Release 4 5

This page is part of the FHIR Specification (v4.0.1: R4 (v5.0.0: R5 - Mixed Normative and STU ) ). This is the current published version in it's permanent home (it will always be available at this URL). The current version which supercedes this version is 5.0.0 . For a full list of available versions, see the Directory of published versions . Page versions: R5 R4B R4 R3 R2

Diagnosticreport.profile.xml

Example StructureDefinition/DiagnosticReport (XML)

Orders and Observations Work Group Maturity Level : N/A Standards Status : Informative Compartments : Device , Encounter , Patient , Practitioner

Raw XML ( canonical form + also see XML Format Specification )

Jump past Narrative

StructureDefinition for diagnosticreport

<?xml version="1.0" encoding="UTF-8"?>


  
  
    
  
  
    
    
      
        
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            AABJRU5ErkJggg== 
            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.
            
          
          vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           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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          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., 

<StructureDefinition xmlns="http://hl7.org/fhir">
  <id value="DiagnosticReport"/> 
  <meta> 
    <lastUpdated value="2023-03-26T15:21:02.749+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 &amp; 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="data:(snipped in html view)" 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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          MKAACAKwNp30CqZFfFmwAAAABJRU5ErkJggg==)">
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/>             <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: white; background-color: inherit" title="Resource"/>              <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: When a Composition is referenced in `Diagnostic.composition`, all Observation

               resources referenced in `Composition.entry` must also be referenced in `Diagnostic.entry`
               or in the references Observations in `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., 
            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 &quot;clinically
             safe&quot; 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., 

             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
             &quot;clinically safe&quot; 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 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., 

             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 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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           solid; padding:0px 4px 0px 4pxBusiness identifier for report
            
          
        

        
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          vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4pxWhat was requested
            
          
        

        
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           solid; padding:0px 4px 0px 4pxregistered | partial | preliminary | final +
            
             (
            )
          
        

        
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             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:
           url(data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCAYAAACg/LjIAAAALUlEQVR4Xu3IoREAIAw
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            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/>             <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/>             <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: #F7F7F7; background-color: inherit" title="Data Type"/>              <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
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           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:
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           #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 | modified | final | amended | corrected | appended
             | cancelled | entered-in-error | unknown
            <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> )
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         white">
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           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:(snipped in html view)" style="background-color: inherit"/>             <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/>             <img alt="." class="hierarchy" src="data:(snipped in html view)" 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.
            
          
          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;
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          vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
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          vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           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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          vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0
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             (
            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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           padding:0px 4px 0px 4px
            
          
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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 4px
            (
             | 
             | 
             | 
            )
          
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           padding:0px 4px 0px 4px
        

        
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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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            (
            )
          
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           solid; padding:0px 4px 0px 4px
        

        
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             MRI). This is used for searching, sorting and display purposes.">category</span> 
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           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:(snipped in html view)" style="background-color: inherit"/>             <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/>             <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: white; background-color: inherit" title="Choice of Types"/>              <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> 
            <a name="DiagnosticReport.effective_x_"> </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"/> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0

           solid; padding:0px 4px 0px 4px">Clinically relevant time/time-period for report
            <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/LjIAAAAMUlEQVR4Xu3LMQoAIBA
          Dwftr/v8GtdbqEAthAtMspJJUx9rYW8ftHwAA+NcRAAAAXplLq0BWj/rZigAAAABJRU5ErkJggg==)">
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/>             <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/>             <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/>             <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: #F7F7F7; background-color: inherit" title="Primitive Data Type"/>              <span title="A date, date-time or partial date (e.g. just year or year + month).  If hours and

             minutes are specified, a UTC offset 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.">effectiveDateTime</span> 
          </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"/> 
          <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#dateTime">dateTime</a>           </td>           <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px

           #F0F0F0 solid; padding:0px 4px 0px 4px"/> 
        </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:(snipped in html view)" style="background-color: inherit"/>             <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/>             <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/>             <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: white; background-color: inherit" title="Data Type"/>              <span title="A time period defined by a start and end date and optionally time.">effectivePeriod</span>           </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"/> 
          <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#Period">Period</a>           </td>           <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0

           solid; padding:0px 4px 0px 4px"/> 
        </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:(snipped in html view)" style="background-color: inherit"/>             <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/>             <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: #F7F7F7; background-color: inherit" title="Primitive Data Type"/>              <span title="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.">issued</span> 
            <a name="DiagnosticReport.issued"> </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..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#instant">instant</a>           </td>           <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px

           #F0F0F0 solid; padding:0px 4px 0px 4px">DateTime this version was made
            <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:(snipped in html view)" style="background-color: inherit"/>             <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/>             <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: white; background-color: inherit" title="Reference to another Resource"/>              <span title="DiagnosticReport.performer : The diagnostic service that is responsible for issuing

             the report.">performer</span> 
            <a name="DiagnosticReport.performer"> </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="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

           solid; padding:0px 4px 0px 4px">Responsible Diagnostic Service
            <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:(snipped in html view)" style="background-color: inherit"/>             <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/>             <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: #F7F7F7; background-color: inherit" title="Reference to another Resource"/>              <span title="DiagnosticReport.resultsInterpreter : The practitioner or organization that is

             responsible for the report's conclusions and interpretations.">resultsInterpreter</span> 
            <a name="DiagnosticReport.resultsInterpreter"> </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="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

           #F0F0F0 solid; padding:0px 4px 0px 4px">Primary result interpreter
            <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:(snipped in html view)" style="background-color: inherit"/>             <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/>             <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: white; background-color: inherit" title="Reference to another Resource"/>              <span title="DiagnosticReport.specimen : Details about the specimens on which this diagnostic

             report is based.">specimen</span> 
            <a name="DiagnosticReport.specimen"> </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="specimen.html">Specimen</a> )          </td>           <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0

           solid; padding:0px 4px 0px 4px">Specimens this report is based on
            <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:(snipped in html view)" style="background-color: inherit"/>             <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/>             <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: #F7F7F7; background-color: inherit" title="Reference to another Resource"/>              <span title="DiagnosticReport.result : [Observations](observation.html)  that are part of this

             diagnostic report.">result</span> 
            <a name="DiagnosticReport.result"> </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#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: #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="observation.html">Observation</a> )          </td>           <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px

           #F0F0F0 solid; padding:0px 4px 0px 4px">Observations
            <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:(snipped in html view)" style="background-color: inherit"/>             <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/>             <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: white; background-color: inherit" title="Data Type"/>              <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:
           url(data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCAYAAACg/LjIAAAALUlEQVR4Xu3IoREAIAw
          EwfT6/ddA0GBAxO3NrLlKUj9263wAAAAvrgEAADClAVWFQIBRHMicAAAAAElFTkSuQmCC)">
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/>             <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/>             <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: #F7F7F7; background-color: inherit" title="Reference to another Resource"/>              <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

           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:(snipped in html view)" style="background-color: inherit"/>             <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/>             <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: white; background-color: inherit" title="Element"/>              <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

           #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image:
           url(data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCAYAAACg/LjIAAAAMUlEQVR4Xu3LMQoAIBA
          Dwftr/v8GtdbqEAthAtMspJJUx9rYW8ftHwAA+NcRAAAAXplLq0BWj/rZigAAAABJRU5ErkJggg==)">
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/>             <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/>             <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/>             <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: #F7F7F7; background-color: inherit" title="Data Type"/>              <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/5.1.0/ValueSet-v2-0936.html" title="Supporting information role code">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

           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:(snipped in html view)" style="background-color: inherit"/>             <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/>             <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/>             <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: white; background-color: inherit" title="Reference to another Resource"/>              <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:

         #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:(snipped in html view)" style="background-color: inherit"/>             <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/>             <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: #F7F7F7; background-color: inherit" title="Element"/>              <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
          e64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCAYAAACg/LjIAAAAMUlEQVR4Xu3LMQoAIBADwftr/v8GtdbqEAthAtMspJ
          JUx9rYW8ftHwAA+NcRAAAAXplLq0BWj/rZigAAAABJRU5ErkJggg==)">
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/>             <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/>             <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/>             <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: white; background-color: inherit" title="Primitive Data Type"/>              <span title="DiagnosticReport.media.comment : 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</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

           solid; padding:0px 4px 0px 4px">Comment about the image or data (e.g. explanation)
            <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:(snipped in html view)" style="background-color: inherit"/>             <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/>             <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/>             <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: #F7F7F7; background-color: inherit" title="Reference to another Resource"/>              <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
          e64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCAYAAACg/LjIAAAALUlEQVR4Xu3IoREAIAwEwfT6/ddA0GBAxO3NrLlKUj
          9263wAAAAvrgEAADClAVWFQIBRHMicAAAAAElFTkSuQmCC)">
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/>             <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/>             <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: white; background-color: inherit" title="Reference to another Resource"/>              <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:
           url(data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCAYAAACg/LjIAAAALUlEQVR4Xu3IoREAIAw
          EwfT6/ddA0GBAxO3NrLlKUj9263wAAAAvrgEAADClAVWFQIBRHMicAAAAAElFTkSuQmCC)">
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/>             <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/>             <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: #F7F7F7; background-color: inherit" title="Primitive Data Type"/>  
            <span title="DiagnosticReport.conclusion : Concise and clinically contextualized summary conclusion
             (interpretation/impression) of the diagnostic report.
            
          
          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 4px
        

        
          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,iV
          BORw0KGgoAAAANSUhEUgAAAyAAAAACCAYAAACg/LjIAAAAL0lEQVR42u3XsQ0AQAgCQHdl/xn8jxvYWB3JlTR0VJLa+OltBwAAYP6
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            DiagnosticReport.conclusionCode : One or more codes that represent the summary conclusion
             (interpretation/impression) of the diagnostic report.
            
          
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          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 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.)
            
          
        

        
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           padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KG
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            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.

             (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
          e64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCAYAAACg/LjIAAAALUlEQVR4Xu3IoREAIAwEwfT6/ddA0GBAxO3NrLlKUj
          9263wAAAAvrgEAADClAVWFQIBRHMicAAAAAElFTkSuQmCC)">
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/>             <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/>             <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: white; background-color: inherit" title="Data Type"/>              <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" title="Diagnosis codes provided as adjuncts to the report.">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:
           url(data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCAYAAACg/LjIAAAAJUlEQVR4Xu3IIQEAAAg
          DsHd9/w4EQIOamFnaBgAA4MMKAACAKwNp30CqZFfFmwAAAABJRU5ErkJggg==)">
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/>             <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/>             <img alt="." class="hierarchy" src="data:(snipped in html view)" 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="data:(snipped in html view)" 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"/>   <name value="DiagnosticReport"/>   <status value="draft"/>   <experimental value="false"/>   <date value="2023-03-26T15:21:02+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"/>   <mapping>     <identity value="workflow"/>     <uri value="http://hl7.org/fhir/workflow"/>     <name value="Workflow Pattern"/>   </mapping>   <mapping>     <identity value="w5"/>     <uri value="http://hl7.org/fhir/fivews"/>     <name value="FiveWs Pattern Mapping"/>   </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>   <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.
      
      
      
      
      
      
      
      
      
        
        
        
      
      
        
        
        
        
        
        
      
      
        
        
        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 in (%resource.descendants().reference | %resource.descendants().as(canonica
        l) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(refer
        ence = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(c
        anonical) = '#').exists()).not()).trace('unmatched', id).empty()
        not(exists(for $id in f:contained/*/f:id/@value return $contained[not(parent::*/descendant::f:refere
        nce/@value=concat('#', $contained/*/id/@value) or 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.
      
      
      
        
        
        
      
    <!--  Note: special primitive values have a FHIRPath system type. e.g. this is compiler magic
       (j)  -->
      
        
          
        
        
      
      
      
    
    
      
      

       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="When a Composition is referenced in `Diagnostic.composition`, all Observation resources

         referenced in `Composition.entry` must also be referenced in `Diagnostic.entry`
         or in the references Observations in `Observation.hasMember`"/> 
        <expression value="composition.exists() implies (composition.resolve().section.entry.reference.where(resolve()

         is Observation) in (result.reference|result.reference.resolve().hasMember.reference))"/> 
        <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,Observation[classCode=OBS, moodCode=EVN]"/>       </mapping>       <mapping>         <identity value="workflow"/>         <map value="Event"/>       </mapping>       <mapping>         <identity value="w5"/>         <map value="clinical.diagnostics"/>       </mapping>       <mapping>         <identity value="v2"/>         <map value="ORU -&gt; OBR"/>       </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>       <!--  Note: special primitive values have a FHIRPath system type. e.g. this is compiler

       magic (j)  -->
      <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.
      
      
      
        
        
        
      
      
        
      
      
        
        
        
        
        
        
      
      
      
    
    
      
      
      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.
      
      
      
        
        
        
      
      
        
      
      
        
        
        
        
        
        
      
      

       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() &gt; 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() &gt; 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 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 &quot;clinically
       safe&quot; 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 &quot;text blob&quot;
       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.
      
      
      
      
      
      
        
        
        
      
      
        
      
      
      
      
        
        
      
    
    
      
      

       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() &gt; 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"/>         <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
       &quot;clinically safe&quot; 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 &quot;text blob&quot; 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() &gt; 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 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.
      
      
      
      
      
        
        
        
      
      
        
      
      
        
        
        
        
        
        
      
      
        
        
        
        
        
        
      
      
      
      
        
        
      
    
    
      
      

       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() &gt; 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 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
      
      
        
        
      
    
    
      
      
      

       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() &gt; 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).
      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
      
      
        
        
      
    
    
      
      
      

       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() &gt; 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.
      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 &quot;revise&quot;
      
    
    
      
      
      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.
      
      
      
        
        
        
      
    <!--  Note: special primitive values have a FHIRPath system type. e.g. this is compiler magic
       (j)  -->
      
        
          
        
        
      
      
      
      
        
        
      
    
    
      
      

       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() &gt; 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 | modified | final | amended | corrected | appended

       | cancelled | entered-in-error | unknown"/> 
      <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() &gt; 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"/>       </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 &quot;revise&quot;"/> 
      </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() &gt; 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/tools/StructureDefinition/binding-definition">          <valueString value="Codes for diagnostic service sections."/>         </extension>         <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 &lt;

         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() &gt; 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/tools/StructureDefinition/binding-definition">          <valueString value="Codes that describe Diagnostic Reports."/>         </extension>         <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() &gt; 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>     </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() &gt; 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() &gt; 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() &gt; 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() &gt; 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 = &quot;PO&quot;)"/>       </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() &gt; 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 = &quot;PI&quot;)"/>       </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() &gt; 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() &gt; 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() &gt; 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() &gt; 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() &gt; 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>       <!--  Note: special primitive values have a FHIRPath system type. e.g. this is compiler

       magic (j)  -->
      <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 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.
      
      
      
      
      
        
        
        
      
      
        
      
      
        
        
        
        
        
        
      
      
        
        
        
        
        
        
      
      
      
      
        
        
      
    
    
      
      

       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() &gt; 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 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=&quot;annotation&quot;]
        .value
      
    
    
      
      
      
      
      
      
        
        
        
      
      
        
        
      
      
        
        
        
        
        
        
      
      
      
      
        
        
      
    
    
      
      
      Concise and clinically contextualized summary conclusion (interpretation/impression) of
       the diagnostic report.
      
      
      
      
      
        
        
        
      
      
        
      
      
        
        
        
        
        
        
      
      
      
      
        
        
      
      
        
        inboundRelationship[typeCode=&quot;SPRT&quot;].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.
      &quot;application/pdf&quot; 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.

       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() &gt; 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() &gt; 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/tools/StructureDefinition/binding-definition">          <valueString value="Supporting information role code"/>         </extension>         <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() &gt; 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() &gt; 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>       <!--  Note: special primitive values have a FHIRPath system type. e.g. this is compiler

       magic (j)  -->
      <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() &gt; 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() &gt; 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() &gt; 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=&quot;annotation

        &quot;].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() &gt; 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() &gt; 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() &gt; 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=&quot;SPRT&quot;].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() &gt; 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/tools/StructureDefinition/binding-definition">          <valueString value="Diagnosis codes provided as adjuncts to the report."/>         </extension>         <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="&quot;application/pdf&quot; 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() &gt; 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.
      
      
      
      
      
      
      
      
      
        
        
      
      
        
        
      
      
        
        
      
    
    
      
      
      

       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="When a Composition is referenced in `Diagnostic.composition`, all Observation resources

         referenced in `Composition.entry` must also be referenced in `Diagnostic.entry`
         or in the references Observations in `Observation.hasMember`"/> 
        <expression value="composition.exists() implies (composition.resolve().section.entry.reference.where(resolve()

         is Observation) in (result.reference|result.reference.resolve().hasMember.reference))"/> 
        <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="w5"/>         <map value="clinical.diagnostics"/>       </mapping>       <mapping>         <identity value="v2"/>         <map value="ORU -&gt; OBR"/>       </mapping>       <mapping>         <identity value="rim"/>         <map value="Observation[classCode=OBS, moodCode=EVN]"/>       </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).
      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
      
      
        
        
      
    
    
      
      
      

       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.
      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 &quot;revise&quot;
      
    
    
      
      
      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=&quot;annotation&quot;]
        .value
      
    
    
      
      
      
      
      
      
        
        
      
      
      
        
        
      
    
    
      
      
      Concise and clinically contextualized summary conclusion (interpretation/impression) of
       the diagnostic report.
      
      
      
      
      
        
      
      
        
        
      
      
        
        inboundRelationship[typeCode=&quot;SPRT&quot;].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.
      &quot;application/pdf&quot; is recommended as the most reliable and interoperable in this
       context.
      
      
      
      
        
      
      
        
        
      
      
        
        
      
    
  

       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 | modified | final | amended | corrected | appended

       | cancelled | entered-in-error | unknown"/> 
      <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"/>       </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 &quot;revise&quot;"/> 
      </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/tools/StructureDefinition/binding-definition">          <valueString value="Codes for diagnostic service sections."/>         </extension>         <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 &lt;

         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/tools/StructureDefinition/binding-definition">          <valueString value="Codes that describe Diagnostic Reports."/>         </extension>         <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>     </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 = &quot;PO&quot;)"/>       </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 = &quot;PI&quot;)"/>       </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/tools/StructureDefinition/binding-definition">          <valueString value="Supporting information role code"/>         </extension>         <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=&quot;annotation

        &quot;].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=&quot;SPRT&quot;].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/tools/StructureDefinition/binding-definition">          <valueString value="Diagnosis codes provided as adjuncts to the report."/>         </extension>         <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="&quot;application/pdf&quot; 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.