US Core Implementation Guide
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US Core Implementation Guide, published by HL7 International / Cross-Group Projects. This guide is not an authorized publication; it is the continuous build for version 10.0.0-ballot built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/US-Core/ and changes regularly. See the Directory of published versions

Resource Profile: US Core DiagnosticReport Profile for Laboratory Results Reporting

Official URL: http://hl7.org/fhir/us/core/StructureDefinition/us-core-diagnosticreport-lab Version: 10.0.0-ballot
Standards status: Trial-use Maturity Level: 5 Computable Name: USCoreDiagnosticReportProfileLaboratoryReporting
Other Identifiers: OID:2.16.840.1.113883.4.642.40.2.42.20

The US Core DiagnosticReport Profile for Laboratory Results Reporting inherits from the FHIR DiagnosticReport resource; refer to it for scope and usage definitions. Laboratory results are grouped and summarized using the DiagnosticReport resource, which typically references Observation resource(s). Each Observation resource represents an individual laboratory test and result value or component result values or a nested panel (such as a microbial susceptibility panel) that references other observations. Laboratory results can also be presented in report form or as free text. This profile sets minimum expectations for the DiagnosticReport resource to record, search, and fetch laboratory results associated with a patient. It specifies which core elements, extensions, vocabularies, and value sets SHALL be present and constrains how the elements are used. Providing the floor for standards development for specific use cases promotes interoperability and adoption.

US Core Maturity: 5

Example Usage Scenarios:

The following are example usage scenarios for the US Core DiagnosticReport Profile for Laboratory Results Reporting:

  • Query for lab reports belonging to a Patient
  • Record or update a lab report for a specific Patient

Mandatory and Must Support Data Elements

The following data elements must always be present (Mandatory definition) or must be supported if the data is present in the sending system (Must Support definition). They are presented below in a simple human-readable explanation. Profile specific guidance and examples are provided as well. The Formal Views below provides the formal summary, definitions, and terminology requirements.

Each DiagnosticReport Must Have:

  1. a status
  2. a category code of 'LAB'
  3. a code (preferably a LOINC code) which tells you what is being measured
  4. a patient
  5. the diagnostically relevant time (known as the "effective time" and typically the time of specimen collection)1
  6. when the report was released1

Each DiagnosticReport Must Support:

  1. a timestamp when the resource last changed2
  2. encounter associated with DiagnosticReport
  3. who issues the report3
  4. a results interpreter3
  5. a result

1,2,3 see guidance below

Profile Specific Implementation Guidance

This section provides detailed implementation guidance for the US Core Profile to support implementation and certification.

  • 1DiagnosticReport.effective[x] and DiagnosticReport.issued have the following constraints: SHALL be present if status is 'partial', 'preliminary', 'final', 'amended', 'corrected', or 'appended'.§,§
  • The CLIA/USCDI/HL7 Elements Crossmapping Table provides a crosswalk of Clinical Laboratory Improvement Amendments (CLIA) data elements to corresponding FHIR fields, terminology standards, and naming conventions used in HL7 CDA and HL7 V2 standards. Implementers can use this mapping to help comply with CLIA requirements when using the US Core Laboratory Result Observation Profile.
  • Additional codes that translate or map to the DiagnosticReport codes or category codes are allowed. For example:
    • providing both a local system code and a LOINC code that it maps to
    • providing a more specific category code to the "LAB" category code, such as "CH" (chemistry), in an additional coding element.

  • 3The profile elements DiagnosticReport.performer and DiagnosticReport.resultsInterpreter communicate the individual level provenance author data corresponding to the U.S. Core Data for Interoperability (USCDI) Provenance Author Data Elements.

  • Results that are free text or report form are represented using the DiagnosticReport.presentedForm element.
  • 2See the US Core General Guidance page for Searching Using lastUpdated. Updates to .meta.lastUpdated SHOULD reflect:
    • New laboratory reports§
    • Changes in the status of laboratory reports, including events that trigger the same status (e.g., amended → amended).§
  • The DiagnosticReport.basedOn element connects the DiagnosticReport to the originating order in the EHR. Systems that initiate the lab order SHOULD use this element when reporting the results.§

Usages:

You can also check for usages in the FHIR IG Statistics

Changes since version 9.0.0:

  • No changes

    • Formal Views of Profile Content

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

    NameFlagsCard.TypeDescription & Constraints    Filter: doco
    DiagnosticReport C 0..* DiagnosticReport A Diagnostic report - a combination of request information, atomic results, images, interpretation, as well as formatted reports
    Constraints: us-core-8, us-core-9
    DiagnosticReport.meta This element must be supported. This element is included in summaries. 0..1 Meta Metadata about the resource
    DiagnosticReport.meta.lastUpdated This element must be supported. This element is included in summaries. 0..1 instant When the resource last changed
    DiagnosticReport.implicitRules This element is a modifier element. This element is included in summaries. 0..1 uri A set of rules under which this content was created
    DiagnosticReport.modifierExtension This element is a modifier element. 0..* Extension Extensions that cannot be ignored
    DiagnosticReport.status This element is a modifier element. This element must be supported. This element is included in summaries. C 1..1 code registered | partial | preliminary | final +
    Binding: DiagnosticReportStatus (required)
    DiagnosticReport.Slices for category This element must be supported. This element is included in summaries. 1..* CodeableConcept Service category
    Slice: Unordered, Open by value:$this
    Binding: DiagnosticServiceSectionCodes (example): Codes for diagnostic service sections.

    Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them
    DiagnosticReport.Slices for category.category:LaboratorySlice This element must be supported. This element is included in summaries. 1..1 CodeableConcept Service category
    Binding: DiagnosticServiceSectionCodes (example): Codes for diagnostic service sections.

    Required Pattern: 
    {
  "coding" : [
    {
      "system" : "http://terminology.hl7.org/CodeSystem/v2-0074",
      "code" : "LAB"
    }
  ]
}
    DiagnosticReport.code This element must be supported. This element is included in summaries. 1..1 CodeableConcept US Core Laboratory Report Order Code
    Binding: US Core Laboratory Test Codes (extensible): LOINC codes
    DiagnosticReport.subject This element must be supported. This element is included in summaries. 1..1 Reference(US Core Patient Profile This type must be supported. | Group | US Core Device Profile | US Core Location Profile) The subject of the report - usually, but not always, the patient
    DiagnosticReport.encounter This element must be supported. This element is included in summaries. 0..1 Reference(US Core Encounter Profile) Encounter associated with DiagnosticReport
    DiagnosticReport.effective[x] This element must be supported. This element is included in summaries. C 0..1 Diagnostically relevant time (typically the time of specimen collection)
    DiagnosticReport.effective[x].effectiveDateTime dateTime This target must be supported.
    DiagnosticReport.effective[x].effectivePeriod Period
    DiagnosticReport.issued This element must be supported. This element is included in summaries. C 0..1 instant When the report was released
    DiagnosticReport.performer This element must be supported. This element is included in summaries. 0..* Reference(US Core Practitioner Profile This type must be supported. | US Core Organization Profile | US Core CareTeam Profile | US Core PractitionerRole Profile) Responsible Diagnostic Service
    DiagnosticReport.resultsInterpreter This element must be supported. This element is included in summaries. 0..* Reference(US Core Practitioner Profile This type must be supported. | US Core Organization Profile | PractitionerRole | US Core CareTeam Profile) Who analyzed and reported the conclusions and interpretations
    DiagnosticReport.result This element must be supported. 0..* Reference(US Core Laboratory Result Observation Profile) Observations

    doco Documentation for this format

    Terminology Bindings

    Path Status Usage ValueSet Version Source
    DiagnosticReport.status Base required DiagnosticReportStatus 📦4.0.1 FHIR Std.
    DiagnosticReport.category Base example Diagnostic Service Section Codes 📍4.0.1 FHIR Std.
    DiagnosticReport.category:LaboratorySlice Base example Diagnostic Service Section Codes 📍4.0.1 FHIR Std.
    DiagnosticReport.code Base extensible US Core Laboratory Test Codes 📦10.0.0-ballot This IG

    Constraints

    Id Grade Path(s) Description Expression
    us-core-8 error DiagnosticReport effective[x] SHALL be present if the status is 'partial', 'preliminary', 'final', 'amended', 'corrected' or 'appended' (status='partial' or status='preliminary' or status='final' or status='amended' or status='corrected' or status='appended' ) implies effective.exists()
    us-core-9 error DiagnosticReport issued SHALL be present if the status is 'partial', 'preliminary', 'final', 'amended', 'corrected' or 'appended' (status='partial' or status='preliminary' or status='final' or status='amended' or status='corrected' or status='appended' ) implies issued.exists()

    This structure is derived from DiagnosticReport

    NameFlagsCard.TypeDescription & Constraints    Filter: doco
    DiagnosticReport C 0..* DiagnosticReport A Diagnostic report - a combination of request information, atomic results, images, interpretation, as well as formatted reports
    Constraints: us-core-8, us-core-9
    DiagnosticReport.meta This element must be supported. 0..1 Meta Metadata about the resource
    DiagnosticReport.meta.lastUpdated This element must be supported. 0..1 instant When the resource last changed
    DiagnosticReport.status This element must be supported. C 1..1 code registered | partial | preliminary | final +
    Binding: DiagnosticReportStatus (required)
    DiagnosticReport.Slices for category This element must be supported. 1..* CodeableConcept Service category
    Slice: Unordered, Open by value:$this
    Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them
    DiagnosticReport.Slices for category.category:LaboratorySlice This element must be supported. 1..1 CodeableConcept Service category
    Required Pattern: 
    {
  "coding" : [
    {
      "system" : "http://terminology.hl7.org/CodeSystem/v2-0074",
      "code" : "LAB"
    }
  ]
}
    DiagnosticReport.code This element must be supported. 1..1 CodeableConcept US Core Laboratory Report Order Code
    Binding: US Core Laboratory Test Codes (extensible): LOINC codes
    DiagnosticReport.subject This element must be supported. 1..1 Reference(US Core Patient Profile This type must be supported. | Group | US Core Device Profile | US Core Location Profile) The subject of the report - usually, but not always, the patient
    DiagnosticReport.encounter This element must be supported. 0..1 Reference(US Core Encounter Profile) Encounter associated with DiagnosticReport
    DiagnosticReport.effective[x] This element must be supported. C 0..1 Diagnostically relevant time (typically the time of specimen collection)
    DiagnosticReport.effective[x].effectiveDateTime dateTime This target must be supported.
    DiagnosticReport.effective[x].effectivePeriod Period
    DiagnosticReport.issued This element must be supported. C 0..1 instant When the report was released
    DiagnosticReport.performer This element must be supported. 0..* Reference(US Core Practitioner Profile This type must be supported. | US Core Organization Profile | US Core CareTeam Profile | US Core PractitionerRole Profile) Responsible Diagnostic Service
    DiagnosticReport.resultsInterpreter This element must be supported. 0..* Reference(US Core Practitioner Profile This type must be supported. | US Core Organization Profile | PractitionerRole | US Core CareTeam Profile) Who analyzed and reported the conclusions and interpretations
    DiagnosticReport.result This element must be supported. 0..* Reference(US Core Laboratory Result Observation Profile) Observations

    doco Documentation for this format

    Terminology Bindings (Differential)

    Path Status Usage ValueSet Version Source
    DiagnosticReport.status Base required DiagnosticReportStatus 📦4.0.1 FHIR Std.
    DiagnosticReport.code Base extensible US Core Laboratory Test Codes 📦10.0.0-ballot This IG

    Constraints

    Id Grade Path(s) Description Expression
    us-core-8 error DiagnosticReport effective[x] SHALL be present if the status is 'partial', 'preliminary', 'final', 'amended', 'corrected' or 'appended' (status='partial' or status='preliminary' or status='final' or status='amended' or status='corrected' or status='appended' ) implies effective.exists()
    us-core-9 error DiagnosticReport issued SHALL be present if the status is 'partial', 'preliminary', 'final', 'amended', 'corrected' or 'appended' (status='partial' or status='preliminary' or status='final' or status='amended' or status='corrected' or status='appended' ) implies issued.exists()
    NameFlagsCard.TypeDescription & Constraints    Filter: doco
    DiagnosticReport C 0..* DiagnosticReport A Diagnostic report - a combination of request information, atomic results, images, interpretation, as well as formatted reports
    Constraints: us-core-8, us-core-9
    DiagnosticReport.id This element is included in summaries. 0..1 id Logical id of this artifact
    DiagnosticReport.meta This element must be supported. This element is included in summaries. 0..1 Meta Metadata about the resource
    DiagnosticReport.meta.id 0..1 string Unique id for inter-element referencing
    DiagnosticReport.meta.extension 0..* Extension Additional content defined by implementations
    Slice: Unordered, Open by value:url
    DiagnosticReport.meta.versionId This element is included in summaries. 0..1 id Version specific identifier
    DiagnosticReport.meta.lastUpdated This element must be supported. This element is included in summaries. 0..1 instant When the resource last changed
    DiagnosticReport.meta.source This element is included in summaries. 0..1 uri Identifies where the resource comes from
    DiagnosticReport.meta.profile This element is included in summaries. 0..* canonical(StructureDefinition) Profiles this resource claims to conform to
    DiagnosticReport.meta.security This element is included in summaries. 0..* Coding Security Labels applied to this resource
    Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
    DiagnosticReport.meta.tag This element is included in summaries. 0..* Coding Tags applied to this resource
    Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".
    DiagnosticReport.implicitRules This element is a modifier element. This element is included in summaries. 0..1 uri A set of rules under which this content was created
    DiagnosticReport.language 0..1 code Language of the resource content
    Binding: CommonLanguages (preferred): A human language.
    Additional BindingsPurpose
    AllLanguages Max Binding
    DiagnosticReport.text 0..1 Narrative Text summary of the resource, for human interpretation
    This profile does not constrain the narrative in regard to content, language, or traceability to data elements
    DiagnosticReport.contained 0..* Resource Contained, inline Resources
    DiagnosticReport.extension 0..* Extension Additional content defined by implementations
    DiagnosticReport.modifierExtension This element is a modifier element. 0..* Extension Extensions that cannot be ignored
    DiagnosticReport.identifier This element is included in summaries. 0..* Identifier Business identifier for report
    DiagnosticReport.basedOn 0..* Reference(CarePlan | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest) What was requested
    DiagnosticReport.status This element is a modifier element. This element must be supported. This element is included in summaries. C 1..1 code registered | partial | preliminary | final +
    Binding: DiagnosticReportStatus (required)
    DiagnosticReport.Slices for category This element must be supported. This element is included in summaries. 1..* CodeableConcept Service category
    Slice: Unordered, Open by value:$this
    Binding: DiagnosticServiceSectionCodes (example): Codes for diagnostic service sections.

    Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them
    DiagnosticReport.Slices for category.category:LaboratorySlice This element must be supported. This element is included in summaries. 1..1 CodeableConcept Service category
    Binding: DiagnosticServiceSectionCodes (example): Codes for diagnostic service sections.

    Required Pattern: 
    {
  "coding" : [
    {
      "system" : "http://terminology.hl7.org/CodeSystem/v2-0074",
      "code" : "LAB"
    }
  ]
}
    DiagnosticReport.code This element must be supported. This element is included in summaries. 1..1 CodeableConcept US Core Laboratory Report Order Code
    Binding: US Core Laboratory Test Codes (extensible): LOINC codes
    DiagnosticReport.subject This element must be supported. This element is included in summaries. 1..1 Reference(US Core Patient Profile This type must be supported. | Group | US Core Device Profile | US Core Location Profile) The subject of the report - usually, but not always, the patient
    DiagnosticReport.encounter This element must be supported. This element is included in summaries. 0..1 Reference(US Core Encounter Profile) Encounter associated with DiagnosticReport
    DiagnosticReport.effective[x] This element must be supported. This element is included in summaries. C 0..1 Diagnostically relevant time (typically the time of specimen collection)
    DiagnosticReport.effective[x].effectiveDateTime dateTime This target must be supported.
    DiagnosticReport.effective[x].effectivePeriod Period
    DiagnosticReport.issued This element must be supported. This element is included in summaries. C 0..1 instant When the report was released
    DiagnosticReport.performer This element must be supported. This element is included in summaries. 0..* Reference(US Core Practitioner Profile This type must be supported. | US Core Organization Profile | US Core CareTeam Profile | US Core PractitionerRole Profile) Responsible Diagnostic Service
    DiagnosticReport.resultsInterpreter This element must be supported. This element is included in summaries. 0..* Reference(US Core Practitioner Profile This type must be supported. | US Core Organization Profile | PractitionerRole | US Core CareTeam Profile) Who analyzed and reported the conclusions and interpretations
    DiagnosticReport.specimen 0..* Reference(Specimen) Specimens this report is based on
    DiagnosticReport.result This element must be supported. 0..* Reference(US Core Laboratory Result Observation Profile) Observations
    DiagnosticReport.imagingStudy 0..* Reference(ImagingStudy) Reference to full details of imaging associated with the diagnostic report
    DiagnosticReport.media This element is included in summaries. 0..* BackboneElement Key images associated with this report
    DiagnosticReport.media.id 0..1 string Unique id for inter-element referencing
    DiagnosticReport.media.extension 0..* Extension Additional content defined by implementations
    DiagnosticReport.media.modifierExtension This element is a modifier element. This element is included in summaries. 0..* Extension Extensions that cannot be ignored even if unrecognized
    DiagnosticReport.media.comment 0..1 string Comment about the image (e.g. explanation)
    DiagnosticReport.media.link This element is included in summaries. 1..1 Reference(Media) Reference to the image source
    DiagnosticReport.conclusion 0..1 string Clinical conclusion (interpretation) of test results
    DiagnosticReport.conclusionCode 0..* CodeableConcept Codes for the clinical conclusion of test results
    Binding: SNOMEDCTClinicalFindings (example): Diagnosis codes provided as adjuncts to the report.
    DiagnosticReport.presentedForm 0..* Attachment Entire report as issued

    doco Documentation for this format

    Terminology Bindings

    Path Status Usage ValueSet Version Source
    DiagnosticReport.meta.​security Base extensible SecurityLabels 📍4.0.1 FHIR Std.
    DiagnosticReport.meta.​tag Base example Common Tags 📍4.0.1 FHIR Std.
    DiagnosticReport.language Base preferred Common Languages 📍4.0.1 FHIR Std.
    DiagnosticReport.status Base required DiagnosticReportStatus 📦4.0.1 FHIR Std.
    DiagnosticReport.category Base example Diagnostic Service Section Codes 📍4.0.1 FHIR Std.
    DiagnosticReport.category:LaboratorySlice Base example Diagnostic Service Section Codes 📍4.0.1 FHIR Std.
    DiagnosticReport.code Base extensible US Core Laboratory Test Codes 📦10.0.0-ballot This IG
    DiagnosticReport.conclusionCode Base example SNOMED CT Clinical Findings 📍4.0.1 FHIR Std.

    Constraints

    Id Grade Path(s) Description Expression
    us-core-8 error DiagnosticReport effective[x] SHALL be present if the status is 'partial', 'preliminary', 'final', 'amended', 'corrected' or 'appended' (status='partial' or status='preliminary' or status='final' or status='amended' or status='corrected' or status='appended' ) implies effective.exists()
    us-core-9 error DiagnosticReport issued SHALL be present if the status is 'partial', 'preliminary', 'final', 'amended', 'corrected' or 'appended' (status='partial' or status='preliminary' or status='final' or status='amended' or status='corrected' or status='appended' ) implies issued.exists()

    Key Elements View

    NameFlagsCard.TypeDescription & Constraints    Filter: doco
    DiagnosticReport C 0..* DiagnosticReport A Diagnostic report - a combination of request information, atomic results, images, interpretation, as well as formatted reports
    Constraints: us-core-8, us-core-9
    DiagnosticReport.meta This element must be supported. This element is included in summaries. 0..1 Meta Metadata about the resource
    DiagnosticReport.meta.lastUpdated This element must be supported. This element is included in summaries. 0..1 instant When the resource last changed
    DiagnosticReport.implicitRules This element is a modifier element. This element is included in summaries. 0..1 uri A set of rules under which this content was created
    DiagnosticReport.modifierExtension This element is a modifier element. 0..* Extension Extensions that cannot be ignored
    DiagnosticReport.status This element is a modifier element. This element must be supported. This element is included in summaries. C 1..1 code registered | partial | preliminary | final +
    Binding: DiagnosticReportStatus (required)
    DiagnosticReport.Slices for category This element must be supported. This element is included in summaries. 1..* CodeableConcept Service category
    Slice: Unordered, Open by value:$this
    Binding: DiagnosticServiceSectionCodes (example): Codes for diagnostic service sections.

    Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them
    DiagnosticReport.Slices for category.category:LaboratorySlice This element must be supported. This element is included in summaries. 1..1 CodeableConcept Service category
    Binding: DiagnosticServiceSectionCodes (example): Codes for diagnostic service sections.

    Required Pattern: 
    {
  "coding" : [
    {
      "system" : "http://terminology.hl7.org/CodeSystem/v2-0074",
      "code" : "LAB"
    }
  ]
}
    DiagnosticReport.code This element must be supported. This element is included in summaries. 1..1 CodeableConcept US Core Laboratory Report Order Code
    Binding: US Core Laboratory Test Codes (extensible): LOINC codes
    DiagnosticReport.subject This element must be supported. This element is included in summaries. 1..1 Reference(US Core Patient Profile This type must be supported. | Group | US Core Device Profile | US Core Location Profile) The subject of the report - usually, but not always, the patient
    DiagnosticReport.encounter This element must be supported. This element is included in summaries. 0..1 Reference(US Core Encounter Profile) Encounter associated with DiagnosticReport
    DiagnosticReport.effective[x] This element must be supported. This element is included in summaries. C 0..1 Diagnostically relevant time (typically the time of specimen collection)
    DiagnosticReport.effective[x].effectiveDateTime dateTime This target must be supported.
    DiagnosticReport.effective[x].effectivePeriod Period
    DiagnosticReport.issued This element must be supported. This element is included in summaries. C 0..1 instant When the report was released
    DiagnosticReport.performer This element must be supported. This element is included in summaries. 0..* Reference(US Core Practitioner Profile This type must be supported. | US Core Organization Profile | US Core CareTeam Profile | US Core PractitionerRole Profile) Responsible Diagnostic Service
    DiagnosticReport.resultsInterpreter This element must be supported. This element is included in summaries. 0..* Reference(US Core Practitioner Profile This type must be supported. | US Core Organization Profile | PractitionerRole | US Core CareTeam Profile) Who analyzed and reported the conclusions and interpretations
    DiagnosticReport.result This element must be supported. 0..* Reference(US Core Laboratory Result Observation Profile) Observations

    doco Documentation for this format

    Terminology Bindings

    Path Status Usage ValueSet Version Source
    DiagnosticReport.status Base required DiagnosticReportStatus 📦4.0.1 FHIR Std.
    DiagnosticReport.category Base example Diagnostic Service Section Codes 📍4.0.1 FHIR Std.
    DiagnosticReport.category:LaboratorySlice Base example Diagnostic Service Section Codes 📍4.0.1 FHIR Std.
    DiagnosticReport.code Base extensible US Core Laboratory Test Codes 📦10.0.0-ballot This IG

    Constraints

    Id Grade Path(s) Description Expression
    us-core-8 error DiagnosticReport effective[x] SHALL be present if the status is 'partial', 'preliminary', 'final', 'amended', 'corrected' or 'appended' (status='partial' or status='preliminary' or status='final' or status='amended' or status='corrected' or status='appended' ) implies effective.exists()
    us-core-9 error DiagnosticReport issued SHALL be present if the status is 'partial', 'preliminary', 'final', 'amended', 'corrected' or 'appended' (status='partial' or status='preliminary' or status='final' or status='amended' or status='corrected' or status='appended' ) implies issued.exists()

    Differential View

    This structure is derived from DiagnosticReport

    NameFlagsCard.TypeDescription & Constraints    Filter: doco
    DiagnosticReport C 0..* DiagnosticReport A Diagnostic report - a combination of request information, atomic results, images, interpretation, as well as formatted reports
    Constraints: us-core-8, us-core-9
    DiagnosticReport.meta This element must be supported. 0..1 Meta Metadata about the resource
    DiagnosticReport.meta.lastUpdated This element must be supported. 0..1 instant When the resource last changed
    DiagnosticReport.status This element must be supported. C 1..1 code registered | partial | preliminary | final +
    Binding: DiagnosticReportStatus (required)
    DiagnosticReport.Slices for category This element must be supported. 1..* CodeableConcept Service category
    Slice: Unordered, Open by value:$this
    Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them
    DiagnosticReport.Slices for category.category:LaboratorySlice This element must be supported. 1..1 CodeableConcept Service category
    Required Pattern: 
    {
  "coding" : [
    {
      "system" : "http://terminology.hl7.org/CodeSystem/v2-0074",
      "code" : "LAB"
    }
  ]
}
    DiagnosticReport.code This element must be supported. 1..1 CodeableConcept US Core Laboratory Report Order Code
    Binding: US Core Laboratory Test Codes (extensible): LOINC codes
    DiagnosticReport.subject This element must be supported. 1..1 Reference(US Core Patient Profile This type must be supported. | Group | US Core Device Profile | US Core Location Profile) The subject of the report - usually, but not always, the patient
    DiagnosticReport.encounter This element must be supported. 0..1 Reference(US Core Encounter Profile) Encounter associated with DiagnosticReport
    DiagnosticReport.effective[x] This element must be supported. C 0..1 Diagnostically relevant time (typically the time of specimen collection)
    DiagnosticReport.effective[x].effectiveDateTime dateTime This target must be supported.
    DiagnosticReport.effective[x].effectivePeriod Period
    DiagnosticReport.issued This element must be supported. C 0..1 instant When the report was released
    DiagnosticReport.performer This element must be supported. 0..* Reference(US Core Practitioner Profile This type must be supported. | US Core Organization Profile | US Core CareTeam Profile | US Core PractitionerRole Profile) Responsible Diagnostic Service
    DiagnosticReport.resultsInterpreter This element must be supported. 0..* Reference(US Core Practitioner Profile This type must be supported. | US Core Organization Profile | PractitionerRole | US Core CareTeam Profile) Who analyzed and reported the conclusions and interpretations
    DiagnosticReport.result This element must be supported. 0..* Reference(US Core Laboratory Result Observation Profile) Observations

    doco Documentation for this format

    Terminology Bindings (Differential)

    Path Status Usage ValueSet Version Source
    DiagnosticReport.status Base required DiagnosticReportStatus 📦4.0.1 FHIR Std.
    DiagnosticReport.code Base extensible US Core Laboratory Test Codes 📦10.0.0-ballot This IG

    Constraints

    Id Grade Path(s) Description Expression
    us-core-8 error DiagnosticReport effective[x] SHALL be present if the status is 'partial', 'preliminary', 'final', 'amended', 'corrected' or 'appended' (status='partial' or status='preliminary' or status='final' or status='amended' or status='corrected' or status='appended' ) implies effective.exists()
    us-core-9 error DiagnosticReport issued SHALL be present if the status is 'partial', 'preliminary', 'final', 'amended', 'corrected' or 'appended' (status='partial' or status='preliminary' or status='final' or status='amended' or status='corrected' or status='appended' ) implies issued.exists()

    Snapshot View

    NameFlagsCard.TypeDescription & Constraints    Filter: doco
    DiagnosticReport C 0..* DiagnosticReport A Diagnostic report - a combination of request information, atomic results, images, interpretation, as well as formatted reports
    Constraints: us-core-8, us-core-9
    DiagnosticReport.id This element is included in summaries. 0..1 id Logical id of this artifact
    DiagnosticReport.meta This element must be supported. This element is included in summaries. 0..1 Meta Metadata about the resource
    DiagnosticReport.meta.id 0..1 string Unique id for inter-element referencing
    DiagnosticReport.meta.extension 0..* Extension Additional content defined by implementations
    Slice: Unordered, Open by value:url
    DiagnosticReport.meta.versionId This element is included in summaries. 0..1 id Version specific identifier
    DiagnosticReport.meta.lastUpdated This element must be supported. This element is included in summaries. 0..1 instant When the resource last changed
    DiagnosticReport.meta.source This element is included in summaries. 0..1 uri Identifies where the resource comes from
    DiagnosticReport.meta.profile This element is included in summaries. 0..* canonical(StructureDefinition) Profiles this resource claims to conform to
    DiagnosticReport.meta.security This element is included in summaries. 0..* Coding Security Labels applied to this resource
    Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
    DiagnosticReport.meta.tag This element is included in summaries. 0..* Coding Tags applied to this resource
    Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".
    DiagnosticReport.implicitRules This element is a modifier element. This element is included in summaries. 0..1 uri A set of rules under which this content was created
    DiagnosticReport.language 0..1 code Language of the resource content
    Binding: CommonLanguages (preferred): A human language.
    Additional BindingsPurpose
    AllLanguages Max Binding
    DiagnosticReport.text 0..1 Narrative Text summary of the resource, for human interpretation
    This profile does not constrain the narrative in regard to content, language, or traceability to data elements
    DiagnosticReport.contained 0..* Resource Contained, inline Resources
    DiagnosticReport.extension 0..* Extension Additional content defined by implementations
    DiagnosticReport.modifierExtension This element is a modifier element. 0..* Extension Extensions that cannot be ignored
    DiagnosticReport.identifier This element is included in summaries. 0..* Identifier Business identifier for report
    DiagnosticReport.basedOn 0..* Reference(CarePlan | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest) What was requested
    DiagnosticReport.status This element is a modifier element. This element must be supported. This element is included in summaries. C 1..1 code registered | partial | preliminary | final +
    Binding: DiagnosticReportStatus (required)
    DiagnosticReport.Slices for category This element must be supported. This element is included in summaries. 1..* CodeableConcept Service category
    Slice: Unordered, Open by value:$this
    Binding: DiagnosticServiceSectionCodes (example): Codes for diagnostic service sections.

    Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them
    DiagnosticReport.Slices for category.category:LaboratorySlice This element must be supported. This element is included in summaries. 1..1 CodeableConcept Service category
    Binding: DiagnosticServiceSectionCodes (example): Codes for diagnostic service sections.

    Required Pattern: 
    {
  "coding" : [
    {
      "system" : "http://terminology.hl7.org/CodeSystem/v2-0074",
      "code" : "LAB"
    }
  ]
}
    DiagnosticReport.code This element must be supported. This element is included in summaries. 1..1 CodeableConcept US Core Laboratory Report Order Code
    Binding: US Core Laboratory Test Codes (extensible): LOINC codes
    DiagnosticReport.subject This element must be supported. This element is included in summaries. 1..1 Reference(US Core Patient Profile This type must be supported. | Group | US Core Device Profile | US Core Location Profile) The subject of the report - usually, but not always, the patient
    DiagnosticReport.encounter This element must be supported. This element is included in summaries. 0..1 Reference(US Core Encounter Profile) Encounter associated with DiagnosticReport
    DiagnosticReport.effective[x] This element must be supported. This element is included in summaries. C 0..1 Diagnostically relevant time (typically the time of specimen collection)
    DiagnosticReport.effective[x].effectiveDateTime dateTime This target must be supported.
    DiagnosticReport.effective[x].effectivePeriod Period
    DiagnosticReport.issued This element must be supported. This element is included in summaries. C 0..1 instant When the report was released
    DiagnosticReport.performer This element must be supported. This element is included in summaries. 0..* Reference(US Core Practitioner Profile This type must be supported. | US Core Organization Profile | US Core CareTeam Profile | US Core PractitionerRole Profile) Responsible Diagnostic Service
    DiagnosticReport.resultsInterpreter This element must be supported. This element is included in summaries. 0..* Reference(US Core Practitioner Profile This type must be supported. | US Core Organization Profile | PractitionerRole | US Core CareTeam Profile) Who analyzed and reported the conclusions and interpretations
    DiagnosticReport.specimen 0..* Reference(Specimen) Specimens this report is based on
    DiagnosticReport.result This element must be supported. 0..* Reference(US Core Laboratory Result Observation Profile) Observations
    DiagnosticReport.imagingStudy 0..* Reference(ImagingStudy) Reference to full details of imaging associated with the diagnostic report
    DiagnosticReport.media This element is included in summaries. 0..* BackboneElement Key images associated with this report
    DiagnosticReport.media.id 0..1 string Unique id for inter-element referencing
    DiagnosticReport.media.extension 0..* Extension Additional content defined by implementations
    DiagnosticReport.media.modifierExtension This element is a modifier element. This element is included in summaries. 0..* Extension Extensions that cannot be ignored even if unrecognized
    DiagnosticReport.media.comment 0..1 string Comment about the image (e.g. explanation)
    DiagnosticReport.media.link This element is included in summaries. 1..1 Reference(Media) Reference to the image source
    DiagnosticReport.conclusion 0..1 string Clinical conclusion (interpretation) of test results
    DiagnosticReport.conclusionCode 0..* CodeableConcept Codes for the clinical conclusion of test results
    Binding: SNOMEDCTClinicalFindings (example): Diagnosis codes provided as adjuncts to the report.
    DiagnosticReport.presentedForm 0..* Attachment Entire report as issued

    doco Documentation for this format

    Terminology Bindings

    Path Status Usage ValueSet Version Source
    DiagnosticReport.meta.​security Base extensible SecurityLabels 📍4.0.1 FHIR Std.
    DiagnosticReport.meta.​tag Base example Common Tags 📍4.0.1 FHIR Std.
    DiagnosticReport.language Base preferred Common Languages 📍4.0.1 FHIR Std.
    DiagnosticReport.status Base required DiagnosticReportStatus 📦4.0.1 FHIR Std.
    DiagnosticReport.category Base example Diagnostic Service Section Codes 📍4.0.1 FHIR Std.
    DiagnosticReport.category:LaboratorySlice Base example Diagnostic Service Section Codes 📍4.0.1 FHIR Std.
    DiagnosticReport.code Base extensible US Core Laboratory Test Codes 📦10.0.0-ballot This IG
    DiagnosticReport.conclusionCode Base example SNOMED CT Clinical Findings 📍4.0.1 FHIR Std.

    Constraints

    Id Grade Path(s) Description Expression
    us-core-8 error DiagnosticReport effective[x] SHALL be present if the status is 'partial', 'preliminary', 'final', 'amended', 'corrected' or 'appended' (status='partial' or status='preliminary' or status='final' or status='amended' or status='corrected' or status='appended' ) implies effective.exists()
    us-core-9 error DiagnosticReport issued SHALL be present if the status is 'partial', 'preliminary', 'final', 'amended', 'corrected' or 'appended' (status='partial' or status='preliminary' or status='final' or status='amended' or status='corrected' or status='appended' ) implies issued.exists()

     

    Other representations of profile: CSV, Excel, Schematron

    Notes:

    Quick Start

    Below is an overview of the required Server RESTful FHIR interactions for this profile - for example, search and read operations - when supporting the US Core interactions to access this profile's information (Profile Support + Interaction Support). Note that systems that support only US Core Profiles (Profile Only Support) are not required to support these interactions. See the US Core Server CapabilityStatement for a complete list of supported RESTful interactions for this IG.

    • See the Scopes Format section for a description of the SMART scopes syntax.
    • See the Search Syntax section for a description of the US Core search syntax.
    • See the General Requirements section for additional rules and expectations when a Server requires status parameters.
    • See the General Guidance section for additional guidance on searching for multiple patients.

    US Core Scopes

    Servers providing access to laboratory data SHALL support these US Core SMART Scopes:

    Mandatory Search Parameters:

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

    1. SHALL support searching for all diagnosticreports for a patient using the patient search parameter

      GET [base]/DiagnosticReport?patient={Patient/}[id]

      Example:

      1. GET [base]/DiagnosticReport?patient=Patient/1137192

      Implementation Notes: Fetches a bundle of all US Core DiagnosticReport Profile for Laboratory Results Reporting resources for the specified patient ( see how to search by reference).

    2. SHALL support searching for all Observations using the combination of the patient and category search parameters

      GET [base]/DiagnosticReport?patient={Patient/}[id]&category={system|}[search_code]

      Example:

      1. GET [base]/DiagnosticReport?patient=Patient/1137192&category=http://terminology.hl7.org/CodeSystem/v2-0074|LAB

      Implementation Notes: Fetches a bundle of all US Core DiagnosticReport Profile for Laboratory Results Reporting resources for the specified patient and a category code = "LAB" ( see how to search by reference and how to search by token).

    3. SHALL support searching for all Observations by code using the combination of the patient and code search parameters

      • Including optional support OR search on code (e.g.code={system|}[code],{system|}[code],...)

      GET [base]/DiagnosticReport?patient={Patient/}[id]&code={system|}[search_code]{,{system|}[code],...}

      Example:

      1. GET [base]/DiagnosticReport?patient=Patient/1137192&code=http://loinc.org|24323-8

      Implementation Notes: Fetches a bundle of all US Core DiagnosticReport Profile for Laboratory Results Reporting resources for the specified patient and report code(s). SHOULD support search by multiple report codes. ( see how to search by reference and how to search by token).

    4. SHALL support searching for all Observations by date using the combination of the patient and category and date search parameters

      • Including optional support for AND search on date (e.g.date=[date]&date=[date]&...)

      • Including support for these date comparators: "gt", "lt", "ge", "le"

      GET [base]/DiagnosticReport?patient={Patient/}[id]&category={system|}[search_code]&date={gt|lt|ge|le}[dateTime]{&date={gt|lt|ge|le}[dateTime]&...}

      Example:

      1. GET [base]/DiagnosticReport?patient=Patient/1137192&category=http://terminology.hl7.org/CodeSystem/v2-0074|LAB&date=ge2010-01-14T00:00:00Z

      Implementation Notes: Fetches a bundle of all US Core DiagnosticReport Profile for Laboratory Results Reporting resources for the specified patient and date and a category code = "LAB" ( see how to search by reference and how to search by token and how to search by date).

    Optional Search Parameters:

    The following search parameters and search parameter combinations SHOULD be supported

    1. SHOULD support searching for all reports for a patient by a business identifier using the combination of the patient and identifier search parameters

      GET [base]/DiagnosticReport?patient={Patient/}[id]&identifier={system|}[search_code]

      Example:

      1. GET [base]/DiagnosticReport?patient=Patient/1137192&identifier=http://example.org/radiology/accession|A20190203001

      Implementation Notes: Fetches a bundle of all US Core DiagnosticReport Profile for Laboratory Results Reporting resources for the specified patient and identifier. This allows a known accession or business identifier to be used to locate the corresponding report. ( see how to search by reference and how to search by token).

    2. SHOULD support searching for all Observations for a patient for a given status (for example completed reports ) using the combination of the patient and status search parameters

      • Including support OR search on status (e.g.status={system|}[code],{system|}[code],...)

      GET [base]/DiagnosticReport?patient={Patient/}[id]&status={system|}[search_code]{,{system|}[code],...}

      Example:

      1. GET [base]/DiagnosticReport?patient=Patient/1137192&status=completed

      Implementation Notes: Fetches a bundle of all US Core DiagnosticReport Profile for Laboratory Results Reporting resources for the specified patient and status ( see how to search by reference and how to search by token).

    3. SHOULD support searching using the combination of the patient and category and _lastUpdated search parameters

      • Including optional support for AND search on _lastUpdated (e.g._lastUpdated=[date]&_lastUpdated=[date]&...)

      • Including support for these _lastUpdated comparators: "gt", "lt", "ge", "le"

      GET [base]/DiagnosticReport?patient={Patient/}[id]&category={system|}[search_code]&_lastUpdated=[dateTime]

      Example:

      1. GET [base]/DiagnosticReport?patient=Patient/1137192&category=http://terminology.hl7.org/CodeSystem/v2-0074|LAB&_lastUpdated=ge2010-01-14T00:00:00Z

      Implementation Notes: Fetches a bundle of all US Core DiagnosticReport Profile for Laboratory Results Reporting resources for the specified patient and category = "LAB" and _lastUpdated. See the US Core General Guidance page for Searching Using lastUpdated. ( see how to search by reference and how to search by token and how to search by date).

    4. SHOULD support searching for Observations by code and date using the combination of the patient and code and date search parameters

      • Including optional support OR search on code (e.g.code={system|}[code],{system|}[code],...)

      • Including optional support for AND search on date (e.g.date=[date]&date=[date]&...)

      • Including support for these date comparators: "gt", "lt", "ge", "le"

      GET [base]/DiagnosticReport?patient={Patient/}[id]&code={system|}[search_code]{,{system|}[code],...}&date={gt|lt|ge|le}[dateTime]{&date={gt|lt|ge|le}[dateTime]&...}

      Example:

      1. GET [base]/DiagnosticReport?patient=Patient/1137192&code=http://loinc.org|24323-8&date=ge2019-01-14T00:00:00Z

      Implementation Notes: Fetches a bundle of all US Core DiagnosticReport Profile for Laboratory Results Reporting resources for the specified patient and date and report code(s). SHOULD support search by multiple report codes. ( see how to search by reference and how to search by token and how to search by date).