Argo CGM Write
0.1.0 - ci-build International flag

Argo CGM Write, published by Argonaut. This guide is not an authorized publication; it is the continuous build for version 0.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/cgm/ and changes regularly. See the Directory of published versions

Resource Profile: CGMSummaryPDF - Detailed Descriptions

Draft as of 2024-11-04

Definitions for the cgm-summary-pdf resource profile.

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

0. DiagnosticReport
Complies with ProfileThis profile compiles with the profile
2. DiagnosticReport.category
Control1..?
SlicingThis element introduces a set of slices on DiagnosticReport.category. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • value @ $this
  • 4. DiagnosticReport.category:labCategory
    Slice NamelabCategory
    ShortLab category
    Control1..1
    Must Supporttrue
    Pattern Value{
      "coding" : [{
        "system" : "http://terminology.hl7.org/CodeSystem/v2-0074",
        "code" : "LAB"
      }]
    }
    6. DiagnosticReport.code
    ShortCode for CGM Summary report
    Pattern Value{
      "coding" : [{
        "system" : "http://hl7.org/uv/cgm/CodeSystem/cgm-summary-codes-temporary",
        "code" : "cgm-summary"
      }]
    }
    8. DiagnosticReport.subject
    ShortPatient for the report
    Control1..?
    Must Supporttrue
    10. DiagnosticReport.effective[x]
    Control1..?
    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
    SlicingThis element introduces a set of slices on DiagnosticReport.effective[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
    • type @ $this
    • 12. DiagnosticReport.effective[x]:effectivePeriod
      Slice NameeffectivePeriod
      Control1..1
      TypePeriod
      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
      Must Supporttrue
      14. DiagnosticReport.effective[x]:effectivePeriod.start
      ShortStart date of the reporting period (YYYY-MM-DD)
      Control1..?
      Must Supporttrue
      16. DiagnosticReport.effective[x]:effectivePeriod.end
      ShortEnd date of the reporting period (YYYY-MM-DD)
      Control1..?
      Must Supporttrue
      18. DiagnosticReport.result
      ShortCGM Summary observation
      SlicingThis element introduces a set of slices on DiagnosticReport.result. The slices areUnordered and Open, and can be differentiated using the following discriminators:
      • value @ resolve().code
      • 20. DiagnosticReport.result:cgmSummary
        Slice NamecgmSummary
        ShortCGM Summary observation
        Control0..*
        TypeReference(CGM Summary Observation)
        Must Supporttrue
        22. DiagnosticReport.presentedForm
        ShortCGM Summary PDF report
        Control1..?
        SlicingThis element introduces a set of slices on DiagnosticReport.presentedForm. The slices areUnordered and Open, and can be differentiated using the following discriminators:
        • value @ contentType
        • 24. DiagnosticReport.presentedForm:cgmSummaryPDF
          Slice NamecgmSummaryPDF
          Control1..*
          Must Supporttrue
          26. DiagnosticReport.presentedForm:cgmSummaryPDF.contentType
          ShortPDF content type
          Control1..?
          Pattern Valueapplication/pdf
          28. DiagnosticReport.presentedForm:cgmSummaryPDF.data
          ShortBase64-encoded PDF report data
          Control1..?
          Must Supporttrue

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

          0. DiagnosticReport
          Definition

          The findings and interpretation of diagnostic tests performed on patients, groups of patients, devices, and locations, and/or specimens derived from these. The report includes clinical context such as requesting and provider information, and some mix of atomic results, images, textual and coded interpretations, and formatted representation of diagnostic reports.

          ShortA Diagnostic report - a combination of request information, atomic results, images, interpretation, as well as formatted reports
          Comments

          This is intended to capture a single report and is not suitable for use in displaying summary information that covers multiple reports. For example, this resource has not been designed for laboratory cumulative reporting formats nor detailed structured reports for sequencing.

          Control0..*
          Is Modifierfalse
          Complies with ProfileThis profile compiles with the profile
          Summaryfalse
          Alternate NamesReport, Test, Result, Results, Labs, Laboratory
          Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
          dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
          dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
          dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
          dom-6: A resource should have narrative for robust management (text.`div`.exists())
          2. DiagnosticReport.implicitRules
          Definition

          A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

          ShortA set of rules under which this content was created
          Comments

          Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

          Control0..1
          Typeuri
          Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          4. DiagnosticReport.modifierExtension
          Definition

          May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

          Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

          ShortExtensions that cannot be ignored
          Comments

          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

          Control0..*
          TypeExtension
          Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
          Summaryfalse
          Requirements

          Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

          Alternate Namesextensions, user content
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          6. DiagnosticReport.status
          Definition

          The status of the diagnostic report.

          Shortregistered | partial | preliminary | final +
          Control1..1
          BindingThe codes SHALL be taken from DiagnosticReportStatushttp://hl7.org/fhir/ValueSet/diagnostic-report-status|4.0.1
          (required to http://hl7.org/fhir/ValueSet/diagnostic-report-status|4.0.1)

          The status of the diagnostic report.

          Typecode
          Is Modifiertrue because This element is labeled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Requirements

          Diagnostic services routinely issue provisional/incomplete reports, and sometimes withdraw previously released reports.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          8. DiagnosticReport.category
          Definition

          A code that classifies the clinical discipline, department or diagnostic service that created the report (e.g. cardiology, biochemistry, hematology, MRI). This is used for searching, sorting and display purposes.

          ShortService category
          Comments

          Multiple categories are allowed using various categorization schemes. The level of granularity is defined by the category concepts in the value set. More fine-grained filtering can be performed using the metadata and/or terminology hierarchy in DiagnosticReport.code.

          Control10..*
          BindingFor example codes, see DiagnosticServiceSectionCodeshttp://hl7.org/fhir/ValueSet/diagnostic-service-sections
          (example to http://hl7.org/fhir/ValueSet/diagnostic-service-sections)

          Codes for diagnostic service sections.

          TypeCodeableConcept
          Is Modifierfalse
          Summarytrue
          Alternate NamesDepartment, Sub-department, Service, Discipline
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          SlicingThis element introduces a set of slices on DiagnosticReport.category. The slices areUnordered and Open, and can be differentiated using the following discriminators:
          • value @ $this
          • 10. DiagnosticReport.category:labCategory
            Slice NamelabCategory
            Definition

            A code that classifies the clinical discipline, department or diagnostic service that created the report (e.g. cardiology, biochemistry, hematology, MRI). This is used for searching, sorting and display purposes.

            ShortLab categoryService category
            Comments

            Multiple categories are allowed using various categorization schemes. The level of granularity is defined by the category concepts in the value set. More fine-grained filtering can be performed using the metadata and/or terminology hierarchy in DiagnosticReport.code.

            Control10..1*
            BindingFor example codes, see DiagnosticServiceSectionCodeshttp://hl7.org/fhir/ValueSet/diagnostic-service-sections
            (example to http://hl7.org/fhir/ValueSet/diagnostic-service-sections)

            Codes for diagnostic service sections.

            TypeCodeableConcept
            Is Modifierfalse
            Must Supporttrue
            Summarytrue
            Alternate NamesDepartment, Sub-department, Service, Discipline
            Pattern Value{
              "coding" : [{
                "system" : "http://terminology.hl7.org/CodeSystem/v2-0074",
                "code" : "LAB"
              }]
            }
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            12. DiagnosticReport.code
            Definition

            A code or name that describes this diagnostic report.

            ShortCode for CGM Summary reportName/Code for this diagnostic report
            Control1..1
            BindingThe codes SHOULD be taken from LOINCDiagnosticReportCodeshttp://hl7.org/fhir/ValueSet/report-codes
            (preferred to http://hl7.org/fhir/ValueSet/report-codes)

            Codes that describe Diagnostic Reports.

            TypeCodeableConcept
            Is Modifierfalse
            Summarytrue
            Alternate NamesType
            Pattern Value{
              "coding" : [{
                "system" : "http://hl7.org/uv/cgm/CodeSystem/cgm-summary-codes-temporary",
                "code" : "cgm-summary"
              }]
            }
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            14. DiagnosticReport.subject
            Definition

            The subject of the report. Usually, but not always, this is a patient. However, diagnostic services also perform analyses on specimens collected from a variety of other sources.

            ShortPatient for the reportThe subject of the report - usually, but not always, the patient
            Control10..1
            TypeReference(Patient, Group, Device, Location)
            Is Modifierfalse
            Must Supporttrue
            Must Support TypesNo must-support rules about the choice of types/profiles
            Summarytrue
            Requirements

            SHALL know the subject context.

            Alternate NamesPatient
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            16. DiagnosticReport.effective[x]
            Definition

            The time or time-period the observed values are related to. When the subject of the report is a patient, this is usually either the time of the procedure or of specimen collection(s), but very often the source of the date/time is not known, only the date/time itself.

            ShortClinically relevant time/time-period for report
            Comments

            If the diagnostic procedure was performed on the patient, this is the time it was performed. If there are specimens, the diagnostically relevant time can be derived from the specimen collection times, but the specimen information is not always available, and the exact relationship between the specimens and the diagnostically relevant time is not always automatic.

            Control10..1
            TypePeriod, dateTime
            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
            Is Modifierfalse
            Summarytrue
            Requirements

            Need to know where in the patient history to file/present this report.

            Alternate NamesObservation time, Effective Time, Occurrence
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            SlicingThis element introduces a set of slices on DiagnosticReport.effective[x]. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
            • type @ $this
            • 18. DiagnosticReport.effective[x]:effectivePeriod
              Slice NameeffectivePeriod
              Definition

              The time or time-period the observed values are related to. When the subject of the report is a patient, this is usually either the time of the procedure or of specimen collection(s), but very often the source of the date/time is not known, only the date/time itself.

              ShortClinically relevant time/time-period for report
              Comments

              If the diagnostic procedure was performed on the patient, this is the time it was performed. If there are specimens, the diagnostically relevant time can be derived from the specimen collection times, but the specimen information is not always available, and the exact relationship between the specimens and the diagnostically relevant time is not always automatic.

              Control10..1
              TypePeriod, dateTime
              [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
              Is Modifierfalse
              Must Supporttrue
              Summarytrue
              Requirements

              Need to know where in the patient history to file/present this report.

              Alternate NamesObservation time, Effective Time, Occurrence
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              20. DiagnosticReport.effective[x]:effectivePeriod.start
              Definition

              The start of the period. The boundary is inclusive.

              ShortStart date of the reporting period (YYYY-MM-DD)Starting time with inclusive boundary
              Comments

              If the low element is missing, the meaning is that the low boundary is not known.

              Control10..1
              This element is affected by the following invariants: per-1
              TypedateTime
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Must Supporttrue
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              22. DiagnosticReport.effective[x]:effectivePeriod.end
              Definition

              The end of the period. If the end of the period is missing, it means no end was known or planned at the time the instance was created. The start may be in the past, and the end date in the future, which means that period is expected/planned to end at that time.

              ShortEnd date of the reporting period (YYYY-MM-DD)End time with inclusive boundary, if not ongoing
              Comments

              The high value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has an end value of 2012-02-03.

              Control10..1
              This element is affected by the following invariants: per-1
              TypedateTime
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Must Supporttrue
              Summarytrue
              Meaning if MissingIf the end of the period is missing, it means that the period is ongoing
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              24. DiagnosticReport.result
              Definition

              Observations that are part of this diagnostic report.

              ShortCGM Summary observationObservations
              Comments

              Observations can contain observations.

              Control0..*
              TypeReference(Observation)
              Is Modifierfalse
              Summaryfalse
              Requirements

              Need to support individual results, or groups of results, where the result grouping is arbitrary, but meaningful.

              Alternate NamesData, Atomic Value, Result, Atomic result, Data, Test, Analyte, Battery, Organizer
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              SlicingThis element introduces a set of slices on DiagnosticReport.result. The slices areUnordered and Open, and can be differentiated using the following discriminators:
              • value @ resolve().code
              • 26. DiagnosticReport.result:cgmSummary
                Slice NamecgmSummary
                Definition

                Observations that are part of this diagnostic report.

                ShortCGM Summary observationObservations
                Comments

                Observations can contain observations.

                Control0..*
                TypeReference(CGM Summary Observation, Observation)
                Is Modifierfalse
                Must Supporttrue
                Summaryfalse
                Requirements

                Need to support individual results, or groups of results, where the result grouping is arbitrary, but meaningful.

                Alternate NamesData, Atomic Value, Result, Atomic result, Data, Test, Analyte, Battery, Organizer
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                28. DiagnosticReport.presentedForm
                Definition

                Rich text representation of the entire result as issued by the diagnostic service. Multiple formats are allowed but they SHALL be semantically equivalent.

                ShortCGM Summary PDF reportEntire report as issued
                Comments

                "application/pdf" is recommended as the most reliable and interoperable in this context.

                Control10..*
                TypeAttachment
                Is Modifierfalse
                Summaryfalse
                Requirements

                Gives laboratory the ability to provide its own fully formatted report for clinical fidelity.

                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                SlicingThis element introduces a set of slices on DiagnosticReport.presentedForm. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                • value @ contentType
                • 30. DiagnosticReport.presentedForm:cgmSummaryPDF
                  Slice NamecgmSummaryPDF
                  Definition

                  Rich text representation of the entire result as issued by the diagnostic service. Multiple formats are allowed but they SHALL be semantically equivalent.

                  ShortEntire report as issued
                  Comments

                  "application/pdf" is recommended as the most reliable and interoperable in this context.

                  Control10..*
                  TypeAttachment
                  Is Modifierfalse
                  Must Supporttrue
                  Summaryfalse
                  Requirements

                  Gives laboratory the ability to provide its own fully formatted report for clinical fidelity.

                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  32. DiagnosticReport.presentedForm:cgmSummaryPDF.contentType
                  Definition

                  Identifies the type of the data in the attachment and allows a method to be chosen to interpret or render the data. Includes mime type parameters such as charset where appropriate.

                  ShortPDF content typeMime type of the content, with charset etc.
                  Control10..1
                  BindingThe codes SHALL be taken from Mime Typeshttp://hl7.org/fhir/ValueSet/mimetypes|4.0.1
                  (required to http://hl7.org/fhir/ValueSet/mimetypes|4.0.1)

                  The mime type of an attachment. Any valid mime type is allowed.

                  Typecode
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Summarytrue
                  Requirements

                  Processors of the data need to be able to know how to interpret the data.

                  Pattern Valueapplication/pdf
                  Example<br/><b>General</b>:text/plain; charset=UTF-8, image/png
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  34. DiagnosticReport.presentedForm:cgmSummaryPDF.data
                  Definition

                  The actual data of the attachment - a sequence of bytes, base64 encoded.

                  ShortBase64-encoded PDF report dataData inline, base64ed
                  Comments

                  The base64-encoded data SHALL be expressed in the same character set as the base resource XML or JSON.

                  Control10..1
                  Typebase64Binary
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Must Supporttrue
                  Summaryfalse
                  Requirements

                  The data needs to able to be transmitted inline.

                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

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

                  0. DiagnosticReport
                  Definition

                  The findings and interpretation of diagnostic tests performed on patients, groups of patients, devices, and locations, and/or specimens derived from these. The report includes clinical context such as requesting and provider information, and some mix of atomic results, images, textual and coded interpretations, and formatted representation of diagnostic reports.

                  ShortA Diagnostic report - a combination of request information, atomic results, images, interpretation, as well as formatted reports
                  Comments

                  This is intended to capture a single report and is not suitable for use in displaying summary information that covers multiple reports. For example, this resource has not been designed for laboratory cumulative reporting formats nor detailed structured reports for sequencing.

                  Control0..*
                  Is Modifierfalse
                  Complies with ProfileThis profile compiles with the profile
                  Summaryfalse
                  Alternate NamesReport, Test, Result, Results, Labs, Laboratory
                  Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
                  dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
                  dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
                  dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
                  dom-6: A resource should have narrative for robust management (text.`div`.exists())
                  2. DiagnosticReport.id
                  Definition

                  The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

                  ShortLogical id of this artifact
                  Comments

                  The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

                  Control0..1
                  Typeid
                  Is Modifierfalse
                  Summarytrue
                  4. DiagnosticReport.meta
                  Definition

                  The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.

                  ShortMetadata about the resource
                  Control0..1
                  TypeMeta
                  Is Modifierfalse
                  Summarytrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  6. DiagnosticReport.implicitRules
                  Definition

                  A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

                  ShortA set of rules under which this content was created
                  Comments

                  Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

                  Control0..1
                  Typeuri
                  Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Summarytrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  8. DiagnosticReport.language
                  Definition

                  The base language in which the resource is written.

                  ShortLanguage of the resource content
                  Comments

                  Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).

                  Control0..1
                  BindingThe codes SHOULD be taken from CommonLanguages
                  (preferred to http://hl7.org/fhir/ValueSet/languages)

                  A human language.

                  Additional BindingsPurpose
                  AllLanguagesMax Binding
                  Typecode
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Summaryfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  10. DiagnosticReport.text
                  Definition

                  A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.

                  ShortText summary of the resource, for human interpretation
                  Comments

                  Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.

                  Control0..1
                  TypeNarrative
                  Is Modifierfalse
                  Summaryfalse
                  Alternate Namesnarrative, html, xhtml, display
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  12. DiagnosticReport.contained
                  Definition

                  These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.

                  ShortContained, inline Resources
                  Comments

                  This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.

                  Control0..*
                  TypeResource
                  Is Modifierfalse
                  Summaryfalse
                  Alternate Namesinline resources, anonymous resources, contained resources
                  14. DiagnosticReport.extension
                  Definition

                  May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                  ShortAdditional content defined by implementations
                  Comments

                  There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                  Control0..*
                  TypeExtension
                  Is Modifierfalse
                  Summaryfalse
                  Alternate Namesextensions, user content
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                  16. DiagnosticReport.modifierExtension
                  Definition

                  May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                  Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                  ShortExtensions that cannot be ignored
                  Comments

                  There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                  Control0..*
                  TypeExtension
                  Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
                  Summaryfalse
                  Requirements

                  Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                  Alternate Namesextensions, user content
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                  18. DiagnosticReport.identifier
                  Definition

                  Identifiers assigned to this report by the performer or other systems.

                  ShortBusiness identifier for report
                  Comments

                  Usually assigned by the Information System of the diagnostic service provider (filler id).

                  NoteThis is a business identifier, not a resource identifier (see discussion)
                  Control0..*
                  TypeIdentifier
                  Is Modifierfalse
                  Summarytrue
                  Requirements

                  Need to know what identifier to use when making queries about this report from the source laboratory, and for linking to the report outside FHIR context.

                  Alternate NamesReportID, Filler ID, Placer ID
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  20. DiagnosticReport.basedOn
                  Definition

                  Details concerning a service requested.

                  ShortWhat was requested
                  Comments

                  Note: Usually there is one test request for each result, however in some circumstances multiple test requests may be represented using a single test result resource. Note that there are also cases where one request leads to multiple reports.

                  Control0..*
                  TypeReference(CarePlan, ImmunizationRecommendation, MedicationRequest, NutritionOrder, ServiceRequest)
                  Is Modifierfalse
                  Summaryfalse
                  Requirements

                  This allows tracing of authorization for the report and tracking whether proposals/recommendations were acted upon.

                  Alternate NamesRequest
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  22. DiagnosticReport.status
                  Definition

                  The status of the diagnostic report.

                  Shortregistered | partial | preliminary | final +
                  Control1..1
                  BindingThe codes SHALL be taken from DiagnosticReportStatus
                  (required to http://hl7.org/fhir/ValueSet/diagnostic-report-status|4.0.1)

                  The status of the diagnostic report.

                  Typecode
                  Is Modifiertrue because This element is labeled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Summarytrue
                  Requirements

                  Diagnostic services routinely issue provisional/incomplete reports, and sometimes withdraw previously released reports.

                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  24. DiagnosticReport.category
                  Definition

                  A code that classifies the clinical discipline, department or diagnostic service that created the report (e.g. cardiology, biochemistry, hematology, MRI). This is used for searching, sorting and display purposes.

                  ShortService category
                  Comments

                  Multiple categories are allowed using various categorization schemes. The level of granularity is defined by the category concepts in the value set. More fine-grained filtering can be performed using the metadata and/or terminology hierarchy in DiagnosticReport.code.

                  Control1..*
                  BindingFor example codes, see DiagnosticServiceSectionCodes
                  (example to http://hl7.org/fhir/ValueSet/diagnostic-service-sections)

                  Codes for diagnostic service sections.

                  TypeCodeableConcept
                  Is Modifierfalse
                  Summarytrue
                  Alternate NamesDepartment, Sub-department, Service, Discipline
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  SlicingThis element introduces a set of slices on DiagnosticReport.category. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                  • value @ $this
                  • 26. DiagnosticReport.category:labCategory
                    Slice NamelabCategory
                    Definition

                    A code that classifies the clinical discipline, department or diagnostic service that created the report (e.g. cardiology, biochemistry, hematology, MRI). This is used for searching, sorting and display purposes.

                    ShortLab category
                    Comments

                    Multiple categories are allowed using various categorization schemes. The level of granularity is defined by the category concepts in the value set. More fine-grained filtering can be performed using the metadata and/or terminology hierarchy in DiagnosticReport.code.

                    Control1..1
                    BindingFor example codes, see DiagnosticServiceSectionCodes
                    (example to http://hl7.org/fhir/ValueSet/diagnostic-service-sections)

                    Codes for diagnostic service sections.

                    TypeCodeableConcept
                    Is Modifierfalse
                    Must Supporttrue
                    Summarytrue
                    Alternate NamesDepartment, Sub-department, Service, Discipline
                    Pattern Value{
                      "coding" : [{
                        "system" : "http://terminology.hl7.org/CodeSystem/v2-0074",
                        "code" : "LAB"
                      }]
                    }
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    28. DiagnosticReport.code
                    Definition

                    A code or name that describes this diagnostic report.

                    ShortCode for CGM Summary report
                    Control1..1
                    BindingThe codes SHOULD be taken from LOINCDiagnosticReportCodes
                    (preferred to http://hl7.org/fhir/ValueSet/report-codes)

                    Codes that describe Diagnostic Reports.

                    TypeCodeableConcept
                    Is Modifierfalse
                    Summarytrue
                    Alternate NamesType
                    Pattern Value{
                      "coding" : [{
                        "system" : "http://hl7.org/uv/cgm/CodeSystem/cgm-summary-codes-temporary",
                        "code" : "cgm-summary"
                      }]
                    }
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    30. DiagnosticReport.subject
                    Definition

                    The subject of the report. Usually, but not always, this is a patient. However, diagnostic services also perform analyses on specimens collected from a variety of other sources.

                    ShortPatient for the report
                    Control1..1
                    TypeReference(Patient, Group, Device, Location)
                    Is Modifierfalse
                    Must Supporttrue
                    Must Support TypesNo must-support rules about the choice of types/profiles
                    Summarytrue
                    Requirements

                    SHALL know the subject context.

                    Alternate NamesPatient
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    32. DiagnosticReport.encounter
                    Definition

                    The healthcare event (e.g. a patient and healthcare provider interaction) which this DiagnosticReport is about.

                    ShortHealth care event when test ordered
                    Comments

                    This will typically be the encounter the event occurred within, but some events may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter (e.g. pre-admission laboratory tests).

                    Control0..1
                    TypeReference(Encounter)
                    Is Modifierfalse
                    Summarytrue
                    Requirements

                    Links the request to the Encounter context.

                    Alternate NamesContext
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    34. DiagnosticReport.effective[x]
                    Definition

                    The time or time-period the observed values are related to. When the subject of the report is a patient, this is usually either the time of the procedure or of specimen collection(s), but very often the source of the date/time is not known, only the date/time itself.

                    ShortClinically relevant time/time-period for report
                    Comments

                    If the diagnostic procedure was performed on the patient, this is the time it was performed. If there are specimens, the diagnostically relevant time can be derived from the specimen collection times, but the specimen information is not always available, and the exact relationship between the specimens and the diagnostically relevant time is not always automatic.

                    Control1..1
                    TypePeriod
                    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                    Is Modifierfalse
                    Summarytrue
                    Requirements

                    Need to know where in the patient history to file/present this report.

                    Alternate NamesObservation time, Effective Time, Occurrence
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    SlicingThis element introduces a set of slices on DiagnosticReport.effective[x]. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
                    • type @ $this
                    • 36. DiagnosticReport.effective[x]:effectivePeriod
                      Slice NameeffectivePeriod
                      Definition

                      The time or time-period the observed values are related to. When the subject of the report is a patient, this is usually either the time of the procedure or of specimen collection(s), but very often the source of the date/time is not known, only the date/time itself.

                      ShortClinically relevant time/time-period for report
                      Comments

                      If the diagnostic procedure was performed on the patient, this is the time it was performed. If there are specimens, the diagnostically relevant time can be derived from the specimen collection times, but the specimen information is not always available, and the exact relationship between the specimens and the diagnostically relevant time is not always automatic.

                      Control1..1
                      TypePeriod
                      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                      Is Modifierfalse
                      Must Supporttrue
                      Summarytrue
                      Requirements

                      Need to know where in the patient history to file/present this report.

                      Alternate NamesObservation time, Effective Time, Occurrence
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      38. DiagnosticReport.effective[x]:effectivePeriod.id
                      Definition

                      Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                      ShortUnique id for inter-element referencing
                      Control0..1
                      Typestring
                      Is Modifierfalse
                      XML FormatIn the XML format, this property is represented as an attribute.
                      Summaryfalse
                      40. DiagnosticReport.effective[x]:effectivePeriod.extension
                      Definition

                      May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                      ShortAdditional content defined by implementations
                      Comments

                      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                      Control0..*
                      TypeExtension
                      Is Modifierfalse
                      Summaryfalse
                      Alternate Namesextensions, user content
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                      SlicingThis element introduces a set of slices on DiagnosticReport.effective[x].extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                      • value @ url
                      • 42. DiagnosticReport.effective[x]:effectivePeriod.start
                        Definition

                        The start of the period. The boundary is inclusive.

                        ShortStart date of the reporting period (YYYY-MM-DD)
                        Comments

                        If the low element is missing, the meaning is that the low boundary is not known.

                        Control1..1
                        This element is affected by the following invariants: per-1
                        TypedateTime
                        Is Modifierfalse
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Must Supporttrue
                        Summarytrue
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        44. DiagnosticReport.effective[x]:effectivePeriod.end
                        Definition

                        The end of the period. If the end of the period is missing, it means no end was known or planned at the time the instance was created. The start may be in the past, and the end date in the future, which means that period is expected/planned to end at that time.

                        ShortEnd date of the reporting period (YYYY-MM-DD)
                        Comments

                        The high value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has an end value of 2012-02-03.

                        Control1..1
                        This element is affected by the following invariants: per-1
                        TypedateTime
                        Is Modifierfalse
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Must Supporttrue
                        Summarytrue
                        Meaning if MissingIf the end of the period is missing, it means that the period is ongoing
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        46. DiagnosticReport.issued
                        Definition

                        The date and time that this version of the report was made available to providers, typically after the report was reviewed and verified.

                        ShortDateTime this version was made
                        Comments

                        May be different from the update time of the resource itself, because that is the status of the record (potentially a secondary copy), not the actual release time of the report.

                        Control0..1
                        Typeinstant
                        Is Modifierfalse
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Summarytrue
                        Requirements

                        Clinicians need to be able to check the date that the report was released.

                        Alternate NamesDate published, Date Issued, Date Verified
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        48. DiagnosticReport.performer
                        Definition

                        The diagnostic service that is responsible for issuing the report.

                        ShortResponsible Diagnostic Service
                        Comments

                        This is not necessarily the source of the atomic data items or the entity that interpreted the results. It is the entity that takes responsibility for the clinical report.

                        Control0..*
                        TypeReference(Practitioner, PractitionerRole, Organization, CareTeam)
                        Is Modifierfalse
                        Summarytrue
                        Requirements

                        Need to know whom to contact if there are queries about the results. Also may need to track the source of reports for secondary data analysis.

                        Alternate NamesLaboratory, Service, Practitioner, Department, Company, Authorized by, Director
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        50. DiagnosticReport.resultsInterpreter
                        Definition

                        The practitioner or organization that is responsible for the report's conclusions and interpretations.

                        ShortPrimary result interpreter
                        Comments

                        Might not be the same entity that takes responsibility for the clinical report.

                        Control0..*
                        TypeReference(Practitioner, PractitionerRole, Organization, CareTeam)
                        Is Modifierfalse
                        Summarytrue
                        Requirements

                        Need to know whom to contact if there are queries about the results. Also may need to track the source of reports for secondary data analysis.

                        Alternate NamesAnalyzed by, Reported by
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        52. DiagnosticReport.specimen
                        Definition

                        Details about the specimens on which this diagnostic report is based.

                        ShortSpecimens this report is based on
                        Comments

                        If the specimen is sufficiently specified with a code in the test result name, then this additional data may be redundant. If there are multiple specimens, these may be represented per observation or group.

                        Control0..*
                        TypeReference(Specimen)
                        Is Modifierfalse
                        Summaryfalse
                        Requirements

                        Need to be able to report information about the collected specimens on which the report is based.

                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        54. DiagnosticReport.result
                        Definition

                        Observations that are part of this diagnostic report.

                        ShortCGM Summary observation
                        Comments

                        Observations can contain observations.

                        Control0..*
                        TypeReference(Observation)
                        Is Modifierfalse
                        Summaryfalse
                        Requirements

                        Need to support individual results, or groups of results, where the result grouping is arbitrary, but meaningful.

                        Alternate NamesData, Atomic Value, Result, Atomic result, Data, Test, Analyte, Battery, Organizer
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        SlicingThis element introduces a set of slices on DiagnosticReport.result. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                        • value @ resolve().code
                        • 56. DiagnosticReport.result:cgmSummary
                          Slice NamecgmSummary
                          Definition

                          Observations that are part of this diagnostic report.

                          ShortCGM Summary observation
                          Comments

                          Observations can contain observations.

                          Control0..*
                          TypeReference(CGM Summary Observation)
                          Is Modifierfalse
                          Must Supporttrue
                          Summaryfalse
                          Requirements

                          Need to support individual results, or groups of results, where the result grouping is arbitrary, but meaningful.

                          Alternate NamesData, Atomic Value, Result, Atomic result, Data, Test, Analyte, Battery, Organizer
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          58. DiagnosticReport.imagingStudy
                          Definition

                          One or more links to full details of any imaging performed during the diagnostic investigation. Typically, this is imaging performed by DICOM enabled modalities, but this is not required. A fully enabled PACS viewer can use this information to provide views of the source images.

                          ShortReference to full details of imaging associated with the diagnostic report
                          Comments

                          ImagingStudy and the image element are somewhat overlapping - typically, the list of image references in the image element will also be found in one of the imaging study resources. However, each caters to different types of displays for different types of purposes. Neither, either, or both may be provided.

                          Control0..*
                          TypeReference(ImagingStudy)
                          Is Modifierfalse
                          Summaryfalse
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          60. DiagnosticReport.media
                          Definition

                          A list of key images associated with this report. The images are generally created during the diagnostic process, and may be directly of the patient, or of treated specimens (i.e. slides of interest).

                          ShortKey images associated with this report
                          Control0..*
                          TypeBackboneElement
                          Is Modifierfalse
                          Summarytrue
                          Requirements

                          Many diagnostic services include images in the report as part of their service.

                          Alternate NamesDICOM, Slides, Scans
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          62. DiagnosticReport.media.id
                          Definition

                          Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                          ShortUnique id for inter-element referencing
                          Control0..1
                          Typestring
                          Is Modifierfalse
                          XML FormatIn the XML format, this property is represented as an attribute.
                          Summaryfalse
                          64. DiagnosticReport.media.extension
                          Definition

                          May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                          ShortAdditional content defined by implementations
                          Comments

                          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                          Control0..*
                          TypeExtension
                          Is Modifierfalse
                          Summaryfalse
                          Alternate Namesextensions, user content
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                          66. DiagnosticReport.media.modifierExtension
                          Definition

                          May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                          Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                          ShortExtensions that cannot be ignored even if unrecognized
                          Comments

                          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                          Control0..*
                          TypeExtension
                          Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                          Summarytrue
                          Requirements

                          Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                          Alternate Namesextensions, user content, modifiers
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                          68. DiagnosticReport.media.comment
                          Definition

                          A comment about the image. Typically, this is used to provide an explanation for why the image is included, or to draw the viewer's attention to important features.

                          ShortComment about the image (e.g. explanation)
                          Comments

                          The comment should be displayed with the image. It would be common for the report to include additional discussion of the image contents in other sections such as the conclusion.

                          Control0..1
                          Typestring
                          Is Modifierfalse
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Summaryfalse
                          Requirements

                          The provider of the report should make a comment about each image included in the report.

                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          70. DiagnosticReport.media.link
                          Definition

                          Reference to the image source.

                          ShortReference to the image source
                          Control1..1
                          TypeReference(Media)
                          Is Modifierfalse
                          Summarytrue
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          72. DiagnosticReport.conclusion
                          Definition

                          Concise and clinically contextualized summary conclusion (interpretation/impression) of the diagnostic report.

                          ShortClinical conclusion (interpretation) of test results
                          Control0..1
                          Typestring
                          Is Modifierfalse
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Summaryfalse
                          Requirements

                          Need to be able to provide a conclusion that is not lost among the basic result data.

                          Alternate NamesReport
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          74. DiagnosticReport.conclusionCode
                          Definition

                          One or more codes that represent the summary conclusion (interpretation/impression) of the diagnostic report.

                          ShortCodes for the clinical conclusion of test results
                          Control0..*
                          BindingFor example codes, see SNOMEDCTClinicalFindings
                          (example to http://hl7.org/fhir/ValueSet/clinical-findings)

                          Diagnosis codes provided as adjuncts to the report.

                          TypeCodeableConcept
                          Is Modifierfalse
                          Summaryfalse
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          76. DiagnosticReport.presentedForm
                          Definition

                          Rich text representation of the entire result as issued by the diagnostic service. Multiple formats are allowed but they SHALL be semantically equivalent.

                          ShortCGM Summary PDF report
                          Comments

                          "application/pdf" is recommended as the most reliable and interoperable in this context.

                          Control1..*
                          TypeAttachment
                          Is Modifierfalse
                          Summaryfalse
                          Requirements

                          Gives laboratory the ability to provide its own fully formatted report for clinical fidelity.

                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          SlicingThis element introduces a set of slices on DiagnosticReport.presentedForm. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                          • value @ contentType
                          • 78. DiagnosticReport.presentedForm:cgmSummaryPDF
                            Slice NamecgmSummaryPDF
                            Definition

                            Rich text representation of the entire result as issued by the diagnostic service. Multiple formats are allowed but they SHALL be semantically equivalent.

                            ShortEntire report as issued
                            Comments

                            "application/pdf" is recommended as the most reliable and interoperable in this context.

                            Control1..*
                            TypeAttachment
                            Is Modifierfalse
                            Must Supporttrue
                            Summaryfalse
                            Requirements

                            Gives laboratory the ability to provide its own fully formatted report for clinical fidelity.

                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            80. DiagnosticReport.presentedForm:cgmSummaryPDF.id
                            Definition

                            Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                            ShortUnique id for inter-element referencing
                            Control0..1
                            Typestring
                            Is Modifierfalse
                            XML FormatIn the XML format, this property is represented as an attribute.
                            Summaryfalse
                            82. DiagnosticReport.presentedForm:cgmSummaryPDF.extension
                            Definition

                            May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                            ShortAdditional content defined by implementations
                            Comments

                            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                            Control0..*
                            TypeExtension
                            Is Modifierfalse
                            Summaryfalse
                            Alternate Namesextensions, user content
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                            SlicingThis element introduces a set of slices on DiagnosticReport.presentedForm.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                            • value @ url
                            • 84. DiagnosticReport.presentedForm:cgmSummaryPDF.contentType
                              Definition

                              Identifies the type of the data in the attachment and allows a method to be chosen to interpret or render the data. Includes mime type parameters such as charset where appropriate.

                              ShortPDF content type
                              Control1..1
                              BindingThe codes SHALL be taken from Mime Types
                              (required to http://hl7.org/fhir/ValueSet/mimetypes|4.0.1)

                              The mime type of an attachment. Any valid mime type is allowed.

                              Typecode
                              Is Modifierfalse
                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                              Summarytrue
                              Requirements

                              Processors of the data need to be able to know how to interpret the data.

                              Pattern Valueapplication/pdf
                              Example<br/><b>General</b>:text/plain; charset=UTF-8, image/png
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              86. DiagnosticReport.presentedForm:cgmSummaryPDF.language
                              Definition

                              The human language of the content. The value can be any valid value according to BCP 47.

                              ShortHuman language of the content (BCP-47)
                              Control0..1
                              BindingThe codes SHOULD be taken from CommonLanguages
                              (preferred to http://hl7.org/fhir/ValueSet/languages)

                              A human language.

                              Additional BindingsPurpose
                              AllLanguagesMax Binding
                              Typecode
                              Is Modifierfalse
                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                              Summarytrue
                              Requirements

                              Users need to be able to choose between the languages in a set of attachments.

                              Example<br/><b>General</b>:en-AU
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              88. DiagnosticReport.presentedForm:cgmSummaryPDF.data
                              Definition

                              The actual data of the attachment - a sequence of bytes, base64 encoded.

                              ShortBase64-encoded PDF report data
                              Comments

                              The base64-encoded data SHALL be expressed in the same character set as the base resource XML or JSON.

                              Control1..1
                              Typebase64Binary
                              Is Modifierfalse
                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                              Must Supporttrue
                              Summaryfalse
                              Requirements

                              The data needs to able to be transmitted inline.

                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              90. DiagnosticReport.presentedForm:cgmSummaryPDF.url
                              Definition

                              A location where the data can be accessed.

                              ShortUri where the data can be found
                              Comments

                              If both data and url are provided, the url SHALL point to the same content as the data contains. Urls may be relative references or may reference transient locations such as a wrapping envelope using cid: though this has ramifications for using signatures. Relative URLs are interpreted relative to the service url, like a resource reference, rather than relative to the resource itself. If a URL is provided, it SHALL resolve to actual data.

                              Control0..1
                              Typeurl
                              Is Modifierfalse
                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                              Summarytrue
                              Requirements

                              The data needs to be transmitted by reference.

                              Example<br/><b>General</b>:http://www.acme.com/logo-small.png
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              92. DiagnosticReport.presentedForm:cgmSummaryPDF.size
                              Definition

                              The number of bytes of data that make up this attachment (before base64 encoding, if that is done).

                              ShortNumber of bytes of content (if url provided)
                              Comments

                              The number of bytes is redundant if the data is provided as a base64binary, but is useful if the data is provided as a url reference.

                              Control0..1
                              TypeunsignedInt
                              Is Modifierfalse
                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                              Summarytrue
                              Requirements

                              Representing the size allows applications to determine whether they should fetch the content automatically in advance, or refuse to fetch it at all.

                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              94. DiagnosticReport.presentedForm:cgmSummaryPDF.hash
                              Definition

                              The calculated hash of the data using SHA-1. Represented using base64.

                              ShortHash of the data (sha-1, base64ed)
                              Comments

                              The hash is calculated on the data prior to base64 encoding, if the data is based64 encoded. The hash is not intended to support digital signatures. Where protection against malicious threats a digital signature should be considered, see Provenance.signature for mechanism to protect a resource with a digital signature.

                              Control0..1
                              Typebase64Binary
                              Is Modifierfalse
                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                              Summarytrue
                              Requirements

                              Included so that applications can verify that the contents of a location have not changed due to technical failures (e.g., storage rot, transport glitch, incorrect version).

                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              96. DiagnosticReport.presentedForm:cgmSummaryPDF.title
                              Definition

                              A label or set of text to display in place of the data.

                              ShortLabel to display in place of the data
                              Control0..1
                              Typestring
                              Is Modifierfalse
                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                              Summarytrue
                              Requirements

                              Applications need a label to display to a human user in place of the actual data if the data cannot be rendered or perceived by the viewer.

                              Example<br/><b>General</b>:Official Corporate Logo
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              98. DiagnosticReport.presentedForm:cgmSummaryPDF.creation
                              Definition

                              The date that the attachment was first created.

                              ShortDate attachment was first created
                              Control0..1
                              TypedateTime
                              Is Modifierfalse
                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                              Summarytrue
                              Requirements

                              This is often tracked as an integrity issue for use of the attachment.

                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))