CH ELM (R4), published by Federal Office of Public Health FOPH. This guide is not an authorized publication; it is the continuous build for version 1.3.0-ci-build built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/ahdis/ch-elm/ and changes regularly. See the Directory of published versions

• Content
• Detailed Descriptions
• Mappings
• Examples
• XML
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Resource Profile: CH ELM DiagnosticReport: Laboratory Report

This CH ELM base profile constrains the DiagnosticReport resource for the purpose of laboratory test reports.

Usage:

• Use this Resource Profile: CH ELM Document: Laboratory Report

Formal Views of Profile Content

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

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

This structure is derived from ChLabDiagnosticReport

Name	Flags	Card.	Type	Description & Constraints
DiagnosticReport		0..*	ChLabDiagnosticReport	CH ELM DiagnosticReport: Laboratory Report
identifier		1..1	Identifier	Persistent, unique identifier for the diagnostic report (UUID)
system		1..1	uri	The namespace for the identifier value Required Pattern: urn:ietf:rfc:3986
value	C	1..1	string	The value that is unique ch-elm-doc-identifier: The identifier must be an UUID. Example CH ELM: urn:uuid:d494503a-7bef-4551-853c-f3dced2c518f
basedOn		1..1	Reference(CH ELM ServiceRequest: Laboratory Order)	What was requested
status		1..1	code	registered | partial | preliminary | final + Required Pattern: final
subject		1..1	Reference(CH ELM Patient)	The subject of the report - usually, but not always, the patient
performer		1..1	Reference(CH ELM Organization: Lab)	Responsible Diagnostic Service
specimen		1..1	Reference(CH ELM Specimen: Laboratory)	Specimens this report is based on
result		1..1	Reference(CH ELM Observation Results: Laboratory)	Observations
Documentation for this format

Constraints

Id	Grade	Path(s)	Details	Requirements
ch-elm-doc-identifier	error	DiagnosticReport.identifier.value	The identifier must be an UUID. : startsWith('urn:uuid:')

Name	Flags	Card.	Type	Description & Constraints
DiagnosticReport	C	0..*	ChLabDiagnosticReport	CH ELM DiagnosticReport: Laboratory Report ch-lab-dr1: The resource should be conform to the corresponding EU LAB profile
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
Slices for extension		1..*	Extension	Extension Slice: Unordered, Open by value:url
DiagnosticReportCompositionR5		1..1	(Complex)	Associated Lab Report Composition URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-DiagnosticReport.composition
extension		0..0
url		1..1	uri	"http://hl7.org/fhir/5.0/StructureDefinition/extension-DiagnosticReport.composition"
value[x]		1..1	Reference(CH Lab Composition: Laboratory Report)	Value of extension
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	1..1	Identifier	Persistent, unique identifier for the diagnostic report (UUID)
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
system	Σ	1..1	uri	The namespace for the identifier value Required Pattern: urn:ietf:rfc:3986
value	ΣC	1..1	string	The value that is unique ch-elm-doc-identifier: The identifier must be an UUID. Example General: 123456 Example CH ELM: urn:uuid:d494503a-7bef-4551-853c-f3dced2c518f
basedOn		1..1	Reference(CH ELM ServiceRequest: Laboratory Order)	What was requested
status	?!Σ	1..1	code	registered | partial | preliminary | final + Binding: DiagnosticReportStatus (required): The status of the diagnostic report. Required Pattern: final
Slices for category	Σ	0..*	CodeableConceptIPS	Report Category Slice: Unordered, Open by pattern:$this Binding: DiagnosticServiceSectionCodes (example): Codes for diagnostic service sections.
category:studyType	Σ	0..*	CodeableConcept	The clinical domain of the laboratory performing the observation (e.g. microbiology, toxicology, chemistry) Binding: Lab Study Types in Switzerland (required)
category:specialty	Σ	0..*	CodeableConcept	The way of grouping of the test results into clinically meaningful groups (e.g. liver test; minerals; glucose profiles) Binding: Laboratory Specialty (required)
code	Σ	1..1	CodeableConcept	Laboratory report Binding: LOINCDiagnosticReportCodes (preferred): Codes that describe Diagnostic Reports. Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
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
Slices for coding	Σ	1..*	Coding	Code defined by a terminology system Slice: Unordered, Open by value:code, value:system
coding:CodeCode	Σ	1..1	Coding	Code defined by a terminology system
system	Σ	1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
code	Σ	1..1	code	Symbol in syntax defined by the system Fixed Value: 11502-2
subject	Σ	1..1	Reference(CH ELM Patient)	The subject of the report - usually, but not always, the patient
performer	Σ	1..1	Reference(CH ELM Organization: Lab)	Responsible Diagnostic Service
specimen		1..1	Reference(CH ELM Specimen: Laboratory)	Specimens this report is based on
result		1..1	Reference(CH ELM Observation Results: Laboratory)	Observations
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
DiagnosticReport.identifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 from the FHIR Standard
DiagnosticReport.status	required	Pattern: final 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:studyType	required	LabStudyTypesEuVs http://fhir.ch/ig/ch-lab-report/ValueSet/ch-lab-report-lab-study-types
DiagnosticReport.category:specialty	required	LabSpecialtyEuVs http://hl7.eu/fhir/laboratory/ValueSet/lab-specialty-eu-lab
DiagnosticReport.code	preferred	Pattern: LOINC code 11502-2 http://hl7.org/fhir/ValueSet/report-codes from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
ch-elm-doc-identifier	error	DiagnosticReport.identifier.value	The identifier must be an UUID. : startsWith('urn:uuid:')
ch-lab-dr1	warning	DiagnosticReport	The resource should be conform to the corresponding EU LAB profile : conformsTo('http://hl7.eu/fhir/laboratory/StructureDefinition/DiagnosticReport-eu-lab')
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	C	0..*	ChLabDiagnosticReport	CH ELM DiagnosticReport: Laboratory Report ch-lab-dr1: The resource should be conform to the corresponding EU LAB 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
Slices for extension		1..*	Extension	Extension Slice: Unordered, Open by value:url
DiagnosticReportCompositionR5		1..1	(Complex)	Associated Lab Report Composition URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-DiagnosticReport.composition
id		0..1	string	Unique id for inter-element referencing
extension		0..0
url		1..1	uri	"http://hl7.org/fhir/5.0/StructureDefinition/extension-DiagnosticReport.composition"
value[x]		1..1	Reference(CH Lab Composition: Laboratory Report)	Value of extension
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	1..1	Identifier	Persistent, unique identifier for the diagnostic report (UUID)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type	Σ	0..1	CodeableConcept	Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
system	Σ	1..1	uri	The namespace for the identifier value Required Pattern: urn:ietf:rfc:3986
value	ΣC	1..1	string	The value that is unique ch-elm-doc-identifier: The identifier must be an UUID. Example General: 123456 Example CH ELM: urn:uuid:d494503a-7bef-4551-853c-f3dced2c518f
period	Σ	0..1	Period	Time period when id is/was valid for use
assigner	Σ	0..1	Reference(Organization)	Organization that issued id (may be just text)
basedOn		1..1	Reference(CH ELM ServiceRequest: Laboratory Order)	What was requested
status	?!Σ	1..1	code	registered | partial | preliminary | final + Binding: DiagnosticReportStatus (required): The status of the diagnostic report. Required Pattern: final
Slices for category	Σ	0..*	CodeableConceptIPS	Report Category Slice: Unordered, Open by pattern:$this Binding: DiagnosticServiceSectionCodes (example): Codes for diagnostic service sections.
category:studyType	Σ	0..*	CodeableConcept	The clinical domain of the laboratory performing the observation (e.g. microbiology, toxicology, chemistry) Binding: Lab Study Types in Switzerland (required)
category:specialty	Σ	0..*	CodeableConcept	The way of grouping of the test results into clinically meaningful groups (e.g. liver test; minerals; glucose profiles) Binding: Laboratory Specialty (required)
code	Σ	1..1	CodeableConcept	Laboratory report Binding: LOINCDiagnosticReportCodes (preferred): Codes that describe Diagnostic Reports. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 11502-2
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
Slices for coding	Σ	1..*	Coding	Code defined by a terminology system Slice: Unordered, Open by value:code, value:system
coding:CodeCode	Σ	1..1	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
subject	Σ	1..1	Reference(CH ELM Patient)	The subject of the report - usually, but not always, the patient
encounter	Σ	0..1	Reference(Encounter)	Health care event when test ordered
effective[x]	Σ	0..1		Clinically relevant time/time-period for report
effectiveDateTime			dateTime
effectivePeriod			Period
issued	Σ	0..1	instant	DateTime this version was made
performer	Σ	1..1	Reference(CH ELM Organization: Lab)	Responsible Diagnostic Service
resultsInterpreter	Σ	0..*	Reference(Practitioner | PractitionerRole | Organization | CareTeam)	Primary result interpreter
specimen		1..1	Reference(CH ELM Specimen: Laboratory)	Specimens this report is based on
result		1..1	Reference(CH ELM Observation Results: Laboratory)	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	Codes for the clinical conclusion of test results Binding: SNOMEDCTClinicalFindings (example): Diagnosis codes provided as adjuncts to the report.
presentedForm		0..*	Attachment	Entire report as issued
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
DiagnosticReport.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding http://hl7.org/fhir/ValueSet/languages from the FHIR Standard
DiagnosticReport.identifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 from the FHIR Standard
DiagnosticReport.identifier.type	extensible	Identifier Type Codes http://hl7.org/fhir/ValueSet/identifier-type from the FHIR Standard
DiagnosticReport.status	required	Pattern: final 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:studyType	required	LabStudyTypesEuVs http://fhir.ch/ig/ch-lab-report/ValueSet/ch-lab-report-lab-study-types
DiagnosticReport.category:specialty	required	LabSpecialtyEuVs http://hl7.eu/fhir/laboratory/ValueSet/lab-specialty-eu-lab
DiagnosticReport.code	preferred	Pattern: LOINC code 11502-2 http://hl7.org/fhir/ValueSet/report-codes from the FHIR Standard
DiagnosticReport.conclusionCode	example	SNOMEDCTClinicalFindings http://hl7.org/fhir/ValueSet/clinical-findings from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
ch-elm-doc-identifier	error	DiagnosticReport.identifier.value	The identifier must be an UUID. : startsWith('urn:uuid:')
ch-lab-dr1	warning	DiagnosticReport	The resource should be conform to the corresponding EU LAB profile : conformsTo('http://hl7.eu/fhir/laboratory/StructureDefinition/DiagnosticReport-eu-lab')
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 ChLabDiagnosticReport

Summary

Mandatory: 5 elements

Structures

This structure refers to these other structures:

• CH ELM ServiceRequest: Laboratory Order (http://fhir.ch/ig/ch-elm/StructureDefinition/ch-elm-servicerequest-laboratory-order)
• CH ELM Patient (http://fhir.ch/ig/ch-elm/StructureDefinition/ch-elm-patient)
• CH ELM Organization: Lab (http://fhir.ch/ig/ch-elm/StructureDefinition/ch-elm-organization-lab)
• CH ELM Specimen: Laboratory (http://fhir.ch/ig/ch-elm/StructureDefinition/ch-elm-specimen)
• CH ELM Observation Results: Laboratory (http://fhir.ch/ig/ch-elm/StructureDefinition/ch-elm-observation-results-laboratory)

Differential View

This structure is derived from ChLabDiagnosticReport

Name	Flags	Card.	Type	Description & Constraints
DiagnosticReport		0..*	ChLabDiagnosticReport	CH ELM DiagnosticReport: Laboratory Report
identifier		1..1	Identifier	Persistent, unique identifier for the diagnostic report (UUID)
system		1..1	uri	The namespace for the identifier value Required Pattern: urn:ietf:rfc:3986
value	C	1..1	string	The value that is unique ch-elm-doc-identifier: The identifier must be an UUID. Example CH ELM: urn:uuid:d494503a-7bef-4551-853c-f3dced2c518f
basedOn		1..1	Reference(CH ELM ServiceRequest: Laboratory Order)	What was requested
status		1..1	code	registered | partial | preliminary | final + Required Pattern: final
subject		1..1	Reference(CH ELM Patient)	The subject of the report - usually, but not always, the patient
performer		1..1	Reference(CH ELM Organization: Lab)	Responsible Diagnostic Service
specimen		1..1	Reference(CH ELM Specimen: Laboratory)	Specimens this report is based on
result		1..1	Reference(CH ELM Observation Results: Laboratory)	Observations
Documentation for this format

Constraints

Id	Grade	Path(s)	Details	Requirements
ch-elm-doc-identifier	error	DiagnosticReport.identifier.value	The identifier must be an UUID. : startsWith('urn:uuid:')

Key Elements View

Name	Flags	Card.	Type	Description & Constraints
DiagnosticReport	C	0..*	ChLabDiagnosticReport	CH ELM DiagnosticReport: Laboratory Report ch-lab-dr1: The resource should be conform to the corresponding EU LAB profile
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
Slices for extension		1..*	Extension	Extension Slice: Unordered, Open by value:url
DiagnosticReportCompositionR5		1..1	(Complex)	Associated Lab Report Composition URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-DiagnosticReport.composition
extension		0..0
url		1..1	uri	"http://hl7.org/fhir/5.0/StructureDefinition/extension-DiagnosticReport.composition"
value[x]		1..1	Reference(CH Lab Composition: Laboratory Report)	Value of extension
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	1..1	Identifier	Persistent, unique identifier for the diagnostic report (UUID)
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
system	Σ	1..1	uri	The namespace for the identifier value Required Pattern: urn:ietf:rfc:3986
value	ΣC	1..1	string	The value that is unique ch-elm-doc-identifier: The identifier must be an UUID. Example General: 123456 Example CH ELM: urn:uuid:d494503a-7bef-4551-853c-f3dced2c518f
basedOn		1..1	Reference(CH ELM ServiceRequest: Laboratory Order)	What was requested
status	?!Σ	1..1	code	registered | partial | preliminary | final + Binding: DiagnosticReportStatus (required): The status of the diagnostic report. Required Pattern: final
Slices for category	Σ	0..*	CodeableConceptIPS	Report Category Slice: Unordered, Open by pattern:$this Binding: DiagnosticServiceSectionCodes (example): Codes for diagnostic service sections.
category:studyType	Σ	0..*	CodeableConcept	The clinical domain of the laboratory performing the observation (e.g. microbiology, toxicology, chemistry) Binding: Lab Study Types in Switzerland (required)
category:specialty	Σ	0..*	CodeableConcept	The way of grouping of the test results into clinically meaningful groups (e.g. liver test; minerals; glucose profiles) Binding: Laboratory Specialty (required)
code	Σ	1..1	CodeableConcept	Laboratory report Binding: LOINCDiagnosticReportCodes (preferred): Codes that describe Diagnostic Reports. Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
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
Slices for coding	Σ	1..*	Coding	Code defined by a terminology system Slice: Unordered, Open by value:code, value:system
coding:CodeCode	Σ	1..1	Coding	Code defined by a terminology system
system	Σ	1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
code	Σ	1..1	code	Symbol in syntax defined by the system Fixed Value: 11502-2
subject	Σ	1..1	Reference(CH ELM Patient)	The subject of the report - usually, but not always, the patient
performer	Σ	1..1	Reference(CH ELM Organization: Lab)	Responsible Diagnostic Service
specimen		1..1	Reference(CH ELM Specimen: Laboratory)	Specimens this report is based on
result		1..1	Reference(CH ELM Observation Results: Laboratory)	Observations
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
DiagnosticReport.identifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 from the FHIR Standard
DiagnosticReport.status	required	Pattern: final 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:studyType	required	LabStudyTypesEuVs http://fhir.ch/ig/ch-lab-report/ValueSet/ch-lab-report-lab-study-types
DiagnosticReport.category:specialty	required	LabSpecialtyEuVs http://hl7.eu/fhir/laboratory/ValueSet/lab-specialty-eu-lab
DiagnosticReport.code	preferred	Pattern: LOINC code 11502-2 http://hl7.org/fhir/ValueSet/report-codes from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
ch-elm-doc-identifier	error	DiagnosticReport.identifier.value	The identifier must be an UUID. : startsWith('urn:uuid:')
ch-lab-dr1	warning	DiagnosticReport	The resource should be conform to the corresponding EU LAB profile : conformsTo('http://hl7.eu/fhir/laboratory/StructureDefinition/DiagnosticReport-eu-lab')
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	C	0..*	ChLabDiagnosticReport	CH ELM DiagnosticReport: Laboratory Report ch-lab-dr1: The resource should be conform to the corresponding EU LAB 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
Slices for extension		1..*	Extension	Extension Slice: Unordered, Open by value:url
DiagnosticReportCompositionR5		1..1	(Complex)	Associated Lab Report Composition URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-DiagnosticReport.composition
id		0..1	string	Unique id for inter-element referencing
extension		0..0
url		1..1	uri	"http://hl7.org/fhir/5.0/StructureDefinition/extension-DiagnosticReport.composition"
value[x]		1..1	Reference(CH Lab Composition: Laboratory Report)	Value of extension
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	1..1	Identifier	Persistent, unique identifier for the diagnostic report (UUID)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type	Σ	0..1	CodeableConcept	Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
system	Σ	1..1	uri	The namespace for the identifier value Required Pattern: urn:ietf:rfc:3986
value	ΣC	1..1	string	The value that is unique ch-elm-doc-identifier: The identifier must be an UUID. Example General: 123456 Example CH ELM: urn:uuid:d494503a-7bef-4551-853c-f3dced2c518f
period	Σ	0..1	Period	Time period when id is/was valid for use
assigner	Σ	0..1	Reference(Organization)	Organization that issued id (may be just text)
basedOn		1..1	Reference(CH ELM ServiceRequest: Laboratory Order)	What was requested
status	?!Σ	1..1	code	registered | partial | preliminary | final + Binding: DiagnosticReportStatus (required): The status of the diagnostic report. Required Pattern: final
Slices for category	Σ	0..*	CodeableConceptIPS	Report Category Slice: Unordered, Open by pattern:$this Binding: DiagnosticServiceSectionCodes (example): Codes for diagnostic service sections.
category:studyType	Σ	0..*	CodeableConcept	The clinical domain of the laboratory performing the observation (e.g. microbiology, toxicology, chemistry) Binding: Lab Study Types in Switzerland (required)
category:specialty	Σ	0..*	CodeableConcept	The way of grouping of the test results into clinically meaningful groups (e.g. liver test; minerals; glucose profiles) Binding: Laboratory Specialty (required)
code	Σ	1..1	CodeableConcept	Laboratory report Binding: LOINCDiagnosticReportCodes (preferred): Codes that describe Diagnostic Reports. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 11502-2
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
Slices for coding	Σ	1..*	Coding	Code defined by a terminology system Slice: Unordered, Open by value:code, value:system
coding:CodeCode	Σ	1..1	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
subject	Σ	1..1	Reference(CH ELM Patient)	The subject of the report - usually, but not always, the patient
encounter	Σ	0..1	Reference(Encounter)	Health care event when test ordered
effective[x]	Σ	0..1		Clinically relevant time/time-period for report
effectiveDateTime			dateTime
effectivePeriod			Period
issued	Σ	0..1	instant	DateTime this version was made
performer	Σ	1..1	Reference(CH ELM Organization: Lab)	Responsible Diagnostic Service
resultsInterpreter	Σ	0..*	Reference(Practitioner | PractitionerRole | Organization | CareTeam)	Primary result interpreter
specimen		1..1	Reference(CH ELM Specimen: Laboratory)	Specimens this report is based on
result		1..1	Reference(CH ELM Observation Results: Laboratory)	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	Codes for the clinical conclusion of test results Binding: SNOMEDCTClinicalFindings (example): Diagnosis codes provided as adjuncts to the report.
presentedForm		0..*	Attachment	Entire report as issued
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
DiagnosticReport.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding http://hl7.org/fhir/ValueSet/languages from the FHIR Standard
DiagnosticReport.identifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 from the FHIR Standard
DiagnosticReport.identifier.type	extensible	Identifier Type Codes http://hl7.org/fhir/ValueSet/identifier-type from the FHIR Standard
DiagnosticReport.status	required	Pattern: final 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:studyType	required	LabStudyTypesEuVs http://fhir.ch/ig/ch-lab-report/ValueSet/ch-lab-report-lab-study-types
DiagnosticReport.category:specialty	required	LabSpecialtyEuVs http://hl7.eu/fhir/laboratory/ValueSet/lab-specialty-eu-lab
DiagnosticReport.code	preferred	Pattern: LOINC code 11502-2 http://hl7.org/fhir/ValueSet/report-codes from the FHIR Standard
DiagnosticReport.conclusionCode	example	SNOMEDCTClinicalFindings http://hl7.org/fhir/ValueSet/clinical-findings from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
ch-elm-doc-identifier	error	DiagnosticReport.identifier.value	The identifier must be an UUID. : startsWith('urn:uuid:')
ch-lab-dr1	warning	DiagnosticReport	The resource should be conform to the corresponding EU LAB profile : conformsTo('http://hl7.eu/fhir/laboratory/StructureDefinition/DiagnosticReport-eu-lab')
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 ChLabDiagnosticReport

Summary

Mandatory: 5 elements

Structures

This structure refers to these other structures:

• CH ELM ServiceRequest: Laboratory Order (http://fhir.ch/ig/ch-elm/StructureDefinition/ch-elm-servicerequest-laboratory-order)
• CH ELM Patient (http://fhir.ch/ig/ch-elm/StructureDefinition/ch-elm-patient)
• CH ELM Organization: Lab (http://fhir.ch/ig/ch-elm/StructureDefinition/ch-elm-organization-lab)
• CH ELM Specimen: Laboratory (http://fhir.ch/ig/ch-elm/StructureDefinition/ch-elm-specimen)
• CH ELM Observation Results: Laboratory (http://fhir.ch/ig/ch-elm/StructureDefinition/ch-elm-observation-results-laboratory)

Other representations of profile: CSV, Excel, Schematron