Canadian Baseline
1.2.0 - CI Build

Canadian Baseline, published by HL7 Canada - FHIR Implementation Work Group. This guide is not an authorized publication; it is the continuous build for version 1.2.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7-Canada/ca-baseline/ and changes regularly. See the Directory of published versions

## Resource Profile: DiagnosticReport Profile for Laboratory Results Reporting

Official URL: http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-diagnosticreport | Version: 1.2.0
Draft as of 2024-12-27 | Computable Name: DiagnosticReportProfile

Proposed constraints on the DiagnosticReport resource for the minimal set of data to query and retrieve diagnostic reports associated with laboratory and other results

# CA Core DiagnosticReport (Laboratory Results) Profile

This profile sets minimum expectations for the DiagnosticReport resource to record, search, and fetch laboratory results associated with a patient. It identifies which core elements, constraints and value sets SHALL be present in the resource instance when using this profile.

This profile defines core localisation concepts for use in an Canadian context.

## Mandatory Data Elements

All elements or attributes defined in FHIR have cardinality as part of their definition - a minimum number of required appearances and a maximum number.

Most elements in FHIR specification have a minimum cardinality of 0, which means that they may be missing from a resource when it is exchanged between systems.

Required elements:

- status of the diagnostic report
- code that describes the diagnostic report

## Must Support Data Elements

Some elements are labeled as MustSupport meaning that implementations that produce or consume resources SHALL provide "support" for the element in some meaningful way (see Must Support definition).

Following elements are marked as Must Support in the Canadian DiagnosticReport profile to aid record matching in databases.

Must Support elements:

- code that describes the diagnostic report
- subject of the report
- healthcare event this report is about
- Observations that are part of this report

## Usage Note

The following are example usage scenarios for the DiagnosticReport profile.

- Query for lab reports belonging to a Patient
- Record or update a lab report for a specific Patient

Usages:

- Refer to this Profile: Immunization Profile, MedicationAdministration Profile, MedicationStatement Profile, Procedure Profile and ServiceRequest Profile for Results Reporting

You can also check for usages in the FHIR IG Statistics

### Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work.

- Key Elements Table
- Differential Table
- Snapshot Table
- Statistics/References
- All

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
DiagnosticReport |  | 0..* | DiagnosticReport | DiagnosticReport Profile
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
Slices for extension |  |  |  | Content/Rules for all slices
extension:note |  | 0..* | Annotation | Optional Extensions Element URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-DiagnosticReport.note
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
status | ?!Σ | 1..1 | code | registered | partial | preliminary | final + Binding: DiagnosticReportStatus (required): The status of the diagnostic report.
Slices for category | S Σ | 0..* | CodeableConcept | Service category Slice: Unordered, Open by pattern:$this Binding: DiagnosticServiceSectionCodes (example): Codes for diagnostic service sections.
category:LabResult | Σ | 0..* | CodeableConcept | Service category Binding: DiagnosticServiceSectionCodes (example): Codes for diagnostic service sections.
code | S Σ | 1..1 | CodeableConcept | Name/Code for this diagnostic report Binding: LOINCDiagnosticReportCodes (preferred): Codes that describe Diagnostic Reports.
Slices for coding | Σ | 0..* | Coding | Code defined by a terminology system Slice: Unordered, Open by pattern:$this
coding:LabResult | Σ | 0..* | Coding | Code defined by a terminology system
system | Σ | 1..1 | uri | Identity of the terminology system Fixed Value: http://loinc.org
code | Σ | 1..1 | code | Symbol in syntax defined by the system Fixed Value: 11502-2
coding:@default | Σ | 0..* | Coding | Code defined by a terminology system
system | Σ | 1..1 | uri | Identity of the terminology system
code | Σ | 1..1 | code | Symbol in syntax defined by the system
subject | S Σ | 0..1 | Reference(Patient Profile | Device Profile (Implantable) | Location Profile) | The subject of the report - usually, but not always, the patient
encounter | Σ | 0..1 | Reference(Encounter Profile) | Health care event when test ordered
effective[x] | Σ | 0..1 |  | Time of the report or note
effectiveDateTime |  |  | dateTime |
effectivePeriod |  |  | Period |
performer | Σ | 0..* | Reference(Practitioner Profile (General) | PractitionerRole Profile (General) | Organization Profile) | Responsible Diagnostic Service
resultsInterpreter | Σ | 0..* | Reference(Practitioner Profile (General) | PractitionerRole Profile (General) | Organization Profile) | Primary result interpreter
Slices for specimen |  | 0..* | Reference(Specimen) | Specimens this report is based on Slice: Unordered, Open by pattern:$this
specimen:LabResult |  | 0..* | Reference(Specimen) | Specimens this report is based on
specimen:@default |  | 0..* | Reference(Specimen) | Specimens this report is based on
Slices for result | S | 0..* | Reference(Observation) | Observations Slice: Unordered, Open by profile:$this
result:LabResult |  | 0..* | Reference(Observation Profile (Laboratory Results)) | Observations
result:@default | S | 0..* | Reference(Observation Profile (General Use)) | Observations
conclusionCode |  | 0..* | CodeableConcept | CHI identification of the condition, problem or diagnosis Binding: HealthConcernCode (example): Represents the patient's relevant clinical problems, conditions, diagnoses, symptoms, findings and complaints, as interpreted by the provider.
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
DiagnosticReport.status | Base | required | DiagnosticReportStatus | 📍4.0.1 | FHIR Std.
DiagnosticReport.category | Base | example | Diagnostic Service Section Codes | 📍4.0.1 | FHIR Std.
DiagnosticReport.category:LabResult | Base | example | Diagnostic Service Section Codes | 📍4.0.1 | FHIR Std.
DiagnosticReport.code | Base | preferred | LOINC Diagnostic Report Codes | 📍4.0.1 | FHIR Std.
DiagnosticReport.conclusionCode | Base | example | HealthConcernCode | ⏿1.0.0 | terminologystandardsservice.ca

#### Constraints

Id | Grade | Path(s) | Description | Expression
dom-2 | error | DiagnosticReport | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | DiagnosticReport | 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-4 | error | DiagnosticReport | 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-5 | error | DiagnosticReport | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | DiagnosticReport | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`

This structure is derived from DiagnosticReport

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
DiagnosticReport |  | 0..* | DiagnosticReport | DiagnosticReport Profile
Slices for extension |  |  |  | Content/Rules for all slices
extension:note |  | 0..* | Annotation | Optional Extensions Element URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-DiagnosticReport.note
Slices for category | S | 0..* | CodeableConcept | Service category Slice: Unordered, Open by pattern:$this
category:LabResult |  | 0..* | CodeableConcept | Service category
coding |  |  |  |
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0074
code | S | 1..1 | CodeableConcept | Name/Code for this diagnostic report
Slices for coding |  | 0..* | Coding | Code defined by a terminology system Slice: Unordered, Open by pattern:$this
coding:LabResult |  | 0..* | Coding | Code defined by a terminology system
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://loinc.org
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: 11502-2
coding:@default |  | 0..* | Coding | Code defined by a terminology system
system |  | 1..1 | uri | Identity of the terminology system
code |  | 1..1 | code | Symbol in syntax defined by the system
subject | S | 0..1 | Reference(Patient Profile | Device Profile (Implantable) | Location Profile) | The subject of the report - usually, but not always, the patient
encounter |  | 0..1 | Reference(Encounter Profile) | Health care event when test ordered
effective[x] |  | 0..1 |  | Time of the report or note
effectiveDateTime |  |  | dateTime |
effectivePeriod |  |  | Period |
performer |  | 0..* | Reference(Practitioner Profile (General) | PractitionerRole Profile (General) | Organization Profile) | Responsible Diagnostic Service
resultsInterpreter |  | 0..* | Reference(Practitioner Profile (General) | PractitionerRole Profile (General) | Organization Profile) | Primary result interpreter
Slices for specimen |  | 0..* | Reference(Specimen) | Specimens this report is based on Slice: Unordered, Open by pattern:$this
specimen:LabResult |  | 0..* | Reference(Specimen) | Specimens this report is based on
specimen:@default |  | 0..* | Reference(Specimen) | Specimens this report is based on
Slices for result | S | 0..* | Reference(Observation) | Observations Slice: Unordered, Open by profile:$this
result:LabResult |  | 0..* | Reference(Observation Profile (Laboratory Results)) | Observations
result:@default | S | 0..* | Reference(Observation Profile (General Use)) | Observations
conclusionCode |  | 0..* | CodeableConcept | CHI identification of the condition, problem or diagnosis Binding: HealthConcernCode (example): Represents the patient's relevant clinical problems, conditions, diagnoses, symptoms, findings and complaints, as interpreted by the provider.
Documentation for this format

#### Terminology Bindings (Differential)

Path | Status | Usage | ValueSet | Version | Source
DiagnosticReport.conclusionCode | Base | example | HealthConcernCode | ⏿1.0.0 | terminologystandardsservice.ca

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
DiagnosticReport |  | 0..* | DiagnosticReport | DiagnosticReport Profile
id | Σ | 0..1 | id | Logical id of this artifact
meta | Σ | 0..1 | Meta | Metadata about the resource
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
language |  | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
text |  | 0..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained |  | 0..* | Resource | Contained, inline Resources
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:note |  | 0..* | Annotation | Optional Extensions Element URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-DiagnosticReport.note
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
identifier | Σ | 0..* | Identifier | Business identifier for report
basedOn |  | 0..* | Reference(CarePlan | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest) | What was requested
status | ?!Σ | 1..1 | code | registered | partial | preliminary | final + Binding: DiagnosticReportStatus (required): The status of the diagnostic report.
Slices for category | S Σ | 0..* | CodeableConcept | Service category Slice: Unordered, Open by pattern:$this Binding: DiagnosticServiceSectionCodes (example): Codes for diagnostic service sections.
category:LabResult | Σ | 0..* | CodeableConcept | Service category Binding: DiagnosticServiceSectionCodes (example): Codes for diagnostic service sections.
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
coding | Σ | 0..* | Coding | Code defined by a terminology system
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
system | Σ | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0074
version | Σ | 0..1 | string | Version of the system - if relevant
code | Σ | 0..1 | code | Symbol in syntax defined by the system
display | Σ | 0..1 | string | Representation defined by the system
userSelected | Σ | 0..1 | boolean | If this coding was chosen directly by the user
text | Σ | 0..1 | string | Plain text representation of the concept
code | S Σ | 1..1 | CodeableConcept | Name/Code for this diagnostic report Binding: LOINCDiagnosticReportCodes (preferred): Codes that describe Diagnostic Reports.
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
Slices for coding | Σ | 0..* | Coding | Code defined by a terminology system Slice: Unordered, Open by pattern:$this
coding:LabResult | Σ | 0..* | Coding | Code defined by a terminology system
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
system | Σ | 1..1 | uri | Identity of the terminology system Fixed Value: http://loinc.org
version | Σ | 0..1 | string | Version of the system - if relevant
code | Σ | 1..1 | code | Symbol in syntax defined by the system Fixed Value: 11502-2
display | Σ | 0..1 | string | Representation defined by the system
userSelected | Σ | 0..1 | boolean | If this coding was chosen directly by the user
coding:@default | Σ | 0..* | Coding | Code defined by a terminology system
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
system | Σ | 1..1 | uri | Identity of the terminology system
version | Σ | 0..1 | string | Version of the system - if relevant
code | Σ | 1..1 | code | Symbol in syntax defined by the system
display | Σ | 0..1 | string | Representation defined by the system
userSelected | Σ | 0..1 | boolean | If this coding was chosen directly by the user
text | Σ | 0..1 | string | Plain text representation of the concept
subject | S Σ | 0..1 | Reference(Patient Profile | Device Profile (Implantable) | Location Profile) | The subject of the report - usually, but not always, the patient
encounter | Σ | 0..1 | Reference(Encounter Profile) | Health care event when test ordered
effective[x] | Σ | 0..1 |  | Time of the report or note
effectiveDateTime |  |  | dateTime |
effectivePeriod |  |  | Period |
issued | Σ | 0..1 | instant | DateTime this version was made
performer | Σ | 0..* | Reference(Practitioner Profile (General) | PractitionerRole Profile (General) | Organization Profile) | Responsible Diagnostic Service
resultsInterpreter | Σ | 0..* | Reference(Practitioner Profile (General) | PractitionerRole Profile (General) | Organization Profile) | Primary result interpreter
Slices for specimen |  | 0..* | Reference(Specimen) | Specimens this report is based on Slice: Unordered, Open by pattern:$this
specimen:LabResult |  | 0..* | Reference(Specimen) | Specimens this report is based on
specimen:@default |  | 0..* | Reference(Specimen) | Specimens this report is based on
Slices for result | S | 0..* | Reference(Observation) | Observations Slice: Unordered, Open by profile:$this
result:LabResult |  | 0..* | Reference(Observation Profile (Laboratory Results)) | Observations
result:@default | S | 0..* | Reference(Observation Profile (General Use)) | Observations
imagingStudy |  | 0..* | Reference(ImagingStudy) | Reference to full details of imaging associated with the diagnostic report
media | Σ | 0..* | BackboneElement | Key images associated with this report
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
comment |  | 0..1 | string | Comment about the image (e.g. explanation)
link | Σ | 1..1 | Reference(Media) | Reference to the image source
conclusion |  | 0..1 | string | Clinical conclusion (interpretation) of test results
conclusionCode |  | 0..* | CodeableConcept | CHI identification of the condition, problem or diagnosis Binding: HealthConcernCode (example): Represents the patient's relevant clinical problems, conditions, diagnoses, symptoms, findings and complaints, as interpreted by the provider.
presentedForm |  | 0..* | Attachment | Entire report as issued
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
DiagnosticReport.language | Base | preferred | Common Languages | 📍4.0.1 | FHIR Std.
DiagnosticReport.status | Base | required | DiagnosticReportStatus | 📍4.0.1 | FHIR Std.
DiagnosticReport.category | Base | example | Diagnostic Service Section Codes | 📍4.0.1 | FHIR Std.
DiagnosticReport.category:LabResult | Base | example | Diagnostic Service Section Codes | 📍4.0.1 | FHIR Std.
DiagnosticReport.code | Base | preferred | LOINC Diagnostic Report Codes | 📍4.0.1 | FHIR Std.
DiagnosticReport.conclusionCode | Base | example | HealthConcernCode | ⏿1.0.0 | terminologystandardsservice.ca

#### Constraints

Id | Grade | Path(s) | Description | Expression
dom-2 | error | DiagnosticReport | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | DiagnosticReport | 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-4 | error | DiagnosticReport | 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-5 | error | DiagnosticReport | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | DiagnosticReport | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`

This structure is derived from DiagnosticReport

Summary

Mandatory: 0 element(5 nested mandatory elements)
Must-Support: 5 elements
Fixed: 3 elements

Structures

This structure refers to these other structures:

- Patient Profile (http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-patient)
- Device Profile (Implantable) (http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-device)
- Location Profile (http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-location)
- Encounter Profile (http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-encounter)
- Practitioner Profile (General) (http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-practitioner)
- PractitionerRole Profile (General) (http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-practitionerrole)
- Organization Profile (http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-organization)
- Observation Profile (Laboratory Results) (http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-observation-results)
- Observation Profile (General Use) (http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-observation)

Extensions

This structure refers to these extensions:

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

Slices

This structure defines the following Slices:

- The element 1 is sliced based on the value of DiagnosticReport.category
- The element 1 is sliced based on the value of DiagnosticReport.code.coding
- The element 1 is sliced based on the value of DiagnosticReport.specimen
- The element 1 is sliced based on the value of DiagnosticReport.result

Key Elements View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
DiagnosticReport |  | 0..* | DiagnosticReport | DiagnosticReport Profile
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
Slices for extension |  |  |  | Content/Rules for all slices
extension:note |  | 0..* | Annotation | Optional Extensions Element URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-DiagnosticReport.note
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
status | ?!Σ | 1..1 | code | registered | partial | preliminary | final + Binding: DiagnosticReportStatus (required): The status of the diagnostic report.
Slices for category | S Σ | 0..* | CodeableConcept | Service category Slice: Unordered, Open by pattern:$this Binding: DiagnosticServiceSectionCodes (example): Codes for diagnostic service sections.
category:LabResult | Σ | 0..* | CodeableConcept | Service category Binding: DiagnosticServiceSectionCodes (example): Codes for diagnostic service sections.
code | S Σ | 1..1 | CodeableConcept | Name/Code for this diagnostic report Binding: LOINCDiagnosticReportCodes (preferred): Codes that describe Diagnostic Reports.
Slices for coding | Σ | 0..* | Coding | Code defined by a terminology system Slice: Unordered, Open by pattern:$this
coding:LabResult | Σ | 0..* | Coding | Code defined by a terminology system
system | Σ | 1..1 | uri | Identity of the terminology system Fixed Value: http://loinc.org
code | Σ | 1..1 | code | Symbol in syntax defined by the system Fixed Value: 11502-2
coding:@default | Σ | 0..* | Coding | Code defined by a terminology system
system | Σ | 1..1 | uri | Identity of the terminology system
code | Σ | 1..1 | code | Symbol in syntax defined by the system
subject | S Σ | 0..1 | Reference(Patient Profile | Device Profile (Implantable) | Location Profile) | The subject of the report - usually, but not always, the patient
encounter | Σ | 0..1 | Reference(Encounter Profile) | Health care event when test ordered
effective[x] | Σ | 0..1 |  | Time of the report or note
effectiveDateTime |  |  | dateTime |
effectivePeriod |  |  | Period |
performer | Σ | 0..* | Reference(Practitioner Profile (General) | PractitionerRole Profile (General) | Organization Profile) | Responsible Diagnostic Service
resultsInterpreter | Σ | 0..* | Reference(Practitioner Profile (General) | PractitionerRole Profile (General) | Organization Profile) | Primary result interpreter
Slices for specimen |  | 0..* | Reference(Specimen) | Specimens this report is based on Slice: Unordered, Open by pattern:$this
specimen:LabResult |  | 0..* | Reference(Specimen) | Specimens this report is based on
specimen:@default |  | 0..* | Reference(Specimen) | Specimens this report is based on
Slices for result | S | 0..* | Reference(Observation) | Observations Slice: Unordered, Open by profile:$this
result:LabResult |  | 0..* | Reference(Observation Profile (Laboratory Results)) | Observations
result:@default | S | 0..* | Reference(Observation Profile (General Use)) | Observations
conclusionCode |  | 0..* | CodeableConcept | CHI identification of the condition, problem or diagnosis Binding: HealthConcernCode (example): Represents the patient's relevant clinical problems, conditions, diagnoses, symptoms, findings and complaints, as interpreted by the provider.
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
DiagnosticReport.status | Base | required | DiagnosticReportStatus | 📍4.0.1 | FHIR Std.
DiagnosticReport.category | Base | example | Diagnostic Service Section Codes | 📍4.0.1 | FHIR Std.
DiagnosticReport.category:LabResult | Base | example | Diagnostic Service Section Codes | 📍4.0.1 | FHIR Std.
DiagnosticReport.code | Base | preferred | LOINC Diagnostic Report Codes | 📍4.0.1 | FHIR Std.
DiagnosticReport.conclusionCode | Base | example | HealthConcernCode | ⏿1.0.0 | terminologystandardsservice.ca

#### Constraints

Id | Grade | Path(s) | Description | Expression
dom-2 | error | DiagnosticReport | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | DiagnosticReport | 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-4 | error | DiagnosticReport | 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-5 | error | DiagnosticReport | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | DiagnosticReport | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`

Differential View

This structure is derived from DiagnosticReport

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
DiagnosticReport |  | 0..* | DiagnosticReport | DiagnosticReport Profile
Slices for extension |  |  |  | Content/Rules for all slices
extension:note |  | 0..* | Annotation | Optional Extensions Element URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-DiagnosticReport.note
Slices for category | S | 0..* | CodeableConcept | Service category Slice: Unordered, Open by pattern:$this
category:LabResult |  | 0..* | CodeableConcept | Service category
coding |  |  |  |
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0074
code | S | 1..1 | CodeableConcept | Name/Code for this diagnostic report
Slices for coding |  | 0..* | Coding | Code defined by a terminology system Slice: Unordered, Open by pattern:$this
coding:LabResult |  | 0..* | Coding | Code defined by a terminology system
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://loinc.org
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: 11502-2
coding:@default |  | 0..* | Coding | Code defined by a terminology system
system |  | 1..1 | uri | Identity of the terminology system
code |  | 1..1 | code | Symbol in syntax defined by the system
subject | S | 0..1 | Reference(Patient Profile | Device Profile (Implantable) | Location Profile) | The subject of the report - usually, but not always, the patient
encounter |  | 0..1 | Reference(Encounter Profile) | Health care event when test ordered
effective[x] |  | 0..1 |  | Time of the report or note
effectiveDateTime |  |  | dateTime |
effectivePeriod |  |  | Period |
performer |  | 0..* | Reference(Practitioner Profile (General) | PractitionerRole Profile (General) | Organization Profile) | Responsible Diagnostic Service
resultsInterpreter |  | 0..* | Reference(Practitioner Profile (General) | PractitionerRole Profile (General) | Organization Profile) | Primary result interpreter
Slices for specimen |  | 0..* | Reference(Specimen) | Specimens this report is based on Slice: Unordered, Open by pattern:$this
specimen:LabResult |  | 0..* | Reference(Specimen) | Specimens this report is based on
specimen:@default |  | 0..* | Reference(Specimen) | Specimens this report is based on
Slices for result | S | 0..* | Reference(Observation) | Observations Slice: Unordered, Open by profile:$this
result:LabResult |  | 0..* | Reference(Observation Profile (Laboratory Results)) | Observations
result:@default | S | 0..* | Reference(Observation Profile (General Use)) | Observations
conclusionCode |  | 0..* | CodeableConcept | CHI identification of the condition, problem or diagnosis Binding: HealthConcernCode (example): Represents the patient's relevant clinical problems, conditions, diagnoses, symptoms, findings and complaints, as interpreted by the provider.
Documentation for this format

#### Terminology Bindings (Differential)

Path | Status | Usage | ValueSet | Version | Source
DiagnosticReport.conclusionCode | Base | example | HealthConcernCode | ⏿1.0.0 | terminologystandardsservice.ca

Snapshot View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
DiagnosticReport |  | 0..* | DiagnosticReport | DiagnosticReport Profile
id | Σ | 0..1 | id | Logical id of this artifact
meta | Σ | 0..1 | Meta | Metadata about the resource
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
language |  | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
text |  | 0..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained |  | 0..* | Resource | Contained, inline Resources
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:note |  | 0..* | Annotation | Optional Extensions Element URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-DiagnosticReport.note
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
identifier | Σ | 0..* | Identifier | Business identifier for report
basedOn |  | 0..* | Reference(CarePlan | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest) | What was requested
status | ?!Σ | 1..1 | code | registered | partial | preliminary | final + Binding: DiagnosticReportStatus (required): The status of the diagnostic report.
Slices for category | S Σ | 0..* | CodeableConcept | Service category Slice: Unordered, Open by pattern:$this Binding: DiagnosticServiceSectionCodes (example): Codes for diagnostic service sections.
category:LabResult | Σ | 0..* | CodeableConcept | Service category Binding: DiagnosticServiceSectionCodes (example): Codes for diagnostic service sections.
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
coding | Σ | 0..* | Coding | Code defined by a terminology system
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
system | Σ | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0074
version | Σ | 0..1 | string | Version of the system - if relevant
code | Σ | 0..1 | code | Symbol in syntax defined by the system
display | Σ | 0..1 | string | Representation defined by the system
userSelected | Σ | 0..1 | boolean | If this coding was chosen directly by the user
text | Σ | 0..1 | string | Plain text representation of the concept
code | S Σ | 1..1 | CodeableConcept | Name/Code for this diagnostic report Binding: LOINCDiagnosticReportCodes (preferred): Codes that describe Diagnostic Reports.
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
Slices for coding | Σ | 0..* | Coding | Code defined by a terminology system Slice: Unordered, Open by pattern:$this
coding:LabResult | Σ | 0..* | Coding | Code defined by a terminology system
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
system | Σ | 1..1 | uri | Identity of the terminology system Fixed Value: http://loinc.org
version | Σ | 0..1 | string | Version of the system - if relevant
code | Σ | 1..1 | code | Symbol in syntax defined by the system Fixed Value: 11502-2
display | Σ | 0..1 | string | Representation defined by the system
userSelected | Σ | 0..1 | boolean | If this coding was chosen directly by the user
coding:@default | Σ | 0..* | Coding | Code defined by a terminology system
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
system | Σ | 1..1 | uri | Identity of the terminology system
version | Σ | 0..1 | string | Version of the system - if relevant
code | Σ | 1..1 | code | Symbol in syntax defined by the system
display | Σ | 0..1 | string | Representation defined by the system
userSelected | Σ | 0..1 | boolean | If this coding was chosen directly by the user
text | Σ | 0..1 | string | Plain text representation of the concept
subject | S Σ | 0..1 | Reference(Patient Profile | Device Profile (Implantable) | Location Profile) | The subject of the report - usually, but not always, the patient
encounter | Σ | 0..1 | Reference(Encounter Profile) | Health care event when test ordered
effective[x] | Σ | 0..1 |  | Time of the report or note
effectiveDateTime |  |  | dateTime |
effectivePeriod |  |  | Period |
issued | Σ | 0..1 | instant | DateTime this version was made
performer | Σ | 0..* | Reference(Practitioner Profile (General) | PractitionerRole Profile (General) | Organization Profile) | Responsible Diagnostic Service
resultsInterpreter | Σ | 0..* | Reference(Practitioner Profile (General) | PractitionerRole Profile (General) | Organization Profile) | Primary result interpreter
Slices for specimen |  | 0..* | Reference(Specimen) | Specimens this report is based on Slice: Unordered, Open by pattern:$this
specimen:LabResult |  | 0..* | Reference(Specimen) | Specimens this report is based on
specimen:@default |  | 0..* | Reference(Specimen) | Specimens this report is based on
Slices for result | S | 0..* | Reference(Observation) | Observations Slice: Unordered, Open by profile:$this
result:LabResult |  | 0..* | Reference(Observation Profile (Laboratory Results)) | Observations
result:@default | S | 0..* | Reference(Observation Profile (General Use)) | Observations
imagingStudy |  | 0..* | Reference(ImagingStudy) | Reference to full details of imaging associated with the diagnostic report
media | Σ | 0..* | BackboneElement | Key images associated with this report
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
comment |  | 0..1 | string | Comment about the image (e.g. explanation)
link | Σ | 1..1 | Reference(Media) | Reference to the image source
conclusion |  | 0..1 | string | Clinical conclusion (interpretation) of test results
conclusionCode |  | 0..* | CodeableConcept | CHI identification of the condition, problem or diagnosis Binding: HealthConcernCode (example): Represents the patient's relevant clinical problems, conditions, diagnoses, symptoms, findings and complaints, as interpreted by the provider.
presentedForm |  | 0..* | Attachment | Entire report as issued
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
DiagnosticReport.language | Base | preferred | Common Languages | 📍4.0.1 | FHIR Std.
DiagnosticReport.status | Base | required | DiagnosticReportStatus | 📍4.0.1 | FHIR Std.
DiagnosticReport.category | Base | example | Diagnostic Service Section Codes | 📍4.0.1 | FHIR Std.
DiagnosticReport.category:LabResult | Base | example | Diagnostic Service Section Codes | 📍4.0.1 | FHIR Std.
DiagnosticReport.code | Base | preferred | LOINC Diagnostic Report Codes | 📍4.0.1 | FHIR Std.
DiagnosticReport.conclusionCode | Base | example | HealthConcernCode | ⏿1.0.0 | terminologystandardsservice.ca

#### Constraints

Id | Grade | Path(s) | Description | Expression
dom-2 | error | DiagnosticReport | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | DiagnosticReport | 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-4 | error | DiagnosticReport | 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-5 | error | DiagnosticReport | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | DiagnosticReport | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`

This structure is derived from DiagnosticReport

Summary

Mandatory: 0 element(5 nested mandatory elements)
Must-Support: 5 elements
Fixed: 3 elements

Structures

This structure refers to these other structures:

- Patient Profile (http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-patient)
- Device Profile (Implantable) (http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-device)
- Location Profile (http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-location)
- Encounter Profile (http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-encounter)
- Practitioner Profile (General) (http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-practitioner)
- PractitionerRole Profile (General) (http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-practitionerrole)
- Organization Profile (http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-organization)
- Observation Profile (Laboratory Results) (http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-observation-results)
- Observation Profile (General Use) (http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-observation)

Extensions

This structure refers to these extensions:

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

Slices

This structure defines the following Slices:

- The element 1 is sliced based on the value of DiagnosticReport.category
- The element 1 is sliced based on the value of DiagnosticReport.code.coding
- The element 1 is sliced based on the value of DiagnosticReport.specimen
- The element 1 is sliced based on the value of DiagnosticReport.result

Other representations of profile: CSV, Excel, Schematron

### Notes:

## Category

The DiagnosticReport.category element is required in this profile since a typical use would involve searching, sorting for Laboratory test(s) and Laboratory result(s).

Multiple categories are allowed using various categorization schemes but at least one SHALL come from the FHIR defined value set that includes codes from HL7v2 Table 0074.

## ConclusionCode

The DiagnosticReport.conclusionCode element represents codes with the summary conclusion (interpretation/impression) of the diagnostic report.

The Canada Health Infoway Health Concern Code identification of the clinical problems, conditions, diagnoses, symptoms, findings and complaints is provided as a sample only.