings"/> </binding> <mapping> <identity value="v2"/> <map value="OBX"/> </mapping> <mapping> <identity value="rim"/> <map value="inboundRelationship[typeCode=SPRT].source[classCode=OBS, moodCode=EVN, code=LOINC:54531-9].va
lue (type=CD)"/>
</mapping> </element> <element id="DiagnosticReport.presentedForm"> <path value="DiagnosticReport.presentedForm"/> <short value="Entire report as issued"/> <definition value="Rich text representation of the entire result as issued by the diagnostic service.
Multiple formats are allowed but they SHALL be semantically equivalent."/>
<comment value=""application/pdf" is recommended as the most reliable and interoperable
in this context."/>
<requirements value="Gives laboratory the ability to provide its own fully formatted report for clinical
fidelity."/>
<min value="0"/> <max value="*"/> <type> <code value="Attachment"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="v2"/> <map value="OBX"/> </mapping> <mapping> <identity value="rim"/> <map value="text (type=ED)"/> </mapping> </element> </differential>
</
StructureDefinition
>
Usage
note:
every
effort
has
been
made
to
ensure
that
the
examples
are
correct
and
useful,
but
they
are
not
a
normative
part
of
the
specification.
Diagnostics
.
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