# US Quality Core DiagnosticReport Profile for Report and Note Exchange - US Quality Core Implementation Guide v0.1.0

* [**Table of Contents**](toc.md)
* [**Artifacts Summary**](artifacts.md)
* **US Quality Core DiagnosticReport Profile for Report and Note Exchange**

## Resource Profile: US Quality Core DiagnosticReport Profile for Report and Note Exchange 

| | |
| :--- | :--- |
| *Official URL*:http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-diagnosticreport-note | *Version*:0.1.0 |
| Active as of 2023-08-01 | *Computable Name*:USQualityCoreDiagnosticReportNote |

 
Profile of DiagnosticReport for Note exchange for decision support/quality metrics. Defines the core set of elements and extensions for quality rule and measure authors. 

**Usage**
  See the [patterns](patterns.md) page for implementation and usage patterns.  

### Examples

 

| |
| :--- |
| [Radiology Diagnostic Report Example](DiagnosticReport-note-example.md) |

 

**USCDI+ Quality Elements:**

* status: (USCDI+ Quality) (USCDI) registered \| partial \| preliminary \| final +
* category:us-core: (USCDI+ Quality) (USCDI) Service category
* code: (USCDI+ Quality) (USCDI) US Quality Core Report Code
* effective[x]: (USCDI+ Quality) (USCDI) Diagnostically relevant time (typically the time of the procedure)
* result: (USCDI+ Quality) (USCDI) Observations
* imagingStudy: (USCDI+ Quality) Reference to full details of imaging associated with the diagnostic report

**Usages:**

* Refer to this Profile: [US Quality Core ImagingStudy](StructureDefinition-us-quality-core-imagingstudy.md) and [US Quality Core Procedure](StructureDefinition-us-quality-core-procedure.md)
* Examples for this Profile: [DiagnosticReport/note-example](DiagnosticReport-note-example.md)
* CapabilityStatements using this Profile: [US Quality Core Client CapabilityStatement](CapabilityStatement-us-quality-core-client.md) and [US Quality Core Server CapabilityStatement](CapabilityStatement-us-quality-core-server.md)

You can also check for [usages in the FHIR IG Statistics](https://packages2.fhir.org/xig/fhir.astp.us-quality-core|current/StructureDefinition/us-quality-core-diagnosticreport-note)

### Formal Views of Profile Content

 [Description of Profiles, Differentials, Snapshots and how the different presentations work](http://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#structure-definitions). 

 

Other representations of profile: [CSV](StructureDefinition-us-quality-core-diagnosticreport-note.csv), [Excel](StructureDefinition-us-quality-core-diagnosticreport-note.xlsx), [Schematron](StructureDefinition-us-quality-core-diagnosticreport-note.sch) 



## Resource Content

```json
{
  "resourceType" : "StructureDefinition",
  "id" : "us-quality-core-diagnosticreport-note",
  "url" : "http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-diagnosticreport-note",
  "version" : "0.1.0",
  "name" : "USQualityCoreDiagnosticReportNote",
  "title" : "US Quality Core DiagnosticReport Profile for Report and Note Exchange",
  "status" : "active",
  "experimental" : false,
  "date" : "2023-08-01",
  "publisher" : "ASTP",
  "contact" : [{
    "telecom" : [{
      "system" : "url",
      "value" : "https://www.healthit.gov/"
    }]
  }],
  "description" : "Profile of DiagnosticReport for Note exchange for decision support/quality metrics. Defines the core set of elements and extensions for quality rule and measure authors.",
  "jurisdiction" : [{
    "coding" : [{
      "system" : "urn:iso:std:iso:3166",
      "code" : "US",
      "display" : "United States of America"
    }],
    "text" : "USA"
  }],
  "fhirVersion" : "4.0.1",
  "mapping" : [{
    "identity" : "workflow",
    "uri" : "http://hl7.org/fhir/workflow",
    "name" : "Workflow Pattern"
  },
  {
    "identity" : "v2",
    "uri" : "http://hl7.org/v2",
    "name" : "HL7 v2 Mapping"
  },
  {
    "identity" : "rim",
    "uri" : "http://hl7.org/v3",
    "name" : "RIM Mapping"
  },
  {
    "identity" : "w5",
    "uri" : "http://hl7.org/fhir/fivews",
    "name" : "FiveWs Pattern Mapping"
  }],
  "kind" : "resource",
  "abstract" : false,
  "type" : "DiagnosticReport",
  "baseDefinition" : "http://hl7.org/fhir/us/core/StructureDefinition/us-core-diagnosticreport-note",
  "derivation" : "constraint",
  "differential" : {
    "element" : [{
      "id" : "DiagnosticReport",
      "path" : "DiagnosticReport"
    },
    {
      "id" : "DiagnosticReport.status",
      "extension" : [{
        "url" : "http://hl7.org/fhir/us/core/StructureDefinition/uscdi-requirement",
        "valueBoolean" : true
      },
      {
        "url" : "http://fhir.org/guides/astp/us-quality-core/StructureDefinition/uscdiplusquality",
        "valueBoolean" : true
      }],
      "path" : "DiagnosticReport.status",
      "short" : "(USCDI+ Quality) (USCDI) registered | partial | preliminary | final +"
    },
    {
      "id" : "DiagnosticReport.category",
      "extension" : [{
        "url" : "http://hl7.org/fhir/us/core/StructureDefinition/uscdi-requirement",
        "valueBoolean" : true
      }],
      "path" : "DiagnosticReport.category",
      "slicing" : {
        "discriminator" : [{
          "type" : "pattern",
          "path" : "$this"
        }],
        "rules" : "open"
      },
      "short" : "(USCDI) Service Category",
      "min" : 1
    },
    {
      "id" : "DiagnosticReport.category:us-core",
      "extension" : [{
        "url" : "http://hl7.org/fhir/us/core/StructureDefinition/uscdi-requirement",
        "valueBoolean" : true
      },
      {
        "url" : "http://fhir.org/guides/astp/us-quality-core/StructureDefinition/uscdiplusquality",
        "valueBoolean" : true
      }],
      "path" : "DiagnosticReport.category",
      "sliceName" : "us-core",
      "short" : "(USCDI+ Quality) (USCDI) Service category"
    },
    {
      "id" : "DiagnosticReport.code",
      "extension" : [{
        "url" : "http://hl7.org/fhir/us/core/StructureDefinition/uscdi-requirement",
        "valueBoolean" : true
      },
      {
        "url" : "http://fhir.org/guides/astp/us-quality-core/StructureDefinition/uscdiplusquality",
        "valueBoolean" : true
      }],
      "path" : "DiagnosticReport.code",
      "short" : "(USCDI+ Quality) (USCDI) US Quality Core Report Code",
      "definition" : "The test, panel, report, or note that was ordered.",
      "comment" : "The typical patterns for codes are:  1)  a LOINC code either as a translation from a \"local\" code or as a primary code, or 2)  a local code only if no suitable LOINC exists,  or 3)  both the local and the LOINC translation.   Systems SHALL be capable of sending the local code if one exists.",
      "alias" : ["Type"],
      "min" : 1,
      "max" : "1",
      "base" : {
        "path" : "DiagnosticReport.code",
        "min" : 1,
        "max" : "1"
      },
      "type" : [{
        "code" : "CodeableConcept"
      }],
      "isModifier" : false,
      "isSummary" : true,
      "binding" : {
        "strength" : "extensible",
        "description" : "LOINC codes",
        "valueSet" : "http://hl7.org/fhir/us/core/ValueSet/us-core-diagnosticreport-report-and-note-codes"
      }
    },
    {
      "id" : "DiagnosticReport.subject",
      "extension" : [{
        "url" : "http://hl7.org/fhir/us/core/StructureDefinition/uscdi-requirement",
        "valueBoolean" : true
      }],
      "path" : "DiagnosticReport.subject",
      "short" : "(USCDI) The subject of the report - usually, but not always, the patient",
      "type" : [{
        "code" : "Reference",
        "targetProfile" : ["http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-patient"]
      }]
    },
    {
      "id" : "DiagnosticReport.encounter",
      "extension" : [{
        "url" : "http://hl7.org/fhir/us/core/StructureDefinition/uscdi-requirement",
        "valueBoolean" : true
      }],
      "path" : "DiagnosticReport.encounter",
      "short" : "(USCDI) Health care event when test ordered",
      "type" : [{
        "code" : "Reference",
        "targetProfile" : ["http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-encounter"]
      }]
    },
    {
      "id" : "DiagnosticReport.effective[x]",
      "extension" : [{
        "url" : "http://hl7.org/fhir/us/core/StructureDefinition/uscdi-requirement",
        "valueBoolean" : true
      },
      {
        "url" : "http://fhir.org/guides/astp/us-quality-core/StructureDefinition/uscdiplusquality",
        "valueBoolean" : true
      }],
      "path" : "DiagnosticReport.effective[x]",
      "short" : "(USCDI+ Quality) (USCDI) Diagnostically relevant time (typically the time of the procedure)",
      "min" : 0,
      "max" : "1",
      "base" : {
        "path" : "DiagnosticReport.effective[x]",
        "min" : 0,
        "max" : "1"
      },
      "type" : [{
        "code" : "dateTime"
      },
      {
        "code" : "Period"
      }],
      "isModifier" : false,
      "isSummary" : true
    },
    {
      "id" : "DiagnosticReport.issued",
      "extension" : [{
        "url" : "http://hl7.org/fhir/us/core/StructureDefinition/uscdi-requirement",
        "valueBoolean" : true
      }],
      "path" : "DiagnosticReport.issued",
      "short" : "(USCDI) DateTime this version was made"
    },
    {
      "id" : "DiagnosticReport.performer",
      "extension" : [{
        "url" : "http://hl7.org/fhir/us/core/StructureDefinition/uscdi-requirement",
        "valueBoolean" : true
      }],
      "path" : "DiagnosticReport.performer",
      "short" : "(USCDI) Responsible Diagnostic Service",
      "type" : [{
        "code" : "Reference",
        "targetProfile" : ["http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-practitioner",
        "http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-organization"]
      }]
    },
    {
      "id" : "DiagnosticReport.result",
      "extension" : [{
        "url" : "http://hl7.org/fhir/us/core/StructureDefinition/uscdi-requirement",
        "valueBoolean" : true
      },
      {
        "url" : "http://fhir.org/guides/astp/us-quality-core/StructureDefinition/uscdiplusquality",
        "valueBoolean" : true
      }],
      "path" : "DiagnosticReport.result",
      "short" : "(USCDI+ Quality) (USCDI) Observations",
      "type" : [{
        "code" : "Reference",
        "targetProfile" : ["http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-observation-lab",
        "http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-observation-clinical-result"]
      }]
    },
    {
      "id" : "DiagnosticReport.imagingStudy",
      "extension" : [{
        "url" : "http://fhir.org/guides/astp/us-quality-core/StructureDefinition/uscdiplusquality",
        "valueBoolean" : true
      }],
      "path" : "DiagnosticReport.imagingStudy",
      "short" : "(USCDI+ Quality) Reference to full details of imaging associated with the diagnostic report",
      "type" : [{
        "code" : "Reference",
        "targetProfile" : ["http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-imagingstudy"]
      }]
    },
    {
      "id" : "DiagnosticReport.media",
      "extension" : [{
        "url" : "http://hl7.org/fhir/us/core/StructureDefinition/uscdi-requirement",
        "valueBoolean" : true
      }],
      "path" : "DiagnosticReport.media",
      "short" : "(USCDI) Key images associated with this report"
    }]
  }
}

```
