SGHI FHIR Profile Implementation Guide
0.1.0 - ci-build

SGHI FHIR Profile Implementation Guide, published by Kathurima Kimathi. This guide is not an authorized publication; it is the continuous build for version 0.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/savannahghi/sil_fhir_profile_ig/ and changes regularly. See the Directory of published versions

## Resource Profile: SGHIDiagnosticReport - Detailed Descriptions

Draft as of 2026-05-21

Definitions for the diagnosticreport resource profile.

- Key Elements Table
- Differential Elements Table
- Snapshot Elements Table

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

0. DiagnosticReport
Definition | The findings and interpretation of diagnostic tests performed on patients, groups of patients, products, substances, devices, and locations, and/or specimens derived from these. The report includes clinical context such as requesting provider information, and some mix of atomic results, images, textual and coded interpretations, and formatted representation of diagnostic reports. The report also includes non-clinical context such as batch analysis and stability reporting of products and substances.
Short | A Diagnostic report - a combination of request information, atomic results, images, interpretation, as well as formatted reports
Comments | This is intended to capture a single report and is not suitable for use in displaying summary information that covers multiple reports. For example, this resource has not been designed for laboratory cumulative reporting formats nor detailed structured reports for sequencing.
Control | 0..*
Is Modifier | false
Must Support | false
Summary | false
Alternate Names | Report, Test, Result, Results, Labs, Laboratory
Invariants | dgr-1: When a Composition is referenced in `Diagnostic.composition`, all Observation resources referenced in `Composition.entry` must also be referenced in `Diagnostic.entry` or in the references Observations in `Observation.hasMember` (composition.exists() implies (composition.resolve().section.entry.reference.where(resolve() is Observation) in (result.reference|result.reference.resolve().hasMember.reference))) dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty()) dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().ofType(canonical) | %resource.descendants().ofType(uri) | %resource.descendants().ofType(url))) or descendants().where(reference = '#').exists() or descendants().where(ofType(canonical) = '#').exists() or descendants().where(ofType(canonical) = '#').exists()).not()).trace('unmatched', id).empty()) dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()) dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty()) dom-6: A resource should have narrative for robust management (text.`div`.exists())
2. DiagnosticReport.implicitRules
Definition | A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.
Short | A set of rules under which this content was created
Comments | Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of its narrative along with other profiles, value sets, etc.
Control | 0..1
Type | uri
Is Modifier | true because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies its meaning or interpretation
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
4. DiagnosticReport.contained
Definition | These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, nor can they have their own independent transaction scope. This is allowed to be a Parameters resource if and only if it is referenced by a resource that provides context/meaning.
Short | Contained, inline Resources
Comments | This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags in their meta elements, but SHALL NOT have security labels.
Control | 0..* This element is affected by the following invariants: dom-2, dom-4, dom-3, dom-5
Type | Resource
Is Modifier | false
Must Support | false
Summary | false
Alternate Names | inline resources, anonymous resources, contained resources
6. DiagnosticReport.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
Must Support | false
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
8. DiagnosticReport.identifier
Definition | Identifiers assigned to this report by the performer or other systems.
Short | Business identifier for report
Comments | Usually assigned by the Information System of the diagnostic service provider (filler id).
Note | This is a business identifier, not a resource identifier (see discussion)
Control | 10..*
Type | Identifier
Is Modifier | false
Must Support | false
Summary | true
Requirements | Need to know what identifier to use when making queries about this report from the source laboratory, and for linking to the report outside FHIR context.
Alternate Names | ReportID, Filler ID, Placer ID
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
10. DiagnosticReport.identifier.use
Definition | The purpose of this identifier.
Short | usual | official | temp | secondary | old (If known)
Comments | Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.
Control | 0..1
Binding | The codes SHALL be taken from IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|5.0.0 (required to `http://hl7.org/fhir/ValueSet/identifier-use` )
Type | code
Is Modifier | true because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
12. DiagnosticReport.identifier.type
Definition | A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.
Short | Description of identifier
Comments | This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.
Control | 0..1
Binding | The codes SHALL be taken from Unless not suitable, these codes SHALL be taken from SGHI Default Identifier Types http://hl7.org/fhir/ValueSet/identifier-type|5.0.0 (required to `https://fhir.slade360.co.ke/fhir/ValueSet/default-identifier-types` )
Type | CodeableConcept(SGHI CodeableConcept)
Is Modifier | false
Summary | true
Requirements | Allows users to make use of identifiers when the identifier system is not known.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
14. DiagnosticReport.identifier.system
Definition | Establishes the namespace for the value - that is, an absolute URL that describes a set values that are unique.
Short | The namespace for the identifier value
Comments | Identifier.system is always case sensitive.
Control | 10..1
Type | uri
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.
Example | General: http://www.acme.com/identifiers/patient
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
16. DiagnosticReport.identifier.value
Definition | The portion of the identifier typically relevant to the user and which is unique within the context of the system.
Short | The value that is unique
Comments | If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the http://hl7.org/fhir/StructureDefinition/rendered-value). Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.
Control | 10..1 This element is affected by the following invariants: ident-1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Example | General: 123456
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
18. DiagnosticReport.identifier.assigner
Definition | Organization that issued/manages the identifier.
Short | Organization that issued id (may be just text)
Comments | The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.
Control | 10..1
Type | Reference(SGHI Reference)(SGHI Organization, Organization)
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
20. DiagnosticReport.basedOn
Definition | Details concerning a service requested.
Short | What was requested
Comments | Note: Usually there is one test request for each result, however in some circumstances multiple test requests may be represented using a single test result resource. Note that there are also cases where one request leads to multiple reports.
Control | 0..*
Type | Reference(SGHI Reference)(SGHI MedicationRequest, SGHI ServiceRequest, CarePlan, ImmunizationRecommendation, MedicationRequest, NutritionOrder, ServiceRequest)
Is Modifier | false
Must Support | false
Summary | false
Requirements | This allows tracing of authorization for the report and tracking whether proposals/recommendations were acted upon.
Alternate Names | Request
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
22. DiagnosticReport.status
Definition | The status of the diagnostic report.
Short | registered | partial | preliminary | modified | final | amended | corrected | appended | cancelled | entered-in-error | unknown
Control | 1..1
Binding | The codes SHALL be taken from DiagnosticReportStatus http://hl7.org/fhir/ValueSet/diagnostic-report-status|5.0.0 (required to `http://hl7.org/fhir/ValueSet/diagnostic-report-status|5.0.0` ) The status of the diagnostic report.
Type | code
Is Modifier | true because This element is labeled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | false
Summary | true
Requirements | Diagnostic services routinely issue provisional/incomplete reports, and sometimes withdraw previously released reports.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
24. DiagnosticReport.category
Definition | A code that classifies the clinical discipline, department or diagnostic service that created the report (e.g. cardiology, biochemistry, hematology, MRI). This is used for searching, sorting and display purposes.
Short | Service category
Comments | Multiple categories are allowed using various categorization schemes. The level of granularity is defined by the category concepts in the value set. More fine-grained filtering can be performed using the metadata and/or terminology hierarchy in DiagnosticReport.code.
Control | 10..*
Binding | For example codes, see DiagnosticServiceSectionCodes http://hl7.org/fhir/ValueSet/diagnostic-service-sections|5.0.0 (example to `http://hl7.org/fhir/ValueSet/diagnostic-service-sections|5.0.0` ) HL7 V2 table 0074
Type | CodeableConcept(SGHI CodeableConcept)
Is Modifier | false
Must Support | false
Summary | true
Alternate Names | Department, Sub-department, Service, Discipline
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
26. DiagnosticReport.code
Definition | A code or name that describes this diagnostic report.
Short | Name/Code for this diagnostic report
Control | 1..1
Binding | The codes SHOULD be taken from LOINCDiagnosticReportCodes http://hl7.org/fhir/ValueSet/report-codes|5.0.0 (preferred to `http://hl7.org/fhir/ValueSet/report-codes|5.0.0` ) LOINC Codes for Diagnostic Reports
Type | CodeableConcept(SGHI CodeableConcept)
Is Modifier | false
Must Support | false
Summary | true
Alternate Names | Type
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
28. DiagnosticReport.subject
Definition | The subject of the report. Usually, but not always, this is a patient. However, diagnostic services also perform analyses on specimens collected from a variety of other sources.
Short | The subject of the report - usually, but not always, the patient
Control | 10..1
Type | Reference(SGHI Reference)(SGHI Patient, Patient, Group, Device, Location, Organization, Practitioner, Medication, Substance, BiologicallyDerivedProduct)
Is Modifier | false
Must Support | false
Summary | true
Requirements | SHALL know the subject context.
Alternate Names | Patient
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
30. DiagnosticReport.encounter
Definition | The healthcare event (e.g. a patient and healthcare provider interaction) which this DiagnosticReport is about.
Short | Health care event when test ordered
Comments | This will typically be the encounter the event occurred within, but some events may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter (e.g. pre-admission laboratory tests).
Control | 10..1
Type | Reference(SGHI Reference)(SGHI Encounter, Encounter)
Is Modifier | false
Must Support | false
Summary | true
Requirements | Links the request to the Encounter context.
Alternate Names | Context
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
32. DiagnosticReport.effective[x]
Definition | The time or time-period the observed values are related to. When the subject of the report is a patient, this is usually either the time of the procedure or of specimen collection(s), but very often the source of the date/time is not known, only the date/time itself.
Short | Clinically relevant time/time-period for report
Comments | If the diagnostic procedure was performed on the patient, this is the time it was performed. If there are specimens, the diagnostically relevant time can be derived from the specimen collection times, but the specimen information is not always available, and the exact relationship between the specimens and the diagnostically relevant time is not always automatic.
Control | 10..1
Type | dateTime, Period
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | false
Summary | true
Requirements | Need to know where in the patient history to file/present this report.
Alternate Names | Observation time, Effective Time, Occurrence
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
34. DiagnosticReport.issued
Definition | The date and time that this version of the report was made available to providers, typically after the report was reviewed and verified.
Short | DateTime this version was made
Comments | May be different from the update time of the resource itself, because that is the status of the record (potentially a secondary copy), not the actual release time of the report.
Control | 10..1
Type | instant
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | false
Summary | true
Requirements | Clinicians need to be able to check the date that the report was released.
Alternate Names | Date published, Date Issued, Date Verified
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
36. DiagnosticReport.performer
Definition | The diagnostic service that is responsible for issuing the report.
Short | Responsible Diagnostic Service
Comments | This is not necessarily the source of the atomic data items or the entity that interpreted the results. It is the entity that takes responsibility for the clinical report.
Control | 10..*
Type | Reference(SGHI Reference)(SGHI Organization, Practitioner, PractitionerRole, Organization, CareTeam)
Is Modifier | false
Must Support | false
Summary | true
Requirements | Need to know whom to contact if there are queries about the results. Also may need to track the source of reports for secondary data analysis.
Alternate Names | Laboratory, Service, Practitioner, Department, Company, Authorized by, Director
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
38. DiagnosticReport.resultsInterpreter
Definition | The practitioner or organization that is responsible for the report's conclusions and interpretations.
Short | Primary result interpreter
Comments | Might not be the same entity that takes responsibility for the clinical report.
Control | 10..*
Type | Reference(SGHI Reference)(SGHI Organization, Practitioner, PractitionerRole, Organization, CareTeam)
Is Modifier | false
Must Support | false
Summary | true
Requirements | Need to know whom to contact if there are queries about the results. Also may need to track the source of reports for secondary data analysis.
Alternate Names | Analyzed by, Reported by
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
40. DiagnosticReport.result
Definition | Observations that are part of this diagnostic report.
Short | Observations
Comments | Observations can contain observations.
Control | 0..* This element is affected by the following invariants: dgr-1
Type | Reference(SGHI Reference)(SGHI Observation, Observation)
Is Modifier | false
Must Support | false
Summary | false
Requirements | Need to support individual results, or groups of results, where the result grouping is arbitrary, but meaningful.
Alternate Names | Data, Atomic Value, Result, Atomic result, Data, Test, Analyte, Battery, Organizer
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
42. DiagnosticReport.conclusionCode
Definition | One or more codes that represent the summary conclusion (interpretation/impression) of the diagnostic report.
Short | Codes for the clinical conclusion of test results
Control | 0..*
Binding | Unless not suitable, these codes SHALL be taken from For example codes, see SGHI Diagnostic Conclusion ICD-11 http://hl7.org/fhir/ValueSet/clinical-findings|5.0.0 (extensible to `https://fhir.slade360.co.ke/fhir/ValueSet/diagnostic-conclusion-icd11` )
Type | CodeableConcept(SGHI CodeableConcept)
Is Modifier | false
Must Support | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

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

0. DiagnosticReport
2. DiagnosticReport.identifier
Note | This is a business identifier, not a resource identifier (see discussion)
Control | 1..?
4. DiagnosticReport.identifier.use
Binding | The codes SHALL be taken from IdentifierUse (required to `http://hl7.org/fhir/ValueSet/identifier-use` )
6. DiagnosticReport.identifier.type
Binding | The codes SHALL be taken from SGHI Default Identifier Types (required to `https://fhir.slade360.co.ke/fhir/ValueSet/default-identifier-types` )
Type | CodeableConcept(SGHI CodeableConcept)
8. DiagnosticReport.identifier.system
Control | 1..?
10. DiagnosticReport.identifier.value
Control | 1..?
12. DiagnosticReport.identifier.assigner
Control | 1..?
Type | Reference(SGHI Reference)(SGHI Organization)
14. DiagnosticReport.basedOn
Type | Reference(SGHI Reference)(SGHI MedicationRequest, SGHI ServiceRequest)
16. DiagnosticReport.category
Control | 1..?
Type | CodeableConcept(SGHI CodeableConcept)
18. DiagnosticReport.code
Type | CodeableConcept(SGHI CodeableConcept)
20. DiagnosticReport.subject
Control | 1..?
Type | Reference(SGHI Reference)(SGHI Patient)
22. DiagnosticReport.encounter
Control | 1..?
Type | Reference(SGHI Reference)(SGHI Encounter)
24. DiagnosticReport.effective[x]
Control | 1..?
Type | dateTime, Period
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
26. DiagnosticReport.issued
Control | 1..?
28. DiagnosticReport.performer
Control | 1..?
Type | Reference(SGHI Reference)(SGHI Organization)
30. DiagnosticReport.resultsInterpreter
Control | 1..?
Type | Reference(SGHI Reference)(SGHI Organization)
32. DiagnosticReport.result
Type | Reference(SGHI Reference)(SGHI Observation)
34. DiagnosticReport.supportingInfo
36. DiagnosticReport.supportingInfo.reference
Type | Reference(SGHI Reference)(SGHI Observation, SGHI DiagnosticReport)
38. DiagnosticReport.conclusionCode
Binding | Unless not suitable, these codes SHALL be taken from SGHI Diagnostic Conclusion ICD-11 (extensible to `https://fhir.slade360.co.ke/fhir/ValueSet/diagnostic-conclusion-icd11` )
Type | CodeableConcept(SGHI CodeableConcept)

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

0. DiagnosticReport
Definition | The findings and interpretation of diagnostic tests performed on patients, groups of patients, products, substances, devices, and locations, and/or specimens derived from these. The report includes clinical context such as requesting provider information, and some mix of atomic results, images, textual and coded interpretations, and formatted representation of diagnostic reports. The report also includes non-clinical context such as batch analysis and stability reporting of products and substances.
Short | A Diagnostic report - a combination of request information, atomic results, images, interpretation, as well as formatted reports
Comments | This is intended to capture a single report and is not suitable for use in displaying summary information that covers multiple reports. For example, this resource has not been designed for laboratory cumulative reporting formats nor detailed structured reports for sequencing.
Control | 0..*
Is Modifier | false
Must Support | false
Summary | false
Alternate Names | Report, Test, Result, Results, Labs, Laboratory
Invariants | dgr-1: When a Composition is referenced in `Diagnostic.composition`, all Observation resources referenced in `Composition.entry` must also be referenced in `Diagnostic.entry` or in the references Observations in `Observation.hasMember` (`composition.exists() implies (composition.resolve().section.entry.reference.where(resolve() is Observation) in (result.reference|result.reference.resolve().hasMember.reference))`) dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (`contained.contained.empty()`) dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (`contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().ofType(canonical) | %resource.descendants().ofType(uri) | %resource.descendants().ofType(url))) or descendants().where(reference = '#').exists() or descendants().where(ofType(canonical) = '#').exists() or descendants().where(ofType(canonical) = '#').exists()).not()).trace('unmatched', id).empty()`) dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (`contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()`) dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (`contained.meta.security.empty()`) dom-6: A resource should have narrative for robust management (`text.`div`.exists()`)
2. DiagnosticReport.id
Definition | The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
Short | Logical id of this artifact
Comments | Within the context of the FHIR RESTful interactions, the resource has an id except for cases like the create and conditional update. Otherwise, the use of the resouce id depends on the given use case.
Control | 0..1
Type | id
Is Modifier | false
Must Support | false
Summary | true
4. DiagnosticReport.meta
Definition | The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.
Short | Metadata about the resource
Control | 0..1
Type | Meta
Is Modifier | false
Must Support | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
6. DiagnosticReport.implicitRules
Definition | A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.
Short | A set of rules under which this content was created
Comments | Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of its narrative along with other profiles, value sets, etc.
Control | 0..1
Type | uri
Is Modifier | true because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies its meaning or interpretation
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
8. DiagnosticReport.language
Definition | The base language in which the resource is written.
Short | Language of the resource content
Comments | Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).
Control | 0..1
Binding | The codes SHALL be taken from AllLanguages (required to `http://hl7.org/fhir/ValueSet/all-languages|5.0.0` ) IETF language tag for a human language
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
10. DiagnosticReport.text
Definition | A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.
Short | Text summary of the resource, for human interpretation
Comments | Contained resources do not have a narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.
Control | 0..1 This element is affected by the following invariants: dom-6
Type | Narrative
Is Modifier | false
Must Support | false
Summary | false
Alternate Names | narrative, html, xhtml, display
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
12. DiagnosticReport.contained
Definition | These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, nor can they have their own independent transaction scope. This is allowed to be a Parameters resource if and only if it is referenced by a resource that provides context/meaning.
Short | Contained, inline Resources
Comments | This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags in their meta elements, but SHALL NOT have security labels.
Control | 0..* This element is affected by the following invariants: dom-2, dom-4, dom-3, dom-5
Type | Resource
Is Modifier | false
Must Support | false
Summary | false
Alternate Names | inline resources, anonymous resources, contained resources
14. DiagnosticReport.extension
Definition | May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | Additional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | false
Must Support | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
16. DiagnosticReport.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
Must Support | false
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
18. DiagnosticReport.identifier
Definition | Identifiers assigned to this report by the performer or other systems.
Short | Business identifier for report
Comments | Usually assigned by the Information System of the diagnostic service provider (filler id).
Note | This is a business identifier, not a resource identifier (see discussion)
Control | 1..*
Type | Identifier
Is Modifier | false
Must Support | false
Summary | true
Requirements | Need to know what identifier to use when making queries about this report from the source laboratory, and for linking to the report outside FHIR context.
Alternate Names | ReportID, Filler ID, Placer ID
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
20. DiagnosticReport.identifier.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1 This element is affected by the following invariants: ele-1
Type | id
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
22. DiagnosticReport.identifier.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | Additional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `DiagnosticReport.identifier.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
24. DiagnosticReport.identifier.use
Definition | The purpose of this identifier.
Short | usual | official | temp | secondary | old (If known)
Comments | Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.
Control | 0..1
Binding | The codes SHALL be taken from IdentifierUse (required to `http://hl7.org/fhir/ValueSet/identifier-use` )
Type | code
Is Modifier | true because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
26. DiagnosticReport.identifier.type
Definition | A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.
Short | Description of identifier
Comments | This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.
Control | 0..1
Binding | The codes SHALL be taken from SGHI Default Identifier Types (required to `https://fhir.slade360.co.ke/fhir/ValueSet/default-identifier-types` )
Type | CodeableConcept(SGHI CodeableConcept)
Is Modifier | false
Summary | true
Requirements | Allows users to make use of identifiers when the identifier system is not known.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
28. DiagnosticReport.identifier.system
Definition | Establishes the namespace for the value - that is, an absolute URL that describes a set values that are unique.
Short | The namespace for the identifier value
Comments | Identifier.system is always case sensitive.
Control | 1..1
Type | uri
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.
Example | General: http://www.acme.com/identifiers/patient
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
30. DiagnosticReport.identifier.value
Definition | The portion of the identifier typically relevant to the user and which is unique within the context of the system.
Short | The value that is unique
Comments | If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the http://hl7.org/fhir/StructureDefinition/rendered-value). Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.
Control | 1..1 This element is affected by the following invariants: ident-1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Example | General: 123456
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
32. DiagnosticReport.identifier.period
Definition | Time period during which identifier is/was valid for use.
Short | Time period when id is/was valid for use
Control | 0..1
Type | Period
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
34. DiagnosticReport.identifier.assigner
Definition | Organization that issued/manages the identifier.
Short | Organization that issued id (may be just text)
Comments | The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.
Control | 1..1
Type | Reference(SGHI Reference)(SGHI Organization)
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
36. DiagnosticReport.basedOn
Definition | Details concerning a service requested.
Short | What was requested
Comments | Note: Usually there is one test request for each result, however in some circumstances multiple test requests may be represented using a single test result resource. Note that there are also cases where one request leads to multiple reports.
Control | 0..*
Type | Reference(SGHI Reference)(SGHI MedicationRequest, SGHI ServiceRequest)
Is Modifier | false
Must Support | false
Summary | false
Requirements | This allows tracing of authorization for the report and tracking whether proposals/recommendations were acted upon.
Alternate Names | Request
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
38. DiagnosticReport.status
Definition | The status of the diagnostic report.
Short | registered | partial | preliminary | modified | final | amended | corrected | appended | cancelled | entered-in-error | unknown
Control | 1..1
Binding | The codes SHALL be taken from DiagnosticReportStatus (required to `http://hl7.org/fhir/ValueSet/diagnostic-report-status|5.0.0` ) The status of the diagnostic report.
Type | code
Is Modifier | true because This element is labeled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | false
Summary | true
Requirements | Diagnostic services routinely issue provisional/incomplete reports, and sometimes withdraw previously released reports.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
40. DiagnosticReport.category
Definition | A code that classifies the clinical discipline, department or diagnostic service that created the report (e.g. cardiology, biochemistry, hematology, MRI). This is used for searching, sorting and display purposes.
Short | Service category
Comments | Multiple categories are allowed using various categorization schemes. The level of granularity is defined by the category concepts in the value set. More fine-grained filtering can be performed using the metadata and/or terminology hierarchy in DiagnosticReport.code.
Control | 1..*
Binding | For example codes, see DiagnosticServiceSectionCodes (example to `http://hl7.org/fhir/ValueSet/diagnostic-service-sections|5.0.0` ) HL7 V2 table 0074
Type | CodeableConcept(SGHI CodeableConcept)
Is Modifier | false
Must Support | false
Summary | true
Alternate Names | Department, Sub-department, Service, Discipline
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
42. DiagnosticReport.code
Definition | A code or name that describes this diagnostic report.
Short | Name/Code for this diagnostic report
Control | 1..1
Binding | The codes SHOULD be taken from LOINCDiagnosticReportCodes (preferred to `http://hl7.org/fhir/ValueSet/report-codes|5.0.0` ) LOINC Codes for Diagnostic Reports
Type | CodeableConcept(SGHI CodeableConcept)
Is Modifier | false
Must Support | false
Summary | true
Alternate Names | Type
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
44. DiagnosticReport.subject
Definition | The subject of the report. Usually, but not always, this is a patient. However, diagnostic services also perform analyses on specimens collected from a variety of other sources.
Short | The subject of the report - usually, but not always, the patient
Control | 1..1
Type | Reference(SGHI Reference)(SGHI Patient)
Is Modifier | false
Must Support | false
Summary | true
Requirements | SHALL know the subject context.
Alternate Names | Patient
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
46. DiagnosticReport.encounter
Definition | The healthcare event (e.g. a patient and healthcare provider interaction) which this DiagnosticReport is about.
Short | Health care event when test ordered
Comments | This will typically be the encounter the event occurred within, but some events may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter (e.g. pre-admission laboratory tests).
Control | 1..1
Type | Reference(SGHI Reference)(SGHI Encounter)
Is Modifier | false
Must Support | false
Summary | true
Requirements | Links the request to the Encounter context.
Alternate Names | Context
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
48. DiagnosticReport.effective[x]
Definition | The time or time-period the observed values are related to. When the subject of the report is a patient, this is usually either the time of the procedure or of specimen collection(s), but very often the source of the date/time is not known, only the date/time itself.
Short | Clinically relevant time/time-period for report
Comments | If the diagnostic procedure was performed on the patient, this is the time it was performed. If there are specimens, the diagnostically relevant time can be derived from the specimen collection times, but the specimen information is not always available, and the exact relationship between the specimens and the diagnostically relevant time is not always automatic.
Control | 1..1
Type | dateTime
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | false
Summary | true
Requirements | Need to know where in the patient history to file/present this report.
Alternate Names | Observation time, Effective Time, Occurrence
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
50. DiagnosticReport.issued
Definition | The date and time that this version of the report was made available to providers, typically after the report was reviewed and verified.
Short | DateTime this version was made
Comments | May be different from the update time of the resource itself, because that is the status of the record (potentially a secondary copy), not the actual release time of the report.
Control | 1..1
Type | instant
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | false
Summary | true
Requirements | Clinicians need to be able to check the date that the report was released.
Alternate Names | Date published, Date Issued, Date Verified
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
52. DiagnosticReport.performer
Definition | The diagnostic service that is responsible for issuing the report.
Short | Responsible Diagnostic Service
Comments | This is not necessarily the source of the atomic data items or the entity that interpreted the results. It is the entity that takes responsibility for the clinical report.
Control | 1..*
Type | Reference(SGHI Reference)(SGHI Organization)
Is Modifier | false
Must Support | false
Summary | true
Requirements | Need to know whom to contact if there are queries about the results. Also may need to track the source of reports for secondary data analysis.
Alternate Names | Laboratory, Service, Practitioner, Department, Company, Authorized by, Director
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
54. DiagnosticReport.resultsInterpreter
Definition | The practitioner or organization that is responsible for the report's conclusions and interpretations.
Short | Primary result interpreter
Comments | Might not be the same entity that takes responsibility for the clinical report.
Control | 1..*
Type | Reference(SGHI Reference)(SGHI Organization)
Is Modifier | false
Must Support | false
Summary | true
Requirements | Need to know whom to contact if there are queries about the results. Also may need to track the source of reports for secondary data analysis.
Alternate Names | Analyzed by, Reported by
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
56. DiagnosticReport.specimen
Definition | Details about the specimens on which this diagnostic report is based.
Short | Specimens this report is based on
Comments | If the specimen is sufficiently specified with a code in the test result name, then this additional data may be redundant. If there are multiple specimens, these may be represented per observation or group.
Control | 0..*
Type | Reference(Specimen)
Is Modifier | false
Must Support | false
Summary | false
Requirements | Need to be able to report information about the collected specimens on which the report is based.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
58. DiagnosticReport.result
Definition | Observations that are part of this diagnostic report.
Short | Observations
Comments | Observations can contain observations.
Control | 0..* This element is affected by the following invariants: dgr-1
Type | Reference(SGHI Reference)(SGHI Observation)
Is Modifier | false
Must Support | false
Summary | false
Requirements | Need to support individual results, or groups of results, where the result grouping is arbitrary, but meaningful.
Alternate Names | Data, Atomic Value, Result, Atomic result, Data, Test, Analyte, Battery, Organizer
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
60. DiagnosticReport.note
Definition | Comments about the diagnostic report.
Short | Comments about the diagnostic report
Comments | May include general statements about the diagnostic report, or statements about significant, unexpected or unreliable results values contained within the diagnostic report, or information about its source when relevant to its interpretation.
Control | 0..*
Type | Annotation
Is Modifier | false
Must Support | false
Summary | false
Requirements | Need to be able to provide free text additional information.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
62. DiagnosticReport.study
Definition | One or more links to full details of any study performed during the diagnostic investigation. An ImagingStudy might comprise a set of radiologic images obtained via a procedure that are analyzed as a group. Typically, this is imaging performed by DICOM enabled modalities, but this is not required. A fully enabled PACS viewer can use this information to provide views of the source images. A GenomicStudy might comprise one or more analyses, each serving a specific purpose. These analyses may vary in method (e.g., karyotyping, CNV, or SNV detection), performer, software, devices used, or regions targeted.
Short | Reference to full details of an analysis associated with the diagnostic report
Comments | For laboratory-type studies like GenomeStudy, type resources will be used for tracking additional metadata and workflow aspects of complex studies. ImagingStudy and the media element are somewhat overlapping - typically, the list of image references in the media element will also be found in one of the imaging study resources. However, each caters to different types of displays for different types of purposes. Neither, either, or both may be provided.
Control | 0..*
Type | Reference(GenomicStudy, ImagingStudy)
Is Modifier | false
Must Support | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
64. DiagnosticReport.supportingInfo
Definition | This backbone element contains supporting information that was used in the creation of the report not included in the results already included in the report.
Short | Additional information supporting the diagnostic report
Control | 0..*
Type | BackboneElement
Is Modifier | false
Must Support | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
66. DiagnosticReport.supportingInfo.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1 This element is affected by the following invariants: ele-1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
68. DiagnosticReport.supportingInfo.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | Additional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
70. DiagnosticReport.supportingInfo.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
72. DiagnosticReport.supportingInfo.type
Definition | The code value for the role of the supporting information in the diagnostic report.
Short | Supporting information role code
Control | 1..1
Binding | For example codes, see hl7VS-VS-observationType (example to `http://terminology.hl7.org/ValueSet/v2-0936` ) The code value for the role of the supporting information in the diagnostic report.
Type | CodeableConcept
Is Modifier | false
Must Support | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
74. DiagnosticReport.supportingInfo.reference
Definition | The reference for the supporting information in the diagnostic report.
Short | Supporting information reference
Control | 1..1
Type | Reference(SGHI Reference)(SGHI Observation, SGHI DiagnosticReport)
Is Modifier | false
Must Support | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
76. DiagnosticReport.media
Definition | A list of key images or data associated with this report. The images or data are generally created during the diagnostic process, and may be directly of the patient, or of treated specimens (i.e. slides of interest).
Short | Key images or data associated with this report
Control | 0..*
Type | BackboneElement
Is Modifier | false
Must Support | false
Summary | true
Requirements | Many diagnostic services include images or data in the report as part of their service.
Alternate Names | DICOM, Slides, Scans
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
78. DiagnosticReport.media.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1 This element is affected by the following invariants: ele-1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
80. DiagnosticReport.media.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | Additional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
82. DiagnosticReport.media.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
84. DiagnosticReport.media.comment
Definition | A comment about the image or data. Typically, this is used to provide an explanation for why the image or data is included, or to draw the viewer's attention to important features.
Short | Comment about the image or data (e.g. explanation)
Comments | The comment should be displayed with the image or data. It would be common for the report to include additional discussion of the image or data contents or in other sections such as the conclusion.
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | false
Summary | false
Requirements | The provider of the report should make a comment about each image or data included in the report.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
86. DiagnosticReport.media.link
Definition | Reference to the image or data source.
Short | Reference to the image or data source
Control | 1..1
Type | Reference(DocumentReference)
Is Modifier | false
Must Support | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
88. DiagnosticReport.composition
Definition | Reference to a Composition resource instance that provides structure for organizing the contents of the DiagnosticReport.
Short | Reference to a Composition resource for the DiagnosticReport structure
Comments | The Composition provides structure to the content of the DiagnosticReport (and only contains contents referenced in the DiagnosticReport) - e.g., to order the sections of an anatomic pathology structured report.
Control | 0..1 This element is affected by the following invariants: dgr-1
Type | Reference(Composition)
Is Modifier | false
Must Support | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
90. DiagnosticReport.conclusion
Definition | Concise and clinically contextualized summary conclusion (interpretation/impression) of the diagnostic report.
Short | Clinical conclusion (interpretation) of test results
Control | 0..1
Type | markdown
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | false
Summary | false
Requirements | Need to be able to provide a conclusion that is not lost among the basic result data.
Alternate Names | Report
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
92. DiagnosticReport.conclusionCode
Definition | One or more codes that represent the summary conclusion (interpretation/impression) of the diagnostic report.
Short | Codes for the clinical conclusion of test results
Control | 0..*
Binding | Unless not suitable, these codes SHALL be taken from SGHI Diagnostic Conclusion ICD-11 (extensible to `https://fhir.slade360.co.ke/fhir/ValueSet/diagnostic-conclusion-icd11` )
Type | CodeableConcept(SGHI CodeableConcept)
Is Modifier | false
Must Support | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
94. DiagnosticReport.presentedForm
Definition | Rich text representation of the entire result as issued by the diagnostic service. Multiple formats are allowed but they SHALL be semantically equivalent.
Short | Entire report as issued
Comments | "application/pdf" is recommended as the most reliable and interoperable in this context.
Control | 0..*
Type | Attachment
Is Modifier | false
Must Support | false
Summary | false
Requirements | Gives laboratory the ability to provide its own fully formatted report for clinical fidelity.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)