Release 4

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Diagnosticreport-example-papsmear.ttl

Orders and Observations Work GroupMaturity Level: N/AStandards Status: InformativeCompartments: Device, Encounter, Patient, Practitioner

Raw Turtle (+ also see Turtle/RDF Format Specification)

An example of a principally narrative anatomic pathology report

@prefix fhir: <http://hl7.org/fhir/> .
@prefix loinc: <http://loinc.org/rdf#> .
@prefix owl: <http://www.w3.org/2002/07/owl#> .
@prefix rdfs: <http://www.w3.org/2000/01/rdf-schema#> .
@prefix xsd: <http://www.w3.org/2001/XMLSchema#> .

# - resource -------------------------------------------------------------------

<http://hl7.org/fhir/DiagnosticReport/pap> a fhir:DiagnosticReport;
  fhir:nodeRole fhir:treeRoot;
  fhir:Resource.id [ fhir:value "pap"];
  fhir:DomainResource.text [
     fhir:Narrative.status [ fhir:value "additional" ];
     fhir:Narrative.div "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n			<p>Acme Anatomic Pathology Services<br/>2216 Santa Monica Blvd, Suite 114<br/>Santa Monica, CA 90404<br/>===============================================================<br/>GYN CYTOLOGY (PAP SMEAR) REPORT<br/>===============================================================</p>\n			<p>Patient: Everywoman, Eve Report Date: 2/14/2013<br/>DOB: 05/31/1973 Age: 30 Sex: F MRN: PATID14567<br/>Patient Address: 2222 Home Street<br/> Huntington Park<br/> CA 90255<br/>Order: ORD40<br/>Physician: Careful, Adam 5742200012 (NPI)<br/>SpecimenID: GHSID40<br/>Collected Date: 2/11/2013<br/>Received Date: 2/12/2013<br/>LMP: 1/28/2013<br/>Specimen Source: Cervical Cytology (ThinPrep)<br/>Previously abnormal Pap? Unknown</p>\n			<p>Specimen Adequacy: Satisfactory<br/>Diagnostic Interpretation: Epithelial cell abnormality: Atypical squamous cells<br/>of undetermined significance<br/>Hormonal Evaluations: not possible, due to presence of atypical cells<br/>Recommendations: Appropriate Follow-up. Suggest repeat as clinically indicated<br/>Comments: Abnormal report reviewed by pathologist for confirmation</p>\n			<p/>\n		</div>"
  ];
  fhir:DiagnosticReport.status [ fhir:value "final"];
  fhir:DiagnosticReport.code [
     fhir:CodeableConcept.coding [
       fhir:index 0;
       a loinc:47527-7;
       fhir:Coding.system [ fhir:value "http://loinc.org" ];
       fhir:Coding.code [ fhir:value "47527-7" ]
     ]
  ];
  fhir:DiagnosticReport.subject [
     fhir:link <http://hl7.org/fhir/Patient/b248b1b2-1686-4b94-9936-37d7a5f94b51>;
     fhir:Reference.reference [ fhir:value "Patient/b248b1b2-1686-4b94-9936-37d7a5f94b51" ]
  ];
  fhir:DiagnosticReport.effectiveDateTime [ fhir:value "2013-02-11T10:33:33+11:00"^^xsd:dateTime];
  fhir:DiagnosticReport.issued [ fhir:value "2013-02-13T11:45:33+11:00"^^xsd:dateTime];
  fhir:DiagnosticReport.performer [
     fhir:index 0;
     fhir:link <http://hl7.org/fhir/Practitioner/example>;
     fhir:Reference.reference [ fhir:value "Practitioner/example" ]
  ] .

<http://hl7.org/fhir/Patient/b248b1b2-1686-4b94-9936-37d7a5f94b51> a fhir:Patient .

<http://hl7.org/fhir/Practitioner/example> a fhir:Practitioner .

# - ontology header ------------------------------------------------------------

<http://hl7.org/fhir/DiagnosticReport/pap.ttl> a owl:Ontology;
  owl:imports fhir:fhir.ttl;
  owl:versionIRI <http://build.fhir.org/DiagnosticReport/pap.ttl> .

# -------------------------------------------------------------------------------------

Usage note: every effort has been made to ensure that the examples are correct and useful, but they are not a normative part of the specification.