StructureDefinition UKCore-DiagnosticReport-Lab

Canonical_URLStatusCurrent_VersionLast_UpdatedDescription
https://fhir.hl7.org.uk/StructureDefinition/UKCore-DiagnosticReport-Labactive2.0.12024-07-23

This profile defines the UK constraints and extensions on the International FHIR resource DiagnosticReport, to provide laboratory specific support for test results.


Profile_Purpose

To provide implementers with additional support when implementing test result data and to provide a consistent structure to how the data is presented.

idΣ0..1string
metaΣ0..1Meta
implicitRulesΣ ?!0..1uri
language0..1codeBinding
text0..1Narrative
contained0..*Resource
id0..1string
extensionI0..*Extension
url1..1uriFixed Value
valueReferenceReference(Composition)
id0..1string
extensionI0..*Extension
url1..1uriFixed Value
valueAnnotationAnnotation
id0..1string
id0..1string
extensionI0..*Extension
url1..1uriFixed Value
valueCodeableConceptCodeableConcept
id0..1string
extensionI0..*Extension
url1..1uriFixed Value
valueReferenceReference(Procedure | Observation | DiagnosticReport)
url1..1uriFixed Value
modifierExtension?! I0..*Extension
identifierΣ0..*Identifier
basedOnI0..*Reference(CarePlan | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest)
statusS Σ ?!1..1codeBinding
id0..1string
extensionI0..*Extension
id0..1string
extensionI0..*Extension
systemΣ0..1uriFixed Value
versionΣ0..1string
codeΣ0..1codeFixed Value
displayΣ0..1string
userSelectedΣ0..1boolean
textΣ0..1string
codeS Σ1..1CodeableConceptBinding
subjectS Σ I1..1Reference(Patient)
encounterΣ I0..1Reference(Encounter)
effectiveDateTimedateTime
effectivePeriodPeriod
issuedS Σ0..1instant
id0..1string
deviceReferenceI0..1Extension(Reference(Device))
referenceΣ I0..1string
typeΣ0..1uriBinding
identifierΣ0..1Identifier
displayΣ0..1string
id0..1string
deviceReferenceI0..*Extension(Reference(Device))
referenceΣ I0..1string
typeΣ0..1uriBinding
identifierΣ0..1Identifier
displayΣ0..1string
specimenI0..*Reference(Specimen)
resultS I0..*Reference(Observation)
imagingStudyI0..*Reference(ImagingStudy)
id0..1string
extensionI0..*Extension
modifierExtensionΣ ?! I0..*Extension
comment0..1string
conclusion0..1string
conclusionCode0..*CodeableConceptBinding
presentedFormI0..*Attachment

Detailed Descriptions

DiagnosticReport
DefinitionThe 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.
Cardinality0...*
AliasReport, Test, Result, Results, Labs, Laboratory
Comments

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.

Invariants
  • dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources
    contained.contained.empty()
  • dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
    contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
  • dom-3: 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
    contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
  • dom-6: A resource should have narrative for robust management
    text.`div`.exists()
  • dom-5: If a resource is contained in another resource, it SHALL NOT have a security label
    contained.meta.security.empty()
  • ukcore-diag-lab-001: An issued time SHOULD be present if status = partial, preliminary, final, amended, corrected or appended
    issued.exists() or (issued.empty() and (status in ('partial' | 'preliminary' | 'final' | 'amended' | 'corrected' | 'appended')).not())
Mappings
  • rim: Entity. Role, or Act
  • workflow: Event
  • v2: ORU -> OBR
  • rim: Observation[classCode=OBS, moodCode=EVN]
DiagnosticReport.id
DefinitionThe logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
Cardinality0...1
Typestring
SummaryTrue
Comments

The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

DiagnosticReport.meta
DefinitionThe 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.
Cardinality0...1
TypeMeta
SummaryTrue
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: N/A
DiagnosticReport.implicitRules
DefinitionA 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.
Cardinality0...1
Typeuri
ModifierTrue
SummaryTrue
Comments

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.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
DiagnosticReport.language
DefinitionThe base language in which the resource is written.
Cardinality0...1
Typecode
Binding

A human language.

CommonLanguages (preferred)
Comments

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).

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
DiagnosticReport.text
DefinitionA 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.
Cardinality0...1
TypeNarrative
Aliasnarrative, html, xhtml, display
Comments

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 information is added later.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: N/A
  • rim: Act.text?
DiagnosticReport.contained
DefinitionThese 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.
Cardinality0...*
TypeResource
Aliasinline resources, anonymous resources, contained resources
Comments

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. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.

Mappings
  • rim: Entity. Role, or Act
  • rim: N/A
DiagnosticReport.extension
DefinitionMay be used to represent additional information that is not part of the basic definition of the resource. 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.
Cardinality0...*
TypeExtension
Aliasextensions, user content
Comments

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.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
DiagnosticReport.extension:compositionReferenceR5
DefinitionA Reference to a Composition resource instance that provides structure for organizing the contents of the DiagnosticReport.
Cardinality0...1
TypeExtension(Reference(Composition))
Aliasextensions, user content
Comments

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.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
DiagnosticReport.extension:compositionReferenceR5.id
DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Mappings
  • rim: n/a
DiagnosticReport.extension:compositionReferenceR5.extension
DefinitionMay 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.
Cardinality0...*
TypeExtension
Aliasextensions, user content
Comments

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.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
DiagnosticReport.extension:compositionReferenceR5.url
DefinitionSource of the definition for the extension code - a logical name or a URL.
Cardinality1...1
Typeuri
Comments

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Fixed Value

http://hl7.org/fhir/5.0/StructureDefinition/extension-DiagnosticReport.composition

Mappings
  • rim: N/A
DiagnosticReport.extension:compositionReferenceR5.value[x]
DefinitionReference to a Composition resource instance that provides structure for organizing the contents of the DiagnosticReport.
Cardinality1...1
TypeReference(Composition)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: N/A
DiagnosticReport.extension:noteR5
DefinitionMay include general statements about the diagnostic report, or statements about significant, unexpected or unreliable results values contained within the diagnostic report, or information about its source when relevant to its interpretation.
Cardinality0...*
TypeExtension(Annotation)
Aliasextensions, user content
Comments

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.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
DiagnosticReport.extension:noteR5.id
DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Mappings
  • rim: n/a
DiagnosticReport.extension:noteR5.extension
DefinitionMay 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.
Cardinality0...*
TypeExtension
Aliasextensions, user content
Comments

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.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
DiagnosticReport.extension:noteR5.url
DefinitionSource of the definition for the extension code - a logical name or a URL.
Cardinality1...1
Typeuri
Comments

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Fixed Value

http://hl7.org/fhir/5.0/StructureDefinition/extension-DiagnosticReport.note

Mappings
  • rim: N/A
DiagnosticReport.extension:noteR5.value[x]
DefinitionMay include general statements about the diagnostic report, or statements about significant, unexpected or unreliable results values contained within the diagnostic report, or information about its source when relevant to its interpretation.
Cardinality1...1
TypeAnnotation
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: N/A
DiagnosticReport.extension:supportingInfoR5
DefinitionThis backbone element contains supporting information that was used in the creation of the report not included in the results already included in the report.
Cardinality0...*
TypeExtension(Complex)
Aliasextensions, user content
Comments

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.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
DiagnosticReport.extension:supportingInfoR5.id
DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Mappings
  • rim: n/a
DiagnosticReport.extension:supportingInfoR5.extension
DefinitionMay 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.
Cardinality2...*
TypeExtension
Aliasextensions, user content
Comments

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.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
DiagnosticReport.extension:supportingInfoR5.extension:type
DefinitionThe code value for the role of the supporting information in the diagnostic report.
Cardinality1...1
TypeExtension
Bindinghttp://terminology.hl7.org/ValueSet/v2-0936 (example)
Aliasextensions, user content
Comments

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.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
DiagnosticReport.extension:supportingInfoR5.extension:type.id
DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Mappings
  • rim: n/a
DiagnosticReport.extension:supportingInfoR5.extension:type.extension
DefinitionMay 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.
Cardinality0...*
TypeExtension
Aliasextensions, user content
Comments

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.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
DiagnosticReport.extension:supportingInfoR5.extension:type.url
DefinitionSource of the definition for the extension code - a logical name or a URL.
Cardinality1...1
Typeuri
Comments

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Fixed Value

type

Mappings
  • rim: N/A
DiagnosticReport.extension:supportingInfoR5.extension:type.value[x]
DefinitionValue of extension - must be one of a constrained set of the data types (see [Extensibility](extensibility.html) for a list).
Cardinality1...1
TypeCodeableConcept
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: N/A
DiagnosticReport.extension:supportingInfoR5.extension:reference
DefinitionThe reference for the supporting information in the diagnostic report.
Cardinality1...1
TypeExtension
Aliasextensions, user content
Comments

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.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
DiagnosticReport.extension:supportingInfoR5.extension:reference.id
DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Mappings
  • rim: n/a
DiagnosticReport.extension:supportingInfoR5.extension:reference.extension
DefinitionMay 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.
Cardinality0...*
TypeExtension
Aliasextensions, user content
Comments

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.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
DiagnosticReport.extension:supportingInfoR5.extension:reference.url
DefinitionSource of the definition for the extension code - a logical name or a URL.
Cardinality1...1
Typeuri
Comments

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Fixed Value

reference

Mappings
  • rim: N/A
DiagnosticReport.extension:supportingInfoR5.extension:reference.value[x]
DefinitionValue of extension - must be one of a constrained set of the data types (see [Extensibility](extensibility.html) for a list).
Cardinality1...1
TypeReference(Procedure | Observation | DiagnosticReport)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: N/A
DiagnosticReport.extension:supportingInfoR5.url
DefinitionSource of the definition for the extension code - a logical name or a URL.
Cardinality1...1
Typeuri
Comments

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Fixed Value

http://hl7.org/fhir/5.0/StructureDefinition/extension-DiagnosticReport.supportingInfo

Mappings
  • rim: N/A
DiagnosticReport.extension:supportingInfoR5.value[x]
DefinitionValue of extension - must be one of a constrained set of the data types (see [Extensibility](extensibility.html) for a list).
Cardinality0...0
Typebase64Binary
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: N/A
DiagnosticReport.modifierExtension
DefinitionMay 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 and/or the understanding of the containing element's descendants. 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. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Cardinality0...*
TypeExtension
ModifierTrue
Aliasextensions, user content
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Comments

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.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
DiagnosticReport.identifier
DefinitionIdentifiers assigned to this report by the performer or other systems.
Cardinality0...*
TypeIdentifier
SummaryTrue
AliasReportID, Filler ID, Placer 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.

Comments

Usually assigned by the Information System of the diagnostic service provider (filler id).

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CX / EI (occasionally, more often EI maps to a resource id or a URL)
  • rim: II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
  • servd: Identifier
  • workflow: Event.identifier
  • w5: FiveWs.identifier
  • v2: 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
  • rim: id
DiagnosticReport.basedOn
DefinitionDetails concerning a service requested.
Cardinality0...*
TypeReference(CarePlan | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest)
AliasRequest
Requirements

This allows tracing of authorization for the report and tracking whether proposals/recommendations were acted upon.

Comments

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.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • workflow: Event.basedOn
  • v2: ORC? OBR-2/3?
  • rim: outboundRelationship[typeCode=FLFS].target
DiagnosticReport.status
DefinitionThe status of the diagnostic report.
Cardinality1...1
Typecode
Binding

The status of the diagnostic report.

DiagnosticReportStatus (required)
Must SupportTrue
ModifierTrue
SummaryTrue
Requirements

Diagnostic services routinely issue provisional/incomplete reports, and sometimes withdraw previously released reports.

Comments

Note that FHIR strings SHALL NOT exceed 1MB in size

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • workflow: Event.status
  • w5: FiveWs.status
  • v2: OBR-25 (not 1:1 mapping)
  • rim: statusCode Note: final and amended are distinguished by whether observation is the subject of a ControlAct event of type "revise"
DiagnosticReport.category
DefinitionA 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.
Cardinality1...*
TypeCodeableConcept
Binding

Codes for diagnostic service sections.

DiagnosticServiceSectionCodes (example)
Must SupportTrue
SummaryTrue
AliasDepartment, Sub-department, Service, Discipline
Comments

Multiple categories are allowed using various categorization schemes. 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.

SlicingUnordered, Open, by coding.code(Value)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE
  • rim: CD
  • orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
  • w5: FiveWs.class
  • v2: OBR-24
  • rim: inboundRelationship[typeCode=COMP].source[classCode=LIST, moodCode=EVN, code < LabService].code
DiagnosticReport.category:laboratory
DefinitionA 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.
Cardinality1...1
TypeCodeableConcept
Binding

Codes for diagnostic service sections.

DiagnosticServiceSectionCodes (example)
Must SupportTrue
SummaryTrue
AliasDepartment, Sub-department, Service, Discipline
Comments

Multiple categories are allowed using various categorization schemes. 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.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE
  • rim: CD
  • orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
  • w5: FiveWs.class
  • v2: OBR-24
  • rim: inboundRelationship[typeCode=COMP].source[classCode=LIST, moodCode=EVN, code < LabService].code
DiagnosticReport.category:laboratory.id
DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Mappings
  • rim: n/a
DiagnosticReport.category:laboratory.extension
DefinitionMay 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.
Cardinality0...*
TypeExtension
Aliasextensions, user content
Comments

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.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
DiagnosticReport.category:laboratory.coding
DefinitionA reference to a code defined by a terminology system.
Cardinality0...*
TypeCoding
SummaryTrue
Requirements

Allows for alternative encodings within a code system, and translations to other code systems.

Comments

Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6
  • rim: CV
  • orim: fhir:Coding rdfs:subClassOf dt:CDCoding
  • v2: C*E.1-8, C*E.10-22
  • rim: union(., ./translation)
  • orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
DiagnosticReport.category:laboratory.coding.id
DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Mappings
  • rim: n/a
DiagnosticReport.category:laboratory.coding.extension
DefinitionMay 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.
Cardinality0...*
TypeExtension
Aliasextensions, user content
Comments

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.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
DiagnosticReport.category:laboratory.coding.system
DefinitionThe identification of the code system that defines the meaning of the symbol in the code.
Cardinality0...1
Typeuri
SummaryTrue
Requirements

Need to be unambiguous about the source of the definition of the symbol.

Comments

The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Fixed Value

http://terminology.hl7.org/CodeSystem/v2-0074

Mappings
  • rim: n/a
  • v2: C*E.3
  • rim: ./codeSystem
  • orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
DiagnosticReport.category:laboratory.coding.version
DefinitionThe version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.
Cardinality0...1
Typestring
SummaryTrue
Comments

Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: C*E.7
  • rim: ./codeSystemVersion
  • orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
DiagnosticReport.category:laboratory.coding.code
DefinitionA symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).
Cardinality0...1
Typecode
SummaryTrue
Requirements

Need to refer to a particular code in the system.

Comments

Note that FHIR strings SHALL NOT exceed 1MB in size

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Fixed Value

LAB

Mappings
  • rim: n/a
  • v2: C*E.1
  • rim: ./code
  • orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
DiagnosticReport.category:laboratory.coding.display
DefinitionA representation of the meaning of the code in the system, following the rules of the system.
Cardinality0...1
Typestring
SummaryTrue
Requirements

Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

Comments

Note that FHIR strings SHALL NOT exceed 1MB in size

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: C*E.2 - but note this is not well followed
  • rim: CV.displayName
  • orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
DiagnosticReport.category:laboratory.coding.userSelected
DefinitionIndicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).
Cardinality0...1
Typeboolean
SummaryTrue
Requirements

This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

Comments

Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: Sometimes implied by being first
  • rim: CD.codingRationale
  • orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]
DiagnosticReport.category:laboratory.text
DefinitionA human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.
Cardinality0...1
Typestring
SummaryTrue
Requirements

The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

Comments

Very often the text is the same as a displayName of one of the codings.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: C*E.9. But note many systems use C*E.2 for this
  • rim: ./originalText[mediaType/code="text/plain"]/data
  • orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
DiagnosticReport.code
DefinitionA code or name that describes this diagnostic report.
Cardinality1...1
TypeCodeableConcept
Binding

Codes that describe Diagnostic Reports.

UKCoreReportCode (preferred)
Must SupportTrue
SummaryTrue
AliasType
Comments

Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE
  • rim: CD
  • orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
  • workflow: Event.code
  • w5: FiveWs.what[x]
  • v2: OBR-4 (HL7 v2 doesn't provide an easy way to indicate both the ordered test and the performed panel)
  • rim: code
DiagnosticReport.subject
DefinitionThe 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.
Cardinality1...1
TypeReference(Patient)
Must SupportTrue
SummaryTrue
AliasPatient
Requirements

SHALL know the subject context.

Comments

References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • workflow: Event.subject
  • w5: FiveWs.subject[x]
  • v2: PID-3 (no HL7 v2 mapping for Group or Device)
  • rim: participation[typeCode=SBJ]
  • w5: FiveWs.subject
DiagnosticReport.encounter
DefinitionThe healthcare event (e.g. a patient and healthcare provider interaction) which this DiagnosticReport is about.
Cardinality0...1
TypeReference(Encounter)
SummaryTrue
AliasContext
Requirements

Links the request to the Encounter context.

Comments

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 but still be tied to the context of the encounter (e.g. pre-admission laboratory tests).

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • workflow: Event.encounter
  • w5: FiveWs.context
  • v2: PV1-19
  • rim: inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN]
DiagnosticReport.effective[x]
DefinitionThe 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.
Cardinality0...1
TypedateTime
SummaryTrue
AliasObservation time, Effective Time, Occurrence
Requirements

Need to know where in the patient history to file/present this report.

Comments

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.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • workflow: Event.occurrence[x]
  • w5: FiveWs.done[x]
  • v2: OBR-7
  • rim: effectiveTime
DiagnosticReport.issued
DefinitionThe date and time that this version of the report was made available to providers, typically after the report was reviewed and verified.
Cardinality0...1
Typeinstant
Must SupportTrue
SummaryTrue
AliasDate published, Date Issued, Date Verified
Requirements

Clinicians need to be able to check the date that the report was released.

Comments

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.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • w5: FiveWs.recorded
  • v2: OBR-22
  • rim: participation[typeCode=VRF or AUT].time
DiagnosticReport.performer
DefinitionThe diagnostic service that is responsible for issuing the report.
Cardinality0...*
TypeReference(Practitioner | PractitionerRole | Organization | CareTeam)
SummaryTrue
AliasLaboratory, Service, Practitioner, Department, Company, Authorized by, Director
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.

Comments

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.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • workflow: Event.performer.actor
  • w5: FiveWs.actor
  • v2: PRT-8 (where this PRT-4-Participation = "PO")
  • rim: .participation[typeCode=PRF]
DiagnosticReport.performer.id
DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Mappings
  • rim: n/a
DiagnosticReport.performer.extension
DefinitionMay 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.
Cardinality0...*
TypeExtension
Aliasextensions, user content
Comments

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.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
DiagnosticReport.performer.extension:deviceReference
DefinitionAn additional Device reference for a DiagnosticReport, to allow Software as a Medical Device to perform / interpret a DiagnosticReport
Cardinality0...1
TypeExtension(Reference(Device))
Aliasextensions, user content
Comments

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.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
DiagnosticReport.performer.reference
DefinitionA reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.
Cardinality0...1
Typestring
SummaryTrue
Comments

Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: N/A
DiagnosticReport.performer.type
DefinitionThe expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).
Cardinality0...1
Typeuri
Binding

Aa resource (or, for logical models, the URI of the logical model).

ResourceType (extensible)
SummaryTrue
Comments

This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: N/A
DiagnosticReport.performer.identifier
DefinitionAn identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.
Cardinality0...1
TypeIdentifier
SummaryTrue
Comments

When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CX / EI (occasionally, more often EI maps to a resource id or a URL)
  • rim: II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
  • servd: Identifier
  • rim: .identifier
DiagnosticReport.performer.display
DefinitionPlain text narrative that identifies the resource in addition to the resource reference.
Cardinality0...1
Typestring
SummaryTrue
Comments

This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: N/A
DiagnosticReport.resultsInterpreter
DefinitionThe practitioner or organization that is responsible for the report's conclusions and interpretations.
Cardinality0...*
TypeReference(Practitioner | PractitionerRole | Organization | CareTeam)
SummaryTrue
AliasAnalyzed by, Reported by
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.

Comments

Might not be the same entity that takes responsibility for the clinical report.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • workflow: Event.performer.actor
  • w5: FiveWs.actor
  • v2: OBR-32, PRT-8 (where this PRT-4-Participation = "PI")
  • rim: .participation[typeCode=PRF]
DiagnosticReport.resultsInterpreter.id
DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Mappings
  • rim: n/a
DiagnosticReport.resultsInterpreter.extension
DefinitionMay 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.
Cardinality0...*
TypeExtension
Aliasextensions, user content
Comments

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.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
DiagnosticReport.resultsInterpreter.extension:deviceReference
DefinitionAn additional Device reference for a DiagnosticReport, to allow Software as a Medical Device to perform / interpret a DiagnosticReport
Cardinality0...*
TypeExtension(Reference(Device))
Aliasextensions, user content
Comments

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.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
DiagnosticReport.resultsInterpreter.reference
DefinitionA reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.
Cardinality0...1
Typestring
SummaryTrue
Comments

Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: N/A
DiagnosticReport.resultsInterpreter.type
DefinitionThe expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).
Cardinality0...1
Typeuri
Binding

Aa resource (or, for logical models, the URI of the logical model).

ResourceType (extensible)
SummaryTrue
Comments

This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: N/A
DiagnosticReport.resultsInterpreter.identifier
DefinitionAn identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.
Cardinality0...1
TypeIdentifier
SummaryTrue
Comments

When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CX / EI (occasionally, more often EI maps to a resource id or a URL)
  • rim: II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
  • servd: Identifier
  • rim: .identifier
DiagnosticReport.resultsInterpreter.display
DefinitionPlain text narrative that identifies the resource in addition to the resource reference.
Cardinality0...1
Typestring
SummaryTrue
Comments

This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: N/A
DiagnosticReport.specimen
DefinitionDetails about the specimens on which this diagnostic report is based.
Cardinality0...*
TypeReference(Specimen)
Requirements

Need to be able to report information about the collected specimens on which the report is based.

Comments

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.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • v2: SPM
  • rim: participation[typeCode=SBJ]
DiagnosticReport.result
Definition[Observations](observation.html) that are part of this diagnostic report.
Cardinality0...*
TypeReference(Observation)
Must SupportTrue
AliasData, Atomic Value, Result, Atomic result, Data, Test, Analyte, Battery, Organizer
Requirements

Need to support individual results, or groups of results, where the result grouping is arbitrary, but meaningful.

Comments

Observations can contain observations.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • v2: OBXs
  • rim: outboundRelationship[typeCode=COMP].target
DiagnosticReport.imagingStudy
DefinitionOne 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.
Cardinality0...*
TypeReference(ImagingStudy)
Comments

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.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • rim: outboundRelationship[typeCode=COMP].target[classsCode=DGIMG, moodCode=EVN]
DiagnosticReport.media
DefinitionA 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).
Cardinality0...*
TypeBackboneElement
SummaryTrue
AliasDICOM, Slides, Scans
Requirements

Many diagnostic services include images in the report as part of their service.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: OBX?
  • rim: outboundRelationship[typeCode=COMP].target
DiagnosticReport.media.id
DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Mappings
  • rim: n/a
DiagnosticReport.media.extension
DefinitionMay 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.
Cardinality0...*
TypeExtension
Aliasextensions, user content
Comments

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.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
DiagnosticReport.media.modifierExtension
DefinitionMay 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 and/or the understanding of the containing element's descendants. 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. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Cardinality0...*
TypeExtension
ModifierTrue
SummaryTrue
Aliasextensions, user content, modifiers
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Comments

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.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
DiagnosticReport.media.comment
DefinitionA 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.
Cardinality0...1
Typestring
Requirements

The provider of the report should make a comment about each image included in the report.

Comments

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.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: .inboundRelationship[typeCode=COMP].source[classCode=OBS, moodCode=EVN, code="annotation"].value
DiagnosticReport.media.link
DefinitionReference to the image source.
Cardinality1...1
TypeReference(Media)
SummaryTrue
Comments

References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • rim: .value.reference
DiagnosticReport.conclusion
DefinitionConcise and clinically contextualized summary conclusion (interpretation/impression) of the diagnostic report.
Cardinality0...1
Typestring
AliasReport
Requirements

Need to be able to provide a conclusion that is not lost among the basic result data.

Comments

Note that FHIR strings SHALL NOT exceed 1MB in size

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: OBX
  • rim: inboundRelationship[typeCode="SPRT"].source[classCode=OBS, moodCode=EVN, code=LOINC:48767-8].value (type=ST)
DiagnosticReport.conclusionCode
DefinitionOne or more codes that represent the summary conclusion (interpretation/impression) of the diagnostic report.
Cardinality0...*
TypeCodeableConcept
Binding

Diagnosis codes provided as adjuncts to the report.

SNOMEDCTClinicalFindings (preferred)
Comments

Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE
  • rim: CD
  • orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
  • v2: OBX
  • rim: inboundRelationship[typeCode=SPRT].source[classCode=OBS, moodCode=EVN, code=LOINC:54531-9].value (type=CD)
DiagnosticReport.presentedForm
DefinitionRich text representation of the entire result as issued by the diagnostic service. Multiple formats are allowed but they SHALL be semantically equivalent.
Cardinality0...*
TypeAttachment
Requirements

Gives laboratory the ability to provide its own fully formatted report for clinical fidelity.

Comments

"application/pdf" is recommended as the most reliable and interoperable in this context.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • att-1: If the Attachment has data, it SHALL have a contentType
    data.empty() or contentType.exists()
Mappings
  • rim: n/a
  • v2: ED/RP
  • rim: ED
  • v2: OBX
  • rim: text (type=ED)

Table View

DiagnosticReport..
DiagnosticReport.extensionExtension..1
DiagnosticReport.extension.value[x]..
DiagnosticReport.extensionExtension..
DiagnosticReport.extension.value[x]..
DiagnosticReport.extensionExtension..
DiagnosticReport.extension.extension2..
DiagnosticReport.status..
DiagnosticReport.category1..
DiagnosticReport.category1..1
DiagnosticReport.category.coding..
DiagnosticReport.category.coding.system..
DiagnosticReport.category.coding.code..
DiagnosticReport.code..
DiagnosticReport.subjectReference(Patient)1..
DiagnosticReport.issued..
DiagnosticReport.performer..
DiagnosticReport.performer.extensionExtension..1
DiagnosticReport.resultsInterpreter..
DiagnosticReport.resultsInterpreter.extensionExtension..
DiagnosticReport.result..
DiagnosticReport.conclusionCode..

XML View

<StructureDefinition xmlns="http://hl7.org/fhir">
    <id value="UKCore-DiagnosticReport-Lab" />
    <url value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-DiagnosticReport-Lab" />
    <version value="2.0.1" />
    <name value="UKCoreDiagnosticReportLab" />
    <title value="UK Core Diagnostic Report Lab" />
    <status value="active" />
    <date value="2024-07-23" />
    <publisher value="HL7 UK" />
    <contact>
        <name value="HL7 UK" />
        <telecom>
            <system value="email" />
            <value value="ukcore@hl7.org.uk" />
            <use value="work" />
            <rank value="1" />
        </telecom>
    </contact>
    <description value="This profile defines the UK constraints and extensions on the International FHIR resource [DiagnosticReport](https://hl7.org/fhir/R4/DiagnosticReport.html), to provide laboratory specific support for test results." />
    <purpose value="To provide implementers with additional support when implementing test result data and to provide a consistent structure to how the data is presented." />
    <copyright value="Copyright &#169; 2021+ HL7 UK Licensed under the Apache License, Version 2.0 (the &quot;License&quot;); you may not use this file except in compliance with the License. You may obtain a copy of the License at  http://www.apache.org/licenses/LICENSE-2.0 Unless required by applicable law or agreed to in writing, software distributed under the License is distributed on an &quot;AS IS&quot; BASIS, WITHOUT WARRANTIES OR CONDITIONS OF ANY KIND, either express or implied. See the License for the specific language governing permissions and limitations under the License. HL7&#174; FHIR&#174; standard Copyright &#169; 2011+ HL7 The HL7&#174; FHIR&#174; standard is used under the FHIR license. You may obtain a copy of the FHIR license at  https://www.hl7.org/fhir/license.html." />
    <fhirVersion value="4.0.1" />
    <kind value="resource" />
    <abstract value="false" />
    <type value="DiagnosticReport" />
    <baseDefinition value="http://hl7.org/fhir/StructureDefinition/DiagnosticReport" />
    <derivation value="constraint" />
    <differential>
        <element id="DiagnosticReport">
            <path value="DiagnosticReport" />
            <constraint>
                <key value="ukcore-diag-lab-001" />
                <severity value="warning" />
                <human value="An issued time SHOULD be present if status = partial, preliminary, final, amended, corrected or appended" />
                <expression value="issued.exists() or (issued.empty() and (status in (&#39;partial&#39; | &#39;preliminary&#39; | &#39;final&#39; | &#39;amended&#39; | &#39;corrected&#39; | &#39;appended&#39;)).not())" />
            </constraint>
        </element>
        <element id="DiagnosticReport.extension:compositionReferenceR5">
            <path value="DiagnosticReport.extension" />
            <sliceName value="compositionReferenceR5" />
            <short value="A Composition reference for a DiagnosticReport. This is a R5 backport." />
            <max value="1" />
            <type>
                <code value="Extension" />
                <profile value="http://hl7.org/fhir/5.0/StructureDefinition/extension-DiagnosticReport.composition" />
            </type>
            <isModifier value="false" />
        </element>
        <element id="DiagnosticReport.extension:compositionReferenceR5.value[x]">
            <path value="DiagnosticReport.extension.value[x]" />
            <short value="Reference to a Composition resource." />
            <definition value="Reference to a Composition resource instance that provides structure for organizing the contents of the DiagnosticReport." />
        </element>
        <element id="DiagnosticReport.extension:noteR5">
            <path value="DiagnosticReport.extension" />
            <sliceName value="noteR5" />
            <short value="Comments about the diagnostic report. This is a R5 backport." />
            <type>
                <code value="Extension" />
                <profile value="http://hl7.org/fhir/5.0/StructureDefinition/extension-DiagnosticReport.note" />
            </type>
            <isModifier value="false" />
        </element>
        <element id="DiagnosticReport.extension:noteR5.value[x]">
            <path value="DiagnosticReport.extension.value[x]" />
            <definition value="May include general statements about the diagnostic report, or statements about significant, unexpected or unreliable results values contained within the diagnostic report, or information about its source when relevant to its interpretation." />
        </element>
        <element id="DiagnosticReport.extension:supportingInfoR5">
            <path value="DiagnosticReport.extension" />
            <sliceName value="supportingInfoR5" />
            <short value="Additional info supporting the diagnostic report. This is a R5 backport." />
            <type>
                <code value="Extension" />
                <profile value="http://hl7.org/fhir/5.0/StructureDefinition/extension-DiagnosticReport.supportingInfo" />
            </type>
            <isModifier value="false" />
        </element>
        <element id="DiagnosticReport.extension:supportingInfoR5.extension">
            <path value="DiagnosticReport.extension.extension" />
            <min value="2" />
        </element>
        <element id="DiagnosticReport.status">
            <path value="DiagnosticReport.status" />
            <short value="The status of the diagnostic report." />
            <mustSupport value="true" />
        </element>
        <element id="DiagnosticReport.category">
            <path value="DiagnosticReport.category" />
            <slicing>
                <discriminator>
                    <type value="value" />
                    <path value="coding.code" />
                </discriminator>
                <rules value="open" />
            </slicing>
            <short value="A code that classifies the clinical discipline, department or diagnostic service that created the report." />
            <min value="1" />
            <mustSupport value="true" />
        </element>
        <element id="DiagnosticReport.category:laboratory">
            <path value="DiagnosticReport.category" />
            <sliceName value="laboratory" />
            <short value="A mandatory slice that states this resource is categorized as laboratory related content." />
            <min value="1" />
            <max value="1" />
            <mustSupport value="true" />
        </element>
        <element id="DiagnosticReport.category:laboratory.coding.system">
            <path value="DiagnosticReport.category.coding.system" />
            <fixedUri value="http://terminology.hl7.org/CodeSystem/v2-0074" />
        </element>
        <element id="DiagnosticReport.category:laboratory.coding.code">
            <path value="DiagnosticReport.category.coding.code" />
            <fixedCode value="LAB" />
        </element>
        <element id="DiagnosticReport.code">
            <path value="DiagnosticReport.code" />
            <short value="A code or name that describes this diagnostic report." />
            <mustSupport value="true" />
            <binding>
                <strength value="preferred" />
                <valueSet value="https://fhir.hl7.org.uk/ValueSet/UKCore-ReportCode" />
            </binding>
        </element>
        <element id="DiagnosticReport.subject">
            <path value="DiagnosticReport.subject" />
            <short value="The patient that is the subject of the report." />
            <min value="1" />
            <type>
                <code value="Reference" />
                <targetProfile value="http://hl7.org/fhir/StructureDefinition/Patient" />
            </type>
            <mustSupport value="true" />
        </element>
        <element id="DiagnosticReport.issued">
            <path value="DiagnosticReport.issued" />
            <short value="Clinically relevant time / time-period for report." />
            <mustSupport value="true" />
        </element>
        <element id="DiagnosticReport.performer.extension:deviceReference">
            <path value="DiagnosticReport.performer.extension" />
            <sliceName value="deviceReference" />
            <short value="A reference to a Device which interprets / performs the results of the DiagnosticReport." />
            <max value="1" />
            <type>
                <code value="Extension" />
                <profile value="https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-DeviceReference" />
            </type>
            <isModifier value="false" />
        </element>
        <element id="DiagnosticReport.resultsInterpreter.extension:deviceReference">
            <path value="DiagnosticReport.resultsInterpreter.extension" />
            <sliceName value="deviceReference" />
            <short value="A reference to a Device which interprets / performs the results of the DiagnosticReport." />
            <type>
                <code value="Extension" />
                <profile value="https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-DeviceReference" />
            </type>
            <isModifier value="false" />
        </element>
        <element id="DiagnosticReport.result">
            <path value="DiagnosticReport.result" />
            <short value="Lab related Observations that are part of this diagnostic report." />
            <mustSupport value="true" />
        </element>
        <element id="DiagnosticReport.conclusionCode">
            <path value="DiagnosticReport.conclusionCode" />
            <binding>
                <strength value="preferred" />
            </binding>
        </element>
    </differential>
</StructureDefinition>

JSON View

{
    "resourceType": "StructureDefinition",
    "id": "UKCore-DiagnosticReport-Lab",
    "url": "https://fhir.hl7.org.uk/StructureDefinition/UKCore-DiagnosticReport-Lab",
    "version": "2.0.1",
    "name": "UKCoreDiagnosticReportLab",
    "title": "UK Core Diagnostic Report Lab",
    "status": "active",
    "date": "2024-07-23",
    "publisher": "HL7 UK",
    "contact":  [
        {
            "name": "HL7 UK",
            "telecom":  [
                {
                    "system": "email",
                    "value": "ukcore@hl7.org.uk",
                    "use": "work",
                    "rank": 1
                }
            ]
        }
    ],
    "description": "This profile defines the UK constraints and extensions on the International FHIR resource [DiagnosticReport](https://hl7.org/fhir/R4/DiagnosticReport.html), to provide laboratory specific support for test results.",
    "purpose": "To provide implementers with additional support when implementing test result data and to provide a consistent structure to how the data is presented.",
    "copyright": "Copyright © 2021+ HL7 UK Licensed under the Apache License, Version 2.0 (the \"License\"); you may not use this file except in compliance with the License. You may obtain a copy of the License at  http://www.apache.org/licenses/LICENSE-2.0 Unless required by applicable law or agreed to in writing, software distributed under the License is distributed on an \"AS IS\" BASIS, WITHOUT WARRANTIES OR CONDITIONS OF ANY KIND, either express or implied. See the License for the specific language governing permissions and limitations under the License. HL7® FHIR® standard Copyright © 2011+ HL7 The HL7® FHIR® standard is used under the FHIR license. You may obtain a copy of the FHIR license at  https://www.hl7.org/fhir/license.html.",
    "fhirVersion": "4.0.1",
    "kind": "resource",
    "abstract": false,
    "type": "DiagnosticReport",
    "baseDefinition": "http://hl7.org/fhir/StructureDefinition/DiagnosticReport",
    "derivation": "constraint",
    "differential": {
        "element":  [
            {
                "id": "DiagnosticReport",
                "path": "DiagnosticReport",
                "constraint":  [
                    {
                        "key": "ukcore-diag-lab-001",
                        "severity": "warning",
                        "human": "An issued time SHOULD be present if status = partial, preliminary, final, amended, corrected or appended",
                        "expression": "issued.exists() or (issued.empty() and (status in ('partial' | 'preliminary' | 'final' | 'amended' | 'corrected' | 'appended')).not())"
                    }
                ]
            },
            {
                "id": "DiagnosticReport.extension:compositionReferenceR5",
                "path": "DiagnosticReport.extension",
                "sliceName": "compositionReferenceR5",
                "short": "A Composition reference for a DiagnosticReport. This is a R5 backport.",
                "max": "1",
                "type":  [
                    {
                        "code": "Extension",
                        "profile":  [
                            "http://hl7.org/fhir/5.0/StructureDefinition/extension-DiagnosticReport.composition"
                        ]
                    }
                ],
                "isModifier": false
            },
            {
                "id": "DiagnosticReport.extension:compositionReferenceR5.value[x]",
                "path": "DiagnosticReport.extension.value[x]",
                "short": "Reference to a Composition resource.",
                "definition": "Reference to a Composition resource instance that provides structure for organizing the contents of the DiagnosticReport."
            },
            {
                "id": "DiagnosticReport.extension:noteR5",
                "path": "DiagnosticReport.extension",
                "sliceName": "noteR5",
                "short": "Comments about the diagnostic report. This is a R5 backport.",
                "type":  [
                    {
                        "code": "Extension",
                        "profile":  [
                            "http://hl7.org/fhir/5.0/StructureDefinition/extension-DiagnosticReport.note"
                        ]
                    }
                ],
                "isModifier": false
            },
            {
                "id": "DiagnosticReport.extension:noteR5.value[x]",
                "path": "DiagnosticReport.extension.value[x]",
                "definition": "May include general statements about the diagnostic report, or statements about significant, unexpected or unreliable results values contained within the diagnostic report, or information about its source when relevant to its interpretation."
            },
            {
                "id": "DiagnosticReport.extension:supportingInfoR5",
                "path": "DiagnosticReport.extension",
                "sliceName": "supportingInfoR5",
                "short": "Additional info supporting the diagnostic report. This is a R5 backport.",
                "type":  [
                    {
                        "code": "Extension",
                        "profile":  [
                            "http://hl7.org/fhir/5.0/StructureDefinition/extension-DiagnosticReport.supportingInfo"
                        ]
                    }
                ],
                "isModifier": false
            },
            {
                "id": "DiagnosticReport.extension:supportingInfoR5.extension",
                "path": "DiagnosticReport.extension.extension",
                "min": 2
            },
            {
                "id": "DiagnosticReport.status",
                "path": "DiagnosticReport.status",
                "short": "The status of the diagnostic report.",
                "mustSupport": true
            },
            {
                "id": "DiagnosticReport.category",
                "path": "DiagnosticReport.category",
                "slicing": {
                    "discriminator":  [
                        {
                            "type": "value",
                            "path": "coding.code"
                        }
                    ],
                    "rules": "open"
                },
                "short": "A code that classifies the clinical discipline, department or diagnostic service that created the report.",
                "min": 1,
                "mustSupport": true
            },
            {
                "id": "DiagnosticReport.category:laboratory",
                "path": "DiagnosticReport.category",
                "sliceName": "laboratory",
                "short": "A mandatory slice that states this resource is categorized as laboratory related content.",
                "min": 1,
                "max": "1",
                "mustSupport": true
            },
            {
                "id": "DiagnosticReport.category:laboratory.coding.system",
                "path": "DiagnosticReport.category.coding.system",
                "fixedUri": "http://terminology.hl7.org/CodeSystem/v2-0074"
            },
            {
                "id": "DiagnosticReport.category:laboratory.coding.code",
                "path": "DiagnosticReport.category.coding.code",
                "fixedCode": "LAB"
            },
            {
                "id": "DiagnosticReport.code",
                "path": "DiagnosticReport.code",
                "short": "A code or name that describes this diagnostic report.",
                "mustSupport": true,
                "binding": {
                    "strength": "preferred",
                    "valueSet": "https://fhir.hl7.org.uk/ValueSet/UKCore-ReportCode"
                }
            },
            {
                "id": "DiagnosticReport.subject",
                "path": "DiagnosticReport.subject",
                "short": "The patient that is the subject of the report.",
                "min": 1,
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "http://hl7.org/fhir/StructureDefinition/Patient"
                        ]
                    }
                ],
                "mustSupport": true
            },
            {
                "id": "DiagnosticReport.issued",
                "path": "DiagnosticReport.issued",
                "short": "Clinically relevant time / time-period for report.",
                "mustSupport": true
            },
            {
                "id": "DiagnosticReport.performer.extension:deviceReference",
                "path": "DiagnosticReport.performer.extension",
                "sliceName": "deviceReference",
                "short": "A reference to a Device which interprets / performs the results of the DiagnosticReport.",
                "max": "1",
                "type":  [
                    {
                        "code": "Extension",
                        "profile":  [
                            "https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-DeviceReference"
                        ]
                    }
                ],
                "isModifier": false
            },
            {
                "id": "DiagnosticReport.resultsInterpreter.extension:deviceReference",
                "path": "DiagnosticReport.resultsInterpreter.extension",
                "sliceName": "deviceReference",
                "short": "A reference to a Device which interprets / performs the results of the DiagnosticReport.",
                "type":  [
                    {
                        "code": "Extension",
                        "profile":  [
                            "https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-DeviceReference"
                        ]
                    }
                ],
                "isModifier": false
            },
            {
                "id": "DiagnosticReport.result",
                "path": "DiagnosticReport.result",
                "short": "Lab related Observations that are part of this diagnostic report.",
                "mustSupport": true
            },
            {
                "id": "DiagnosticReport.conclusionCode",
                "path": "DiagnosticReport.conclusionCode",
                "binding": {
                    "strength": "preferred"
                }
            }
        ]
    }
}

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Report issue for UKCore-DiagnosticReport-Lab, , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , ,

Examples

Diagnostic Studies Report - An example to illustrate a diagnostic studies report containing a specimen and observation for a patient.
Example UKCore-DiagnosticReport-Lab-DiagnosticStudiesReport

Example Usage Scenarios

The following are example usage scenarios for the UK Core DiagnosticReport Lab profile:

  • Query for a specific patient laboratory test result
  • Query for recent laboratory test results
  • Record or update a laboratory test result

Services that should consider using the UK Core DiagnosticReport profile are:

  • Lab Result

The DiagnosticReport-Lab profile is expected to reference either:

  • a set of laboratory observations (Observation-Lab) that are grouped under one observation (Observation-LabGroup), for example a urea and electrolyte test that contains many sub tests,
  • a single laboratory observation (Observation-Lab) that does not form part of a group of tests, for example Serum ferritin level,
  • combinations of the above, for example a blood test may include multiple grouped tests such as Urea and electrolytes, Liver function tests, Full blood count, each having a single instance of Observation-LabGroup, along with single tests such as Serum C reactive protein level, eGFR using creatinine and Serum ferritin level, each having a single instance of Observation-Lab.

The workflow below shows a possible way to group a set of related laboratory observations into the derived Profile UKCore-Observation-Group-Lab, which is then referenced within a diagnostic report. Seperate laboratory observations MAY be directly referenced within the diagnostic report.
Derived Profiles Lab Example



Depending upon the countries or trusts workflow, an alternative is to have any separate laboratory observations referenced in a Profile UKCore-Observation-Group-Lab before being referenced in the diagnostic report. Although this creates extra resources it standardises the workflow.

Derived Profiles Lab Example Extra Group

Profile Specific Implementation Guidance:

Mandatory and Must Support Data Elements

The following elements are identified as MustSupport, and it is expected that consumers and suppliers SHALL support these as per the MustSupport Guidance.

ElementReason
DiagnosticReport.statusThe status of the diagnostic report.
DiagnosticReport.categoryA code that classifies the clinical discipline, department or diagnostic service that created the report.
DiagnosticReport.categoryA mandatory slice that states this resource is categorized as laboratory related content.
DiagnosticReport.codeA code or name that describes this diagnostic report.
DiagnosticReport.subjectThe patient that is the subject of the report.
DiagnosticReport.issuedClinically relevant time / time-period for report.
DiagnosticReport.resultLab related Observations that are part of this diagnostic report.


Extensions

More information about the extensions can be found using the links below.

Extension Context Link Comment
compositionReferenceR5 DiagnosticReport Extension UKCore-DiagnosticReportComposition A Composition reference for a DiagnosticReport. This is a R5 backport, for more details, see Pre-adopted R5 Elements.
noteR5 DiagnosticReport Extension UKCore-DiagnosticReportNote Comments about the diagnostic report. This is a R5 backport, for more details, see Pre-adopted R5 Elements.
deviceReference DiagnosticReport.resultsInterpreter
DiagnosticReport.performer
Extension UKCore-DeviceReference A reference to a Device which interprets / performs the results of the DiagnosticReport.
supportingInfoR5 DiagnosticReport Extension UKCore-DiagnosticReportSupportingInfo Comments about the diagnostic report. This is a R5 backport, for more details, see Pre-adopted R5 Elements.
supportingInfoR5 DiagnosticReport Extension-UKCore-DiagnosticReportMediaLink Comments about the diagnostic report. This is a R5 backport, for more details, see Pre-adopted R5 Elements.

Bindings (differential)

More information about the bindings to UK Core ValueSets can be found below.

ContextStrengthLink
DiagnosticReport.codepreferredhttps://fhir.hl7.org.uk/ValueSet/UKCore-ReportCode


Constraints (differential)

More information about the constraints on the UKCore-DiagnosticReport-Lab profile can be found below.

KeySeverityExpressionHuman_Description
ukcore-diag-lab-001warningissued.exists() or (issued.empty() and (status in ('partial' | 'preliminary' | 'final' | 'amended' | 'corrected' | 'appended')).not())An issued time SHOULD be present if status = partial, preliminary, final, amended, corrected or appended


Extension:compositionReferenceR5

This is a backport from R5 to allow referencing to a Composition resource instance that provides structure for organizing the contents of the DiagnosticReport.

Note that the R5 element has the following rule that SHOULD be followed:

Key Severity Expression Human Description
dgr-1 error composition.exists() implies (composition.resolve().section.entry.reference.where(resolve() is Observation) in (result.reference|result.reference.resolve().hasMember.reference)) When a Composition is referenced in Diagnostic.composition, all Observation resources referenced in Composition.entry must also be referenced in Diagnostic.entry or in the references Observations in Observation.hasMember.

category

This element has an open slice, differentiated by the value of DiagnosticReport.category.coding.code, and MAY be used to differentiate the specific laboratory's speciality. There is one defined mandatory slice DiagnosticReport.category:laboratory, with a fixed value, which SHALL be populated when this profile is used, and additional category code's can be populated.

DiagnosticReport.category:laboratory

The following SHALL be used for this profile:

  • DiagnosticReport.category.coding.system = http://terminology.hl7.org/CodeSystem/v2-0074
  • DiagnosticReport.category.coding.code = LAB
  • DiagnosticReport.category.coding.display = Laboratory.

basedOn

Where possible, it is expected that the resource being referenced SHOULD conform to one of the following UK Core profiles:


subject

Where possible, it is expected that the resource being referenced SHOULD conform to Profile UKCore-Patient


encounter

Where possible, it is expected that the resource being referenced SHOULD conform to Profile UKCore-Encounter.


performer

Where possible, it is expected that the resource being referenced SHOULD conform to one of the following UK Core profiles:

In addition, a UKCore-Device (draft) can be referenced via the Extension UKCore-DeviceReference as deviceReference.


resultsInterpreter

Where possible, it is expected that the resource being referenced SHOULD conform to one of the following UK Core profiles:

In addition, a UKCore-Device (draft) can be referenced via the Extension UKCore-DeviceReference as deviceReference.


specimen

Where possible, it is expected that the resource being referenced SHOULD conform to Profile UKCore-Specimen.


result

Where possible, it is expected that the resource being referenced SHOULD conform to one of the following UK Core profiles:


imagingStudy

Where possible, it is expected that the resource being referenced SHOULD conform to UKCore-ImagingStudy (draft).