| Package | hl7.fhir.uv.fhircast |
| Type | StructureDefinition |
| Id | Id |
| FHIR Version | R4 |
| Source | http://hl7.org/fhir/uv/fhircast/https://build.fhir.org/ig/HL7/fhircast-docs/StructureDefinition-fhircast-diagnostic-report-open.html |
| Url | http://hl7.org/fhir/uv/fhircast/StructureDefinition/fhircast-diagnostic-report-open |
| Version | 3.0.0-ballot |
| Status | draft |
| Date | 2024-12-13T16:33:33+00:00 |
| Name | FHIRcastDiagnosticReportOpen |
| Title | FHIRcast Diagnostic Report for Open Events |
| Experimental | False |
| Realm | uv |
| Authority | hl7 |
| Description | Provides guidance as to which DiagnosticReport attributes should be present and considerations as to how each attribute should be valued in all [FHIR resource]-open events. At least one business identifier of the DiagnosticReport SHALL be provided in a [FHIR resource]-open request. Typically the report is associated with an order from an information system. In this case the accession number of the order is provided in the DiagnosticReport's `basedOn` array attribute as a reference using a ServiceRequest reference type and the “ACSN” identifier type. The accession number SHALL be included as a business identifier if it is known. A reporting system may also include its own identifier and should use an appropriate identifier type and system when supplying such a business identifier. In radiology reports or other image related uses of FHIRcast, at least one imaging study would likely be the subject of the report and included in the event's context. In this case, the reference to one or more ImagingStudy resources would be provided. **FHIR R4 versus FHIR R5** In the FHIR R4 DiagnosticReport resource image study references would be placed in the `imagingStudy` attribute. In a FHIR R5 (or above) DiagnosticReport this attribute has been renamed `study` since the allowed reference types has been expanded to include references to GenomicStudy resources. This is obviously a breaking change. In FHIRcast deployments based on FHIR R5, the attribute `study` SHALL be used rather than the `imagingStudy` attribute. Additionally FHIR R5 includes a `supportingInfo` attribute. While not yet formally provided for in FHIR R5, it has been recommended that the next release of FHIR allow an ImagingStudy reference be included in this attribute so that the DiagnosticReport could indicate one or more image studies were consulted during the creation of the report. As such in FHIR R5 deployments, this field is considered labeled as must support. |
| Type | DiagnosticReport |
| Kind | resource |
No resources found
| StructureDefinition | |
fhircast-imaging-study-open  | FHIRcast ImagingStudy for Open Events |
| fhircast-patient-open | FHIRcast Patient for Open Events |
Note: links and images are rebased to the (stated) source
Generated Narrative: StructureDefinition fhircast-diagnostic-report-open
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
  DiagnosticReport | C | 0..* | DiagnosticReport | A Diagnostic report - a combination of request information, atomic results, images, interpretation, as well as formatted reports business-identifier: identifier array or basedOn array SHALL contain at least one element |
  id | 1..1 | id | A logical id of the resource SHALL be provided. | |
| identifier | S | 0..* | Identifier | A business identifier of the DiagnosticReport may be provided as part of the [FHIR resource]-open request (see detailed description). |
| basedOn | S | 0..* | Reference(CarePlan | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest) | At least one business identifier of the DiagnosticReport SHALL be provided in a [FHIR resource]-open request (see detailed description). |
| status | 1..1 | code | Status of the DiagnosticReport, note this may not be known and hence have a value of `unknown`; however, is included since it is required by FHIR | |
 subject | 1..1 | Reference(FHIRcast Patient for Open Events) | Reference to the Patient resource associated with the DiagnosticReport | |
 imagingStudy | 0..* | Reference(FHIRcast ImagingStudy for Open Events) | Imaging study (or studies) which are the subject of this report | |
| Documentation for this format | ||||
FHIR{
"resourceType" : "StructureDefinition",
"id" : "fhircast-diagnostic-report-open",
"text" : {
"status" : "extensions",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p class=\"res-header-id\"><b>Generated Narrative: StructureDefinition fhircast-diagnostic-report-open</b></p><a name=\"fhircast-diagnostic-report-open\"> </a><a name=\"hcfhircast-diagnostic-report-open\"> </a><a name=\"fhircast-diagnostic-report-open-en-US\"> </a><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 style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><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 style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><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 style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views\" title=\"Minimum and Maximum # of times the element can appear in the instance\">Card.</a></th><th style=\"width: 100px\" class=\"hierarchy\"><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 style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views\" title=\"Additional information about the element\">Description & Constraints</a><span style=\"float: right\"><a href=\"https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views\" title=\"Legend for this format\"><img src=\"data:image/png;base64,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\" alt=\"doco\" style=\"background-color: inherit\"/></a></span></th></tr><tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td 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(tbl_bck1.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_resource.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Resource\" class=\"hierarchy\"/> <a href=\"StructureDefinition-fhircast-diagnostic-report-open-definitions.html#DiagnosticReport\">DiagnosticReport</a><a name=\"DiagnosticReport\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"padding-left: 3px; padding-right: 3px; border: 1px maroon solid; font-weight: bold; color: #301212; background-color: #fdf4f4;\" href=\"http://hl7.org/fhir/R4/conformance-rules.html#constraints\" title=\"This element has or is affected by constraints ( business-identifier )\">C</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">0</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">*</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/diagnosticreport.html\">DiagnosticReport</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">A Diagnostic report - a combination of request information, atomic results, images, interpretation, as well as formatted reports</span><br/><span style=\"font-weight:bold\">business-identifier: </span>identifier array or basedOn array SHALL contain at least one element</td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td 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(tbl_bck10.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-fhircast-diagnostic-report-open-definitions.html#DiagnosticReport.id\" title=\"A logical id of the resource SHALL be provided. It may be the `id` associated with the resource as persisted in a FHIR server. If the resource is not stored in a FHIR server, the Subscriber requesting the context change SHOULD use a mechanism to generate the `id` such that it will be globally unique (e.g., a [UUID](https://en.wikipedia.org/wiki/Universally_unique_identifier)). When a [FHIR resource]-close event including this report is requested, the Subscriber requesting the context be closed SHALL use the same DiagnosticReport `id` which was provided in the [FHIR resource]-open event (see also [FHIRcast DiagnosticReport for Close Events](StructureDefinition-fhircast-diagnostic-report-close.html)).\">id</a><a name=\"DiagnosticReport.id\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..<span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#id\">id</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">A logical id of the resource SHALL be provided.</td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td 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(tbl_bck10.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-fhircast-diagnostic-report-open-definitions.html#DiagnosticReport.identifier\" title=\"The Study Instance UID SHALL be included as a business identifier if it is known. In FHIR, the Study Instance UID of an ImagingStudy is stored in the `identifier` array using the Identifier system of `urn:dicom:uid` and prefix the UID value with `urn:oid:`.\">identifier</a><a name=\"DiagnosticReport.identifier\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">0</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">*</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#Identifier\">Identifier</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">A business identifier of the DiagnosticReport may be provided as part of the [FHIR resource]-open request (see detailed description).</td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td 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(tbl_bck10.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-fhircast-diagnostic-report-open-definitions.html#DiagnosticReport.basedOn\" title=\"The accession number of the order which directly or in directly triggered the report to be created SHALL be included as a business identifier if it is known. The accession number is stored as Reference.identifier using the ServiceRequest Reference type and the “ACSN†identifier type.\">basedOn</a><a name=\"DiagnosticReport.basedOn\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">0</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">*</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/references.html\">Reference</a>(<a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/careplan.html\">CarePlan</a> | <a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/immunizationrecommendation.html\">ImmunizationRecommendation</a> | <a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/medicationrequest.html\">MedicationRequest</a> | <a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/nutritionorder.html\">NutritionOrder</a> | <a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/servicerequest.html\">ServiceRequest</a>)</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">At least one business identifier of the DiagnosticReport SHALL be provided in a [FHIR resource]-open request (see detailed description).</td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td 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(tbl_bck10.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-fhircast-diagnostic-report-open-definitions.html#DiagnosticReport.status\" title=\"While initially the `status` of the report may begin as `unknown` or `preliminary` (or something else), throughout the lifecycle of the context the report's status may transition. For example, a reporting application may enable a clinician to sign the report. In such a situation this change in status could become final and would be communicated through a [`DiagnosticReport-update`](3-6-3-DiagnosticReport-update.html)\nevent prior to the DiagnosticReport context being closed by a DiagnosticReport-close event. \">status</a><a name=\"DiagnosticReport.status\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">1</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#code\">code</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Status of the DiagnosticReport, note this may not be known and hence have a value of `unknown`; however, is included since it is required by FHIR</td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td 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(tbl_bck10.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_reference.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Reference to another Resource\" class=\"hierarchy\"/> <a href=\"StructureDefinition-fhircast-diagnostic-report-open-definitions.html#DiagnosticReport.subject\" title=\"A reference to the FHIR Patient resource describing the patient whose report is currently in context SHALL be present.\">subject</a><a name=\"DiagnosticReport.subject\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..<span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/references.html\">Reference</a>(<a href=\"StructureDefinition-fhircast-patient-open.html\">FHIRcast Patient for Open Events</a>)</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Reference to the Patient resource associated with the DiagnosticReport</td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td 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(tbl_bck00.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_reference.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Reference to another Resource\" class=\"hierarchy\"/> <a href=\"StructureDefinition-fhircast-diagnostic-report-open-definitions.html#DiagnosticReport.imagingStudy\" title=\"If the report is created as part of an imaging scenario, at least one imaging study would likely be the subject of the report and included in the event's context. In this case a reference to the ImagingStudy (or references to the ImagingStudy's) in the event's context SHALL be present in the `imagingStudy` array if known.\">imagingStudy</a><a name=\"DiagnosticReport.imagingStudy\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">0</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">*</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/references.html\">Reference</a>(<a href=\"StructureDefinition-fhircast-imaging-study-open.html\">FHIRcast ImagingStudy for Open Events</a>)</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Imaging study (or studies) which are the subject of this report</td></tr>\r\n<tr><td colspan=\"5\" class=\"hierarchy\"><br/><a href=\"https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views\" title=\"Legend for this format\"><img src=\"data:image/png;base64,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\" alt=\"doco\" style=\"background-color: inherit\"/> Documentation for this format</a></td></tr></table></div>"
},
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg",
"valueCode" : "inm"
}
],
"url" : "http://hl7.org/fhir/uv/fhircast/StructureDefinition/fhircast-diagnostic-report-open",
"version" : "3.0.0-ballot",
"name" : "FHIRcastDiagnosticReportOpen",
"title" : "FHIRcast Diagnostic Report for Open Events",
"status" : "draft",
"date" : "2024-12-13T16:33:33+00:00",
"publisher" : "HL7 International / Infrastructure And Messaging",
"contact" : [
{
"name" : "HL7 International / Infrastructure And Messaging",
"telecom" : [
{
"system" : "url",
"value" : "http://www.hl7.org/Special/committees/inm"
},
{
"system" : "email",
"value" : "inm@lists.HL7.org"
}
]
},
{
"name" : "HL7 International / Infrastructure And Messaging",
"telecom" : [
{
"system" : "url",
"value" : "http://www.hl7.org/Special/committees/inm"
},
{
"system" : "email",
"value" : "inm@lists.HL7.org"
}
]
}
],
"description" : "Provides guidance as to which DiagnosticReport attributes should be present and considerations as to how each attribute should be valued in all [FHIR resource]-open events.\n\nAt least one business identifier of the DiagnosticReport SHALL be provided in a [FHIR resource]-open request.\n\nTypically the report is associated with an order from an information system. In this case the accession number of the order is provided in the DiagnosticReport's `basedOn` array attribute as a reference using a ServiceRequest reference type and the “ACSN†identifier type. The accession number SHALL be included as a business identifier if it is known.\n\nA reporting system may also include its own identifier and should use an appropriate identifier type and system when supplying such a business identifier.\n\nIn radiology reports or other image related uses of FHIRcast, at least one imaging study would likely be the subject of the report and included in the event's context. In this case, the reference to one or more ImagingStudy resources would be provided.\n\n**FHIR R4 versus FHIR R5**\nIn the FHIR R4 DiagnosticReport resource image study references would be placed in the `imagingStudy` attribute. In a FHIR R5 (or above) DiagnosticReport this attribute has been renamed `study` since the allowed reference types has been expanded to include references to GenomicStudy resources. This is obviously a breaking change.\n\nIn FHIRcast deployments based on FHIR R5, the attribute `study` SHALL be used rather than the `imagingStudy` attribute.\n\nAdditionally FHIR R5 includes a `supportingInfo` attribute. While not yet formally provided for in FHIR R5, it has been recommended that the next release of FHIR allow an ImagingStudy reference be included in this attribute so that the DiagnosticReport could indicate one or more image studies were consulted during the creation of the report. As such in FHIR R5 deployments, this field is considered labeled as must support.",
"jurisdiction" : [
{
"coding" : [
{
"system" : "http://unstats.un.org/unsd/methods/m49/m49.htm",
"code" : "001"
}
]
}
],
"fhirVersion" : "4.0.1",
"mapping" : [
{
"identity" : "workflow",
"uri" : "http://hl7.org/fhir/workflow",
"name" : "Workflow Pattern"
},
{
"identity" : "v2",
"uri" : "http://hl7.org/v2",
"name" : "HL7 v2 Mapping"
},
{
"identity" : "rim",
"uri" : "http://hl7.org/v3",
"name" : "RIM Mapping"
},
{
"identity" : "w5",
"uri" : "http://hl7.org/fhir/fivews",
"name" : "FiveWs Pattern Mapping"
}
],
"kind" : "resource",
"abstract" : false,
"type" : "DiagnosticReport",
"baseDefinition" : "http://hl7.org/fhir/StructureDefinition/DiagnosticReport",
"derivation" : "constraint",
"snapshot" : {
"element" : [
{
"id" : "DiagnosticReport",
"path" : "DiagnosticReport",
"short" : "A Diagnostic report - a combination of request information, atomic results, images, interpretation, as well as formatted reports",
"definition" : "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.",
"comment" : "This is intended to capture a single report and is not suitable for use in displaying summary information that covers multiple reports. For example, this resource has not been designed for laboratory cumulative reporting formats nor detailed structured reports for sequencing.",
"alias" : [
"Report",
"Test",
"Result",
"Results",
"Labs",
"Laboratory"
],
"min" : 0,
"max" : "*",
"base" : {
"path" : "DiagnosticReport",
"min" : 0,
"max" : "*"
},
"constraint" : [
{
"key" : "dom-2",
"severity" : "error",
"human" : "If the resource is contained in another resource, it SHALL NOT contain nested Resources",
"expression" : "contained.contained.empty()",
"xpath" : "not(parent::f:contained and f:contained)",
"source" : "http://hl7.org/fhir/StructureDefinition/DomainResource"
},
{
"key" : "dom-3",
"severity" : "error",
"human" : "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" : "contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()",
"xpath" : "not(exists(for $id in f:contained/*/f:id/@value return $contained[not(parent::*/descendant::f:reference/@value=concat('#', $contained/*/id/@value) or descendant::f:reference[@value='#'])]))",
"source" : "http://hl7.org/fhir/StructureDefinition/DomainResource"
},
{
"key" : "dom-4",
"severity" : "error",
"human" : "If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated",
"expression" : "contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()",
"xpath" : "not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))",
"source" : "http://hl7.org/fhir/StructureDefinition/DomainResource"
},
{
"key" : "dom-5",
"severity" : "error",
"human" : "If a resource is contained in another resource, it SHALL NOT have a security label",
"expression" : "contained.meta.security.empty()",
"xpath" : "not(exists(f:contained/*/f:meta/f:security))",
"source" : "http://hl7.org/fhir/StructureDefinition/DomainResource"
},
{
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice",
"valueBoolean" : true
},
{
"url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice-explanation",
"valueMarkdown" : "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."
}
],
"key" : "dom-6",
"severity" : "warning",
"human" : "A resource should have narrative for robust management",
"expression" : "text.`div`.exists()",
"xpath" : "exists(f:text/h:div)",
"source" : "http://hl7.org/fhir/StructureDefinition/DomainResource"
},
{
"key" : "business-identifier",
"severity" : "error",
"human" : "identifier array or basedOn array SHALL contain at least one element",
"expression" : "identifier.exists() or basedOn.exists()",
"xpath" : "f:identifier or f:basedOn",
"source" : "http://hl7.org/fhir/uv/fhircast/StructureDefinition/fhircast-diagnostic-report-open"
}
],
"isModifier" : false,
"isSummary" : false,
"mapping" : [
{
"identity" : "rim",
"map" : "Entity. Role, or Act"
},
{
"identity" : "workflow",
"map" : "Event"
},
{
"identity" : "v2",
"map" : "ORU -> OBR"
},
{
"identity" : "rim",
"map" : "Observation[classCode=OBS, moodCode=EVN]"
}
]
},
{
"id" : "DiagnosticReport.id",
"path" : "DiagnosticReport.id",
"short" : "A logical id of the resource SHALL be provided.",
"definition" : "A logical id of the resource SHALL be provided. It may be the `id` associated with the resource as persisted in a FHIR server. If the resource is not stored in a FHIR server, the Subscriber requesting the context change SHOULD use a mechanism to generate the `id` such that it will be globally unique (e.g., a [UUID](https://en.wikipedia.org/wiki/Universally_unique_identifier)). When a [FHIR resource]-close event including this report is requested, the Subscriber requesting the context be closed SHALL use the same DiagnosticReport `id` which was provided in the [FHIR resource]-open event (see also [FHIRcast DiagnosticReport for Close Events](StructureDefinition-fhircast-diagnostic-report-close.html)).",
"comment" : "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
"min" : 1,
"max" : "1",
"base" : {
"path" : "Resource.id",
"min" : 0,
"max" : "1"
},
"type" : [
{
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl" : "id"
}
],
"code" : "http://hl7.org/fhirpath/System.String"
}
],
"isModifier" : false,
"isSummary" : true
},
{
"id" : "DiagnosticReport.meta",
"path" : "DiagnosticReport.meta",
"short" : "Metadata about the resource",
"definition" : "The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.",
"min" : 0,
"max" : "1",
"base" : {
"path" : "Resource.meta",
"min" : 0,
"max" : "1"
},
"type" : [
{
"code" : "Meta"
}
],
"constraint" : [
{
"key" : "ele-1",
"severity" : "error",
"human" : "All FHIR elements must have a @value or children",
"expression" : "hasValue() or (children().count() > id.count())",
"xpath" : "@value|f:*|h:div",
"source" : "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier" : false,
"isSummary" : true
},
{
"id" : "DiagnosticReport.implicitRules",
"path" : "DiagnosticReport.implicitRules",
"short" : "A set of rules under which this content was created",
"definition" : "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" : "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.",
"min" : 0,
"max" : "1",
"base" : {
"path" : "Resource.implicitRules",
"min" : 0,
"max" : "1"
},
"type" : [
{
"code" : "uri"
}
],
"constraint" : [
{
"key" : "ele-1",
"severity" : "error",
"human" : "All FHIR elements must have a @value or children",
"expression" : "hasValue() or (children().count() > id.count())",
"xpath" : "@value|f:*|h:div",
"source" : "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier" : true,
"isModifierReason" : "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",
"isSummary" : true
},
{
"id" : "DiagnosticReport.language",
"path" : "DiagnosticReport.language",
"short" : "Language of the resource content",
"definition" : "The base language in which the resource is written.",
"comment" : "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" : 0,
"max" : "1",
"base" : {
"path" : "Resource.language",
"min" : 0,
"max" : "1"
},
"type" : [
{
"code" : "code"
}
],
"constraint" : [
{
"key" : "ele-1",
"severity" : "error",
"human" : "All FHIR elements must have a @value or children",
"expression" : "hasValue() or (children().count() > id.count())",
"xpath" : "@value|f:*|h:div",
"source" : "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier" : false,
"isSummary" : false,
"binding" : {
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet",
"valueCanonical" : "http://hl7.org/fhir/ValueSet/all-languages"
},
{
"url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString" : "Language"
}
],
"strength" : "preferred",
"description" : "A human language.",
"valueSet" : "http://hl7.org/fhir/ValueSet/languages"
}
},
{
"id" : "DiagnosticReport.text",
"path" : "DiagnosticReport.text",
"short" : "Text summary of the resource, for human interpretation",
"definition" : "A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
"comment" : "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded information is added later.",
"alias" : [
"narrative",
"html",
"xhtml",
"display"
],
"min" : 0,
"max" : "1",
"base" : {
"path" : "DomainResource.text",
"min" : 0,
"max" : "1"
},
"type" : [
{
"code" : "Narrative"
}
],
"constraint" : [
{
"key" : "ele-1",
"severity" : "error",
"human" : "All FHIR elements must have a @value or children",
"expression" : "hasValue() or (children().count() > id.count())",
"xpath" : "@value|f:*|h:div",
"source" : "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier" : false,
"isSummary" : false,
"mapping" : [
{
"identity" : "rim",
"map" : "Act.text?"
}
]
},
{
"id" : "DiagnosticReport.contained",
"path" : "DiagnosticReport.contained",
"short" : "Contained, inline Resources",
"definition" : "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.",
"comment" : "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" : [
"inline resources",
"anonymous resources",
"contained resources"
],
"min" : 0,
"max" : "*",
"base" : {
"path" : "DomainResource.contained",
"min" : 0,
"max" : "*"
},
"type" : [
{
"code" : "Resource"
}
],
"isModifier" : false,
"isSummary" : false,
"mapping" : [
{
"identity" : "rim",
"map" : "N/A"
}
]
},
{
"id" : "DiagnosticReport.extension",
"path" : "DiagnosticReport.extension",
"short" : "Additional content defined by implementations",
"definition" : "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.",
"comment" : "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" : [
"extensions",
"user content"
],
"min" : 0,
"max" : "*",
"base" : {
"path" : "DomainResource.extension",
"min" : 0,
"max" : "*"
},
"type" : [
{
"code" : "Extension"
}
],
"constraint" : [
{
"key" : "ele-1",
"severity" : "error",
"human" : "All FHIR elements must have a @value or children",
"expression" : "hasValue() or (children().count() > id.count())",
"xpath" : "@value|f:*|h:div",
"source" : "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key" : "ext-1",
"severity" : "error",
"human" : "Must have either extensions or value[x], not both",
"expression" : "extension.exists() != value.exists()",
"xpath" : "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source" : "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"isModifier" : false,
"isSummary" : false,
"mapping" : [
{
"identity" : "rim",
"map" : "N/A"
}
]
},
{
"id" : "DiagnosticReport.modifierExtension",
"path" : "DiagnosticReport.modifierExtension",
"short" : "Extensions that cannot be ignored",
"definition" : "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.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
"comment" : "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" : "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](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).",
"alias" : [
"extensions",
"user content"
],
"min" : 0,
"max" : "*",
"base" : {
"path" : "DomainResource.modifierExtension",
"min" : 0,
"max" : "*"
},
"type" : [
{
"code" : "Extension"
}
],
"constraint" : [
{
"key" : "ele-1",
"severity" : "error",
"human" : "All FHIR elements must have a @value or children",
"expression" : "hasValue() or (children().count() > id.count())",
"xpath" : "@value|f:*|h:div",
"source" : "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key" : "ext-1",
"severity" : "error",
"human" : "Must have either extensions or value[x], not both",
"expression" : "extension.exists() != value.exists()",
"xpath" : "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source" : "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"isModifier" : true,
"isModifierReason" : "Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them",
"isSummary" : false,
"mapping" : [
{
"identity" : "rim",
"map" : "N/A"
}
]
},
{
"id" : "DiagnosticReport.identifier",
"path" : "DiagnosticReport.identifier",
"short" : "A business identifier of the DiagnosticReport may be provided as part of the [FHIR resource]-open request (see detailed description).",
"definition" : "The Study Instance UID SHALL be included as a business identifier if it is known. In FHIR, the Study Instance UID of an ImagingStudy is stored in the `identifier` array using the Identifier system of `urn:dicom:uid` and prefix the UID value with `urn:oid:`.",
"comment" : "Usually assigned by the Information System of the diagnostic service provider (filler id).",
"requirements" : "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" : [
"ReportID",
"Filler ID",
"Placer ID"
],
"min" : 0,
"max" : "*",
"base" : {
"path" : "DiagnosticReport.identifier",
"min" : 0,
"max" : "*"
},
"type" : [
{
"code" : "Identifier"
}
],
"constraint" : [
{
"key" : "ele-1",
"severity" : "error",
"human" : "All FHIR elements must have a @value or children",
"expression" : "hasValue() or (children().count() > id.count())",
"xpath" : "@value|f:*|h:div",
"source" : "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mustSupport" : true,
"isModifier" : false,
"isSummary" : true,
"mapping" : [
{
"identity" : "workflow",
"map" : "Event.identifier"
},
{
"identity" : "w5",
"map" : "FiveWs.identifier"
},
{
"identity" : "v2",
"map" : "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"
},
{
"identity" : "rim",
"map" : "id"
}
]
},
{
"id" : "DiagnosticReport.basedOn",
"path" : "DiagnosticReport.basedOn",
"short" : "At least one business identifier of the DiagnosticReport SHALL be provided in a [FHIR resource]-open request (see detailed description).",
"definition" : "The accession number of the order which directly or in directly triggered the report to be created SHALL be included as a business identifier if it is known. The accession number is stored as Reference.identifier using the ServiceRequest Reference type and the “ACSN†identifier type.",
"comment" : "Note: Usually there is one test request for each result, however in some circumstances multiple test requests may be represented using a single test result resource. Note that there are also cases where one request leads to multiple reports.",
"requirements" : "This allows tracing of authorization for the report and tracking whether proposals/recommendations were acted upon.",
"alias" : [
"Request"
],
"min" : 0,
"max" : "*",
"base" : {
"path" : "DiagnosticReport.basedOn",
"min" : 0,
"max" : "*"
},
"type" : [
{
"code" : "Reference",
"targetProfile" : [
"http://hl7.org/fhir/StructureDefinition/CarePlan",
"http://hl7.org/fhir/StructureDefinition/ImmunizationRecommendation",
"http://hl7.org/fhir/StructureDefinition/MedicationRequest",
"http://hl7.org/fhir/StructureDefinition/NutritionOrder",
"http://hl7.org/fhir/StructureDefinition/ServiceRequest"
]
}
],
"constraint" : [
{
"key" : "ele-1",
"severity" : "error",
"human" : "All FHIR elements must have a @value or children",
"expression" : "hasValue() or (children().count() > id.count())",
"xpath" : "@value|f:*|h:div",
"source" : "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mustSupport" : true,
"isModifier" : false,
"isSummary" : false,
"mapping" : [
{
"identity" : "workflow",
"map" : "Event.basedOn"
},
{
"identity" : "v2",
"map" : "ORC? OBR-2/3?"
},
{
"identity" : "rim",
"map" : "outboundRelationship[typeCode=FLFS].target"
}
]
},
{
"id" : "DiagnosticReport.status",
"path" : "DiagnosticReport.status",
"short" : "Status of the DiagnosticReport, note this may not be known and hence have a value of `unknown`; however, is included since it is required by FHIR",
"definition" : "While initially the `status` of the report may begin as `unknown` or `preliminary` (or something else), throughout the lifecycle of the context the report's status may transition. For example, a reporting application may enable a clinician to sign the report. In such a situation this change in status could become final and would be communicated through a [`DiagnosticReport-update`](3-6-3-DiagnosticReport-update.html)\nevent prior to the DiagnosticReport context being closed by a DiagnosticReport-close event. ",
"requirements" : "Diagnostic services routinely issue provisional/incomplete reports, and sometimes withdraw previously released reports.",
"min" : 1,
"max" : "1",
"base" : {
"path" : "DiagnosticReport.status",
"min" : 1,
"max" : "1"
},
"type" : [
{
"code" : "code"
}
],
"constraint" : [
{
"key" : "ele-1",
"severity" : "error",
"human" : "All FHIR elements must have a @value or children",
"expression" : "hasValue() or (children().count() > id.count())",
"xpath" : "@value|f:*|h:div",
"source" : "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier" : true,
"isModifierReason" : "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" : true,
"binding" : {
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString" : "DiagnosticReportStatus"
}
],
"strength" : "required",
"description" : "The status of the diagnostic report.",
"valueSet" : "http://hl7.org/fhir/ValueSet/diagnostic-report-status|4.0.1"
},
"mapping" : [
{
"identity" : "workflow",
"map" : "Event.status"
},
{
"identity" : "w5",
"map" : "FiveWs.status"
},
{
"identity" : "v2",
"map" : "OBR-25 (not 1:1 mapping)"
},
{
"identity" : "rim",
"map" : "statusCode Note: final and amended are distinguished by whether observation is the subject of a ControlAct event of type \"revise\""
}
]
},
{
"id" : "DiagnosticReport.category",
"path" : "DiagnosticReport.category",
"short" : "Service category",
"definition" : "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" : "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.",
"alias" : [
"Department",
"Sub-department",
"Service",
"Discipline"
],
"min" : 0,
"max" : "*",
"base" : {
"path" : "DiagnosticReport.category",
"min" : 0,
"max" : "*"
},
"type" : [
{
"code" : "CodeableConcept"
}
],
"constraint" : [
{
"key" : "ele-1",
"severity" : "error",
"human" : "All FHIR elements must have a @value or children",
"expression" : "hasValue() or (children().count() > id.count())",
"xpath" : "@value|f:*|h:div",
"source" : "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier" : false,
"isSummary" : true,
"binding" : {
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString" : "DiagnosticServiceSection"
}
],
"strength" : "example",
"description" : "Codes for diagnostic service sections.",
"valueSet" : "http://hl7.org/fhir/ValueSet/diagnostic-service-sections"
},
"mapping" : [
{
"identity" : "w5",
"map" : "FiveWs.class"
},
{
"identity" : "v2",
"map" : "OBR-24"
},
{
"identity" : "rim",
"map" : "inboundRelationship[typeCode=COMP].source[classCode=LIST, moodCode=EVN, code < LabService].code"
}
]
},
{
"id" : "DiagnosticReport.code",
"path" : "DiagnosticReport.code",
"short" : "Name/Code for this diagnostic report",
"definition" : "A code or name that describes this diagnostic report.",
"alias" : [
"Type"
],
"min" : 1,
"max" : "1",
"base" : {
"path" : "DiagnosticReport.code",
"min" : 1,
"max" : "1"
},
"type" : [
{
"code" : "CodeableConcept"
}
],
"constraint" : [
{
"key" : "ele-1",
"severity" : "error",
"human" : "All FHIR elements must have a @value or children",
"expression" : "hasValue() or (children().count() > id.count())",
"xpath" : "@value|f:*|h:div",
"source" : "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier" : false,
"isSummary" : true,
"binding" : {
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString" : "DiagnosticReportCodes"
}
],
"strength" : "preferred",
"description" : "Codes that describe Diagnostic Reports.",
"valueSet" : "http://hl7.org/fhir/ValueSet/report-codes"
},
"mapping" : [
{
"identity" : "workflow",
"map" : "Event.code"
},
{
"identity" : "w5",
"map" : "FiveWs.what[x]"
},
{
"identity" : "v2",
"map" : "OBR-4 (HL7 v2 doesn't provide an easy way to indicate both the ordered test and the performed panel)"
},
{
"identity" : "rim",
"map" : "code"
}
]
},
{
"id" : "DiagnosticReport.subject",
"path" : "DiagnosticReport.subject",
"short" : "Reference to the Patient resource associated with the DiagnosticReport",
"definition" : "A reference to the FHIR Patient resource describing the patient whose report is currently in context SHALL be present.",
"requirements" : "SHALL know the subject context.",
"alias" : [
"Patient"
],
"min" : 1,
"max" : "1",
"base" : {
"path" : "DiagnosticReport.subject",
"min" : 0,
"max" : "1"
},
"type" : [
{
"code" : "Reference",
"targetProfile" : [
"http://hl7.org/fhir/uv/fhircast/StructureDefinition/fhircast-patient-open"
]
}
],
"constraint" : [
{
"key" : "ele-1",
"severity" : "error",
"human" : "All FHIR elements must have a @value or children",
"expression" : "hasValue() or (children().count() > id.count())",
"xpath" : "@value|f:*|h:div",
"source" : "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier" : false,
"isSummary" : true,
"mapping" : [
{
"identity" : "workflow",
"map" : "Event.subject"
},
{
"identity" : "w5",
"map" : "FiveWs.subject[x]"
},
{
"identity" : "v2",
"map" : "PID-3 (no HL7 v2 mapping for Group or Device)"
},
{
"identity" : "rim",
"map" : "participation[typeCode=SBJ]"
},
{
"identity" : "w5",
"map" : "FiveWs.subject"
}
]
},
{
"id" : "DiagnosticReport.encounter",
"path" : "DiagnosticReport.encounter",
"short" : "Health care event when test ordered",
"definition" : "The healthcare event (e.g. a patient and healthcare provider interaction) which this DiagnosticReport is about.",
"comment" : "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" : "Links the request to the Encounter context.",
"alias" : [
"Context"
],
"min" : 0,
"max" : "1",
"base" : {
"path" : "DiagnosticReport.encounter",
"min" : 0,
"max" : "1"
},
"type" : [
{
"code" : "Reference",
"targetProfile" : [
"http://hl7.org/fhir/StructureDefinition/Encounter"
]
}
],
"constraint" : [
{
"key" : "ele-1",
"severity" : "error",
"human" : "All FHIR elements must have a @value or children",
"expression" : "hasValue() or (children().count() > id.count())",
"xpath" : "@value|f:*|h:div",
"source" : "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier" : false,
"isSummary" : true,
"mapping" : [
{
"identity" : "workflow",
"map" : "Event.encounter"
},
{
"identity" : "w5",
"map" : "FiveWs.context"
},
{
"identity" : "v2",
"map" : "PV1-19"
},
{
"identity" : "rim",
"map" : "inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN]"
}
]
},
{
"id" : "DiagnosticReport.effective[x]",
"path" : "DiagnosticReport.effective[x]",
"short" : "Clinically relevant time/time-period for report",
"definition" : "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" : "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" : "Need to know where in the patient history to file/present this report.",
"alias" : [
"Observation time",
"Effective Time",
"Occurrence"
],
"min" : 0,
"max" : "1",
"base" : {
"path" : "DiagnosticReport.effective[x]",
"min" : 0,
"max" : "1"
},
"type" : [
{
"code" : "dateTime"
},
{
"code" : "Period"
}
],
"constraint" : [
{
"key" : "ele-1",
"severity" : "error",
"human" : "All FHIR elements must have a @value or children",
"expression" : "hasValue() or (children().count() > id.count())",
"xpath" : "@value|f:*|h:div",
"source" : "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier" : false,
"isSummary" : true,
"mapping" : [
{
"identity" : "workflow",
"map" : "Event.occurrence[x]"
},
{
"identity" : "w5",
"map" : "FiveWs.done[x]"
},
{
"identity" : "v2",
"map" : "OBR-7"
},
{
"identity" : "rim",
"map" : "effectiveTime"
}
]
},
{
"id" : "DiagnosticReport.issued",
"path" : "DiagnosticReport.issued",
"short" : "DateTime this version was made",
"definition" : "The date and time that this version of the report was made available to providers, typically after the report was reviewed and verified.",
"comment" : "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" : "Clinicians need to be able to check the date that the report was released.",
"alias" : [
"Date published",
"Date Issued",
"Date Verified"
],
"min" : 0,
"max" : "1",
"base" : {
"path" : "DiagnosticReport.issued",
"min" : 0,
"max" : "1"
},
"type" : [
{
"code" : "instant"
}
],
"constraint" : [
{
"key" : "ele-1",
"severity" : "error",
"human" : "All FHIR elements must have a @value or children",
"expression" : "hasValue() or (children().count() > id.count())",
"xpath" : "@value|f:*|h:div",
"source" : "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier" : false,
"isSummary" : true,
"mapping" : [
{
"identity" : "w5",
"map" : "FiveWs.recorded"
},
{
"identity" : "v2",
"map" : "OBR-22"
},
{
"identity" : "rim",
"map" : "participation[typeCode=VRF or AUT].time"
}
]
},
{
"id" : "DiagnosticReport.performer",
"path" : "DiagnosticReport.performer",
"short" : "Responsible Diagnostic Service",
"definition" : "The diagnostic service that is responsible for issuing the report.",
"comment" : "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" : "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" : [
"Laboratory",
"Service",
"Practitioner",
"Department",
"Company",
"Authorized by",
"Director"
],
"min" : 0,
"max" : "*",
"base" : {
"path" : "DiagnosticReport.performer",
"min" : 0,
"max" : "*"
},
"type" : [
{
"code" : "Reference",
"targetProfile" : [
"http://hl7.org/fhir/StructureDefinition/Practitioner",
"http://hl7.org/fhir/StructureDefinition/PractitionerRole",
"http://hl7.org/fhir/StructureDefinition/Organization",
"http://hl7.org/fhir/StructureDefinition/CareTeam"
]
}
],
"constraint" : [
{
"key" : "ele-1",
"severity" : "error",
"human" : "All FHIR elements must have a @value or children",
"expression" : "hasValue() or (children().count() > id.count())",
"xpath" : "@value|f:*|h:div",
"source" : "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier" : false,
"isSummary" : true,
"mapping" : [
{
"identity" : "workflow",
"map" : "Event.performer.actor"
},
{
"identity" : "w5",
"map" : "FiveWs.actor"
},
{
"identity" : "v2",
"map" : "PRT-8 (where this PRT-4-Participation = \"PO\")"
},
{
"identity" : "rim",
"map" : ".participation[typeCode=PRF]"
}
]
},
{
"id" : "DiagnosticReport.resultsInterpreter",
"path" : "DiagnosticReport.resultsInterpreter",
"short" : "Primary result interpreter",
"definition" : "The practitioner or organization that is responsible for the report's conclusions and interpretations.",
"comment" : "Might not be the same entity that takes responsibility for the clinical report.",
"requirements" : "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" : [
"Analyzed by",
"Reported by"
],
"min" : 0,
"max" : "*",
"base" : {
"path" : "DiagnosticReport.resultsInterpreter",
"min" : 0,
"max" : "*"
},
"type" : [
{
"code" : "Reference",
"targetProfile" : [
"http://hl7.org/fhir/StructureDefinition/Practitioner",
"http://hl7.org/fhir/StructureDefinition/PractitionerRole",
"http://hl7.org/fhir/StructureDefinition/Organization",
"http://hl7.org/fhir/StructureDefinition/CareTeam"
]
}
],
"constraint" : [
{
"key" : "ele-1",
"severity" : "error",
"human" : "All FHIR elements must have a @value or children",
"expression" : "hasValue() or (children().count() > id.count())",
"xpath" : "@value|f:*|h:div",
"source" : "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier" : false,
"isSummary" : true,
"mapping" : [
{
"identity" : "workflow",
"map" : "Event.performer.actor"
},
{
"identity" : "w5",
"map" : "FiveWs.actor"
},
{
"identity" : "v2",
"map" : "OBR-32, PRT-8 (where this PRT-4-Participation = \"PI\")"
},
{
"identity" : "rim",
"map" : ".participation[typeCode=PRF]"
}
]
},
{
"id" : "DiagnosticReport.specimen",
"path" : "DiagnosticReport.specimen",
"short" : "Specimens this report is based on",
"definition" : "Details about the specimens on which this diagnostic report is based.",
"comment" : "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" : "Need to be able to report information about the collected specimens on which the report is based.",
"min" : 0,
"max" : "*",
"base" : {
"path" : "DiagnosticReport.specimen",
"min" : 0,
"max" : "*"
},
"type" : [
{
"code" : "Reference",
"targetProfile" : [
"http://hl7.org/fhir/StructureDefinition/Specimen"
]
}
],
"constraint" : [
{
"key" : "ele-1",
"severity" : "error",
"human" : "All FHIR elements must have a @value or children",
"expression" : "hasValue() or (children().count() > id.count())",
"xpath" : "@value|f:*|h:div",
"source" : "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier" : false,
"isSummary" : false,
"mapping" : [
{
"identity" : "v2",
"map" : "SPM"
},
{
"identity" : "rim",
"map" : "participation[typeCode=SBJ]"
}
]
},
{
"id" : "DiagnosticReport.result",
"path" : "DiagnosticReport.result",
"short" : "Observations",
"definition" : "[Observations](http://hl7.org/fhir/R4/observation.html) that are part of this diagnostic report.",
"comment" : "Observations can contain observations.",
"requirements" : "Need to support individual results, or groups of results, where the result grouping is arbitrary, but meaningful.",
"alias" : [
"Data",
"Atomic Value",
"Result",
"Atomic result",
"Data",
"Test",
"Analyte",
"Battery",
"Organizer"
],
"min" : 0,
"max" : "*",
"base" : {
"path" : "DiagnosticReport.result",
"min" : 0,
"max" : "*"
},
"type" : [
{
"code" : "Reference",
"targetProfile" : [
"http://hl7.org/fhir/StructureDefinition/Observation"
]
}
],
"constraint" : [
{
"key" : "ele-1",
"severity" : "error",
"human" : "All FHIR elements must have a @value or children",
"expression" : "hasValue() or (children().count() > id.count())",
"xpath" : "@value|f:*|h:div",
"source" : "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier" : false,
"isSummary" : false,
"mapping" : [
{
"identity" : "v2",
"map" : "OBXs"
},
{
"identity" : "rim",
"map" : "outboundRelationship[typeCode=COMP].target"
}
]
},
{
"id" : "DiagnosticReport.imagingStudy",
"path" : "DiagnosticReport.imagingStudy",
"short" : "Imaging study (or studies) which are the subject of this report",
"definition" : "If the report is created as part of an imaging scenario, at least one imaging study would likely be the subject of the report and included in the event's context. In this case a reference to the ImagingStudy (or references to the ImagingStudy's) in the event's context SHALL be present in the `imagingStudy` array if known.",
"comment" : "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.",
"min" : 0,
"max" : "*",
"base" : {
"path" : "DiagnosticReport.imagingStudy",
"min" : 0,
"max" : "*"
},
"type" : [
{
"code" : "Reference",
"targetProfile" : [
"http://hl7.org/fhir/uv/fhircast/StructureDefinition/fhircast-imaging-study-open"
]
}
],
"constraint" : [
{
"key" : "ele-1",
"severity" : "error",
"human" : "All FHIR elements must have a @value or children",
"expression" : "hasValue() or (children().count() > id.count())",
"xpath" : "@value|f:*|h:div",
"source" : "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier" : false,
"isSummary" : false,
"mapping" : [
{
"identity" : "rim",
"map" : "outboundRelationship[typeCode=COMP].target[classsCode=DGIMG, moodCode=EVN]"
}
]
},
{
"id" : "DiagnosticReport.media",
"path" : "DiagnosticReport.media",
"short" : "Key images associated with this report",
"definition" : "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).",
"requirements" : "Many diagnostic services include images in the report as part of their service.",
"alias" : [
"DICOM",
"Slides",
"Scans"
],
"min" : 0,
"max" : "*",
"base" : {
"path" : "DiagnosticReport.media",
"min" : 0,
"max" : "*"
},
"type" : [
{
"code" : "BackboneElement"
}
],
"constraint" : [
{
"key" : "ele-1",
"severity" : "error",
"human" : "All FHIR elements must have a @value or children",
"expression" : "hasValue() or (children().count() > id.count())",
"xpath" : "@value|f:*|h:div",
"source" : "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier" : false,
"isSummary" : true,
"mapping" : [
{
"identity" : "v2",
"map" : "OBX?"
},
{
"identity" : "rim",
"map" : "outboundRelationship[typeCode=COMP].target"
}
]
},
{
"id" : "DiagnosticReport.media.id",
"path" : "DiagnosticReport.media.id",
"representation" : [
"xmlAttr"
],
"short" : "Unique id for inter-element referencing",
"definition" : "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"min" : 0,
"max" : "1",
"base" : {
"path" : "Element.id",
"min" : 0,
"max" : "1"
},
"type" : [
{
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl" : "string"
}
],
"code" : "http://hl7.org/fhirpath/System.String"
}
],
"isModifier" : false,
"isSummary" : false,
"mapping" : [
{
"identity" : "rim",
"map" : "n/a"
}
]
},
{
"id" : "DiagnosticReport.media.extension",
"path" : "DiagnosticReport.media.extension",
"short" : "Additional content defined by implementations",
"definition" : "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.",
"comment" : "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" : [
"extensions",
"user content"
],
"min" : 0,
"max" : "*",
"base" : {
"path" : "Element.extension",
"min" : 0,
"max" : "*"
},
"type" : [
{
"code" : "Extension"
}
],
"constraint" : [
{
"key" : "ele-1",
"severity" : "error",
"human" : "All FHIR elements must have a @value or children",
"expression" : "hasValue() or (children().count() > id.count())",
"xpath" : "@value|f:*|h:div",
"source" : "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key" : "ext-1",
"severity" : "error",
"human" : "Must have either extensions or value[x], not both",
"expression" : "extension.exists() != value.exists()",
"xpath" : "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source" : "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"isModifier" : false,
"isSummary" : false,
"mapping" : [
{
"identity" : "rim",
"map" : "n/a"
}
]
},
{
"id" : "DiagnosticReport.media.modifierExtension",
"path" : "DiagnosticReport.media.modifierExtension",
"short" : "Extensions that cannot be ignored even if unrecognized",
"definition" : "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.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
"comment" : "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" : "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](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).",
"alias" : [
"extensions",
"user content",
"modifiers"
],
"min" : 0,
"max" : "*",
"base" : {
"path" : "BackboneElement.modifierExtension",
"min" : 0,
"max" : "*"
},
"type" : [
{
"code" : "Extension"
}
],
"constraint" : [
{
"key" : "ele-1",
"severity" : "error",
"human" : "All FHIR elements must have a @value or children",
"expression" : "hasValue() or (children().count() > id.count())",
"xpath" : "@value|f:*|h:div",
"source" : "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key" : "ext-1",
"severity" : "error",
"human" : "Must have either extensions or value[x], not both",
"expression" : "extension.exists() != value.exists()",
"xpath" : "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source" : "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"isModifier" : true,
"isModifierReason" : "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
"isSummary" : true,
"mapping" : [
{
"identity" : "rim",
"map" : "N/A"
}
]
},
{
"id" : "DiagnosticReport.media.comment",
"path" : "DiagnosticReport.media.comment",
"short" : "Comment about the image (e.g. explanation)",
"definition" : "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.",
"comment" : "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.",
"requirements" : "The provider of the report should make a comment about each image included in the report.",
"min" : 0,
"max" : "1",
"base" : {
"path" : "DiagnosticReport.media.comment",
"min" : 0,
"max" : "1"
},
"type" : [
{
"code" : "string"
}
],
"constraint" : [
{
"key" : "ele-1",
"severity" : "error",
"human" : "All FHIR elements must have a @value or children",
"expression" : "hasValue() or (children().count() > id.count())",
"xpath" : "@value|f:*|h:div",
"source" : "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier" : false,
"isSummary" : false,
"mapping" : [
{
"identity" : "rim",
"map" : ".inboundRelationship[typeCode=COMP].source[classCode=OBS, moodCode=EVN, code=\"annotation\"].value"
}
]
},
{
"id" : "DiagnosticReport.media.link",
"path" : "DiagnosticReport.media.link",
"short" : "Reference to the image source",
"definition" : "Reference to the image source.",
"min" : 1,
"max" : "1",
"base" : {
"path" : "DiagnosticReport.media.link",
"min" : 1,
"max" : "1"
},
"type" : [
{
"code" : "Reference",
"targetProfile" : [
"http://hl7.org/fhir/StructureDefinition/Media"
]
}
],
"constraint" : [
{
"key" : "ele-1",
"severity" : "error",
"human" : "All FHIR elements must have a @value or children",
"expression" : "hasValue() or (children().count() > id.count())",
"xpath" : "@value|f:*|h:div",
"source" : "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier" : false,
"isSummary" : true,
"mapping" : [
{
"identity" : "rim",
"map" : ".value.reference"
}
]
},
{
"id" : "DiagnosticReport.conclusion",
"path" : "DiagnosticReport.conclusion",
"short" : "Clinical conclusion (interpretation) of test results",
"definition" : "Concise and clinically contextualized summary conclusion (interpretation/impression) of the diagnostic report.",
"requirements" : "Need to be able to provide a conclusion that is not lost among the basic result data.",
"alias" : [
"Report"
],
"min" : 0,
"max" : "1",
"base" : {
"path" : "DiagnosticReport.conclusion",
"min" : 0,
"max" : "1"
},
"type" : [
{
"code" : "string"
}
],
"constraint" : [
{
"key" : "ele-1",
"severity" : "error",
"human" : "All FHIR elements must have a @value or children",
"expression" : "hasValue() or (children().count() > id.count())",
"xpath" : "@value|f:*|h:div",
"source" : "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier" : false,
"isSummary" : false,
"mapping" : [
{
"identity" : "v2",
"map" : "OBX"
},
{
"identity" : "rim",
"map" : "inboundRelationship[typeCode=\"SPRT\"].source[classCode=OBS, moodCode=EVN, code=LOINC:48767-8].value (type=ST)"
}
]
},
{
"id" : "DiagnosticReport.conclusionCode",
"path" : "DiagnosticReport.conclusionCode",
"short" : "Codes for the clinical conclusion of test results",
"definition" : "One or more codes that represent the summary conclusion (interpretation/impression) of the diagnostic report.",
"min" : 0,
"max" : "*",
"base" : {
"path" : "DiagnosticReport.conclusionCode",
"min" : 0,
"max" : "*"
},
"type" : [
{
"code" : "CodeableConcept"
}
],
"constraint" : [
{
"key" : "ele-1",
"severity" : "error",
"human" : "All FHIR elements must have a @value or children",
"expression" : "hasValue() or (children().count() > id.count())",
"xpath" : "@value|f:*|h:div",
"source" : "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier" : false,
"isSummary" : false,
"binding" : {
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString" : "AdjunctDiagnosis"
}
],
"strength" : "example",
"description" : "Diagnosis codes provided as adjuncts to the report.",
"valueSet" : "http://hl7.org/fhir/ValueSet/clinical-findings"
},
"mapping" : [
{
"identity" : "v2",
"map" : "OBX"
},
{
"identity" : "rim",
"map" : "inboundRelationship[typeCode=SPRT].source[classCode=OBS, moodCode=EVN, code=LOINC:54531-9].value (type=CD)"
}
]
},
{
"id" : "DiagnosticReport.presentedForm",
"path" : "DiagnosticReport.presentedForm",
"short" : "Entire report as issued",
"definition" : "Rich text representation of the entire result as issued by the diagnostic service. Multiple formats are allowed but they SHALL be semantically equivalent.",
"comment" : "\"application/pdf\" is recommended as the most reliable and interoperable in this context.",
"requirements" : "Gives laboratory the ability to provide its own fully formatted report for clinical fidelity.",
"min" : 0,
"max" : "*",
"base" : {
"path" : "DiagnosticReport.presentedForm",
"min" : 0,
"max" : "*"
},
"type" : [
{
"code" : "Attachment"
}
],
"constraint" : [
{
"key" : "ele-1",
"severity" : "error",
"human" : "All FHIR elements must have a @value or children",
"expression" : "hasValue() or (children().count() > id.count())",
"xpath" : "@value|f:*|h:div",
"source" : "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier" : false,
"isSummary" : false,
"mapping" : [
{
"identity" : "v2",
"map" : "OBX"
},
{
"identity" : "rim",
"map" : "text (type=ED)"
}
]
}
]
},
"differential" : {
"element" : [
{
"id" : "DiagnosticReport",
"path" : "DiagnosticReport",
"constraint" : [
{
"key" : "business-identifier",
"severity" : "error",
"human" : "identifier array or basedOn array SHALL contain at least one element",
"expression" : "identifier.exists() or basedOn.exists()",
"xpath" : "f:identifier or f:basedOn",
"source" : "http://hl7.org/fhir/uv/fhircast/StructureDefinition/fhircast-diagnostic-report-open"
}
]
},
{
"id" : "DiagnosticReport.id",
"path" : "DiagnosticReport.id",
"short" : "A logical id of the resource SHALL be provided.",
"definition" : "A logical id of the resource SHALL be provided. It may be the `id` associated with the resource as persisted in a FHIR server. If the resource is not stored in a FHIR server, the Subscriber requesting the context change SHOULD use a mechanism to generate the `id` such that it will be globally unique (e.g., a [UUID](https://en.wikipedia.org/wiki/Universally_unique_identifier)). When a [FHIR resource]-close event including this report is requested, the Subscriber requesting the context be closed SHALL use the same DiagnosticReport `id` which was provided in the [FHIR resource]-open event (see also [FHIRcast DiagnosticReport for Close Events](StructureDefinition-fhircast-diagnostic-report-close.html)).",
"min" : 1
},
{
"id" : "DiagnosticReport.identifier",
"path" : "DiagnosticReport.identifier",
"short" : "A business identifier of the DiagnosticReport may be provided as part of the [FHIR resource]-open request (see detailed description).",
"definition" : "The Study Instance UID SHALL be included as a business identifier if it is known. In FHIR, the Study Instance UID of an ImagingStudy is stored in the `identifier` array using the Identifier system of `urn:dicom:uid` and prefix the UID value with `urn:oid:`.",
"mustSupport" : true
},
{
"id" : "DiagnosticReport.basedOn",
"path" : "DiagnosticReport.basedOn",
"short" : "At least one business identifier of the DiagnosticReport SHALL be provided in a [FHIR resource]-open request (see detailed description).",
"definition" : "The accession number of the order which directly or in directly triggered the report to be created SHALL be included as a business identifier if it is known. The accession number is stored as Reference.identifier using the ServiceRequest Reference type and the “ACSN†identifier type.",
"mustSupport" : true
},
{
"id" : "DiagnosticReport.status",
"path" : "DiagnosticReport.status",
"short" : "Status of the DiagnosticReport, note this may not be known and hence have a value of `unknown`; however, is included since it is required by FHIR",
"definition" : "While initially the `status` of the report may begin as `unknown` or `preliminary` (or something else), throughout the lifecycle of the context the report's status may transition. For example, a reporting application may enable a clinician to sign the report. In such a situation this change in status could become final and would be communicated through a [`DiagnosticReport-update`](3-6-3-DiagnosticReport-update.html)\nevent prior to the DiagnosticReport context being closed by a DiagnosticReport-close event. "
},
{
"id" : "DiagnosticReport.subject",
"path" : "DiagnosticReport.subject",
"short" : "Reference to the Patient resource associated with the DiagnosticReport",
"definition" : "A reference to the FHIR Patient resource describing the patient whose report is currently in context SHALL be present.",
"min" : 1,
"type" : [
{
"code" : "Reference",
"targetProfile" : [
"http://hl7.org/fhir/uv/fhircast/StructureDefinition/fhircast-patient-open"
]
}
]
},
{
"id" : "DiagnosticReport.imagingStudy",
"path" : "DiagnosticReport.imagingStudy",
"short" : "Imaging study (or studies) which are the subject of this report",
"definition" : "If the report is created as part of an imaging scenario, at least one imaging study would likely be the subject of the report and included in the event's context. In this case a reference to the ImagingStudy (or references to the ImagingStudy's) in the event's context SHALL be present in the `imagingStudy` array if known.",
"type" : [
{
"code" : "Reference",
"targetProfile" : [
"http://hl7.org/fhir/uv/fhircast/StructureDefinition/fhircast-imaging-study-open"
]
}
]
}
]
}
}
XIG built as of ??metadata-date??. Found ??metadata-resources?? resources in ??metadata-packages?? packages.