StructureDefinition: QICore-DiagnosticOrder - XML

QICore-DiagnosticOrder

<StructureDefinition xmlns="http://hl7.org/fhir">
  <id value="qicore-diagnosticorder"/>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml">to do</div>
  </text>
  <url value="http://hl7.org/fhir/StructureDefinition/qicore-diagnosticorder"/>
  <name value="QICore-DiagnosticOrder"/>
  <status value="draft"/>
  <publisher value="Health Level Seven International (Clinical Quality Information - QICore)"/>
  <contact>
    <telecom>
      <system value="other"/>
      <value value="http://hl7.org/special/committees/CQI"/>
    </telecom>
  </contact>
  <date value="2015-02-27"/>
  <description value="Profile of DiagnosticOrder for decision support/quality metrics. Defines the core set
   of elements and extensions for quality rule and measure authors."/>
  <fhirVersion value="1.0.2"/>
  <mapping>
    <identity value="qdm"/>
    <uri value="http://www.healthit.gov/quality-data-model"/>
    <name value="Quality Data Model"/>
  </mapping>
  <kind value="resource"/>
  <constrainedType value="DiagnosticOrder"/>
  <abstract value="false"/>
  <base value="http://hl7.org/fhir/StructureDefinition/DiagnosticOrder"/>
  <snapshot>
    <element>
      <path value="DiagnosticOrder"/>
      <name value="QICore-DiagnosticOrder"/>
      <short value="A request for a diagnostic service"/>
      <definition value="A record of a request for a diagnostic investigation service to be performed."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="DiagnosticOrder"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="DiagnosticOrder"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="Observation[classCode=OBS, moodCode=RQO, code&lt;&quot;diagnostic order&quot;]"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="clinical.diagnostics"/>
      </mapping>
      <mapping>
        <identity value="qdm"/>
        <map value="&quot;Diagnostic Study, Order&quot;; &quot;Diagnostic Study, Recommended&quot; (when DiagnosticOrder
        .status=&quot;recommended&quot;)"/>
      </mapping>
    </element>
    <element>
      <path value="DiagnosticOrder.id"/>
      <short value="Logical id of this artifact"/>
      <definition value="The logical id of the resource, as used in the URL for the resource. Once assigned, this
       value never changes."/>
      <comments value="The only time that a resource does not have an id is when it is being submitted to the
       server using a create operation. Bundles always have an id, though it is usually a generated
       UUID."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="DiagnosticOrder.id"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="id"/>
      </type>
      <isSummary value="true"/>
    </element>
    <element>
      <path value="DiagnosticOrder.meta"/>
      <short value="Metadata about the resource"/>
      <definition value="The metadata about the resource. This is content that is maintained by the infrastructure.
       Changes to the content may not always be associated with version changes to the resource."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="DiagnosticOrder.meta"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Meta"/>
      </type>
      <isSummary value="true"/>
    </element>
    <element>
      <path value="DiagnosticOrder.implicitRules"/>
      <short value="A set of rules under which this content was created"/>
      <definition value="A reference to a set of rules that were followed when the resource was constructed, and
       which must be understood when processing the content."/>
      <comments value="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 as much as possible."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="DiagnosticOrder.implicitRules"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="uri"/>
      </type>
      <isModifier value="true"/>
      <isSummary value="true"/>
    </element>
    <element>
      <path value="DiagnosticOrder.language"/>
      <short value="Language of the resource content"/>
      <definition value="The base language in which the resource is written."/>
      <comments value="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 value="0"/>
      <max value="1"/>
      <base>
        <path value="DiagnosticOrder.language"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="code"/>
      </type>
      <binding>
        <strength value="required"/>
        <description value="A human language."/>
        <valueSetUri value="http://tools.ietf.org/html/bcp47"/>
      </binding>
    </element>
    <element>
      <path value="DiagnosticOrder.text"/>
      <short value="Text summary of the resource, for human interpretation"/>
      <definition value="A human-readable narrative that contains a summary of the resource, and may 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 &quot;clinically
       safe&quot; for a human to just read the narrative. Resource definitions may define what
       content should be represented in the narrative to ensure clinical safety."/>
      <comments value="Contained resources do not have narrative. Resources that are not contained SHOULD have
       a narrative."/>
      <alias value="narrative"/>
      <alias value="html"/>
      <alias value="xhtml"/>
      <alias value="display"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="DiagnosticOrder.text"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Narrative"/>
      </type>
      <condition value="dom-1"/>
      <mapping>
        <identity value="rim"/>
        <map value="Act.text?"/>
      </mapping>
    </element>
    <element>
      <path value="DiagnosticOrder.contained"/>
      <short value="Contained, inline Resources"/>
      <definition value="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."/>
      <comments value="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 value="inline resources"/>
      <alias value="anonymous resources"/>
      <alias value="contained resources"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="DiagnosticOrder.contained"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Resource"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element>
      <path value="DiagnosticOrder.extension"/>
      <slicing>
        <discriminator value="url"/>
        <ordered value="false"/>
        <rules value="open"/>
      </slicing>
      <short value="Additional Content defined by implementations"/>
      <definition value="May be used to represent additional information that is not part of the basic definition
       of the resource. In order 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."/>
      <comments value="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 value="extensions"/>
      <alias value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="DiagnosticOrder.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element>
      <path value="DiagnosticOrder.extension"/>
      <name value="DiagnosticOrder.reasonRejected"/>
      <short value="Reason order rejected"/>
      <definition value="The coded reason why the order was rejected."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="DiagnosticOrder.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/diagnosticorder-reasonRejected"/>
      </type>
      <binding>
        <strength value="example"/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/qicore-diagnosticorder-reason-rejected"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="qdm"/>
        <map value="negation rationale (when DiagnosticOrder.status=&quot;rejected&quot;)"/>
      </mapping>
    </element>
    <element>
      <path value="DiagnosticOrder.modifierExtension"/>
      <short value="Extensions that cannot be ignored"/>
      <definition value="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. In order 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."/>
      <comments value="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 value="extensions"/>
      <alias value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="DiagnosticOrder.modifierExtension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <isModifier value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element>
      <path value="DiagnosticOrder.subject"/>
      <short value="Who and/or what test is about"/>
      <definition value="Who or what the investigation is to be performed on. This is usually a human patient,
       but diagnostic tests can also be requested on animals, groups of humans or animals, devices
       such as dialysis machines, or even locations (typically for environmental scans)."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="DiagnosticOrder.subject"/>
        <min value="1"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Reference"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/qicore-patient"/>
      </type>
      <type>
        <code value="Reference"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/Group"/>
      </type>
      <type>
        <code value="Reference"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/qicore-location"/>
      </type>
      <type>
        <code value="Reference"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/qicore-device"/>
      </type>
      <mustSupport value="true"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value=".participation[typeCode=SBJ].role"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="who.focus"/>
      </mapping>
    </element>
    <element>
      <path value="DiagnosticOrder.orderer"/>
      <short value="Who ordered the test"/>
      <definition value="The practitioner that holds legal responsibility for ordering the investigation."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="DiagnosticOrder.orderer"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Reference"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/qicore-practitioner"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value=".participation[typeCode=AUT].role"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="who.actor"/>
      </mapping>
    </element>
    <element>
      <path value="DiagnosticOrder.identifier"/>
      <short value="Identifiers assigned to this order"/>
      <definition value="Identifiers assigned to this order instance by the orderer and/or  the receiver and/or
       order fulfiller."/>
      <comments value="The identifier.type element is used to distinguish between the identifiers assigned by
       the orderer (known as the 'Placer' in HL7 v2) and the producer of the observations in
       response to the order (known as the 'Filler' in HL7 v2). For further discussion and examples
       see the [notes section](diagnosticorder.html#4.22.4) below."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="DiagnosticOrder.identifier"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Identifier"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value=".id"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="id"/>
      </mapping>
    </element>
    <element>
      <path value="DiagnosticOrder.encounter"/>
      <short value="The encounter that this diagnostic order is associated with"/>
      <definition value="An encounter that provides additional information about the healthcare context in which
       this request is made."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="DiagnosticOrder.encounter"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Reference"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/qicore-encounter"/>
      </type>
      <mustSupport value="true"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value=".inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN]"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="context"/>
      </mapping>
    </element>
    <element>
      <path value="DiagnosticOrder.reason"/>
      <short value="Explanation/Justification for test"/>
      <definition value="An explanation or justification for why this diagnostic investigation is being requested.
         This is often for billing purposes.  May relate to the resources referred to in supportingInformat
      ion."/>
      <comments value="This may be used to decide how the diagnostic investigation will be performed, or even
       if it will be performed at all.   Use CodeableConcept text element if the data is free
       (uncoded) text as shown in the [CT Scan example](diagnosticorder-example-di.html)."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="DiagnosticOrder.reason"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <binding>
        <strength value="preferred"/>
        <description value="The code for the condition"/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/daf-problem"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="rim"/>
        <map value=".reasonCode"/>
      </mapping>
      <mapping>
        <identity value="qdm"/>
        <map value="reason"/>
      </mapping>
    </element>
    <element>
      <path value="DiagnosticOrder.supportingInformation"/>
      <short value="Additional clinical information"/>
      <definition value="Additional clinical information about the patient or specimen that may influence test
       interpretations.  This includes observations explicitly requested by the producer(filler)
       to provide context or supporting information needed to complete the order."/>
      <comments value="This information includes diagnosis, clinical findings and other observations.  In laboratory
       ordering these are typically referred to as &quot;ask at order entry questions (AOEs)&quot;.
       Examples include reporting the amount of inspired oxygen for blood gasses, the point in
       the menstrual cycle for cervical pap tests, and other conditions that influence test interpretations
      ."/>
      <alias value="Ask at order entry question"/>
      <alias value="AOE"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="DiagnosticOrder.supportingInformation"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Reference"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/qicore-observation"/>
      </type>
      <type>
        <code value="Reference"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/qicore-condition"/>
      </type>
      <type>
        <code value="Reference"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/DocumentReference"/>
      </type>
      <mapping>
        <identity value="v2"/>
        <map value="OBR-13"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="outboundRelationship[typeCode=SPRT]/target[classCode=ACT, moodCode=EVN]"/>
      </mapping>
    </element>
    <element>
      <path value="DiagnosticOrder.specimen"/>
      <short value="If the whole order relates to specific specimens"/>
      <definition value="One or more specimens that the diagnostic investigation is about."/>
      <comments value="Many investigation requests will create a need for specimens, but the request itself is
       not actually about the specimens. This is provided for when the diagnostic investigation
       is requested on already existing specimens."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="DiagnosticOrder.specimen"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Reference"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/qicore-specimen"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value=".participation[typeCode=SPC].role"/>
      </mapping>
    </element>
    <element>
      <path value="DiagnosticOrder.status"/>
      <short value="proposed | draft | planned | requested | received | accepted | in-progress | review |
       completed | cancelled | suspended | rejected | failed"/>
      <definition value="The status of the order."/>
      <comments value="Typically the system placing the order sets the status to &quot;requested&quot;. Thereafter,
       the order is maintained by the receiver that updates the status as the request is handled."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="DiagnosticOrder.status"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="code"/>
      </type>
      <mustSupport value="true"/>
      <isModifier value="true"/>
      <isSummary value="true"/>
      <binding>
        <strength value="required"/>
        <description value="The status of a diagnostic order."/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/diagnostic-order-status"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="rim"/>
        <map value=".statusCode also influenced by whether a ControlAct fulfillment requeste exists, whether
         a promise exists, status of the review component, whether a fulfilling observation exists,
         whether a refusal exists"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="status"/>
      </mapping>
      <mapping>
        <identity value="qdm"/>
        <map value="negation rationale (when DiagnosticOrder.status=&quot;rejected&quot;)"/>
      </mapping>
    </element>
    <element>
      <path value="DiagnosticOrder.priority"/>
      <short value="routine | urgent | stat | asap"/>
      <definition value="The clinical priority associated with this order."/>
      <comments value="The Order resource also has a priority. Generally, these should be the same, but they
       can be different. For instance, where the clinician indicates the order is urgent, but
       the subsequent workflow process overrules the priority for some reason. The effective
       default value is &quot;normal&quot;."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="DiagnosticOrder.priority"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="code"/>
      </type>
      <isSummary value="true"/>
      <binding>
        <strength value="required"/>
        <description value="The clinical priority of a diagnostic order."/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/diagnostic-order-priority"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="rim"/>
        <map value=".priorityCode"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="grade"/>
      </mapping>
    </element>
    <element>
      <path value="DiagnosticOrder.event"/>
      <short value="A list of events of interest in the lifecycle"/>
      <definition value="A summary of the events of interest that have occurred as the request is processed; e.g.
       when the order was made, various processing steps (specimens received), when it was completed."/>
      <comments value="This is not the same as an audit trail. It is a view of the important things that happened
       in the past. Typically, there would only be one entry for any given status, and systems
       may not record all the status events."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="DiagnosticOrder.event"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="BackboneElement"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value=".inboundRelationship[typeCode=FLFS].source"/>
      </mapping>
    </element>
    <element>
      <path value="DiagnosticOrder.event.id"/>
      <representation value="xmlAttr"/>
      <short value="xml:id (or equivalent in JSON)"/>
      <definition value="unique id for the element within a resource (for internal references)."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="DiagnosticOrder.event.id"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="id"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element>
      <path value="DiagnosticOrder.event.extension"/>
      <short value="Additional Content defined by implementations"/>
      <definition value="May be used to represent additional information that is not part of the basic definition
       of the element. In order 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."/>
      <comments value="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 value="extensions"/>
      <alias value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="DiagnosticOrder.event.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element>
      <path value="DiagnosticOrder.event.modifierExtension"/>
      <short value="Extensions that cannot be ignored"/>
      <definition value="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 that contains it. Usually
       modifier elements provide negation or qualification. In order 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."/>
      <comments value="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 value="extensions"/>
      <alias value="user content"/>
      <alias value="modifiers"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="DiagnosticOrder.event.modifierExtension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <isModifier value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element>
      <path value="DiagnosticOrder.event.status"/>
      <short value="proposed | draft | planned | requested | received | accepted | in-progress | review |
       completed | cancelled | suspended | rejected | failed"/>
      <definition value="The status for the event."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="DiagnosticOrder.event.status"/>
        <min value="1"/>
        <max value="1"/>
      </base>
      <type>
        <code value="code"/>
      </type>
      <isSummary value="true"/>
      <binding>
        <strength value="required"/>
        <description value="The status of a diagnostic order."/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/diagnostic-order-status"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="rim"/>
        <map value=".statusCode also influenced by whether a ControlAct fulfillment requeste exists, whether
         a promise exists, status of the review component, whether a fulfilling observation exists,
         whether a refusal exists"/>
      </mapping>
    </element>
    <element>
      <path value="DiagnosticOrder.event.description"/>
      <short value="More information about the event and its context"/>
      <definition value="Additional information about the event that occurred - e.g. if the status remained unchanged."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="DiagnosticOrder.event.description"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <isSummary value="true"/>
      <binding>
        <strength value="example"/>
        <description value="Additional information about an event that occurred to a diagnostic order - e.g. if the
         status remained unchanged."/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/diagnostic-order-event"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="rim"/>
        <map value=".text"/>
      </mapping>
    </element>
    <element>
      <path value="DiagnosticOrder.event.dateTime"/>
      <short value="The date at which the event happened"/>
      <definition value="The date/time at which the event occurred."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="DiagnosticOrder.event.dateTime"/>
        <min value="1"/>
        <max value="1"/>
      </base>
      <type>
        <code value="dateTime"/>
      </type>
      <mustSupport value="true"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value=".effectiveTime"/>
      </mapping>
      <mapping>
        <identity value="qdm"/>
        <map value="start datetime (where event.status=&quot;requested&quot;), stop datetime (where event.status=&quot;i
        n-progress&quot;)"/>
      </mapping>
    </element>
    <element>
      <path value="DiagnosticOrder.event.actor"/>
      <short value="Who recorded or did this"/>
      <definition value="The person responsible for performing or recording the action."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="DiagnosticOrder.event.actor"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Reference"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/qicore-practitioner"/>
      </type>
      <type>
        <code value="Reference"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/qicore-device"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value=".participation[AUT or PFM]"/>
      </mapping>
    </element>
    <element>
      <path value="DiagnosticOrder.item"/>
      <short value="The items the orderer requested"/>
      <definition value="The specific diagnostic investigations that are requested as part of this request. Sometimes,
       there can only be one item per request, but in most contexts, more than one investigation
       can be requested."/>
      <comments value="There would always be at least one item in normal usage, but this is optional so that
       a workflow can quote order details without having to list the items."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="DiagnosticOrder.item"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="BackboneElement"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value=".outboundRelationship[typeCode=COMP].target[classCode=OBS, moodCode=OBS]"/>
      </mapping>
    </element>
    <element>
      <path value="DiagnosticOrder.item.id"/>
      <representation value="xmlAttr"/>
      <short value="xml:id (or equivalent in JSON)"/>
      <definition value="unique id for the element within a resource (for internal references)."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="DiagnosticOrder.item.id"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="id"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element>
      <path value="DiagnosticOrder.item.extension"/>
      <slicing>
        <discriminator value="url"/>
        <ordered value="false"/>
        <rules value="open"/>
      </slicing>
      <short value="Additional Content defined by implementations"/>
      <definition value="May be used to represent additional information that is not part of the basic definition
       of the element. In order 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."/>
      <comments value="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 value="extensions"/>
      <alias value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="DiagnosticOrder.item.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element>
      <path value="DiagnosticOrder.item.extension"/>
      <name value="DiagnosticOrder.item.precondition"/>
      <short value="Extension"/>
      <definition value="An Extension"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="DiagnosticOrder.item.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/diagnosticorder-precondition"/>
      </type>
      <binding>
        <strength value="preferred"/>
        <description value="Code indicating condition, state, or problem that the patient is in or has prior to a
         therapy or procedure."/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/qicore-diagnosticorder-precondition"/>
        </valueSetReference>
      </binding>
    </element>
    <element>
      <path value="DiagnosticOrder.item.modifierExtension"/>
      <short value="Extensions that cannot be ignored"/>
      <definition value="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 that contains it. Usually
       modifier elements provide negation or qualification. In order 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."/>
      <comments value="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 value="extensions"/>
      <alias value="user content"/>
      <alias value="modifiers"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="DiagnosticOrder.item.modifierExtension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <isModifier value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element>
      <path value="DiagnosticOrder.item.code"/>
      <short value="Code to indicate the item (test or panel) being ordered"/>
      <definition value="A code that identifies a particular diagnostic investigation, or panel of investigations,
       that have been requested."/>
      <comments value="Many laboratory tests and radiology tests embed the specimen/organ system in the test
       name, for example,  serum or serum/plasma glucose, or a chest xray. The specimen may not
       be recorded separately from the test code."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="DiagnosticOrder.item.code"/>
        <min value="1"/>
        <max value="1"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <mustSupport value="true"/>
      <isSummary value="true"/>
      <binding>
        <strength value="preferred"/>
        <description value="LOINC codes for tests/services that can be performed by diagnostic services"/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/uslab-obs-codes"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="v2"/>
        <map value="OBX-4"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".code"/>
      </mapping>
      <mapping>
        <identity value="qdm"/>
        <map value="primary code"/>
      </mapping>
    </element>
    <element>
      <path value="DiagnosticOrder.item.specimen"/>
      <short value="If this item relates to specific specimens"/>
      <definition value="If the item is related to a specific specimen."/>
      <comments value="A single specimen should not appear in both DiagnosticOrder.specimen and DiagnosticOrder.item.specim
      en."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="DiagnosticOrder.item.specimen"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Reference"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/qicore-specimen"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value=".participation[typeCode=SPC].role"/>
      </mapping>
    </element>
    <element>
      <path value="DiagnosticOrder.item.bodySite"/>
      <short value="Location of requested test (if applicable)"/>
      <definition value="Anatomical location where the request test should be performed.  This is the target site."/>
      <comments value="If the use case requires BodySite to be handled as a separate resource instead of an inline
       coded element (e.g. to identify and track separately)  then use the standard extension
       [body-site-instance](extension-body-site-instance.html)."/>
      <alias value="location"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="DiagnosticOrder.item.bodySite"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <mustSupport value="true"/>
      <binding>
        <strength value="example"/>
        <description value="Codes describing anatomical locations. May include laterality."/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/body-site"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="rim"/>
        <map value="targetSiteCode"/>
      </mapping>
    </element>
    <element>
      <path value="DiagnosticOrder.item.status"/>
      <short value="proposed | draft | planned | requested | received | accepted | in-progress | review |
       completed | cancelled | suspended | rejected | failed"/>
      <definition value="The status of this individual item within the order."/>
      <comments value="If the request has multiple items that have their own life cycles, then the items will
       have their own status while the overall diagnostic order is (usually) &quot;in-progress&quot;."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="DiagnosticOrder.item.status"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="code"/>
      </type>
      <isSummary value="true"/>
      <binding>
        <strength value="required"/>
        <description value="The status of a diagnostic order."/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/diagnostic-order-status"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="rim"/>
        <map value=".statusCode also influenced by whether a ControlAct fulfillment requeste exists, whether
         a promise exists, status of the review component, whether a fulfilling observation exists,
         whether a refusal exists"/>
      </mapping>
    </element>
    <element>
      <path value="DiagnosticOrder.item.event"/>
      <short value="Events specific to this item"/>
      <definition value="A summary of the events of interest that have occurred as this item of the request is
       processed."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="DiagnosticOrder.item.event"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <nameReference value="event"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value=".inboundRelationship[typeCode=FLFS].source"/>
      </mapping>
    </element>
    <element>
      <path value="DiagnosticOrder.note"/>
      <short value="Other notes and comments"/>
      <definition value="Any other notes associated with this patient, specimen or order (e.g. &quot;patient hates
       needles&quot;)."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="DiagnosticOrder.note"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Annotation"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value=".inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code=&quot;annotation&quot;]
        .value"/>
      </mapping>
    </element>
  </snapshot>
  <differential>
    <element>
      <path value="DiagnosticOrder"/>
      <name value="QICore-DiagnosticOrder"/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="DiagnosticOrder"/>
      </type>
      <mapping>
        <identity value="qdm"/>
        <map value="&quot;Diagnostic Study, Order&quot;; &quot;Diagnostic Study, Recommended&quot; (when DiagnosticOrder
        .status=&quot;recommended&quot;)"/>
      </mapping>
    </element>
    <element>
      <path value="DiagnosticOrder.extension"/>
      <name value="DiagnosticOrder.reasonRejected"/>
      <slicing>
        <discriminator value="url"/>
        <ordered value="false"/>
        <rules value="open"/>
      </slicing>
      <short value="Reason order rejected"/>
      <definition value="The coded reason why the order was rejected."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Extension"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/diagnosticorder-reasonRejected"/>
      </type>
      <binding>
        <strength value="example"/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/qicore-diagnosticorder-reason-rejected"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="qdm"/>
        <map value="negation rationale (when DiagnosticOrder.status=&quot;rejected&quot;)"/>
      </mapping>
    </element>
    <element>
      <path value="DiagnosticOrder.subject"/>
      <type>
        <code value="Reference"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/qicore-patient"/>
      </type>
      <type>
        <code value="Reference"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/Group"/>
      </type>
      <type>
        <code value="Reference"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/qicore-location"/>
      </type>
      <type>
        <code value="Reference"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/qicore-device"/>
      </type>
      <mustSupport value="true"/>
    </element>
    <element>
      <path value="DiagnosticOrder.orderer"/>
      <type>
        <code value="Reference"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/qicore-practitioner"/>
      </type>
    </element>
    <element>
      <path value="DiagnosticOrder.encounter"/>
      <type>
        <code value="Reference"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/qicore-encounter"/>
      </type>
      <mustSupport value="true"/>
    </element>
    <element>
      <path value="DiagnosticOrder.reason"/>
      <binding>
        <strength value="preferred"/>
        <description value="The code for the condition"/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/daf-problem"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="qdm"/>
        <map value="reason"/>
      </mapping>
    </element>
    <element>
      <path value="DiagnosticOrder.supportingInformation"/>
      <type>
        <code value="Reference"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/qicore-observation"/>
      </type>
      <type>
        <code value="Reference"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/qicore-condition"/>
      </type>
      <type>
        <code value="Reference"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/DocumentReference"/>
      </type>
    </element>
    <element>
      <path value="DiagnosticOrder.specimen"/>
      <type>
        <code value="Reference"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/qicore-specimen"/>
      </type>
    </element>
    <element>
      <path value="DiagnosticOrder.status"/>
      <mustSupport value="true"/>
      <mapping>
        <identity value="qdm"/>
        <map value="negation rationale (when DiagnosticOrder.status=&quot;rejected&quot;)"/>
      </mapping>
    </element>
    <element>
      <path value="DiagnosticOrder.event"/>
    </element>
    <element>
      <path value="DiagnosticOrder.event.dateTime"/>
      <mustSupport value="true"/>
      <mapping>
        <identity value="qdm"/>
        <map value="start datetime (where event.status=&quot;requested&quot;), stop datetime (where event.status=&quot;i
        n-progress&quot;)"/>
      </mapping>
    </element>
    <element>
      <path value="DiagnosticOrder.event.actor"/>
      <type>
        <code value="Reference"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/qicore-practitioner"/>
      </type>
      <type>
        <code value="Reference"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/qicore-device"/>
      </type>
    </element>
    <element>
      <path value="DiagnosticOrder.item"/>
    </element>
    <element>
      <path value="DiagnosticOrder.item.extension"/>
      <name value="DiagnosticOrder.item.precondition"/>
      <slicing>
        <discriminator value="url"/>
        <ordered value="false"/>
        <rules value="open"/>
      </slicing>
      <type>
        <code value="Extension"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/diagnosticorder-precondition"/>
      </type>
      <binding>
        <strength value="preferred"/>
        <description value="Code indicating condition, state, or problem that the patient is in or has prior to a
         therapy or procedure."/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/qicore-diagnosticorder-precondition"/>
        </valueSetReference>
      </binding>
    </element>
    <element>
      <path value="DiagnosticOrder.item.code"/>
      <mustSupport value="true"/>
      <binding>
        <strength value="preferred"/>
        <description value="LOINC codes for tests/services that can be performed by diagnostic services"/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/uslab-obs-codes"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="qdm"/>
        <map value="primary code"/>
      </mapping>
    </element>
    <element>
      <path value="DiagnosticOrder.item.specimen"/>
      <type>
        <code value="Reference"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/qicore-specimen"/>
      </type>
    </element>
    <element>
      <path value="DiagnosticOrder.item.bodySite"/>
      <mustSupport value="true"/>
    </element>
  </differential>
</StructureDefinition>