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{
  "resourceType": "StructureDefinition",
  "id": "profile-diagnosticreport",
  "url": "http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-diagnosticreport",
  "version": "1.0.1",
  "name": "DiagnosticReportProfile",
  "title": "DiagnosticReport Profile for Laboratory Results Reporting",
  "status": "draft",
  "date": "2024-12-27",
  "publisher": "HL7 Canada - FHIR Implementation Work Group",
  "contact": [
    {
      "telecom": [
        {
          "system": "url",
          "value": "https://infocentral.infoway-inforoute.ca/en/collaboration/wg/fhir-implementations"
        }
      ]
    }
  ],
  "description": "Proposed constraints on the DiagnosticReport resource for the minimal set of data to query and retrieve diagnostic reports associated with laboratory and other results",
  "jurisdiction": [
    {
      "coding": [
        {
          "system": "urn:iso:std:iso:3166",
          "code": "CA"
        }
      ]
    }
  ],
  "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",
  "differential": {
    "element": [
      {
        "id": "DiagnosticReport",
        "path": "DiagnosticReport",
        "short": "DiagnosticReport Profile",
        "definition": "Diagnostic Report Profile is based upon the core FHIR DiagnosticReport resource and created to meet the Laboratory test(s) and Laboratory value(s)/result(s) requirements."
      },
      {
        "id": "DiagnosticReport.extension:note",
        "path": "DiagnosticReport.extension",
        "sliceName": "note",
        "comment": "This extension is used to preadopt the DiagnosticReport.note element that was introduced in FHIR R5. This was done to socialize a standardized method for conveying notes that apply to the entirety of a diagnostic report as is seen in some Canadian implementations (e.g., OLIS). Before using this extension in your implementation, consider if its fit-for-purpose/fit-for-use applicable for your needs. Users are encouraged to review the https://build.fhir.org/versions.html#extensions.",
        "min": 0,
        "max": "*",
        "type": [
          {
            "code": "Extension",
            "profile": [
              "http://hl7.org/fhir/5.0/StructureDefinition/extension-DiagnosticReport.note"
            ]
          }
        ]
      },
      {
        "id": "DiagnosticReport.category",
        "path": "DiagnosticReport.category",
        "slicing": {
          "discriminator": [
            {
              "type": "pattern",
              "path": "$this"
            }
          ],
          "rules": "open"
        },
        "type": [
          {
            "code": "CodeableConcept"
          }
        ],
        "mustSupport": true
      },
      {
        "id": "DiagnosticReport.category:LabResult",
        "path": "DiagnosticReport.category",
        "sliceName": "LabResult",
        "definition": "A code that classifies the Laboratory test(s) and Laboratory result(s). This is used for searching, sorting and display purposes.",
        "comment": "Multiple categories are allowed using various categorization schemes but at least one SHALL come from the FHIR defined value set that includes codes from HL7v2 Table 0074",
        "type": [
          {
            "code": "CodeableConcept"
          }
        ]
      },
      {
        "id": "DiagnosticReport.category:LabResult.coding.system",
        "path": "DiagnosticReport.category.coding.system",
        "min": 1,
        "fixedUri": "http://terminology.hl7.org/CodeSystem/v2-0074"
      },
      {
        "id": "DiagnosticReport.code",
        "path": "DiagnosticReport.code",
        "mustSupport": true
      },
      {
        "id": "DiagnosticReport.code.coding",
        "path": "DiagnosticReport.code.coding",
        "slicing": {
          "discriminator": [
            {
              "type": "pattern",
              "path": "$this"
            }
          ],
          "rules": "open"
        }
      },
      {
        "id": "DiagnosticReport.code.coding:LabResult",
        "path": "DiagnosticReport.code.coding",
        "sliceName": "LabResult",
        "definition": "A code that classifies the Laboratory test(s) and Laboratory result(s). This is used for searching, sorting and display purposes.",
        "comment": "The code SHALL be LOINC 11502-2 'Laboratory report' code"
      },
      {
        "id": "DiagnosticReport.code.coding:LabResult.system",
        "path": "DiagnosticReport.code.coding.system",
        "min": 1,
        "max": "1",
        "fixedUri": "http://loinc.org"
      },
      {
        "id": "DiagnosticReport.code.coding:LabResult.code",
        "path": "DiagnosticReport.code.coding.code",
        "min": 1,
        "max": "1",
        "fixedCode": "11502-2"
      },
      {
        "id": "DiagnosticReport.code.coding:@default",
        "path": "DiagnosticReport.code.coding",
        "sliceName": "@default",
        "definition": "A code that classifies the report(s) or result(s). This is used for searching, sorting and display purposes.",
        "comment": "It is preferrable that the coding comes from the LOINC code system"
      },
      {
        "id": "DiagnosticReport.code.coding:@default.system",
        "path": "DiagnosticReport.code.coding.system",
        "min": 1,
        "max": "1"
      },
      {
        "id": "DiagnosticReport.code.coding:@default.code",
        "path": "DiagnosticReport.code.coding.code",
        "min": 1,
        "max": "1"
      },
      {
        "id": "DiagnosticReport.subject",
        "path": "DiagnosticReport.subject",
        "type": [
          {
            "code": "Reference",
            "targetProfile": [
              "http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-patient",
              "http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-device",
              "http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-location"
            ]
          }
        ],
        "mustSupport": true
      },
      {
        "id": "DiagnosticReport.encounter",
        "path": "DiagnosticReport.encounter",
        "type": [
          {
            "code": "Reference",
            "targetProfile": [
              "http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-encounter"
            ]
          }
        ]
      },
      {
        "id": "DiagnosticReport.effective[x]",
        "path": "DiagnosticReport.effective[x]",
        "short": "Time of the report or note",
        "definition": "This is the Datetime or Period when the report or note was written.",
        "type": [
          {
            "code": "dateTime"
          },
          {
            "code": "Period"
          }
        ]
      },
      {
        "id": "DiagnosticReport.performer",
        "path": "DiagnosticReport.performer",
        "type": [
          {
            "code": "Reference",
            "targetProfile": [
              "http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-practitioner",
              "http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-practitionerrole",
              "http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-organization"
            ]
          }
        ]
      },
      {
        "id": "DiagnosticReport.resultsInterpreter",
        "path": "DiagnosticReport.resultsInterpreter",
        "type": [
          {
            "code": "Reference",
            "targetProfile": [
              "http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-practitioner",
              "http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-practitionerrole",
              "http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-organization"
            ]
          }
        ]
      },
      {
        "id": "DiagnosticReport.specimen",
        "path": "DiagnosticReport.specimen",
        "slicing": {
          "discriminator": [
            {
              "type": "pattern",
              "path": "$this"
            }
          ],
          "rules": "open"
        },
        "type": [
          {
            "code": "Reference",
            "targetProfile": [
              "http://hl7.org/fhir/StructureDefinition/Specimen"
            ]
          }
        ]
      },
      {
        "id": "DiagnosticReport.specimen:LabResult",
        "path": "DiagnosticReport.specimen",
        "sliceName": "LabResult",
        "comment": "Details about the specimen(s) on which this laboratory report is based on."
      },
      {
        "id": "DiagnosticReport.specimen:@default",
        "path": "DiagnosticReport.specimen",
        "sliceName": "@default",
        "comment": "Details about specimen(s) on which this report is based on.",
        "min": 0,
        "max": "*"
      },
      {
        "id": "DiagnosticReport.result",
        "path": "DiagnosticReport.result",
        "slicing": {
          "discriminator": [
            {
              "type": "profile",
              "path": "$this"
            }
          ],
          "rules": "open"
        },
        "mustSupport": true
      },
      {
        "id": "DiagnosticReport.result:LabResult",
        "path": "DiagnosticReport.result",
        "sliceName": "LabResult",
        "comment": "Observations that represent results produced by laboratory tests or panels/studies",
        "min": 0,
        "max": "*",
        "type": [
          {
            "code": "Reference",
            "targetProfile": [
              "http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-observation-results"
            ]
          }
        ]
      },
      {
        "id": "DiagnosticReport.result:@default",
        "path": "DiagnosticReport.result",
        "sliceName": "@default",
        "comment": "Observations that represent results produced for report",
        "min": 0,
        "max": "*",
        "type": [
          {
            "code": "Reference",
            "targetProfile": [
              "http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-observation"
            ]
          }
        ],
        "mustSupport": true
      },
      {
        "id": "DiagnosticReport.conclusionCode",
        "path": "DiagnosticReport.conclusionCode",
        "short": "CHI identification of the condition, problem or diagnosis",
        "definition": "The code that represents relevant clinical problems, conditions, diagnoses, symptoms, findings and complaints taken from [CHI Health Concern Code](https://fhir.infoway-inforoute.ca/ValueSet/healthconcerncode)",
        "comment": "The binding strength of this element is [Example](https://www.hl7.org/fhir/terminologies.html#strength), meaning that the Canada Health Infoway Health Concern Code value set provides examples of the types of concepts intended to be included",
        "type": [
          {
            "code": "CodeableConcept"
          }
        ],
        "binding": {
          "strength": "example",
          "description": "Represents the patient's relevant clinical problems, conditions, diagnoses, symptoms, findings and complaints, as interpreted by the provider.",
          "valueSet": "https://fhir.infoway-inforoute.ca/ValueSet/healthconcerncode"
        }
      }
    ]
  }
}