Australian Digital Health Agency FHIR Implementation Guide

This profile identifies the additional constraints, extensions, and value sets that build on and extend DiagnosticReport that are supported.

Where a more specific DiagnosticReport profile is applicable, e.g. pathology report or imaging report, an implementation SHALL ensure the resource conforms to that specific profile.

This profile is designed to set a core DiagnosticReport standard for:

• Query for diagnostic reports for a patient
• Record or update diagnostic reports belonging to a patient

This profile may be referred to by APIs, which will be listed here when available.

Profile specific guidance

• DiagnosticReport.category provides an efficient way of supporting system interactions, e.g. restricting searches. Implementers need to understand that data categorisation is somewhat subjective. The categorisation applied by the source may not align with a receiver’s expectations.
• Results that are free text or report form are represented using ‘DiagnosticReport.presentedForm`.
• References to a Media resource are preferred to be contained but may be an external resource.
• The DiagnosticReport resource can represent the clinical conclusion as a text summary with DiagnosticReport.conclusion or a set of codes with DiagnosticReport.conclusionCode.
  • Although both are marked as must support, sending systems are not required to support both a text and a set of codes, but they SHALL support at least one of these elements.
  • A receiving or persisting system SHALL support both elements.
• The DiagnosticReport resource can represent the result as a text summary with DiagnosticReport.conclusion or a set of codes with DiagnosticReport.conclusionCode.
  • Although both are marked as must support, sending systems are not required to support both a text and a set of codes, but they SHALL support at least one of these elements.
  • A receiving or persisting system SHALL support both elements.

Boundaries and relationships

These profiles build on this profile (ADHA Core DiagnosticReport) to define specific roles:

• ADHA Pathology Report

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

This structure is derived from AUBaseDiagnosticReport

Name	Flags	Card.	Type	Description & Constraints
DiagnosticReport	C	0..*	AUBaseDiagnosticReport	A diagnostic report in an Australian healthcare context inv-dh-dir-01: The report shall at least have a result or a presentedForm
identifier	S	1..*	Identifier, AULocalOrderIdentifier, AULocalReportIdentifier, AUAccessionNumber	Business identifier for report
basedOn	S	0..*	Reference(ADHA Core ServiceRequest)	Diagnostic investigation order
status	S	1..1	code	partial | preliminary | final + Binding: DiagnosticReportStatus Report Available (required)
category	S	1..*	CodeableConcept	Service category Binding: DiagnosticServiceSectionCodes (extensible)
code	S	1..1	CodeableConcept	Diagnostic examination name / study name / group name
subject	SC	1..1	Reference(ADHA Core Patient)	The subject of the report - usually, but not always, the patient inv-dh-dir-02: At least reference or a valid identifier shall be present
effective[x]	SC	1..1	dateTime, Period	Clinically relevant time/time-period for report inv-dh-dir-04: Date shall be at least to day
issued	S	1..1	instant	Diagnostic report date time
performer	SC	1..*	Reference(ADHA Authoring PractitionerRole | ADHA Core Organization)	Responsible Diagnostic Service inv-dh-dir-03: At least reference or a valid identifier shall be present
result	SC	0..*	Reference(ADHA Diagnostic Result Observation | ADHA Imaging Result Observation | ADHA Pathology Result Observation)	Observations
reference		1..1	string	Literal reference, Relative, internal or absolute URL
media	S	0..*	BackboneElement	Key images associated with this report
link		1..1	Reference(ADHA Core Media)	Reference to the image source
conclusion	S	0..1	string	Clinical conclusion (interpretation) of test results
conclusionCode	S	0..*	CodeableConcept	Codes for the clinical conclusion of test results
presentedForm	SC	0..*	Attachment	Entire report as issued
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
DiagnosticReport.status	required	DiagnosticReportStatusReportAvailable https://healthterminologies.gov.au/fhir/ValueSet/diagnosticreportstatus-report-available-1 from https://tx.ontoserver.csiro.au/fhir
DiagnosticReport.category	extensible	DiagnosticServiceSectionCodes http://hl7.org/fhir/ValueSet/diagnostic-service-sections from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
inv-dh-dir-01	error	DiagnosticReport	The report shall at least have a result or a presentedForm : result.exists() or presentedForm.exists()
inv-dh-dir-02	error	DiagnosticReport.subject	At least reference or a valid identifier shall be present : reference.exists() or identifier.where(system.count() + value.count() >1).exists()
inv-dh-dir-03	error	DiagnosticReport.performer	At least reference or a valid identifier shall be present : reference.exists() or identifier.where(system.count() + value.count() >1).exists()
inv-dh-dir-04	error	DiagnosticReport.effective[x]	Date shall be at least to day : $this is DateTime implies $this.toString().length() >= 10

Name	Flags	Card.	Type	Description & Constraints
DiagnosticReport	C	0..*	AUBaseDiagnosticReport	A diagnostic report in an Australian healthcare context dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated dom-5: If a resource is contained in another resource, it SHALL NOT have a security label dom-6: A resource should have narrative for robust management inv-dh-dir-01: The report shall at least have a result or a presentedForm
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created ele-1: All FHIR elements must have a @value or children
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
identifier	S	1..*	Identifier, AULocalOrderIdentifier, AULocalReportIdentifier, AUAccessionNumber	Business identifier for report ele-1: All FHIR elements must have a @value or children
basedOn	S	0..*	Reference(ADHA Core ServiceRequest)	Diagnostic investigation order ele-1: All FHIR elements must have a @value or children
status	?!SΣ	1..1	code	partial | preliminary | final + Binding: DiagnosticReportStatus Report Available (required) ele-1: All FHIR elements must have a @value or children
category	SΣ	1..*	CodeableConcept	Service category Binding: DiagnosticServiceSectionCodes (extensible) ele-1: All FHIR elements must have a @value or children
code	SΣ	1..1	CodeableConcept	Diagnostic examination name / study name / group name Binding: Evaluation Procedure (preferred) ele-1: All FHIR elements must have a @value or children
subject	SΣC	1..1	Reference(ADHA Core Patient)	The subject of the report - usually, but not always, the patient ele-1: All FHIR elements must have a @value or children inv-dh-dir-02: At least reference or a valid identifier shall be present
effective[x]	SΣC	1..1		Clinically relevant time/time-period for report ele-1: All FHIR elements must have a @value or children inv-dh-dir-04: Date shall be at least to day
effectiveDateTime			dateTime
effectivePeriod			Period
issued	SΣ	1..1	instant	Diagnostic report date time ele-1: All FHIR elements must have a @value or children
performer	SΣC	1..*	Reference(ADHA Authoring PractitionerRole | ADHA Core Organization)	Responsible Diagnostic Service ele-1: All FHIR elements must have a @value or children inv-dh-dir-03: At least reference or a valid identifier shall be present
result	SC	0..*	Reference(ADHA Diagnostic Result Observation | ADHA Imaging Result Observation | ADHA Pathology Result Observation)	Observations ele-1: All FHIR elements must have a @value or children
reference	ΣC	1..1	string	Literal reference, Relative, internal or absolute URL ele-1: All FHIR elements must have a @value or children
media	SΣ	0..*	BackboneElement	Key images associated with this report ele-1: All FHIR elements must have a @value or children
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
link	Σ	1..1	Reference(ADHA Core Media)	Reference to the image source ele-1: All FHIR elements must have a @value or children
conclusion	S	0..1	string	Clinical conclusion (interpretation) of test results ele-1: All FHIR elements must have a @value or children
conclusionCode	S	0..*	CodeableConcept	Codes for the clinical conclusion of test results Binding: Clinical Finding (preferred) ele-1: All FHIR elements must have a @value or children
presentedForm	SC	0..*	Attachment	Entire report as issued ele-1: All FHIR elements must have a @value or children
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
DiagnosticReport.status	required	DiagnosticReportStatusReportAvailable https://healthterminologies.gov.au/fhir/ValueSet/diagnosticreportstatus-report-available-1 from https://tx.ontoserver.csiro.au/fhir
DiagnosticReport.category	extensible	DiagnosticServiceSectionCodes http://hl7.org/fhir/ValueSet/diagnostic-service-sections from the FHIR Standard
DiagnosticReport.code	preferred	EvaluationProcedure https://healthterminologies.gov.au/fhir/ValueSet/evaluation-procedure-1 from https://tx.ontoserver.csiro.au/fhir
DiagnosticReport.conclusionCode	preferred	ClinicalFinding https://healthterminologies.gov.au/fhir/ValueSet/clinical-finding-1 from https://tx.ontoserver.csiro.au/fhir

Constraints

Id	Grade	Path(s)	Details	Requirements
inv-dh-dir-01	error	DiagnosticReport	The report shall at least have a result or a presentedForm : result.exists() or presentedForm.exists()
inv-dh-dir-02	error	DiagnosticReport.subject	At least reference or a valid identifier shall be present : reference.exists() or identifier.where(system.count() + value.count() >1).exists()
inv-dh-dir-03	error	DiagnosticReport.performer	At least reference or a valid identifier shall be present : reference.exists() or identifier.where(system.count() + value.count() >1).exists()
inv-dh-dir-04	error	DiagnosticReport.effective[x]	Date shall be at least to day : $this is DateTime implies $this.toString().length() >= 10

Name	Flags	Card.	Type	Description & Constraints
DiagnosticReport	C	0..*	AUBaseDiagnosticReport	A diagnostic report in an Australian healthcare context inv-dh-dir-01: The report shall at least have a result or a presentedForm
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	S	1..*	Identifier, AULocalOrderIdentifier, AULocalReportIdentifier, AUAccessionNumber	Business identifier for report
basedOn	S	0..*	Reference(ADHA Core ServiceRequest)	Diagnostic investigation order
status	?!SΣ	1..1	code	partial | preliminary | final + Binding: DiagnosticReportStatus Report Available (required)
category	SΣ	1..*	CodeableConcept	Service category Binding: DiagnosticServiceSectionCodes (extensible)
code	SΣ	1..1	CodeableConcept	Diagnostic examination name / study name / group name Binding: Evaluation Procedure (preferred)
subject	SΣC	1..1	Reference(ADHA Core Patient)	The subject of the report - usually, but not always, the patient inv-dh-dir-02: At least reference or a valid identifier shall be present
encounter	Σ	0..1	Reference(Encounter)	Health care event when test ordered
effective[x]	SΣC	1..1		Clinically relevant time/time-period for report inv-dh-dir-04: Date shall be at least to day
effectiveDateTime			dateTime
effectivePeriod			Period
issued	SΣ	1..1	instant	Diagnostic report date time
performer	SΣC	1..*	Reference(ADHA Authoring PractitionerRole | ADHA Core Organization)	Responsible Diagnostic Service inv-dh-dir-03: At least reference or a valid identifier shall be present
resultsInterpreter	Σ	0..*	Reference(Practitioner | PractitionerRole | Organization | CareTeam)	Primary result interpreter
specimen		0..*	Reference(AU Base Specimen)	Specimens this report is based on
result	SC	0..*	Reference(ADHA Diagnostic Result Observation | ADHA Imaging Result Observation | ADHA Pathology Result Observation)	Observations
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
reference	ΣC	1..1	string	Literal reference, Relative, internal or absolute URL
type	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	Σ	0..1	Identifier	Logical reference, when literal reference is not known
display	Σ	0..1	string	Text alternative for the resource
imagingStudy		0..*	Reference(ImagingStudy)	Reference to full details of imaging associated with the diagnostic report
media	SΣ	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(ADHA Core Media)	Reference to the image source
conclusion	S	0..1	string	Clinical conclusion (interpretation) of test results
conclusionCode	S	0..*	CodeableConcept	Codes for the clinical conclusion of test results Binding: Clinical Finding (preferred)
presentedForm	SC	0..*	Attachment	Entire report as issued
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
DiagnosticReport.language	preferred	CommonLanguages http://hl7.org/fhir/ValueSet/languages from the FHIR Standard Additional Bindings Purpose AllLanguages Max Binding
DiagnosticReport.status	required	DiagnosticReportStatusReportAvailable https://healthterminologies.gov.au/fhir/ValueSet/diagnosticreportstatus-report-available-1 from https://tx.ontoserver.csiro.au/fhir
DiagnosticReport.category	extensible	DiagnosticServiceSectionCodes http://hl7.org/fhir/ValueSet/diagnostic-service-sections from the FHIR Standard
DiagnosticReport.code	preferred	EvaluationProcedure https://healthterminologies.gov.au/fhir/ValueSet/evaluation-procedure-1 from https://tx.ontoserver.csiro.au/fhir
DiagnosticReport.result.type	extensible	ResourceType http://hl7.org/fhir/ValueSet/resource-types from the FHIR Standard
DiagnosticReport.conclusionCode	preferred	ClinicalFinding https://healthterminologies.gov.au/fhir/ValueSet/clinical-finding-1 from https://tx.ontoserver.csiro.au/fhir

Constraints

Id	Grade	Path(s)	Details	Requirements
inv-dh-dir-01	error	DiagnosticReport	The report shall at least have a result or a presentedForm : result.exists() or presentedForm.exists()
inv-dh-dir-02	error	DiagnosticReport.subject	At least reference or a valid identifier shall be present : reference.exists() or identifier.where(system.count() + value.count() >1).exists()
inv-dh-dir-03	error	DiagnosticReport.performer	At least reference or a valid identifier shall be present : reference.exists() or identifier.where(system.count() + value.count() >1).exists()
inv-dh-dir-04	error	DiagnosticReport.effective[x]	Date shall be at least to day : $this is DateTime implies $this.toString().length() >= 10

Differential View

This structure is derived from AUBaseDiagnosticReport

Name	Flags	Card.	Type	Description & Constraints
DiagnosticReport	C	0..*	AUBaseDiagnosticReport	A diagnostic report in an Australian healthcare context inv-dh-dir-01: The report shall at least have a result or a presentedForm
identifier	S	1..*	Identifier, AULocalOrderIdentifier, AULocalReportIdentifier, AUAccessionNumber	Business identifier for report
basedOn	S	0..*	Reference(ADHA Core ServiceRequest)	Diagnostic investigation order
status	S	1..1	code	partial | preliminary | final + Binding: DiagnosticReportStatus Report Available (required)
category	S	1..*	CodeableConcept	Service category Binding: DiagnosticServiceSectionCodes (extensible)
code	S	1..1	CodeableConcept	Diagnostic examination name / study name / group name
subject	SC	1..1	Reference(ADHA Core Patient)	The subject of the report - usually, but not always, the patient inv-dh-dir-02: At least reference or a valid identifier shall be present
effective[x]	SC	1..1	dateTime, Period	Clinically relevant time/time-period for report inv-dh-dir-04: Date shall be at least to day
issued	S	1..1	instant	Diagnostic report date time
performer	SC	1..*	Reference(ADHA Authoring PractitionerRole | ADHA Core Organization)	Responsible Diagnostic Service inv-dh-dir-03: At least reference or a valid identifier shall be present
result	SC	0..*	Reference(ADHA Diagnostic Result Observation | ADHA Imaging Result Observation | ADHA Pathology Result Observation)	Observations
reference		1..1	string	Literal reference, Relative, internal or absolute URL
media	S	0..*	BackboneElement	Key images associated with this report
link		1..1	Reference(ADHA Core Media)	Reference to the image source
conclusion	S	0..1	string	Clinical conclusion (interpretation) of test results
conclusionCode	S	0..*	CodeableConcept	Codes for the clinical conclusion of test results
presentedForm	SC	0..*	Attachment	Entire report as issued
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
DiagnosticReport.status	required	DiagnosticReportStatusReportAvailable https://healthterminologies.gov.au/fhir/ValueSet/diagnosticreportstatus-report-available-1 from https://tx.ontoserver.csiro.au/fhir
DiagnosticReport.category	extensible	DiagnosticServiceSectionCodes http://hl7.org/fhir/ValueSet/diagnostic-service-sections from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
inv-dh-dir-01	error	DiagnosticReport	The report shall at least have a result or a presentedForm : result.exists() or presentedForm.exists()
inv-dh-dir-02	error	DiagnosticReport.subject	At least reference or a valid identifier shall be present : reference.exists() or identifier.where(system.count() + value.count() >1).exists()
inv-dh-dir-03	error	DiagnosticReport.performer	At least reference or a valid identifier shall be present : reference.exists() or identifier.where(system.count() + value.count() >1).exists()
inv-dh-dir-04	error	DiagnosticReport.effective[x]	Date shall be at least to day : $this is DateTime implies $this.toString().length() >= 10

Key Elements View

Name	Flags	Card.	Type	Description & Constraints
DiagnosticReport	C	0..*	AUBaseDiagnosticReport	A diagnostic report in an Australian healthcare context dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated dom-5: If a resource is contained in another resource, it SHALL NOT have a security label dom-6: A resource should have narrative for robust management inv-dh-dir-01: The report shall at least have a result or a presentedForm
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created ele-1: All FHIR elements must have a @value or children
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
identifier	S	1..*	Identifier, AULocalOrderIdentifier, AULocalReportIdentifier, AUAccessionNumber	Business identifier for report ele-1: All FHIR elements must have a @value or children
basedOn	S	0..*	Reference(ADHA Core ServiceRequest)	Diagnostic investigation order ele-1: All FHIR elements must have a @value or children
status	?!SΣ	1..1	code	partial | preliminary | final + Binding: DiagnosticReportStatus Report Available (required) ele-1: All FHIR elements must have a @value or children
category	SΣ	1..*	CodeableConcept	Service category Binding: DiagnosticServiceSectionCodes (extensible) ele-1: All FHIR elements must have a @value or children
code	SΣ	1..1	CodeableConcept	Diagnostic examination name / study name / group name Binding: Evaluation Procedure (preferred) ele-1: All FHIR elements must have a @value or children
subject	SΣC	1..1	Reference(ADHA Core Patient)	The subject of the report - usually, but not always, the patient ele-1: All FHIR elements must have a @value or children inv-dh-dir-02: At least reference or a valid identifier shall be present
effective[x]	SΣC	1..1		Clinically relevant time/time-period for report ele-1: All FHIR elements must have a @value or children inv-dh-dir-04: Date shall be at least to day
effectiveDateTime			dateTime
effectivePeriod			Period
issued	SΣ	1..1	instant	Diagnostic report date time ele-1: All FHIR elements must have a @value or children
performer	SΣC	1..*	Reference(ADHA Authoring PractitionerRole | ADHA Core Organization)	Responsible Diagnostic Service ele-1: All FHIR elements must have a @value or children inv-dh-dir-03: At least reference or a valid identifier shall be present
result	SC	0..*	Reference(ADHA Diagnostic Result Observation | ADHA Imaging Result Observation | ADHA Pathology Result Observation)	Observations ele-1: All FHIR elements must have a @value or children
reference	ΣC	1..1	string	Literal reference, Relative, internal or absolute URL ele-1: All FHIR elements must have a @value or children
media	SΣ	0..*	BackboneElement	Key images associated with this report ele-1: All FHIR elements must have a @value or children
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
link	Σ	1..1	Reference(ADHA Core Media)	Reference to the image source ele-1: All FHIR elements must have a @value or children
conclusion	S	0..1	string	Clinical conclusion (interpretation) of test results ele-1: All FHIR elements must have a @value or children
conclusionCode	S	0..*	CodeableConcept	Codes for the clinical conclusion of test results Binding: Clinical Finding (preferred) ele-1: All FHIR elements must have a @value or children
presentedForm	SC	0..*	Attachment	Entire report as issued ele-1: All FHIR elements must have a @value or children
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
DiagnosticReport.status	required	DiagnosticReportStatusReportAvailable https://healthterminologies.gov.au/fhir/ValueSet/diagnosticreportstatus-report-available-1 from https://tx.ontoserver.csiro.au/fhir
DiagnosticReport.category	extensible	DiagnosticServiceSectionCodes http://hl7.org/fhir/ValueSet/diagnostic-service-sections from the FHIR Standard
DiagnosticReport.code	preferred	EvaluationProcedure https://healthterminologies.gov.au/fhir/ValueSet/evaluation-procedure-1 from https://tx.ontoserver.csiro.au/fhir
DiagnosticReport.conclusionCode	preferred	ClinicalFinding https://healthterminologies.gov.au/fhir/ValueSet/clinical-finding-1 from https://tx.ontoserver.csiro.au/fhir

Constraints

Id	Grade	Path(s)	Details	Requirements
inv-dh-dir-01	error	DiagnosticReport	The report shall at least have a result or a presentedForm : result.exists() or presentedForm.exists()
inv-dh-dir-02	error	DiagnosticReport.subject	At least reference or a valid identifier shall be present : reference.exists() or identifier.where(system.count() + value.count() >1).exists()
inv-dh-dir-03	error	DiagnosticReport.performer	At least reference or a valid identifier shall be present : reference.exists() or identifier.where(system.count() + value.count() >1).exists()
inv-dh-dir-04	error	DiagnosticReport.effective[x]	Date shall be at least to day : $this is DateTime implies $this.toString().length() >= 10

Snapshot View

Name	Flags	Card.	Type	Description & Constraints
DiagnosticReport	C	0..*	AUBaseDiagnosticReport	A diagnostic report in an Australian healthcare context inv-dh-dir-01: The report shall at least have a result or a presentedForm
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	S	1..*	Identifier, AULocalOrderIdentifier, AULocalReportIdentifier, AUAccessionNumber	Business identifier for report
basedOn	S	0..*	Reference(ADHA Core ServiceRequest)	Diagnostic investigation order
status	?!SΣ	1..1	code	partial | preliminary | final + Binding: DiagnosticReportStatus Report Available (required)
category	SΣ	1..*	CodeableConcept	Service category Binding: DiagnosticServiceSectionCodes (extensible)
code	SΣ	1..1	CodeableConcept	Diagnostic examination name / study name / group name Binding: Evaluation Procedure (preferred)
subject	SΣC	1..1	Reference(ADHA Core Patient)	The subject of the report - usually, but not always, the patient inv-dh-dir-02: At least reference or a valid identifier shall be present
encounter	Σ	0..1	Reference(Encounter)	Health care event when test ordered
effective[x]	SΣC	1..1		Clinically relevant time/time-period for report inv-dh-dir-04: Date shall be at least to day
effectiveDateTime			dateTime
effectivePeriod			Period
issued	SΣ	1..1	instant	Diagnostic report date time
performer	SΣC	1..*	Reference(ADHA Authoring PractitionerRole | ADHA Core Organization)	Responsible Diagnostic Service inv-dh-dir-03: At least reference or a valid identifier shall be present
resultsInterpreter	Σ	0..*	Reference(Practitioner | PractitionerRole | Organization | CareTeam)	Primary result interpreter
specimen		0..*	Reference(AU Base Specimen)	Specimens this report is based on
result	SC	0..*	Reference(ADHA Diagnostic Result Observation | ADHA Imaging Result Observation | ADHA Pathology Result Observation)	Observations
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
reference	ΣC	1..1	string	Literal reference, Relative, internal or absolute URL
type	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	Σ	0..1	Identifier	Logical reference, when literal reference is not known
display	Σ	0..1	string	Text alternative for the resource
imagingStudy		0..*	Reference(ImagingStudy)	Reference to full details of imaging associated with the diagnostic report
media	SΣ	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(ADHA Core Media)	Reference to the image source
conclusion	S	0..1	string	Clinical conclusion (interpretation) of test results
conclusionCode	S	0..*	CodeableConcept	Codes for the clinical conclusion of test results Binding: Clinical Finding (preferred)
presentedForm	SC	0..*	Attachment	Entire report as issued
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
DiagnosticReport.language	preferred	CommonLanguages http://hl7.org/fhir/ValueSet/languages from the FHIR Standard Additional Bindings Purpose AllLanguages Max Binding
DiagnosticReport.status	required	DiagnosticReportStatusReportAvailable https://healthterminologies.gov.au/fhir/ValueSet/diagnosticreportstatus-report-available-1 from https://tx.ontoserver.csiro.au/fhir
DiagnosticReport.category	extensible	DiagnosticServiceSectionCodes http://hl7.org/fhir/ValueSet/diagnostic-service-sections from the FHIR Standard
DiagnosticReport.code	preferred	EvaluationProcedure https://healthterminologies.gov.au/fhir/ValueSet/evaluation-procedure-1 from https://tx.ontoserver.csiro.au/fhir
DiagnosticReport.result.type	extensible	ResourceType http://hl7.org/fhir/ValueSet/resource-types from the FHIR Standard
DiagnosticReport.conclusionCode	preferred	ClinicalFinding https://healthterminologies.gov.au/fhir/ValueSet/clinical-finding-1 from https://tx.ontoserver.csiro.au/fhir

Constraints

Id	Grade	Path(s)	Details	Requirements
inv-dh-dir-01	error	DiagnosticReport	The report shall at least have a result or a presentedForm : result.exists() or presentedForm.exists()
inv-dh-dir-02	error	DiagnosticReport.subject	At least reference or a valid identifier shall be present : reference.exists() or identifier.where(system.count() + value.count() >1).exists()
inv-dh-dir-03	error	DiagnosticReport.performer	At least reference or a valid identifier shall be present : reference.exists() or identifier.where(system.count() + value.count() >1).exists()
inv-dh-dir-04	error	DiagnosticReport.effective[x]	Date shall be at least to day : $this is DateTime implies $this.toString().length() >= 10

This structure is derived from AUBaseDiagnosticReport

Summary

Mandatory: 6 elements(1 nested mandatory element)
Must-Support: 14 elements

Structures

This structure refers to these other structures:

• ADHA Core ServiceRequest (http://ns.electronichealth.net.au/fhir/StructureDefinition/dh-servicerequest-core-1)
• ADHA Core Patient (http://ns.electronichealth.net.au/fhir/StructureDefinition/dh-patient-core-1)
• ADHA Authoring PractitionerRole (http://ns.electronichealth.net.au/fhir/StructureDefinition/dh-practitionerrole-author-1)
• ADHA Core Organization (http://ns.electronichealth.net.au/fhir/StructureDefinition/dh-organization-core-1)
• ADHA Diagnostic Result Observation (http://ns.electronichealth.net.au/fhir/StructureDefinition/dh-observation-diagnosticresult-1)
• ADHA Imaging Result Observation (http://ns.electronichealth.net.au/fhir/StructureDefinition/dh-observation-diagnosticresult-imag-1)
• ADHA Pathology Result Observation (http://ns.electronichealth.net.au/fhir/StructureDefinition/dh-observation-diagnosticresult-path-1)
• ADHA Core Media (http://ns.electronichealth.net.au/fhir/StructureDefinition/dh-media-core-1)

Below is an overview of the mandatory and optional search parameters. FHIR search operations and the syntax used to describe the interactions is described here.

Mandatory Search Parameters

The following search parameters and search parameter combinations SHALL be supported:

1. SHALL support searching for all diagnostic reports for a patient using the subject:identifier search parameter:

   GET [base]/DiagnosticReport?subject:identifier={system|}[code]

   Example:

    GET [base]/DiagnosticReport?subject:identifier=http://ns.electronichealth.net.au/id/hi/ihi/1.0|8003608000228437
   

   Implementation Notes: Fetches a bundle of all DiagnosticReport resources for the specified patient (how to search by :identifier)

2. SHALL support searching using the identifier search parameter:

   GET [base]/DiagnosticReport?identifier={system|}[code]

   Example:

    GET [base]/DiagnosticReport?identifier=http://doombenpathlabs.example.com/reports|1032702
   

   Implementation Notes: Fetches a bundle containing any DiagnosticReport resources matching the identifier (how to search by token)

3. SHALL support searching using the combination subject:identifier and category search parameter:

   GET [base]/DiagnosticReport?subject:identifier={system|}[code]&category[code]

   Example:

    GET [base]/DiagnosticReport?subject:identifier=http://ns.electronichealth.net.au/id/hi/ihi/1.0|8003608000228437&category=http://terminology.hl7.org/CodeSystem/v2-0074|AU
   

   Implementation Notes: Fetches a bundle of all DiagnosticReport resources with the category of "Audiology" for the specified patient (how to search by :identifier and how to search by token)

4. SHALL support searching using the combination subject:identifier and code search parameter:

   GET [base]/DiagnosticReport?subject:identifier={system|}[code]&code={system|}[code]

   Example:

    GET [base]/DiagnosticReport?subject:identifier=http://ns.electronichealth.net.au/id/hi/ihi/1.0|8003608000228437&code=http://loinc.org|68635-2
   

   Implementation Notes: Fetches a bundle of all DiagnosticReport resources with the code of an 68635-2 (Audiology Diagnostic study note) for the specified patient (how to search by :identifier and how to search by token)

5. SHALL support searching using the combination of the subject:identifier and date search parameters:

   GET [base]/DiagnosticReport?subject:identifier={system|}[code]&date=[date]

   Example:

    GET [base]/DiagnosticReport?subject:identifier=http://ns.electronichealth.net.au/id/hi/ihi/1.0|8003608000228437&date=ge2013-03-14
   

   Implementation Notes: Fetches a bundle of all DiagnosticReport resources for the specified patient that have a date greater than or equal to 21st Jan 2013. (how to search by :identifier and how to search by date)