Canadian Baseline
1.1.0 - CI Build Canada flag

Canadian Baseline, published by HL7 Canada - FHIR Implementation Work Group. This guide is not an authorized publication; it is the continuous build for version 1.1.0 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: DiagnosticReportProfile - Detailed Descriptions

Draft as of 2020-09-21

Definitions for the profile-diagnosticreport resource profile.

Guidance on how to interpret the contents of this table can be found here

0. DiagnosticReport
Definition

Diagnostic Report Profile is based upon the core FHIR DiagnosticReport resource and created to meet the Laboratory test(s) and Laboratory value(s)/result(s) requirements.

ShortDiagnosticReport Profile
2. DiagnosticReport.category
Control1..*
TypeCodeableConcept
Must Supporttrue
SlicingThis element introduces a set of slices on DiagnosticReport.category. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • pattern @ $this
  • 4. DiagnosticReport.category:LabResult
    Slice NameLabResult
    Definition

    A code that classifies the Laboratory test(s) and Laboratory result(s). This is used for searching, sorting and display purposes.

    Comments

    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

    Control1..1
    TypeCodeableConcept
    6. DiagnosticReport.category:LabResult.coding
    8. DiagnosticReport.category:LabResult.coding.system
    Control1..?
    Fixed Valuehttp://terminology.hl7.org/CodeSystem/v2-0074
    10. DiagnosticReport.code
    Control1..1
    TypeCodeableConcept
    Must Supporttrue
    SlicingThis element introduces a set of slices on DiagnosticReport.code. The slices areUnordered and Open, and can be differentiated using the following discriminators:
    • pattern @ $this
    • 12. DiagnosticReport.code:LabResult
      Slice NameLabResult
      Definition

      A code that classifies the Laboratory test(s) and Laboratory result(s). This is used for searching, sorting and display purposes.

      Comments

      The code SHALL be LOINC 11502-2 'Laboratory report' code

      Control0..1
      TypeCodeableConcept
      14. DiagnosticReport.code:LabResult.coding
      16. DiagnosticReport.code:LabResult.coding.system
      Control1..1
      Fixed Valuehttp://loinc.org
      18. DiagnosticReport.code:LabResult.coding.code
      Control1..1
      Fixed Value11502-2
      20. DiagnosticReport.code:@default
      Slice Name@default
      Definition

      A code that classifies the report(s) or result(s). This is used for searching, sorting and display purposes.

      Comments

      The code is preferrable comes from LOINC code system

      Control0..1
      TypeCodeableConcept
      22. DiagnosticReport.code:@default.coding
      24. DiagnosticReport.code:@default.coding.system
      Control1..1
      26. DiagnosticReport.code:@default.coding.code
      Control1..1
      28. DiagnosticReport.subject
      TypeReference(Patient Profile, Device Profile (Implantable), Location Profile)
      Must Supporttrue
      Must Support TypesNo must-support rules about the choice of types/profiles
      30. DiagnosticReport.encounter
      TypeReference(Encounter Profile)
      32. DiagnosticReport.effective[x]
      Definition

      This is the Datetime or Period when the report or note was written.

      ShortTime of the report or note
      Control1..1
      TypeChoice of: dateTime, Period
      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supporttrue
      Must Support TypesNo must-support rules about the choice of types/profiles
      34. DiagnosticReport.performer
      TypeReference(Practitioner Profile (General), PractitionerRole Profile (General), Organization Profile)
      36. DiagnosticReport.resultsInterpreter
      TypeReference(Practitioner Profile (General), PractitionerRole Profile (General), Organization Profile)
      38. DiagnosticReport.specimen
      TypeReference(Specimen)
      SlicingThis element introduces a set of slices on DiagnosticReport.specimen. The slices areUnordered and Open, and can be differentiated using the following discriminators:
      • pattern @ $this
      • 40. DiagnosticReport.specimen:LabResult
        Slice NameLabResult
        Comments

        Details about the specimen(s) on which this laboratory report is based on.

        Control1..*
        42. DiagnosticReport.specimen:@default
        Slice Name@default
        Comments

        Details about specimen(s) on which this report is based on.

        Control0..*
        44. DiagnosticReport.result
        Must Supporttrue
        SlicingThis element introduces a set of slices on DiagnosticReport.result. The slices areUnordered and Open, and can be differentiated using the following discriminators:
        • profile @ $this
        • 46. DiagnosticReport.result:LabResult
          Slice NameLabResult
          Comments

          Observations that represent results produced by laboratory tests or panels/studies

          Control0..*
          TypeReference(Observation Profile (Laboratory Results))
          48. DiagnosticReport.result:@default
          Slice Name@default
          Comments

          Observations that represent results produced for report

          Control0..*
          TypeReference(Observation Profile (General Use))
          Must Supporttrue
          50. DiagnosticReport.conclusionCode
          Definition

          The code that represents relevant clinical problems, conditions, diagnoses, symptoms, findings and complaints taken from CHI Health Concern Code

          ShortCHI identification of the condition, problem or diagnosis
          Comments

          The binding strength of this element is Example, meaning that the Canada Health Infoway Health Concern Code value set provides examples of the types of concepts intended to be included

          BindingFor example codes, see https://fhir.infoway-inforoute.ca/ValueSet/healthconcerncode
          (example to https://fhir.infoway-inforoute.ca/ValueSet/healthconcerncode)

          Represents the patient's relevant clinical problems, conditions, diagnoses, symptoms, findings and complaints, as interpreted by the provider.

          TypeCodeableConcept

          Guidance on how to interpret the contents of this table can be found here

          0. DiagnosticReport
          Definition

          Diagnostic Report Profile is based upon the core FHIR DiagnosticReport resource and created to meet the Laboratory test(s) and Laboratory value(s)/result(s) requirements.


          The findings and interpretation of diagnostic tests performed on patients, groups of patients, devices, and locations, and/or specimens derived from these. The report includes clinical context such as requesting and provider information, and some mix of atomic results, images, textual and coded interpretations, and formatted representation of diagnostic reports.

          ShortDiagnosticReport ProfileA Diagnostic report - a combination of request information, atomic results, images, interpretation, as well as formatted reports
          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.

          Control0..*
          Is Modifierfalse
          Summaryfalse
          Alternate NamesReport, Test, Result, Results, Labs, Laboratory
          Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.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-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-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
          dom-6: A resource should have narrative for robust management (text.`div`.exists())
          2. DiagnosticReport.implicitRules
          Definition

          A 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.

          ShortA set of rules under which this content was created
          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.

          Control0..1
          Typeuri
          Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          4. DiagnosticReport.modifierExtension
          Definition

          May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it 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).

          ShortExtensions that cannot be ignored
          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.

          Control0..*
          TypeExtension
          Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
          Summaryfalse
          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.

          Alternate Namesextensions, user content
          Invariantsele-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())
          6. DiagnosticReport.status
          Definition

          The status of the diagnostic report.

          Shortregistered | partial | preliminary | final +
          Control1..1
          BindingThe codes SHALL be taken from DiagnosticReportStatushttp://hl7.org/fhir/ValueSet/diagnostic-report-status|4.0.1
          (required to http://hl7.org/fhir/ValueSet/diagnostic-report-status|4.0.1)

          The status of the diagnostic report.

          Typecode
          Is Modifiertrue because This element is labeled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Requirements

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

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          8. DiagnosticReport.category
          Definition

          A 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.

          ShortService category
          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.

          Control10..*
          BindingFor example codes, see DiagnosticServiceSectionCodeshttp://hl7.org/fhir/ValueSet/diagnostic-service-sections
          (example to http://hl7.org/fhir/ValueSet/diagnostic-service-sections)

          Codes for diagnostic service sections.

          TypeCodeableConcept
          Is Modifierfalse
          Must Supporttrue
          Summarytrue
          Alternate NamesDepartment, Sub-department, Service, Discipline
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          SlicingThis element introduces a set of slices on DiagnosticReport.category. The slices areUnordered and Open, and can be differentiated using the following discriminators:
          • pattern @ $this
          • 10. DiagnosticReport.category:LabResult
            Slice NameLabResult
            Definition

            A code that classifies the Laboratory test(s) and Laboratory result(s). This is used for searching, sorting and display purposes.


            A 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.

            ShortService category
            Comments

            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


            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.

            Control10..1*
            BindingFor example codes, see DiagnosticServiceSectionCodeshttp://hl7.org/fhir/ValueSet/diagnostic-service-sections
            (example to http://hl7.org/fhir/ValueSet/diagnostic-service-sections)

            Codes for diagnostic service sections.

            TypeCodeableConcept
            Is Modifierfalse
            Summarytrue
            Alternate NamesDepartment, Sub-department, Service, Discipline
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            12. DiagnosticReport.code
            Definition

            A code or name that describes this diagnostic report.

            ShortName/Code for this diagnostic report
            Control1..1
            BindingThe codes SHOULD be taken from LOINCDiagnosticReportCodeshttp://hl7.org/fhir/ValueSet/report-codes
            (preferred to http://hl7.org/fhir/ValueSet/report-codes)

            Codes that describe Diagnostic Reports.

            TypeCodeableConcept
            Is Modifierfalse
            Must Supporttrue
            Summarytrue
            Alternate NamesType
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            SlicingThis element introduces a set of slices on DiagnosticReport.code. The slices areUnordered and Open, and can be differentiated using the following discriminators:
            • pattern @ $this
            • 14. DiagnosticReport.code:LabResult
              Slice NameLabResult
              Definition

              A code that classifies the Laboratory test(s) and Laboratory result(s). This is used for searching, sorting and display purposes.


              A code or name that describes this diagnostic report.

              ShortName/Code for this diagnostic report
              Comments

              The code SHALL be LOINC 11502-2 'Laboratory report' code

              Control01..1
              BindingThe codes SHOULD be taken from LOINCDiagnosticReportCodeshttp://hl7.org/fhir/ValueSet/report-codes
              (preferred to http://hl7.org/fhir/ValueSet/report-codes)

              Codes that describe Diagnostic Reports.

              TypeCodeableConcept
              Is Modifierfalse
              Summarytrue
              Alternate NamesType
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              16. DiagnosticReport.code:@default
              Slice Name@default
              Definition

              A code that classifies the report(s) or result(s). This is used for searching, sorting and display purposes.


              A code or name that describes this diagnostic report.

              ShortName/Code for this diagnostic report
              Comments

              The code is preferrable comes from LOINC code system

              Control01..1
              BindingThe codes SHOULD be taken from LOINCDiagnosticReportCodeshttp://hl7.org/fhir/ValueSet/report-codes
              (preferred to http://hl7.org/fhir/ValueSet/report-codes)

              Codes that describe Diagnostic Reports.

              TypeCodeableConcept
              Is Modifierfalse
              Summarytrue
              Alternate NamesType
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              18. DiagnosticReport.subject
              Definition

              The 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.

              ShortThe subject of the report - usually, but not always, the patient
              Control0..1
              TypeReference(Patient Profile, Device Profile (Implantable), Location Profile, Patient, Group, Device, Location)
              Is Modifierfalse
              Must Supporttrue
              Must Support TypesNo must-support rules about the choice of types/profiles
              Summarytrue
              Requirements

              SHALL know the subject context.

              Alternate NamesPatient
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              20. DiagnosticReport.encounter
              Definition

              The healthcare event (e.g. a patient and healthcare provider interaction) which this DiagnosticReport is about.

              ShortHealth care event when test ordered
              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).

              Control0..1
              TypeReference(Encounter Profile, Encounter)
              Is Modifierfalse
              Summarytrue
              Requirements

              Links the request to the Encounter context.

              Alternate NamesContext
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              22. DiagnosticReport.effective[x]
              Definition

              This is the Datetime or Period when the report or note was written.


              The 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.

              ShortTime of the report or noteClinically relevant time/time-period for 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.

              Control10..1
              TypeChoice of: dateTime, Period
              [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Must Supporttrue
              Must Support TypesNo must-support rules about the choice of types/profiles
              Summarytrue
              Requirements

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

              Alternate NamesObservation time, Effective Time, Occurrence
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              24. DiagnosticReport.performer
              Definition

              The diagnostic service that is responsible for issuing the report.

              ShortResponsible Diagnostic Service
              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.

              Control0..*
              TypeReference(Practitioner Profile (General), PractitionerRole Profile (General), Organization Profile, Practitioner, PractitionerRole, Organization, CareTeam)
              Is Modifierfalse
              Summarytrue
              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.

              Alternate NamesLaboratory, Service, Practitioner, Department, Company, Authorized by, Director
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              26. DiagnosticReport.resultsInterpreter
              Definition

              The practitioner or organization that is responsible for the report's conclusions and interpretations.

              ShortPrimary result interpreter
              Comments

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

              Control0..*
              TypeReference(Practitioner Profile (General), PractitionerRole Profile (General), Organization Profile, Practitioner, PractitionerRole, Organization, CareTeam)
              Is Modifierfalse
              Summarytrue
              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.

              Alternate NamesAnalyzed by, Reported by
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              28. DiagnosticReport.specimen
              Definition

              Details about the specimens on which this diagnostic report is based.

              ShortSpecimens this report is based on
              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.

              Control0..*
              TypeReference(Specimen)
              Is Modifierfalse
              Summaryfalse
              Requirements

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

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              SlicingThis element introduces a set of slices on DiagnosticReport.specimen. The slices areUnordered and Open, and can be differentiated using the following discriminators:
              • pattern @ $this
              • 30. DiagnosticReport.specimen:LabResult
                Slice NameLabResult
                Definition

                Details about the specimens on which this diagnostic report is based.

                ShortSpecimens this report is based on
                Comments

                Details about the specimen(s) on which this laboratory report is based on.


                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.

                Control10..*
                TypeReference(Specimen)
                Is Modifierfalse
                Summaryfalse
                Requirements

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

                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                32. DiagnosticReport.specimen:@default
                Slice Name@default
                Definition

                Details about the specimens on which this diagnostic report is based.

                ShortSpecimens this report is based on
                Comments

                Details about specimen(s) on which this report is based on.


                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.

                Control0..*
                TypeReference(Specimen)
                Is Modifierfalse
                Summaryfalse
                Requirements

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

                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                34. DiagnosticReport.result
                Definition

                Observations that are part of this diagnostic report.

                ShortObservations
                Comments

                Observations can contain observations.

                Control0..*
                TypeReference(Observation)
                Is Modifierfalse
                Must Supporttrue
                Summaryfalse
                Requirements

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

                Alternate NamesData, Atomic Value, Result, Atomic result, Data, Test, Analyte, Battery, Organizer
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                SlicingThis element introduces a set of slices on DiagnosticReport.result. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                • profile @ $this
                • 36. DiagnosticReport.result:LabResult
                  Slice NameLabResult
                  Definition

                  Observations that are part of this diagnostic report.

                  ShortObservations
                  Comments

                  Observations that represent results produced by laboratory tests or panels/studies


                  Observations can contain observations.

                  Control0..*
                  TypeReference(Observation Profile (Laboratory Results), Observation)
                  Is Modifierfalse
                  Summaryfalse
                  Requirements

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

                  Alternate NamesData, Atomic Value, Result, Atomic result, Data, Test, Analyte, Battery, Organizer
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  38. DiagnosticReport.result:@default
                  Slice Name@default
                  Definition

                  Observations that are part of this diagnostic report.

                  ShortObservations
                  Comments

                  Observations that represent results produced for report


                  Observations can contain observations.

                  Control0..*
                  TypeReference(Observation Profile (General Use), Observation)
                  Is Modifierfalse
                  Must Supporttrue
                  Summaryfalse
                  Requirements

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

                  Alternate NamesData, Atomic Value, Result, Atomic result, Data, Test, Analyte, Battery, Organizer
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  40. DiagnosticReport.conclusionCode
                  Definition

                  The code that represents relevant clinical problems, conditions, diagnoses, symptoms, findings and complaints taken from CHI Health Concern Code


                  One or more codes that represent the summary conclusion (interpretation/impression) of the diagnostic report.

                  ShortCHI identification of the condition, problem or diagnosisCodes for the clinical conclusion of test results
                  Comments

                  The binding strength of this element is Example, meaning that the Canada Health Infoway Health Concern Code value set provides examples of the types of concepts intended to be included

                  Control0..*
                  BindingFor example codes, see https://fhir.infoway-inforoute.ca/ValueSet/healthconcerncodehttp://hl7.org/fhir/ValueSet/clinical-findings
                  (example to https://fhir.infoway-inforoute.ca/ValueSet/healthconcerncode)

                  Represents the patient's relevant clinical problems, conditions, diagnoses, symptoms, findings and complaints, as interpreted by the provider.


                  Diagnosis codes provided as adjuncts to the report.

                  TypeCodeableConcept
                  Is Modifierfalse
                  Summaryfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

                  Guidance on how to interpret the contents of this table can be found here

                  0. DiagnosticReport
                  Definition

                  Diagnostic Report Profile is based upon the core FHIR DiagnosticReport resource and created to meet the Laboratory test(s) and Laboratory value(s)/result(s) requirements.

                  ShortDiagnosticReport Profile
                  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.

                  Control0..*
                  Is Modifierfalse
                  Summaryfalse
                  Alternate NamesReport, Test, Result, Results, Labs, Laboratory
                  Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.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-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-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
                  dom-6: A resource should have narrative for robust management (text.`div`.exists())
                  2. DiagnosticReport.id
                  Definition

                  The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

                  ShortLogical id of this artifact
                  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.

                  Control0..1
                  Typeid
                  Is Modifierfalse
                  Summarytrue
                  4. DiagnosticReport.meta
                  Definition

                  The 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.

                  ShortMetadata about the resource
                  Control0..1
                  TypeMeta
                  Is Modifierfalse
                  Summarytrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  6. DiagnosticReport.implicitRules
                  Definition

                  A 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.

                  ShortA set of rules under which this content was created
                  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.

                  Control0..1
                  Typeuri
                  Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Summarytrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  8. DiagnosticReport.language
                  Definition

                  The base language in which the resource is written.

                  ShortLanguage of the resource content
                  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).

                  Control0..1
                  BindingThe codes SHOULD be taken from CommonLanguages
                  (preferred to http://hl7.org/fhir/ValueSet/languages)

                  A human language.

                  Additional BindingsPurpose
                  AllLanguagesMax Binding
                  Typecode
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Summaryfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  10. DiagnosticReport.text
                  Definition

                  A 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.

                  ShortText summary of the resource, for human interpretation
                  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.

                  Control0..1
                  TypeNarrative
                  Is Modifierfalse
                  Summaryfalse
                  Alternate Namesnarrative, html, xhtml, display
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  12. DiagnosticReport.contained
                  Definition

                  These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.

                  ShortContained, inline 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.

                  Control0..*
                  TypeResource
                  Is Modifierfalse
                  Summaryfalse
                  Alternate Namesinline resources, anonymous resources, contained resources
                  14. DiagnosticReport.extension
                  Definition

                  May 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.

                  ShortAdditional content defined by implementations
                  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.

                  Control0..*
                  TypeExtension
                  Is Modifierfalse
                  Summaryfalse
                  Alternate Namesextensions, user content
                  Invariantsele-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())
                  16. DiagnosticReport.modifierExtension
                  Definition

                  May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it 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).

                  ShortExtensions that cannot be ignored
                  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.

                  Control0..*
                  TypeExtension
                  Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
                  Summaryfalse
                  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.

                  Alternate Namesextensions, user content
                  Invariantsele-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())
                  18. DiagnosticReport.identifier
                  Definition

                  Identifiers assigned to this report by the performer or other systems.

                  ShortBusiness identifier for report
                  Comments

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

                  NoteThis is a business identifier, not a resource identifier (see discussion)
                  Control0..*
                  TypeIdentifier
                  Is Modifierfalse
                  Summarytrue
                  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.

                  Alternate NamesReportID, Filler ID, Placer ID
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  20. DiagnosticReport.basedOn
                  Definition

                  Details concerning a service requested.

                  ShortWhat was requested
                  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.

                  Control0..*
                  TypeReference(CarePlan, ImmunizationRecommendation, MedicationRequest, NutritionOrder, ServiceRequest)
                  Is Modifierfalse
                  Summaryfalse
                  Requirements

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

                  Alternate NamesRequest
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  22. DiagnosticReport.status
                  Definition

                  The status of the diagnostic report.

                  Shortregistered | partial | preliminary | final +
                  Control1..1
                  BindingThe codes SHALL be taken from DiagnosticReportStatus
                  (required to http://hl7.org/fhir/ValueSet/diagnostic-report-status|4.0.1)

                  The status of the diagnostic report.

                  Typecode
                  Is Modifiertrue because This element is labeled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Summarytrue
                  Requirements

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

                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  24. DiagnosticReport.category
                  Definition

                  A 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.

                  ShortService category
                  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.

                  Control1..*
                  BindingFor example codes, see DiagnosticServiceSectionCodes
                  (example to http://hl7.org/fhir/ValueSet/diagnostic-service-sections)

                  Codes for diagnostic service sections.

                  TypeCodeableConcept
                  Is Modifierfalse
                  Must Supporttrue
                  Summarytrue
                  Alternate NamesDepartment, Sub-department, Service, Discipline
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  SlicingThis element introduces a set of slices on DiagnosticReport.category. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                  • pattern @ $this
                  • 26. DiagnosticReport.category:LabResult
                    Slice NameLabResult
                    Definition

                    A code that classifies the Laboratory test(s) and Laboratory result(s). This is used for searching, sorting and display purposes.

                    ShortService category
                    Comments

                    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

                    Control1..1
                    BindingFor example codes, see DiagnosticServiceSectionCodes
                    (example to http://hl7.org/fhir/ValueSet/diagnostic-service-sections)

                    Codes for diagnostic service sections.

                    TypeCodeableConcept
                    Is Modifierfalse
                    Summarytrue
                    Alternate NamesDepartment, Sub-department, Service, Discipline
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    28. DiagnosticReport.category:LabResult.id
                    Definition

                    Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                    ShortUnique id for inter-element referencing
                    Control0..1
                    Typestring
                    Is Modifierfalse
                    XML FormatIn the XML format, this property is represented as an attribute.
                    Summaryfalse
                    30. DiagnosticReport.category:LabResult.extension
                    Definition

                    May 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.

                    ShortAdditional content defined by implementations
                    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.

                    Control0..*
                    TypeExtension
                    Is Modifierfalse
                    Summaryfalse
                    Alternate Namesextensions, user content
                    Invariantsele-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())
                    SlicingThis element introduces a set of slices on DiagnosticReport.category.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                    • value @ url
                    • 32. DiagnosticReport.category:LabResult.coding
                      Definition

                      A reference to a code defined by a terminology system.

                      ShortCode defined by a terminology system
                      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.

                      Control0..*
                      TypeCoding
                      Is Modifierfalse
                      Summarytrue
                      Requirements

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

                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      34. DiagnosticReport.category:LabResult.coding.id
                      Definition

                      Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                      ShortUnique id for inter-element referencing
                      Control0..1
                      Typestring
                      Is Modifierfalse
                      XML FormatIn the XML format, this property is represented as an attribute.
                      Summaryfalse
                      36. DiagnosticReport.category:LabResult.coding.extension
                      Definition

                      May 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.

                      ShortAdditional content defined by implementations
                      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.

                      Control0..*
                      TypeExtension
                      Is Modifierfalse
                      Summaryfalse
                      Alternate Namesextensions, user content
                      Invariantsele-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())
                      SlicingThis element introduces a set of slices on DiagnosticReport.category.coding.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                      • value @ url
                      • 38. DiagnosticReport.category:LabResult.coding.system
                        Definition

                        The identification of the code system that defines the meaning of the symbol in the code.

                        ShortIdentity of the terminology system
                        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.

                        Control1..1
                        Typeuri
                        Is Modifierfalse
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Summarytrue
                        Requirements

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

                        Fixed Valuehttp://terminology.hl7.org/CodeSystem/v2-0074
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        40. DiagnosticReport.category:LabResult.coding.version
                        Definition

                        The 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.

                        ShortVersion of the system - if relevant
                        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.

                        NoteThis is a business version Id, not a resource version Id (see discussion)
                        Control0..1
                        Typestring
                        Is Modifierfalse
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Summarytrue
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        42. DiagnosticReport.category:LabResult.coding.code
                        Definition

                        A 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).

                        ShortSymbol in syntax defined by the system
                        Control0..1
                        Typecode
                        Is Modifierfalse
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Summarytrue
                        Requirements

                        Need to refer to a particular code in the system.

                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        44. DiagnosticReport.category:LabResult.coding.display
                        Definition

                        A representation of the meaning of the code in the system, following the rules of the system.

                        ShortRepresentation defined by the system
                        Control0..1
                        Typestring
                        Is Modifierfalse
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Summarytrue
                        Requirements

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

                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        46. DiagnosticReport.category:LabResult.coding.userSelected
                        Definition

                        Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).

                        ShortIf this coding was chosen directly by the user
                        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.

                        Control0..1
                        Typeboolean
                        Is Modifierfalse
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        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.

                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        48. DiagnosticReport.category:LabResult.text
                        Definition

                        A 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.

                        ShortPlain text representation of the concept
                        Comments

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

                        Control0..1
                        Typestring
                        Is Modifierfalse
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        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.

                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        50. DiagnosticReport.code
                        Definition

                        A code or name that describes this diagnostic report.

                        ShortName/Code for this diagnostic report
                        Control1..1
                        BindingThe codes SHOULD be taken from LOINCDiagnosticReportCodes
                        (preferred to http://hl7.org/fhir/ValueSet/report-codes)

                        Codes that describe Diagnostic Reports.

                        TypeCodeableConcept
                        Is Modifierfalse
                        Must Supporttrue
                        Summarytrue
                        Alternate NamesType
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        SlicingThis element introduces a set of slices on DiagnosticReport.code. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                        • pattern @ $this
                        • 52. DiagnosticReport.code:LabResult
                          Slice NameLabResult
                          Definition

                          A code that classifies the Laboratory test(s) and Laboratory result(s). This is used for searching, sorting and display purposes.

                          ShortName/Code for this diagnostic report
                          Comments

                          The code SHALL be LOINC 11502-2 'Laboratory report' code

                          Control0..1
                          BindingThe codes SHOULD be taken from LOINCDiagnosticReportCodes
                          (preferred to http://hl7.org/fhir/ValueSet/report-codes)

                          Codes that describe Diagnostic Reports.

                          TypeCodeableConcept
                          Is Modifierfalse
                          Summarytrue
                          Alternate NamesType
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          54. DiagnosticReport.code:LabResult.id
                          Definition

                          Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                          ShortUnique id for inter-element referencing
                          Control0..1
                          Typestring
                          Is Modifierfalse
                          XML FormatIn the XML format, this property is represented as an attribute.
                          Summaryfalse
                          56. DiagnosticReport.code:LabResult.extension
                          Definition

                          May 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.

                          ShortAdditional content defined by implementations
                          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.

                          Control0..*
                          TypeExtension
                          Is Modifierfalse
                          Summaryfalse
                          Alternate Namesextensions, user content
                          Invariantsele-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())
                          SlicingThis element introduces a set of slices on DiagnosticReport.code.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                          • value @ url
                          • 58. DiagnosticReport.code:LabResult.coding
                            Definition

                            A reference to a code defined by a terminology system.

                            ShortCode defined by a terminology system
                            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.

                            Control0..*
                            TypeCoding
                            Is Modifierfalse
                            Summarytrue
                            Requirements

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

                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            60. DiagnosticReport.code:LabResult.coding.id
                            Definition

                            Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                            ShortUnique id for inter-element referencing
                            Control0..1
                            Typestring
                            Is Modifierfalse
                            XML FormatIn the XML format, this property is represented as an attribute.
                            Summaryfalse
                            62. DiagnosticReport.code:LabResult.coding.extension
                            Definition

                            May 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.

                            ShortAdditional content defined by implementations
                            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.

                            Control0..*
                            TypeExtension
                            Is Modifierfalse
                            Summaryfalse
                            Alternate Namesextensions, user content
                            Invariantsele-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())
                            SlicingThis element introduces a set of slices on DiagnosticReport.code.coding.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                            • value @ url
                            • 64. DiagnosticReport.code:LabResult.coding.system
                              Definition

                              The identification of the code system that defines the meaning of the symbol in the code.

                              ShortIdentity of the terminology system
                              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.

                              Control1..1
                              Typeuri
                              Is Modifierfalse
                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                              Summarytrue
                              Requirements

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

                              Fixed Valuehttp://loinc.org
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              66. DiagnosticReport.code:LabResult.coding.version
                              Definition

                              The 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.

                              ShortVersion of the system - if relevant
                              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.

                              NoteThis is a business version Id, not a resource version Id (see discussion)
                              Control0..1
                              Typestring
                              Is Modifierfalse
                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                              Summarytrue
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              68. DiagnosticReport.code:LabResult.coding.code
                              Definition

                              A 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).

                              ShortSymbol in syntax defined by the system
                              Control1..1
                              Typecode
                              Is Modifierfalse
                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                              Summarytrue
                              Requirements

                              Need to refer to a particular code in the system.

                              Fixed Value11502-2
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              70. DiagnosticReport.code:LabResult.coding.display
                              Definition

                              A representation of the meaning of the code in the system, following the rules of the system.

                              ShortRepresentation defined by the system
                              Control0..1
                              Typestring
                              Is Modifierfalse
                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                              Summarytrue
                              Requirements

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

                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              72. DiagnosticReport.code:LabResult.coding.userSelected
                              Definition

                              Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).

                              ShortIf this coding was chosen directly by the user
                              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.

                              Control0..1
                              Typeboolean
                              Is Modifierfalse
                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                              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.

                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              74. DiagnosticReport.code:LabResult.text
                              Definition

                              A 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.

                              ShortPlain text representation of the concept
                              Comments

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

                              Control0..1
                              Typestring
                              Is Modifierfalse
                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                              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.

                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              76. DiagnosticReport.code:@default
                              Slice Name@default
                              Definition

                              A code that classifies the report(s) or result(s). This is used for searching, sorting and display purposes.

                              ShortName/Code for this diagnostic report
                              Comments

                              The code is preferrable comes from LOINC code system

                              Control0..1
                              BindingThe codes SHOULD be taken from LOINCDiagnosticReportCodes
                              (preferred to http://hl7.org/fhir/ValueSet/report-codes)

                              Codes that describe Diagnostic Reports.

                              TypeCodeableConcept
                              Is Modifierfalse
                              Summarytrue
                              Alternate NamesType
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              78. DiagnosticReport.code:@default.id
                              Definition

                              Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                              ShortUnique id for inter-element referencing
                              Control0..1
                              Typestring
                              Is Modifierfalse
                              XML FormatIn the XML format, this property is represented as an attribute.
                              Summaryfalse
                              80. DiagnosticReport.code:@default.extension
                              Definition

                              May 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.

                              ShortAdditional content defined by implementations
                              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.

                              Control0..*
                              TypeExtension
                              Is Modifierfalse
                              Summaryfalse
                              Alternate Namesextensions, user content
                              Invariantsele-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())
                              SlicingThis element introduces a set of slices on DiagnosticReport.code.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                              • value @ url
                              • 82. DiagnosticReport.code:@default.coding
                                Definition

                                A reference to a code defined by a terminology system.

                                ShortCode defined by a terminology system
                                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.

                                Control0..*
                                TypeCoding
                                Is Modifierfalse
                                Summarytrue
                                Requirements

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

                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                84. DiagnosticReport.code:@default.coding.id
                                Definition

                                Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                ShortUnique id for inter-element referencing
                                Control0..1
                                Typestring
                                Is Modifierfalse
                                XML FormatIn the XML format, this property is represented as an attribute.
                                Summaryfalse
                                86. DiagnosticReport.code:@default.coding.extension
                                Definition

                                May 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.

                                ShortAdditional content defined by implementations
                                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.

                                Control0..*
                                TypeExtension
                                Is Modifierfalse
                                Summaryfalse
                                Alternate Namesextensions, user content
                                Invariantsele-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())
                                SlicingThis element introduces a set of slices on DiagnosticReport.code.coding.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                • value @ url
                                • 88. DiagnosticReport.code:@default.coding.system
                                  Definition

                                  The identification of the code system that defines the meaning of the symbol in the code.

                                  ShortIdentity of the terminology system
                                  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.

                                  Control1..1
                                  Typeuri
                                  Is Modifierfalse
                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                  Summarytrue
                                  Requirements

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

                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  90. DiagnosticReport.code:@default.coding.version
                                  Definition

                                  The 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.

                                  ShortVersion of the system - if relevant
                                  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.

                                  NoteThis is a business version Id, not a resource version Id (see discussion)
                                  Control0..1
                                  Typestring
                                  Is Modifierfalse
                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                  Summarytrue
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  92. DiagnosticReport.code:@default.coding.code
                                  Definition

                                  A 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).

                                  ShortSymbol in syntax defined by the system
                                  Control1..1
                                  Typecode
                                  Is Modifierfalse
                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                  Summarytrue
                                  Requirements

                                  Need to refer to a particular code in the system.

                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  94. DiagnosticReport.code:@default.coding.display
                                  Definition

                                  A representation of the meaning of the code in the system, following the rules of the system.

                                  ShortRepresentation defined by the system
                                  Control0..1
                                  Typestring
                                  Is Modifierfalse
                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                  Summarytrue
                                  Requirements

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

                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  96. DiagnosticReport.code:@default.coding.userSelected
                                  Definition

                                  Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).

                                  ShortIf this coding was chosen directly by the user
                                  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.

                                  Control0..1
                                  Typeboolean
                                  Is Modifierfalse
                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                  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.

                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  98. DiagnosticReport.code:@default.text
                                  Definition

                                  A 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.

                                  ShortPlain text representation of the concept
                                  Comments

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

                                  Control0..1
                                  Typestring
                                  Is Modifierfalse
                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                  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.

                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  100. DiagnosticReport.subject
                                  Definition

                                  The 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.

                                  ShortThe subject of the report - usually, but not always, the patient
                                  Control0..1
                                  TypeReference(Patient Profile, Device Profile (Implantable), Location Profile)
                                  Is Modifierfalse
                                  Must Supporttrue
                                  Must Support TypesNo must-support rules about the choice of types/profiles
                                  Summarytrue
                                  Requirements

                                  SHALL know the subject context.

                                  Alternate NamesPatient
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  102. DiagnosticReport.encounter
                                  Definition

                                  The healthcare event (e.g. a patient and healthcare provider interaction) which this DiagnosticReport is about.

                                  ShortHealth care event when test ordered
                                  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).

                                  Control0..1
                                  TypeReference(Encounter Profile)
                                  Is Modifierfalse
                                  Summarytrue
                                  Requirements

                                  Links the request to the Encounter context.

                                  Alternate NamesContext
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  104. DiagnosticReport.effective[x]
                                  Definition

                                  This is the Datetime or Period when the report or note was written.

                                  ShortTime of the report or note
                                  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.

                                  Control1..1
                                  TypeChoice of: dateTime, Period
                                  [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                  Is Modifierfalse
                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                  Must Supporttrue
                                  Must Support TypesNo must-support rules about the choice of types/profiles
                                  Summarytrue
                                  Requirements

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

                                  Alternate NamesObservation time, Effective Time, Occurrence
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  106. DiagnosticReport.issued
                                  Definition

                                  The date and time that this version of the report was made available to providers, typically after the report was reviewed and verified.

                                  ShortDateTime this version was made
                                  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.

                                  Control0..1
                                  Typeinstant
                                  Is Modifierfalse
                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                  Summarytrue
                                  Requirements

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

                                  Alternate NamesDate published, Date Issued, Date Verified
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  108. DiagnosticReport.performer
                                  Definition

                                  The diagnostic service that is responsible for issuing the report.

                                  ShortResponsible Diagnostic Service
                                  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.

                                  Control0..*
                                  TypeReference(Practitioner Profile (General), PractitionerRole Profile (General), Organization Profile)
                                  Is Modifierfalse
                                  Summarytrue
                                  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.

                                  Alternate NamesLaboratory, Service, Practitioner, Department, Company, Authorized by, Director
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  110. DiagnosticReport.resultsInterpreter
                                  Definition

                                  The practitioner or organization that is responsible for the report's conclusions and interpretations.

                                  ShortPrimary result interpreter
                                  Comments

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

                                  Control0..*
                                  TypeReference(Practitioner Profile (General), PractitionerRole Profile (General), Organization Profile)
                                  Is Modifierfalse
                                  Summarytrue
                                  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.

                                  Alternate NamesAnalyzed by, Reported by
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  112. DiagnosticReport.specimen
                                  Definition

                                  Details about the specimens on which this diagnostic report is based.

                                  ShortSpecimens this report is based on
                                  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.

                                  Control0..*
                                  TypeReference(Specimen)
                                  Is Modifierfalse
                                  Summaryfalse
                                  Requirements

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

                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  SlicingThis element introduces a set of slices on DiagnosticReport.specimen. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                  • pattern @ $this
                                  • 114. DiagnosticReport.specimen:LabResult
                                    Slice NameLabResult
                                    Definition

                                    Details about the specimens on which this diagnostic report is based.

                                    ShortSpecimens this report is based on
                                    Comments

                                    Details about the specimen(s) on which this laboratory report is based on.

                                    Control1..*
                                    TypeReference(Specimen)
                                    Is Modifierfalse
                                    Summaryfalse
                                    Requirements

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

                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    116. DiagnosticReport.specimen:@default
                                    Slice Name@default
                                    Definition

                                    Details about the specimens on which this diagnostic report is based.

                                    ShortSpecimens this report is based on
                                    Comments

                                    Details about specimen(s) on which this report is based on.

                                    Control0..*
                                    TypeReference(Specimen)
                                    Is Modifierfalse
                                    Summaryfalse
                                    Requirements

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

                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    118. DiagnosticReport.result
                                    Definition

                                    Observations that are part of this diagnostic report.

                                    ShortObservations
                                    Comments

                                    Observations can contain observations.

                                    Control0..*
                                    TypeReference(Observation)
                                    Is Modifierfalse
                                    Must Supporttrue
                                    Summaryfalse
                                    Requirements

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

                                    Alternate NamesData, Atomic Value, Result, Atomic result, Data, Test, Analyte, Battery, Organizer
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    SlicingThis element introduces a set of slices on DiagnosticReport.result. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                    • profile @ $this
                                    • 120. DiagnosticReport.result:LabResult
                                      Slice NameLabResult
                                      Definition

                                      Observations that are part of this diagnostic report.

                                      ShortObservations
                                      Comments

                                      Observations that represent results produced by laboratory tests or panels/studies

                                      Control0..*
                                      TypeReference(Observation Profile (Laboratory Results))
                                      Is Modifierfalse
                                      Summaryfalse
                                      Requirements

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

                                      Alternate NamesData, Atomic Value, Result, Atomic result, Data, Test, Analyte, Battery, Organizer
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      122. DiagnosticReport.result:@default
                                      Slice Name@default
                                      Definition

                                      Observations that are part of this diagnostic report.

                                      ShortObservations
                                      Comments

                                      Observations that represent results produced for report

                                      Control0..*
                                      TypeReference(Observation Profile (General Use))
                                      Is Modifierfalse
                                      Must Supporttrue
                                      Summaryfalse
                                      Requirements

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

                                      Alternate NamesData, Atomic Value, Result, Atomic result, Data, Test, Analyte, Battery, Organizer
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      124. DiagnosticReport.imagingStudy
                                      Definition

                                      One 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.

                                      ShortReference to full details of imaging associated with the diagnostic report
                                      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.

                                      Control0..*
                                      TypeReference(ImagingStudy)
                                      Is Modifierfalse
                                      Summaryfalse
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      126. DiagnosticReport.media
                                      Definition

                                      A 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).

                                      ShortKey images associated with this report
                                      Control0..*
                                      TypeBackboneElement
                                      Is Modifierfalse
                                      Summarytrue
                                      Requirements

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

                                      Alternate NamesDICOM, Slides, Scans
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      128. DiagnosticReport.media.id
                                      Definition

                                      Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                      ShortUnique id for inter-element referencing
                                      Control0..1
                                      Typestring
                                      Is Modifierfalse
                                      XML FormatIn the XML format, this property is represented as an attribute.
                                      Summaryfalse
                                      130. DiagnosticReport.media.extension
                                      Definition

                                      May 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.

                                      ShortAdditional content defined by implementations
                                      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.

                                      Control0..*
                                      TypeExtension
                                      Is Modifierfalse
                                      Summaryfalse
                                      Alternate Namesextensions, user content
                                      Invariantsele-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())
                                      132. DiagnosticReport.media.modifierExtension
                                      Definition

                                      May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element 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).

                                      ShortExtensions that cannot be ignored even if unrecognized
                                      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.

                                      Control0..*
                                      TypeExtension
                                      Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                      Summarytrue
                                      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.

                                      Alternate Namesextensions, user content, modifiers
                                      Invariantsele-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())
                                      134. DiagnosticReport.media.comment
                                      Definition

                                      A 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.

                                      ShortComment about the image (e.g. explanation)
                                      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.

                                      Control0..1
                                      Typestring
                                      Is Modifierfalse
                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                      Summaryfalse
                                      Requirements

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

                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      136. DiagnosticReport.media.link
                                      Definition

                                      Reference to the image source.

                                      ShortReference to the image source
                                      Control1..1
                                      TypeReference(Media)
                                      Is Modifierfalse
                                      Summarytrue
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      138. DiagnosticReport.conclusion
                                      Definition

                                      Concise and clinically contextualized summary conclusion (interpretation/impression) of the diagnostic report.

                                      ShortClinical conclusion (interpretation) of test results
                                      Control0..1
                                      Typestring
                                      Is Modifierfalse
                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                      Summaryfalse
                                      Requirements

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

                                      Alternate NamesReport
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      140. DiagnosticReport.conclusionCode
                                      Definition

                                      The code that represents relevant clinical problems, conditions, diagnoses, symptoms, findings and complaints taken from CHI Health Concern Code

                                      ShortCHI identification of the condition, problem or diagnosis
                                      Comments

                                      The binding strength of this element is Example, meaning that the Canada Health Infoway Health Concern Code value set provides examples of the types of concepts intended to be included

                                      Control0..*
                                      BindingFor example codes, see https://fhir.infoway-inforoute.ca/ValueSet/healthconcerncode
                                      (example to https://fhir.infoway-inforoute.ca/ValueSet/healthconcerncode)

                                      Represents the patient's relevant clinical problems, conditions, diagnoses, symptoms, findings and complaints, as interpreted by the provider.

                                      TypeCodeableConcept
                                      Is Modifierfalse
                                      Summaryfalse
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      142. DiagnosticReport.presentedForm
                                      Definition

                                      Rich text representation of the entire result as issued by the diagnostic service. Multiple formats are allowed but they SHALL be semantically equivalent.

                                      ShortEntire report as issued
                                      Comments

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

                                      Control0..*
                                      TypeAttachment
                                      Is Modifierfalse
                                      Summaryfalse
                                      Requirements

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

                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))