Canadian Baseline
1.1.0 - CI Build
Canadian Baseline, published by HL7 Canada - FHIR Implementation Work Group. This guide is not an authorized publication; it is the continuous build for version 1.1.0 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
Official URL: http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-diagnosticreport | Version: 1.1.0 | |||
Draft as of 2020-09-21 | Computable Name: DiagnosticReportProfile |
Proposed constraints on the DiagnosticReport resource for the minimal set of data to query and retrieve diagnostic reports associated with laboratory and other results
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.
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:
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:
The following are example usage scenarios for the DiagnosticReport profile.
Usage:
Description of Profiles, Differentials, Snapshots and how the different presentations work.
This structure is derived from DiagnosticReport
Name | Flags | Card. | Type | Description & Constraints |
---|---|---|---|---|
DiagnosticReport | 0..* | DiagnosticReport | DiagnosticReport Profile | |
Slices for category | S | 1..* | CodeableConcept | Service category Slice: Unordered, Open by pattern:$this |
category:LabResult | 1..1 | CodeableConcept | Service category | |
coding | ||||
system | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0074 | |
Slices for code | S | 1..1 | CodeableConcept | Name/Code for this diagnostic report Slice: Unordered, Open by pattern:$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] | S | 1..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: https://fhir.infoway-inforoute.ca/ValueSet/healthconcerncode (example): Represents the patient's relevant clinical problems, conditions, diagnoses, symptoms, findings and complaints, as interpreted by the provider. | |
Documentation for this format |
Path | Conformance | ValueSet | URI |
DiagnosticReport.conclusionCode | example | https://fhir.infoway-inforoute.ca/ValueSet/healthconcerncodehttps://fhir.infoway-inforoute.ca/ValueSet/healthconcerncode |
Name | Flags | Card. | Type | Description & Constraints |
---|---|---|---|---|
DiagnosticReport | 0..* | DiagnosticReport | DiagnosticReport Profile | |
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created |
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored |
status | ?!Σ | 1..1 | code | registered | partial | preliminary | final + Binding: DiagnosticReportStatus (required): The status of the diagnostic report. |
Slices for category | SΣ | 1..* | CodeableConcept | Service category Slice: Unordered, Open by pattern:$this Binding: DiagnosticServiceSectionCodes (example): Codes for diagnostic service sections. |
category:LabResult | Σ | 1..1 | CodeableConcept | Service category Binding: DiagnosticServiceSectionCodes (example): Codes for diagnostic service sections. |
Slices for code | SΣ | 1..1 | CodeableConcept | Name/Code for this diagnostic report Slice: Unordered, Open by pattern:$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. |
code:@default | Σ | 0..1 | CodeableConcept | Name/Code for this diagnostic report Binding: LOINCDiagnosticReportCodes (preferred): Codes that describe Diagnostic Reports. |
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] | SΣ | 1..1 | Time of the report or note | |
effectiveDateTime | dateTime | |||
effectivePeriod | Period | |||
performer | Σ | 0..* | Reference(Practitioner Profile (General) | PractitionerRole Profile (General) | Organization Profile) | Responsible Diagnostic Service |
resultsInterpreter | Σ | 0..* | Reference(Practitioner Profile (General) | PractitionerRole Profile (General) | Organization Profile) | Primary result interpreter |
Slices for specimen | 0..* | Reference(Specimen) | Specimens this report is based on Slice: Unordered, Open by pattern:$this | |
specimen:LabResult | 1..* | Reference(Specimen) | Specimens this report is based on | |
specimen:@default | 0..* | Reference(Specimen) | Specimens this report is based on | |
Slices for result | S | 0..* | Reference(Observation) | Observations Slice: Unordered, Open by profile:$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: https://fhir.infoway-inforoute.ca/ValueSet/healthconcerncode (example): Represents the patient's relevant clinical problems, conditions, diagnoses, symptoms, findings and complaints, as interpreted by the provider. | |
Documentation for this format |
Path | Conformance | ValueSet | URI |
DiagnosticReport.status | required | DiagnosticReportStatushttp://hl7.org/fhir/ValueSet/diagnostic-report-status|4.0.1 from the FHIR Standard | |
DiagnosticReport.category | example | DiagnosticServiceSectionCodeshttp://hl7.org/fhir/ValueSet/diagnostic-service-sections from the FHIR Standard | |
DiagnosticReport.category:LabResult | example | DiagnosticServiceSectionCodeshttp://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 | https://fhir.infoway-inforoute.ca/ValueSet/healthconcerncodehttps://fhir.infoway-inforoute.ca/ValueSet/healthconcerncode |
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.
| |||||
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 | 1..* | CodeableConcept | Service category Slice: Unordered, Open by pattern:$this Binding: DiagnosticServiceSectionCodes (example): Codes for diagnostic service sections. | ||||
category:LabResult | Σ | 1..1 | CodeableConcept | Service category Binding: DiagnosticServiceSectionCodes (example): Codes for diagnostic service sections. | ||||
id | 0..1 | string | Unique id for inter-element referencing | |||||
extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
coding | Σ | 0..* | Coding | Code defined by a terminology system | ||||
id | 0..1 | string | Unique id for inter-element referencing | |||||
extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
system | Σ | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0074 | ||||
version | Σ | 0..1 | string | Version of the system - if relevant | ||||
code | Σ | 0..1 | code | Symbol in syntax defined by the system | ||||
display | Σ | 0..1 | string | Representation defined by the system | ||||
userSelected | Σ | 0..1 | boolean | If this coding was chosen directly by the user | ||||
text | Σ | 0..1 | string | Plain text representation of the concept | ||||
Slices for code | SΣ | 1..1 | CodeableConcept | Name/Code for this diagnostic report Slice: Unordered, Open by pattern:$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] | SΣ | 1..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: https://fhir.infoway-inforoute.ca/ValueSet/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 |
Path | Conformance | ValueSet | URI | |||
DiagnosticReport.language | preferred | CommonLanguages
http://hl7.org/fhir/ValueSet/languages from the FHIR Standard | ||||
DiagnosticReport.status | required | DiagnosticReportStatushttp://hl7.org/fhir/ValueSet/diagnostic-report-status|4.0.1 from the FHIR Standard | ||||
DiagnosticReport.category | example | DiagnosticServiceSectionCodeshttp://hl7.org/fhir/ValueSet/diagnostic-service-sections from the FHIR Standard | ||||
DiagnosticReport.category:LabResult | example | DiagnosticServiceSectionCodeshttp://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 | https://fhir.infoway-inforoute.ca/ValueSet/healthconcerncodehttps://fhir.infoway-inforoute.ca/ValueSet/healthconcerncode |
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: 5 elements(5 nested mandatory elements)
Must-Support: 6 elements
Fixed: 3 elements
Structures
This structure refers to these other structures:
Slices
This structure defines the following Slices:
Differential View
This structure is derived from DiagnosticReport
Name | Flags | Card. | Type | Description & Constraints |
---|---|---|---|---|
DiagnosticReport | 0..* | DiagnosticReport | DiagnosticReport Profile | |
Slices for category | S | 1..* | CodeableConcept | Service category Slice: Unordered, Open by pattern:$this |
category:LabResult | 1..1 | CodeableConcept | Service category | |
coding | ||||
system | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0074 | |
Slices for code | S | 1..1 | CodeableConcept | Name/Code for this diagnostic report Slice: Unordered, Open by pattern:$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] | S | 1..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: https://fhir.infoway-inforoute.ca/ValueSet/healthconcerncode (example): Represents the patient's relevant clinical problems, conditions, diagnoses, symptoms, findings and complaints, as interpreted by the provider. | |
Documentation for this format |
Path | Conformance | ValueSet | URI |
DiagnosticReport.conclusionCode | example | https://fhir.infoway-inforoute.ca/ValueSet/healthconcerncodehttps://fhir.infoway-inforoute.ca/ValueSet/healthconcerncode |
Key Elements View
Name | Flags | Card. | Type | Description & Constraints |
---|---|---|---|---|
DiagnosticReport | 0..* | DiagnosticReport | DiagnosticReport Profile | |
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created |
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored |
status | ?!Σ | 1..1 | code | registered | partial | preliminary | final + Binding: DiagnosticReportStatus (required): The status of the diagnostic report. |
Slices for category | SΣ | 1..* | CodeableConcept | Service category Slice: Unordered, Open by pattern:$this Binding: DiagnosticServiceSectionCodes (example): Codes for diagnostic service sections. |
category:LabResult | Σ | 1..1 | CodeableConcept | Service category Binding: DiagnosticServiceSectionCodes (example): Codes for diagnostic service sections. |
Slices for code | SΣ | 1..1 | CodeableConcept | Name/Code for this diagnostic report Slice: Unordered, Open by pattern:$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. |
code:@default | Σ | 0..1 | CodeableConcept | Name/Code for this diagnostic report Binding: LOINCDiagnosticReportCodes (preferred): Codes that describe Diagnostic Reports. |
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] | SΣ | 1..1 | Time of the report or note | |
effectiveDateTime | dateTime | |||
effectivePeriod | Period | |||
performer | Σ | 0..* | Reference(Practitioner Profile (General) | PractitionerRole Profile (General) | Organization Profile) | Responsible Diagnostic Service |
resultsInterpreter | Σ | 0..* | Reference(Practitioner Profile (General) | PractitionerRole Profile (General) | Organization Profile) | Primary result interpreter |
Slices for specimen | 0..* | Reference(Specimen) | Specimens this report is based on Slice: Unordered, Open by pattern:$this | |
specimen:LabResult | 1..* | Reference(Specimen) | Specimens this report is based on | |
specimen:@default | 0..* | Reference(Specimen) | Specimens this report is based on | |
Slices for result | S | 0..* | Reference(Observation) | Observations Slice: Unordered, Open by profile:$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: https://fhir.infoway-inforoute.ca/ValueSet/healthconcerncode (example): Represents the patient's relevant clinical problems, conditions, diagnoses, symptoms, findings and complaints, as interpreted by the provider. | |
Documentation for this format |
Path | Conformance | ValueSet | URI |
DiagnosticReport.status | required | DiagnosticReportStatushttp://hl7.org/fhir/ValueSet/diagnostic-report-status|4.0.1 from the FHIR Standard | |
DiagnosticReport.category | example | DiagnosticServiceSectionCodeshttp://hl7.org/fhir/ValueSet/diagnostic-service-sections from the FHIR Standard | |
DiagnosticReport.category:LabResult | example | DiagnosticServiceSectionCodeshttp://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 | https://fhir.infoway-inforoute.ca/ValueSet/healthconcerncodehttps://fhir.infoway-inforoute.ca/ValueSet/healthconcerncode |
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.
| |||||
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 | 1..* | CodeableConcept | Service category Slice: Unordered, Open by pattern:$this Binding: DiagnosticServiceSectionCodes (example): Codes for diagnostic service sections. | ||||
category:LabResult | Σ | 1..1 | CodeableConcept | Service category Binding: DiagnosticServiceSectionCodes (example): Codes for diagnostic service sections. | ||||
id | 0..1 | string | Unique id for inter-element referencing | |||||
extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
coding | Σ | 0..* | Coding | Code defined by a terminology system | ||||
id | 0..1 | string | Unique id for inter-element referencing | |||||
extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
system | Σ | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0074 | ||||
version | Σ | 0..1 | string | Version of the system - if relevant | ||||
code | Σ | 0..1 | code | Symbol in syntax defined by the system | ||||
display | Σ | 0..1 | string | Representation defined by the system | ||||
userSelected | Σ | 0..1 | boolean | If this coding was chosen directly by the user | ||||
text | Σ | 0..1 | string | Plain text representation of the concept | ||||
Slices for code | SΣ | 1..1 | CodeableConcept | Name/Code for this diagnostic report Slice: Unordered, Open by pattern:$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] | SΣ | 1..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: https://fhir.infoway-inforoute.ca/ValueSet/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 |
Path | Conformance | ValueSet | URI | |||
DiagnosticReport.language | preferred | CommonLanguages
http://hl7.org/fhir/ValueSet/languages from the FHIR Standard | ||||
DiagnosticReport.status | required | DiagnosticReportStatushttp://hl7.org/fhir/ValueSet/diagnostic-report-status|4.0.1 from the FHIR Standard | ||||
DiagnosticReport.category | example | DiagnosticServiceSectionCodeshttp://hl7.org/fhir/ValueSet/diagnostic-service-sections from the FHIR Standard | ||||
DiagnosticReport.category:LabResult | example | DiagnosticServiceSectionCodeshttp://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 | https://fhir.infoway-inforoute.ca/ValueSet/healthconcerncodehttps://fhir.infoway-inforoute.ca/ValueSet/healthconcerncode |
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: 5 elements(5 nested mandatory elements)
Must-Support: 6 elements
Fixed: 3 elements
Structures
This structure refers to these other structures:
Slices
This structure defines the following Slices:
Other representations of profile: CSV, Excel, Schematron
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.
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.