CA Core DiagnosticReport (Laboratory Results) Profile

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

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

Mandatory Data Elements

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

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

Required elements:

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

Must Support Data Elements

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

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

Must Support elements:

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

Usage Note

The following are example usage scenarios for the DiagnosticReport profile.

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

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

This structure is derived from DiagnosticReport

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

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
DiagnosticReport.conclusionCode	example	HealthConcernCode https://fhir.infoway-inforoute.ca/ValueSet/healthconcerncode from https://terminologystandardsservice.ca/tx/fhir

Name	Flags	Card.	Type	Description & Constraints
DiagnosticReport		0..*	DiagnosticReport	DiagnosticReport Profile dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources 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 dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated dom-5: If a resource is contained in another resource, it SHALL NOT have a security label dom-6: A resource should have narrative for robust management
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created ele-1: All FHIR elements must have a @value or children
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
status	?!Σ	1..1	code	registered | partial | preliminary | final + Binding: DiagnosticReportStatus (required): The status of the diagnostic report. ele-1: All FHIR elements must have a @value or children
Slices for category	SΣ	0..*	CodeableConcept	Service category Slice: Unordered, Open by pattern:$this Binding: DiagnosticServiceSectionCodes (example): Codes for diagnostic service sections. ele-1: All FHIR elements must have a @value or children
category:LabResult	Σ	0..*	CodeableConcept	Service category Binding: DiagnosticServiceSectionCodes (example): Codes for diagnostic service sections. ele-1: All FHIR elements must have a @value or children
Slices for code	SΣ	1..1	CodeableConcept	Name/Code for this diagnostic report Slice: Unordered, Open by pattern:$this Binding: LOINCDiagnosticReportCodes (preferred): Codes that describe Diagnostic Reports. ele-1: All FHIR elements must have a @value or children
code:LabResult	Σ	0..1	CodeableConcept	Name/Code for this diagnostic report Binding: LOINCDiagnosticReportCodes (preferred): Codes that describe Diagnostic Reports. ele-1: All FHIR elements must have a @value or children
code:@default	Σ	0..1	CodeableConcept	Name/Code for this diagnostic report Binding: LOINCDiagnosticReportCodes (preferred): Codes that describe Diagnostic Reports. ele-1: All FHIR elements must have a @value or children
subject	SΣ	0..1	Reference(Patient Profile | Device Profile (Implantable) | Location Profile)	The subject of the report - usually, but not always, the patient ele-1: All FHIR elements must have a @value or children
encounter	Σ	0..1	Reference(Encounter Profile)	Health care event when test ordered ele-1: All FHIR elements must have a @value or children
effective[x]	Σ	0..1		Time of the report or note ele-1: All FHIR elements must have a @value or children
effectiveDateTime			dateTime
effectivePeriod			Period
performer	Σ	0..*	Reference(Practitioner Profile (General) | PractitionerRole Profile (General) | Organization Profile)	Responsible Diagnostic Service ele-1: All FHIR elements must have a @value or children
resultsInterpreter	Σ	0..*	Reference(Practitioner Profile (General) | PractitionerRole Profile (General) | Organization Profile)	Primary result interpreter ele-1: All FHIR elements must have a @value or children
Slices for specimen		0..*	Reference(Specimen)	Specimens this report is based on Slice: Unordered, Open by pattern:$this ele-1: All FHIR elements must have a @value or children
specimen:LabResult		1..*	Reference(Specimen)	Specimens this report is based on ele-1: All FHIR elements must have a @value or children
specimen:@default		0..*	Reference(Specimen)	Specimens this report is based on ele-1: All FHIR elements must have a @value or children
Slices for result	S	0..*	Reference(Observation)	Observations Slice: Unordered, Open by profile:$this ele-1: All FHIR elements must have a @value or children
result:LabResult		0..*	Reference(Observation Profile (Laboratory Results))	Observations ele-1: All FHIR elements must have a @value or children
result:@default	S	0..*	Reference(Observation Profile (General Use))	Observations ele-1: All FHIR elements must have a @value or children
conclusionCode		0..*	CodeableConcept	CHI identification of the condition, problem or diagnosis Binding: HealthConcernCode (example): Represents the patient's relevant clinical problems, conditions, diagnoses, symptoms, findings and complaints, as interpreted by the provider. ele-1: All FHIR elements must have a @value or children
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
DiagnosticReport.status	required	DiagnosticReportStatus http://hl7.org/fhir/ValueSet/diagnostic-report-status|4.0.1 from the FHIR Standard
DiagnosticReport.category	example	DiagnosticServiceSectionCodes http://hl7.org/fhir/ValueSet/diagnostic-service-sections from the FHIR Standard
DiagnosticReport.category:LabResult	example	DiagnosticServiceSectionCodes http://hl7.org/fhir/ValueSet/diagnostic-service-sections from the FHIR Standard
DiagnosticReport.code	preferred	LOINCDiagnosticReportCodes (a valid code from LOINC) http://hl7.org/fhir/ValueSet/report-codes from the FHIR Standard
DiagnosticReport.code:LabResult	preferred	LOINCDiagnosticReportCodes (a valid code from LOINC) http://hl7.org/fhir/ValueSet/report-codes from the FHIR Standard
DiagnosticReport.code:@default	preferred	LOINCDiagnosticReportCodes (a valid code from LOINC) http://hl7.org/fhir/ValueSet/report-codes from the FHIR Standard
DiagnosticReport.conclusionCode	example	HealthConcernCode https://fhir.infoway-inforoute.ca/ValueSet/healthconcerncode from https://terminologystandardsservice.ca/tx/fhir

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	DiagnosticReport	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	DiagnosticReport	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	DiagnosticReport	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	DiagnosticReport	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	DiagnosticReport	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()

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

Terminology Bindings

Path	Conformance	ValueSet	URI
DiagnosticReport.language	preferred	CommonLanguages http://hl7.org/fhir/ValueSet/languages from the FHIR Standard Additional Bindings Purpose AllLanguages Max Binding
DiagnosticReport.status	required	DiagnosticReportStatus http://hl7.org/fhir/ValueSet/diagnostic-report-status|4.0.1 from the FHIR Standard
DiagnosticReport.category	example	DiagnosticServiceSectionCodes http://hl7.org/fhir/ValueSet/diagnostic-service-sections from the FHIR Standard
DiagnosticReport.category:LabResult	example	DiagnosticServiceSectionCodes http://hl7.org/fhir/ValueSet/diagnostic-service-sections from the FHIR Standard
DiagnosticReport.code	preferred	LOINCDiagnosticReportCodes (a valid code from LOINC) http://hl7.org/fhir/ValueSet/report-codes from the FHIR Standard
DiagnosticReport.code:LabResult	preferred	LOINCDiagnosticReportCodes (a valid code from LOINC) http://hl7.org/fhir/ValueSet/report-codes from the FHIR Standard
DiagnosticReport.code:@default	preferred	LOINCDiagnosticReportCodes (a valid code from LOINC) http://hl7.org/fhir/ValueSet/report-codes from the FHIR Standard
DiagnosticReport.conclusionCode	example	HealthConcernCode https://fhir.infoway-inforoute.ca/ValueSet/healthconcerncode from https://terminologystandardsservice.ca/tx/fhir

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	DiagnosticReport	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	DiagnosticReport	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	DiagnosticReport	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	DiagnosticReport	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	DiagnosticReport	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()

Differential View

This structure is derived from DiagnosticReport

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

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
DiagnosticReport.conclusionCode	example	HealthConcernCode https://fhir.infoway-inforoute.ca/ValueSet/healthconcerncode from https://terminologystandardsservice.ca/tx/fhir

Key Elements View

Name	Flags	Card.	Type	Description & Constraints
DiagnosticReport		0..*	DiagnosticReport	DiagnosticReport Profile dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources 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 dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated dom-5: If a resource is contained in another resource, it SHALL NOT have a security label dom-6: A resource should have narrative for robust management
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created ele-1: All FHIR elements must have a @value or children
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
status	?!Σ	1..1	code	registered | partial | preliminary | final + Binding: DiagnosticReportStatus (required): The status of the diagnostic report. ele-1: All FHIR elements must have a @value or children
Slices for category	SΣ	0..*	CodeableConcept	Service category Slice: Unordered, Open by pattern:$this Binding: DiagnosticServiceSectionCodes (example): Codes for diagnostic service sections. ele-1: All FHIR elements must have a @value or children
category:LabResult	Σ	0..*	CodeableConcept	Service category Binding: DiagnosticServiceSectionCodes (example): Codes for diagnostic service sections. ele-1: All FHIR elements must have a @value or children
Slices for code	SΣ	1..1	CodeableConcept	Name/Code for this diagnostic report Slice: Unordered, Open by pattern:$this Binding: LOINCDiagnosticReportCodes (preferred): Codes that describe Diagnostic Reports. ele-1: All FHIR elements must have a @value or children
code:LabResult	Σ	0..1	CodeableConcept	Name/Code for this diagnostic report Binding: LOINCDiagnosticReportCodes (preferred): Codes that describe Diagnostic Reports. ele-1: All FHIR elements must have a @value or children
code:@default	Σ	0..1	CodeableConcept	Name/Code for this diagnostic report Binding: LOINCDiagnosticReportCodes (preferred): Codes that describe Diagnostic Reports. ele-1: All FHIR elements must have a @value or children
subject	SΣ	0..1	Reference(Patient Profile | Device Profile (Implantable) | Location Profile)	The subject of the report - usually, but not always, the patient ele-1: All FHIR elements must have a @value or children
encounter	Σ	0..1	Reference(Encounter Profile)	Health care event when test ordered ele-1: All FHIR elements must have a @value or children
effective[x]	Σ	0..1		Time of the report or note ele-1: All FHIR elements must have a @value or children
effectiveDateTime			dateTime
effectivePeriod			Period
performer	Σ	0..*	Reference(Practitioner Profile (General) | PractitionerRole Profile (General) | Organization Profile)	Responsible Diagnostic Service ele-1: All FHIR elements must have a @value or children
resultsInterpreter	Σ	0..*	Reference(Practitioner Profile (General) | PractitionerRole Profile (General) | Organization Profile)	Primary result interpreter ele-1: All FHIR elements must have a @value or children
Slices for specimen		0..*	Reference(Specimen)	Specimens this report is based on Slice: Unordered, Open by pattern:$this ele-1: All FHIR elements must have a @value or children
specimen:LabResult		1..*	Reference(Specimen)	Specimens this report is based on ele-1: All FHIR elements must have a @value or children
specimen:@default		0..*	Reference(Specimen)	Specimens this report is based on ele-1: All FHIR elements must have a @value or children
Slices for result	S	0..*	Reference(Observation)	Observations Slice: Unordered, Open by profile:$this ele-1: All FHIR elements must have a @value or children
result:LabResult		0..*	Reference(Observation Profile (Laboratory Results))	Observations ele-1: All FHIR elements must have a @value or children
result:@default	S	0..*	Reference(Observation Profile (General Use))	Observations ele-1: All FHIR elements must have a @value or children
conclusionCode		0..*	CodeableConcept	CHI identification of the condition, problem or diagnosis Binding: HealthConcernCode (example): Represents the patient's relevant clinical problems, conditions, diagnoses, symptoms, findings and complaints, as interpreted by the provider. ele-1: All FHIR elements must have a @value or children
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
DiagnosticReport.status	required	DiagnosticReportStatus http://hl7.org/fhir/ValueSet/diagnostic-report-status|4.0.1 from the FHIR Standard
DiagnosticReport.category	example	DiagnosticServiceSectionCodes http://hl7.org/fhir/ValueSet/diagnostic-service-sections from the FHIR Standard
DiagnosticReport.category:LabResult	example	DiagnosticServiceSectionCodes http://hl7.org/fhir/ValueSet/diagnostic-service-sections from the FHIR Standard
DiagnosticReport.code	preferred	LOINCDiagnosticReportCodes (a valid code from LOINC) http://hl7.org/fhir/ValueSet/report-codes from the FHIR Standard
DiagnosticReport.code:LabResult	preferred	LOINCDiagnosticReportCodes (a valid code from LOINC) http://hl7.org/fhir/ValueSet/report-codes from the FHIR Standard
DiagnosticReport.code:@default	preferred	LOINCDiagnosticReportCodes (a valid code from LOINC) http://hl7.org/fhir/ValueSet/report-codes from the FHIR Standard
DiagnosticReport.conclusionCode	example	HealthConcernCode https://fhir.infoway-inforoute.ca/ValueSet/healthconcerncode from https://terminologystandardsservice.ca/tx/fhir

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	DiagnosticReport	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	DiagnosticReport	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	DiagnosticReport	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	DiagnosticReport	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	DiagnosticReport	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()

Snapshot View

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

Terminology Bindings

Path	Conformance	ValueSet	URI
DiagnosticReport.language	preferred	CommonLanguages http://hl7.org/fhir/ValueSet/languages from the FHIR Standard Additional Bindings Purpose AllLanguages Max Binding
DiagnosticReport.status	required	DiagnosticReportStatus http://hl7.org/fhir/ValueSet/diagnostic-report-status|4.0.1 from the FHIR Standard
DiagnosticReport.category	example	DiagnosticServiceSectionCodes http://hl7.org/fhir/ValueSet/diagnostic-service-sections from the FHIR Standard
DiagnosticReport.category:LabResult	example	DiagnosticServiceSectionCodes http://hl7.org/fhir/ValueSet/diagnostic-service-sections from the FHIR Standard
DiagnosticReport.code	preferred	LOINCDiagnosticReportCodes (a valid code from LOINC) http://hl7.org/fhir/ValueSet/report-codes from the FHIR Standard
DiagnosticReport.code:LabResult	preferred	LOINCDiagnosticReportCodes (a valid code from LOINC) http://hl7.org/fhir/ValueSet/report-codes from the FHIR Standard
DiagnosticReport.code:@default	preferred	LOINCDiagnosticReportCodes (a valid code from LOINC) http://hl7.org/fhir/ValueSet/report-codes from the FHIR Standard
DiagnosticReport.conclusionCode	example	HealthConcernCode https://fhir.infoway-inforoute.ca/ValueSet/healthconcerncode from https://terminologystandardsservice.ca/tx/fhir

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	DiagnosticReport	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	DiagnosticReport	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	DiagnosticReport	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	DiagnosticReport	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	DiagnosticReport	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()

This structure is derived from DiagnosticReport

Summary

Mandatory: 2 elements(5 nested mandatory elements)
Must-Support: 5 elements
Fixed: 3 elements

Structures

This structure refers to these other structures:

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

Slices

This structure defines the following Slices:

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

Category

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

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

ConclusionCode

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

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