R4 Ballot #1 (Mixed Normative/Trial use)
DiagnosticsThis page is part of the FHIR Specification (v3.3.0: R4 Ballot 2). The current version which supercedes this version is 5.0.0. For a full list of available versions, see the Directory of published versions 
. Page versions: R4B R4 R3
| (No assigned work group) | Maturity Level: 1 | Informative | Use Context: Any |
StructureDefinition for Describes how the DiagnosticReport resource is used to report structured genetic test results
{
"resourceType": "StructureDefinition",
"id": "diagnosticreport-genetics",
"text": {
"status": "generated",
"div": "<div>!-- Snipped for Brevity --></div>"
},
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-ballot-status",
"valueString": "Trial Use"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/diagnosticreport-genetics",
"name": "DiagnosticReport-Genetics",
"status": "draft",
"experimental": false,
"date": "2015-10-09",
"publisher": "Health Level Seven International (Clinical Genomics)",
"contact": [
{
"telecom": [
{
"system": "url",
"value": "http://www.hl7.org/Special/committees/clingenomics"
}
]
}
],
"description": "Describes how the DiagnosticReport resource is used to report structured genetic test results",
"fhirVersion": "3.3.0",
"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"
}
],
"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": "DomainResource"
},
{
"key": "dom-1",
"severity": "error",
"human": "If the resource is contained in another resource, it SHALL NOT contain any narrative",
"expression": "contained.text.empty()",
"xpath": "not(parent::f:contained and f:text)",
"source": "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": "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.all(('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists())",
"xpath": "not(exists(for $contained in f:contained return $contained[not(parent::*/descendant::f:reference/@value=concat('#', $contained/*/id/@value) or descendant::f:reference[@value='#'])]))",
"source": "DomainResource"
}
],
"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": "Logical id of this artifact",
"definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
"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": 0,
"max": "1",
"base": {
"path": "Resource.id",
"min": 0,
"max": "1"
},
"type": [
{
"code": "id"
}
],
"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"
}
],
"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"
}
],
"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"
}
],
"isModifier": false,
"isSummary": false,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet",
"valueReference": {
"reference": "http://hl7.org/fhir/ValueSet/all-languages"
}
},
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "Language"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
"valueBoolean": true
}
],
"strength": "extensible",
"description": "A human language.",
"valueSetCanonical": "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 in formation is added later.",
"alias": [
"narrative",
"html",
"xhtml",
"display"
],
"min": 0,
"max": "1",
"base": {
"path": "DomainResource.text",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Narrative"
}
],
"condition": [
"dom-1"
],
"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.",
"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",
"slicing": {
"id": "7",
"discriminator": [
{
"type": "value",
"path": "url"
}
],
"ordered": false,
"rules": "open"
},
"short": "Extension",
"definition": "An Extension",
"min": 0,
"max": "*",
"base": {
"path": "DomainResource.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"isModifier": false,
"isSummary": false
},
{
"id": "DiagnosticReport.extension:assessedcondition",
"path": "DiagnosticReport.extension",
"sliceName": "AssessedCondition",
"short": "AssessedCondition",
"definition": "Used to denote condition context for genetic testing, which may influence reported variants and interpretation for large genomic testing panels e.g. lung cancer or familial breast cancer.",
"min": 0,
"max": "*",
"base": {
"path": "DomainResource.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension",
"profile": [
"http://hl7.org/fhir/StructureDefinition/DiagnosticReport-geneticsAssessedCondition"
]
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() | (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "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": "Extension"
}
],
"isModifier": false
},
{
"id": "DiagnosticReport.extension:familymemberhistory",
"path": "DiagnosticReport.extension",
"sliceName": "FamilyMemberHistory",
"short": "FamilyHistory",
"definition": "Significant health events and conditions for a person related to the patient relevant in the context of care for the patient.",
"min": 0,
"max": "*",
"base": {
"path": "DomainResource.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension",
"profile": [
"http://hl7.org/fhir/StructureDefinition/DiagnosticReport-geneticsFamilyMemberHistory"
]
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() | (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "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": "Extension"
}
],
"isModifier": false
},
{
"id": "DiagnosticReport.extension:analysis",
"path": "DiagnosticReport.extension",
"sliceName": "Analysis",
"short": "Analysis",
"definition": "Knowledge-based comments on the effect of the sequence on patient's condition/medication reaction.",
"min": 0,
"max": "*",
"base": {
"path": "DomainResource.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension",
"profile": [
"http://hl7.org/fhir/StructureDefinition/DiagnosticReport-geneticsAnalysis"
]
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() | (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "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": "Extension"
}
],
"isModifier": false
},
{
"id": "DiagnosticReport.extension:references",
"path": "DiagnosticReport.extension",
"sliceName": "References",
"short": "References",
"definition": "Additional bibliographic reference information about genetics, medications, clinical trials, etc. associated with knowledge-based information on genetics/genetic condition.",
"min": 0,
"max": "*",
"base": {
"path": "DomainResource.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension",
"profile": [
"http://hl7.org/fhir/StructureDefinition/DiagnosticReport-geneticsReferences"
]
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() | (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "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": "Extension"
}
],
"isModifier": false
},
{
"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. 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.",
"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.modifierExtension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"isModifier": true,
"isModifierReason": "Not known why this is labelled a modifier",
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "DiagnosticReport.identifier",
"path": "DiagnosticReport.identifier",
"short": "Business identifier for report",
"definition": "Identifiers assigned to this report by the performer or other systems.",
"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"
}
],
"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": "What was requested",
"definition": "Details concerning a service requested.",
"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"
]
}
],
"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": "registered | partial | preliminary | final +",
"definition": "The status of the diagnostic report.",
"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"
}
],
"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.",
"valueSetCanonical": "http://hl7.org/fhir/ValueSet/diagnostic-report-status"
},
"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": "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": "1",
"base": {
"path": "DiagnosticReport.category",
"min": 0,
"max": "1"
},
"type": [
{
"code": "CodeableConcept"
}
],
"isModifier": false,
"isSummary": true,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "DiagnosticServiceSection"
}
],
"strength": "example",
"description": "Codes for diagnostic service sections.",
"valueSetCanonical": "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"
}
],
"isModifier": false,
"isSummary": true,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "DiagnosticReportCodes"
}
],
"strength": "preferred",
"description": "Codes that describe Diagnostic Reports.",
"valueSetCanonical": "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": "The subject of the report - usually, but not always, the patient",
"definition": "The subject of the report. Usually, but not always, this is a patient. However diagnostic services also perform analyses on specimens collected from a variety of other sources.",
"requirements": "SHALL know the subject context.",
"alias": [
"Patient"
],
"min": 0,
"max": "1",
"base": {
"path": "DiagnosticReport.subject",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/Patient",
"http://hl7.org/fhir/StructureDefinition/Group",
"http://hl7.org/fhir/StructureDefinition/Device",
"http://hl7.org/fhir/StructureDefinition/Location"
]
}
],
"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.context",
"path": "DiagnosticReport.context",
"short": "Health care event when test ordered",
"definition": "The healthcare event (e.g. a patient and healthcare provider interaction) which this DiagnosticReport per 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 or episode but still be tied to the context of the encounter or episode (e.g. pre-admission laboratory tests).",
"requirements": "Links the request to the Encounter context.",
"alias": [
"Encounter"
],
"min": 0,
"max": "1",
"base": {
"path": "DiagnosticReport.context",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/Encounter",
"http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
]
}
],
"isModifier": false,
"isSummary": true,
"mapping": [
{
"identity": "workflow",
"map": "Event.context"
},
{
"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"
}
],
"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"
}
],
"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"
]
}
],
"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"
]
}
],
"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"
]
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "v2",
"map": "SPM"
},
{
"identity": "rim",
"map": "participation[typeCode=SBJ]"
}
]
},
{
"id": "DiagnosticReport.result",
"path": "DiagnosticReport.result",
"short": "Observations - simple, or complex nested groups",
"definition": "Observations that are part of this diagnostic report. Observations can be simple name/value pairs (e.g. \"atomic\" results), or they can be grouping observations that include references to other members of the group (e.g. \"panels\").",
"requirements": "Need to support individual results, or report groups of results, where the result grouping is arbitrary, but meaningful. This structure is recursive - observations can contain observations.",
"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"
]
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "v2",
"map": "OBXs"
},
{
"identity": "rim",
"map": "outboundRelationship[typeCode=COMP].target"
}
]
},
{
"id": "DiagnosticReport.imagingStudy",
"path": "DiagnosticReport.imagingStudy",
"short": "Reference to full details of imaging associated with the diagnostic report",
"definition": "One or more links to full details of any imaging performed during the diagnostic investigation. Typically, this is imaging performed by DICOM enabled modalities, but this is not required. A fully enabled PACS viewer can use this information to provide views of the source images.",
"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/StructureDefinition/ImagingStudy"
]
}
],
"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() | (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "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": "xml:id (or equivalent in JSON)",
"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": [
{
"code": "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"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "DiagnosticReport.media.modifierExtension",
"path": "DiagnosticReport.media.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 element and that modifies the understanding of the element in which it is contained. 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.",
"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",
"modifiers"
],
"min": 0,
"max": "*",
"base": {
"path": "BackboneElement.modifierExtension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"isModifier": true,
"isModifierReason": "modifierExtension is reserved for use where modifier extensions must be used",
"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"
}
],
"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"
]
}
],
"isModifier": false,
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": ".value.reference"
}
]
},
{
"id": "DiagnosticReport.conclusion",
"path": "DiagnosticReport.conclusion",
"short": "Clinical Interpretation of test results",
"definition": "Concise and clinically contextualized impression / summary 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"
}
],
"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.codedDiagnosis",
"path": "DiagnosticReport.codedDiagnosis",
"short": "Codes for the conclusion",
"definition": "Codes for the conclusion.",
"min": 0,
"max": "0",
"base": {
"path": "DiagnosticReport.codedDiagnosis",
"min": 0,
"max": "*"
},
"type": [
{
"code": "CodeableConcept"
}
],
"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.",
"valueSetCanonical": "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"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "v2",
"map": "OBX"
},
{
"identity": "rim",
"map": "text (type=ED)"
}
]
}
]
},
"differential": {
"element": [
{
"id": "DiagnosticReport",
"path": "DiagnosticReport",
"min": 0,
"max": "*"
},
{
"id": "DiagnosticReport.extension:assessedcondition",
"path": "DiagnosticReport.extension",
"sliceName": "AssessedCondition",
"short": "AssessedCondition",
"definition": "Used to denote condition context for genetic testing, which may influence reported variants and interpretation for large genomic testing panels e.g. lung cancer or familial breast cancer.",
"min": 0,
"max": "*",
"type": [
{
"code": "Extension",
"profile": [
"http://hl7.org/fhir/StructureDefinition/DiagnosticReport-geneticsAssessedCondition"
]
}
]
},
{
"id": "DiagnosticReport.extension:familymemberhistory",
"path": "DiagnosticReport.extension",
"sliceName": "FamilyMemberHistory",
"short": "FamilyHistory",
"definition": "Significant health events and conditions for a person related to the patient relevant in the context of care for the patient.",
"min": 0,
"max": "*",
"type": [
{
"code": "Extension",
"profile": [
"http://hl7.org/fhir/StructureDefinition/DiagnosticReport-geneticsFamilyMemberHistory"
]
}
]
},
{
"id": "DiagnosticReport.extension:analysis",
"path": "DiagnosticReport.extension",
"sliceName": "Analysis",
"short": "Analysis",
"definition": "Knowledge-based comments on the effect of the sequence on patient's condition/medication reaction.",
"min": 0,
"max": "*",
"type": [
{
"code": "Extension",
"profile": [
"http://hl7.org/fhir/StructureDefinition/DiagnosticReport-geneticsAnalysis"
]
}
]
},
{
"id": "DiagnosticReport.extension:references",
"path": "DiagnosticReport.extension",
"sliceName": "References",
"short": "References",
"definition": "Additional bibliographic reference information about genetics, medications, clinical trials, etc. associated with knowledge-based information on genetics/genetic condition.",
"min": 0,
"max": "*",
"type": [
{
"code": "Extension",
"profile": [
"http://hl7.org/fhir/StructureDefinition/DiagnosticReport-geneticsReferences"
]
}
]
},
{
"id": "DiagnosticReport.codedDiagnosis",
"path": "DiagnosticReport.codedDiagnosis",
"min": 0,
"max": "0",
"type": [
{
"code": "CodeableConcept"
}
]
}
]
}
}
®© HL7.org 2011+. FHIR Mixed Nomative/Trial Use Ballot (v3.3.0-13671) generated on Tue, Apr 3, 2018 12:15+1000. QA Page
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