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| Left: | US Core DiagnosticReport Profile for Report and Note Exchange (http://hl7.org/fhir/us/core/StructureDefinition/us-core-diagnosticreport-note) |
| Right: | US Core DiagnosticReport Profile for Report and Note Exchange (http://hl7.org/fhir/us/core/StructureDefinition/us-core-diagnosticreport-note) |
| Error | StructureDefinition.version | Values for version differ: '5.0.1' vs '8.0.0-ballot' |
| Information | StructureDefinition.date | Values for date differ: '2022-04-20' vs '2023-10-17' |
| Information | StructureDefinition.publisher | Values for publisher differ: 'HL7 International - Cross-Group Projects' vs 'HL7 International / Cross-Group Projects' |
| Information | StructureDefinition.definition | Values for definition differ: '\-' vs '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.' |
| Information | StructureDefinition.comment | Values for comment differ: '\-' vs '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.' |
| Information | StructureDefinition.short | Values for short differ: 'Health care event when test ordered' vs 'Encounter associated with DiagnosticReport' |
| Warning | DiagnosticReport.resultsInterpreter | Elements differ in definition for mustSupport: 'false' vs 'true' |
| Warning | DiagnosticReport.media | Elements differ in definition for mustSupport: 'true' vs 'false' |
| Warning | DiagnosticReport.media.link | Elements differ in definition for mustSupport: 'true' vs 'false' |
| Name | Value | Comments | |
|---|---|---|---|
| abstract | false | ||
| baseDefinition | http://hl7.org/fhir/StructureDefinition/DiagnosticReport | ||
| copyright | Used by permission of HL7 International, all rights reserved Creative Commons License | ||
| date | 2022-04-20 | 2023-10-17 |
|
| description | To promote interoperability and adoption through common implementation, this profile sets minimum expectations for searching and fetching Diagnostic Reports and Notes using the DiagnosticReport resource. This profile identifies the mandatory core elements, extensions, vocabularies and value sets which **SHALL** be present in the DiagnosticReport when using this profile. It provides the floor for standards development for specific uses cases. Prior to reviewing this profile, implementers are encouraged to read the Clinical Notes Guidance to understand the overlap of US Core DiagnosticReport Profile for Report and Note exchange and US Core DocumentReference Profile. | The US Core DiagnosticReport Profile for Report and Note Exchange inherits from the FHIR [DiagnosticReport](https://hl7.org/fhir/R4/diagnosticreport.html) resource; refer to it for scope and usage definitions. This profile sets minimum expectations for searching and fetching Diagnostic Reports and Notes using the DiagnosticReport resource. It specifies which core elements, extensions, vocabularies, and value sets **SHALL** be present in the resource and constrains how the elements are used. Providing the floor for standards development for specific use cases promotes interoperability and adoption. Before reviewing this profile, implementers are encouraged to read the Clinical Notes Guidance to understand the overlap of the US Core DiagnosticReport Profile for Report and Note exchange and the US Core DocumentReference Profile. |
|
| experimental | |||
| fhirVersion | 4.0.1 | ||
| jurisdiction | |||
| jurisdiction[0] | urn:iso:std:iso:3166#US | ||
| kind | resource | ||
| name | USCoreDiagnosticReportProfileNoteExchange | ||
| publisher | HL7 International - Cross-Group Projects | HL7 International / Cross-Group Projects |
|
| purpose | |||
| status | active | ||
| title | US Core DiagnosticReport Profile for Report and Note Exchange | ||
| type | DiagnosticReport | ||
| url | http://hl7.org/fhir/us/core/StructureDefinition/us-core-diagnosticreport-note | ||
| version | 5.0.1 | 8.0.0-ballot |
|
| Name | L Flags | L Card. | L Type | L Description & Constraints | R Flags | R Card. | R Type | R Description & Constraints | Comments | ||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
 DiagnosticReport | C | 0..* | DiagnosticReport | A Diagnostic report - a combination of request information, atomic results, images, interpretation, as well as formatted reports us-core-10: effective[x] SHALL be present if the status is 'partial', 'preliminary', 'final', 'amended', 'corrected' or 'appended' | C | 0..* | DiagnosticReport | A Diagnostic report - a combination of request information, atomic results, images, interpretation, as well as formatted reports us-core-10: effective[x] SHALL be present if the status is 'partial', 'preliminary', 'final', 'amended', 'corrected' or 'appended' | |||||||||
 id | Σ | 0..1 | string | Logical id of this artifact | Σ | 0..1 | id | Logical id of this artifact | |||||||||
| meta | Σ | 0..1 | Meta | Metadata about the resource | Σ | 0..1 | Meta | Metadata about the resource | |||||||||
| implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created | ?!Σ | 0..1 | uri | A set of rules under which this content was created | |||||||||
| language | 0..1 | code | Language of the resource content Binding: ?? (preferred): A human language.
| 0..1 | code | Language of the resource content Binding: ?? (preferred): A human language.
| |||||||||||
| text | 0..1 | Narrative | Text summary of the resource, for human interpretation | 0..1 | Narrative | Text summary of the resource, for human interpretation | |||||||||||
| contained | 0..* | Resource | Contained, inline Resources | 0..* | Resource | Contained, inline Resources | |||||||||||
 extension | 0..* | Extension | Additional content defined by implementations | 0..* | Extension | Additional content defined by implementations | |||||||||||
 modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored | ?! | 0..* | Extension | Extensions that cannot be ignored | |||||||||
| identifier | Σ | 0..* | Identifier | Business identifier for report | Σ | 0..* | Identifier | Business identifier for report | |||||||||
| basedOn | 0..* | Reference(CarePlan | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest) | What was requested | 0..* | Reference(CarePlan | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest) | What was requested | |||||||||||
| status | ?!SΣC | 1..1 | code | registered | partial | preliminary | final + Binding: ?? (required) | ?!SΣC | 1..1 | code | registered | partial | preliminary | final + Binding: ?? (required) | |||||||||
| Slices for category | SΣ | 1..* | CodeableConcept | Service category Slice: Unordered, Open by pattern:$this Binding: ?? (example): Codes for diagnostic service sections. | SΣ | 1..* | CodeableConcept | Service category Slice: Unordered, Open by value:$this Binding: ?? (example): Codes for diagnostic service sections. | |||||||||
| code | SΣ | 1..1 | CodeableConcept | US Core Report Code Binding: ?? (extensible): LOINC codes | SΣ | 1..1 | CodeableConcept | US Core Report Code Binding: ?? (extensible): LOINC codes | |||||||||
| subject | SΣ | 1..1 | Reference(US Core Patient Profile) | The subject of the report - usually, but not always, the patient | SΣ | 1..1 | Reference(US Core Patient Profile S | Group | Device | US Core Location Profile) | The subject of the report - usually, but not always, the patient | |||||||||
| encounter | SΣ | 0..1 | Reference(US Core Encounter Profile) | Health care event when test ordered | SΣ | 0..1 | Reference(US Core Encounter Profile) | Encounter associated with DiagnosticReport | |||||||||
| effective[x] | SΣC | 0..1 | dateTime S, Period | Diagnostically relevant time (typically the time of the procedure) | SΣC | 0..1 | dateTime S, Period | Diagnostically relevant time (typically the time of the procedure) | |||||||||
| issued | SΣ | 0..1 | instant | DateTime this version was made | SΣ | 0..1 | instant | DateTime this version was made | |||||||||
| performer | SΣ | 0..* | Reference(US Core Practitioner Profile S | US Core Organization Profile S | US Core PractitionerRole Profile | US Core CareTeam Profile) | Responsible Diagnostic Service | SΣ | 0..* | Reference(US Core Practitioner Profile S | US Core Organization Profile S | US Core PractitionerRole Profile | US Core CareTeam Profile) | Responsible Diagnostic Service | |||||||||
| resultsInterpreter | Σ | 0..* | Reference(Practitioner | PractitionerRole | Organization | CareTeam) | Primary result interpreter | SΣ | 0..* | Reference(US Core Practitioner Profile S | US Core Organization Profile | PractitionerRole | US Core CareTeam Profile) | Primary result interpreter |
| ||||||||
| specimen | 0..* | Reference(Specimen) | Specimens this report is based on | 0..* | Reference(Specimen) | Specimens this report is based on | |||||||||||
| result | S | 0..* | Reference(US Core Laboratory Result Observation Profile S | US Core Observation Clinical Test Result Profile S | US Core Observation Imaging Result Profile S) | Observations | S | 0..* | Reference(US Core Laboratory Result Observation Profile S | US Core Observation Clinical Result Profile S | Observation) | Observations | |||||||||
| imagingStudy | 0..* | Reference(ImagingStudy) | Reference to full details of imaging associated with the diagnostic report | 0..* | Reference(ImagingStudy) | Reference to full details of imaging associated with the diagnostic report | |||||||||||
| media | SΣ | 0..* | BackboneElement | Key images associated with this report | Σ | 0..* | BackboneElement | Key images associated with this report |
| ||||||||
 id | 0..1 | string | Unique id for inter-element referencing | 0..1 | string | Unique id for inter-element referencing | |||||||||||
| extension | 0..* | Extension | Additional content defined by implementations | 0..* | Extension | Additional content defined by implementations | |||||||||||
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | |||||||||
| comment | 0..1 | string | Comment about the image (e.g. explanation) | 0..1 | string | Comment about the image (e.g. explanation) | |||||||||||
| link | SΣ | 1..1 | Reference(Media) | Reference to the image source | Σ | 1..1 | Reference(Media) | Reference to the image source |
| ||||||||
| conclusion | 0..1 | string | Clinical conclusion (interpretation) of test results | 0..1 | string | Clinical conclusion (interpretation) of test results | |||||||||||
| conclusionCode | 0..* | CodeableConcept | Codes for the clinical conclusion of test results Binding: ?? (example): Diagnosis codes provided as adjuncts to the report. | 0..* | CodeableConcept | Codes for the clinical conclusion of test results Binding: ?? (example): Diagnosis codes provided as adjuncts to the report. | |||||||||||
| presentedForm | S | 0..* | Attachment | Entire report as issued | S | 0..* | Attachment | Entire report as issued | |||||||||
| Documentation for this format | |||||||||||||||||