minimal Common Oncology Data Elements (mCODE) Implementation Guide
4.0.0 - STU4 United States of America flag

minimal Common Oncology Data Elements (mCODE) Implementation Guide, published by HL7 International / Clinical Interoperability Council. This guide is not an authorized publication; it is the continuous build for version 4.0.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/fhir-mCODE-ig/ and changes regularly. See the Directory of published versions

Resource Profile: GenomicsReport - XML Profile

Active as of 2024-11-20 Maturity Level: 1

XML representation of the mcode-genomics-report resource profile.

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<StructureDefinition xmlns="http://hl7.org/fhir">
  <id value="mcode-genomics-report"/>
  <text>
    <status value="extensions"/>
    <div xmlns="http://www.w3.org/1999/xhtml"><p class="res-header-id"><b>Generated Narrative: StructureDefinition mcode-genomics-report</b></p><a name="mcode-genomics-report"> </a><a name="hcmcode-genomics-report"> </a><a name="mcode-genomics-report-en-US"> </a><table border="0" cellpadding="0" cellspacing="0" style="border: 0px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top;"><tr style="border: 1px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top"><th style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="The logical name of the element">Name</a></th><th style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="Information about the use of the element">Flags</a></th><th style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="Minimum and Maximum # of times the element can appear in the instance">Card.</a></th><th style="width: 100px" class="hierarchy"><a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="Reference to the type of the element">Type</a></th><th style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="Additional information about the element">Description &amp; Constraints</a><span style="float: right"><a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="Legend for this format"><img src="data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAQCAYAAAAf8/9hAAAABmJLR0QA/wD/AP+gvaeTAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB3RJTUUH3goXBCwdPqAP0wAAAldJREFUOMuNk0tIlFEYhp9z/vE2jHkhxXA0zJCMitrUQlq4lnSltEqCFhFG2MJFhIvIFpkEWaTQqjaWZRkp0g26URZkTpbaaOJkDqk10szoODP//7XIMUe0elcfnPd9zsfLOYplGrpRwZaqTtw3K7PtGem7Q6FoidbGgqHVy/HRb669R+56zx7eRV1L31JGxYbBtjKK93cxeqfyQHbehkZbUkK20goELEuIzEd+dHS+qz/Y8PTSif0FnGkbiwcAjHaU1+QWOptFiyCLp/LnKptpqIuXHx6rbR26kJcBX3yLgBfnd7CxwJmflpP2wUg0HIAoUUpZBmKzELGWcN8nAr6Gpu7tLU/CkwAaoKTWRSQyt89Q8w6J+oVQkKnBoblH7V0PPvUOvDYXfopE/SJmALsxnVm6LbkotrUtNowMeIrVrBcBpaMmdS0j9df7abpSuy7HWehwJdt1lhVwi/J58U5beXGAF6c3UXLycw1wdFklArBn87xdh0ZsZtArghBdAA3+OEDVubG4UEzP6x1FOWneHh2VDAHBAt80IbdXDcesNoCvs3E5AFyNSU5nbrDPZpcUEQQTFZiEVx+51fxMhhyJEAgvlriadIJZZksRuwBYMOPBbO3hePVVqgEJhFeUuFLhIPkRP6BQLIBrmMenujm/3g4zc398awIe90Zb5A1vREALqneMcYgP/xVQWlG+Ncu5vgwwlaUNx+3799rfe96u9K0JSDXcOzOTJg4B6IgmXfsygc7/Bvg9g9E58/cDVmGIBOP/zT8Bz1zqWqpbXIsd0O9hajXfL6u4BaOS6SeWAAAAAElFTkSuQmCC" alt="doco" style="background-color: inherit"/></a></span></th></tr><tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_resource.png" alt="." style="background-color: white; background-color: inherit" title="Resource" class="hierarchy"/> <a href="StructureDefinition-mcode-genomics-report-definitions.html#DiagnosticReport">DiagnosticReport</a><a name="DiagnosticReport"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">0</span><span style="opacity: 0.5">..</span><span style="opacity: 0.5">*</span></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/uv/genomics-reporting/STU2/StructureDefinition-genomics-report.html">GenomicsReport</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">A Diagnostic report - a combination of request information, atomic results, images, interpretation, as well as formatted reports</span></td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_element.gif" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Element" class="hierarchy"/> <a href="StructureDefinition-mcode-genomics-report-definitions.html#DiagnosticReport.status">status</a><a name="DiagnosticReport.status"> </a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="padding-left: 3px; padding-right: 3px; color: white; background-color: red" title="This element must be supported">S</span></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">1</span><span style="opacity: 0.5">..</span><span style="opacity: 0.5">1</span></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a style="opacity: 0.5" href="http://hl7.org/fhir/R4/datatypes.html#code">code</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">registered | partial | preliminary | final +</span></td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_element.gif" alt="." style="background-color: white; background-color: inherit" title="Element" class="hierarchy"/> <a href="StructureDefinition-mcode-genomics-report-definitions.html#DiagnosticReport.category">category</a><a name="DiagnosticReport.category"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="padding-left: 3px; padding-right: 3px; color: white; background-color: red" title="This element must be supported">S</span></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">1</span><span style="opacity: 0.5">..</span><span style="opacity: 0.5">*</span></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a style="opacity: 0.5" href="http://hl7.org/fhir/R4/datatypes.html#CodeableConcept">CodeableConcept</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">Service category</span></td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck13.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_slice.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Slice Definition" class="hierarchy"/> Slices for category<a name="DiagnosticReport.category.2"> </a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Content/Rules for all slices</td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck125.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end_slicer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_slice_item.png" alt="." style="background-color: white; background-color: inherit" title="Slice Item" class="hierarchy"/> <a href="StructureDefinition-mcode-genomics-report-definitions.html#DiagnosticReport.category:Genetics" title="Slice Genetics">category:Genetics</a><a name="DiagnosticReport.category.3"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">1</span><span style="opacity: 0.5">..</span><span style="opacity: 0.5">1</span></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a style="opacity: 0.5" href="http://hl7.org/fhir/R4/datatypes.html#CodeableConcept">CodeableConcept</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">Service category</span></td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1240.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end_slice.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_element.gif" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Element" class="hierarchy"/> <a href="StructureDefinition-mcode-genomics-report-definitions.html#DiagnosticReport.category:Genetics.coding">coding</a><a name="DiagnosticReport.category.coding"> </a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">1</span>..1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a style="opacity: 0.5" href="http://hl7.org/fhir/R4/datatypes.html#Coding">Coding</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">Code defined by a terminology system</span></td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_element.gif" alt="." style="background-color: white; background-color: inherit" title="Element" class="hierarchy"/> <a href="StructureDefinition-mcode-genomics-report-definitions.html#DiagnosticReport.code">code</a><a name="DiagnosticReport.code"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="padding-left: 3px; padding-right: 3px; color: white; background-color: red" title="This element must be supported">S</span></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">1</span><span style="opacity: 0.5">..</span><span style="opacity: 0.5">1</span></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a style="opacity: 0.5" href="http://hl7.org/fhir/R4/datatypes.html#CodeableConcept">CodeableConcept</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">Name/Code for this diagnostic report</span></td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_reference.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Reference to another Resource" class="hierarchy"/> <a href="StructureDefinition-mcode-genomics-report-definitions.html#DiagnosticReport.subject">subject</a><a name="DiagnosticReport.subject"> </a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="padding-left: 3px; padding-right: 3px; color: white; background-color: red" title="This element must be supported">S</span></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">0</span><span style="opacity: 0.5">..</span><span style="opacity: 0.5">1</span></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/references.html">Reference</a>(<a href="StructureDefinition-mcode-cancer-patient.html">Cancer Patient Profile</a>)</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">The subject of the report - usually, but not always, the patient</span></td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_element.gif" alt="." style="background-color: white; background-color: inherit" title="Element" class="hierarchy"/> <a href="StructureDefinition-mcode-genomics-report-definitions.html#DiagnosticReport.effective[x]">effective[x]</a><a name="DiagnosticReport.effective_x_"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="padding-left: 3px; padding-right: 3px; color: white; background-color: red" title="This element must be supported">S</span></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">0</span><span style="opacity: 0.5">..</span><span style="opacity: 0.5">1</span></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a style="opacity: 0.5" href="http://hl7.org/fhir/R4/datatypes.html#dateTime">dateTime</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">Clinically relevant time/time-period for report</span></td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_element.gif" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Element" class="hierarchy"/> <a href="StructureDefinition-mcode-genomics-report-definitions.html#DiagnosticReport.issued">issued</a><a name="DiagnosticReport.issued"> </a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="padding-left: 3px; padding-right: 3px; color: white; background-color: red" title="This element must be supported">S</span></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">0</span><span style="opacity: 0.5">..</span><span style="opacity: 0.5">1</span></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a style="opacity: 0.5" href="http://hl7.org/fhir/R4/datatypes.html#instant">instant</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">DateTime this version was made</span></td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_element.gif" alt="." style="background-color: white; background-color: inherit" title="Element" class="hierarchy"/> <a href="StructureDefinition-mcode-genomics-report-definitions.html#DiagnosticReport.performer">performer</a><a name="DiagnosticReport.performer"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="padding-left: 3px; padding-right: 3px; color: white; background-color: red" title="This element must be supported">S</span></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">0</span><span style="opacity: 0.5">..</span><span style="opacity: 0.5">*</span></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/references.html">Reference</a>(<a style="opacity: 0.5" href="http://hl7.org/fhir/R4/practitioner.html">Practitioner</a> | <a style="opacity: 0.5" href="http://hl7.org/fhir/R4/practitionerrole.html">PractitionerRole</a> | <a style="opacity: 0.5" href="http://hl7.org/fhir/R4/organization.html">Organization</a> | <a style="opacity: 0.5" href="http://hl7.org/fhir/R4/careteam.html">CareTeam</a>)</td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">Responsible Diagnostic Service</span></td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_reference.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Reference to another Resource" class="hierarchy"/> <a href="StructureDefinition-mcode-genomics-report-definitions.html#DiagnosticReport.specimen">specimen</a><a name="DiagnosticReport.specimen"> </a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="padding-left: 3px; padding-right: 3px; color: white; background-color: red" title="This element must be supported">S</span></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">0</span><span style="opacity: 0.5">..</span><span style="opacity: 0.5">*</span></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/references.html">Reference</a>(<a href="StructureDefinition-mcode-human-specimen.html">Human Specimen Profile</a>)</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">Specimens this report is based on</span></td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_element.gif" alt="." style="background-color: white; background-color: inherit" title="Element" class="hierarchy"/> <a href="StructureDefinition-mcode-genomics-report-definitions.html#DiagnosticReport.result">result</a><a name="DiagnosticReport.result"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="padding-left: 3px; padding-right: 3px; color: white; background-color: red" title="This element must be supported">S</span></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">0</span><span style="opacity: 0.5">..</span><span style="opacity: 0.5">*</span></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/references.html">Reference</a>(<a style="opacity: 0.5" href="http://hl7.org/fhir/R4/observation.html">Observation</a>)</td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">Observations</span></td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck03.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_slice.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Slice Definition" class="hierarchy"/> Slices for result<a name="DiagnosticReport.result.2"> </a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Content/Rules for all slices</td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck034.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_slicer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_slice_item.png" alt="." style="background-color: white; background-color: inherit" title="Slice Item" class="hierarchy"/> <a href="StructureDefinition-mcode-genomics-report-definitions.html#DiagnosticReport.result:variant" title="Slice variant">result:variant</a><a name="DiagnosticReport.result.3"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="padding-left: 3px; padding-right: 3px; color: white; background-color: red" title="This element must be supported">S</span></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">0</span><span style="opacity: 0.5">..</span><span style="opacity: 0.5">*</span></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/references.html">Reference</a>(<a href="StructureDefinition-mcode-genomic-variant.html">Genomic Variant Profile</a>)</td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">Variant</span></td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck024.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end_slicer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_slice_item.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Slice Item" class="hierarchy"/> <a href="StructureDefinition-mcode-genomics-report-definitions.html#DiagnosticReport.result:region-studied" title="Slice region-studied">result:region-studied</a><a name="DiagnosticReport.result.4"> </a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="padding-left: 3px; padding-right: 3px; color: white; background-color: red" title="This element must be supported">S</span></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">0</span><span style="opacity: 0.5">..</span><span style="opacity: 0.5">*</span></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/references.html">Reference</a>(<a href="StructureDefinition-mcode-genomic-region-studied.html">Genomic Region Studied Profile</a>)</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">Region Studied</span></td></tr>
<tr><td colspan="5" class="hierarchy"><br/><a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="Legend for this format"><img src="data:image/png;base64,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" alt="doco" style="background-color: inherit"/> Documentation for this format</a></td></tr></table></div>
  </text>
  <extension
             url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm">
    <valueInteger value="1"/>
  </extension>
  <extension
             url="http://hl7.org/fhir/StructureDefinition/structuredefinition-wg">
    <valueCode value="cic"/>
  </extension>
  <url
       value="http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-genomics-report"/>
  <identifier>
    <system value="urn:ietf:rfc:3986"/>
    <value value="urn:oid:2.16.840.1.113883.4.642.40.15.42.20"/>
  </identifier>
  <version value="4.0.0"/>
  <name value="GenomicsReport"/>
  <title value="Genomics Report Profile"/>
  <status value="active"/>
  <date value="2024-11-20T20:23:08+00:00"/>
  <publisher value="HL7 International / Clinical Interoperability Council"/>
  <contact>
    <name value="HL7 International / Clinical Interoperability Council"/>
    <telecom>
      <system value="url"/>
      <value value="http://www.hl7.org/Special/committees/cic"/>
    </telecom>
    <telecom>
      <system value="email"/>
      <value value="ciclist@lists.HL7.org"/>
    </telecom>
  </contact>
  <description
               value="Genomic analysis summary report. The report may include one or more tests, with two distinct test types. The first type is a targeted mutation test, where a specific mutation on a specific gene is tested for. The result is either positive or negative for that mutation. The second type is a more general test for variants. This type of test returns the identity of variants found in a certain region of the genome."/>
  <jurisdiction>
    <coding>
      <system value="urn:iso:std:iso:3166"/>
      <code value="US"/>
      <display value="United States of America"/>
    </coding>
  </jurisdiction>
  <fhirVersion value="4.0.1"/>
  <mapping>
    <identity value="workflow"/>
    <uri value="http://hl7.org/fhir/workflow"/>
    <name value="Workflow Pattern"/>
  </mapping>
  <mapping>
    <identity value="v2"/>
    <uri value="http://hl7.org/v2"/>
    <name value="HL7 v2 Mapping"/>
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  <mapping>
    <identity value="rim"/>
    <uri value="http://hl7.org/v3"/>
    <name value="RIM Mapping"/>
  </mapping>
  <mapping>
    <identity value="w5"/>
    <uri value="http://hl7.org/fhir/fivews"/>
    <name value="FiveWs Pattern Mapping"/>
  </mapping>
  <kind value="resource"/>
  <abstract value="false"/>
  <type value="DiagnosticReport"/>
  <baseDefinition
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  <derivation value="constraint"/>
  <snapshot>
    <element id="DiagnosticReport">
      <path value="DiagnosticReport"/>
      <short
             value="A Diagnostic report - a combination of request information, atomic results, images, interpretation, as well as formatted reports"/>
      <definition
                  value="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."/>
      <comment
               value="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."/>
      <alias value="Report"/>
      <alias value="Test"/>
      <alias value="Result"/>
      <alias value="Results"/>
      <alias value="Labs"/>
      <alias value="Laboratory"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="DiagnosticReport"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <constraint>
        <key value="dom-2"/>
        <severity value="error"/>
        <human
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        <expression value="contained.contained.empty()"/>
        <xpath value="not(parent::f:contained and f:contained)"/>
        <source
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      </constraint>
      <constraint>
        <key value="dom-3"/>
        <severity value="error"/>
        <human
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        <expression
                    value="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()"/>
        <xpath
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        <source
                value="http://hl7.org/fhir/StructureDefinition/DomainResource"/>
      </constraint>
      <constraint>
        <key value="dom-4"/>
        <severity value="error"/>
        <human
               value="If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated"/>
        <expression
                    value="contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()"/>
        <xpath
               value="not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))"/>
        <source
                value="http://hl7.org/fhir/StructureDefinition/DomainResource"/>
      </constraint>
      <constraint>
        <key value="dom-5"/>
        <severity value="error"/>
        <human
               value="If a resource is contained in another resource, it SHALL NOT have a security label"/>
        <expression value="contained.meta.security.empty()"/>
        <xpath value="not(exists(f:contained/*/f:meta/f:security))"/>
        <source
                value="http://hl7.org/fhir/StructureDefinition/DomainResource"/>
      </constraint>
      <constraint>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice">
          <valueBoolean value="true"/>
        </extension>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice-explanation">
          <valueMarkdown
                         value="When a resource has no narrative, only systems that fully understand the data can display the resource to a human safely. Including a human readable representation in the resource makes for a much more robust eco-system and cheaper handling of resources by intermediary systems. Some ecosystems restrict distribution of resources to only those systems that do fully understand the resources, and as a consequence implementers may believe that the narrative is superfluous. However experience shows that such eco-systems often open up to new participants over time."/>
        </extension>
        <key value="dom-6"/>
        <severity value="warning"/>
        <human
               value="A resource should have narrative for robust management"/>
        <expression value="text.`div`.exists()"/>
        <xpath value="exists(f:text/h:div)"/>
        <source
                value="http://hl7.org/fhir/StructureDefinition/DomainResource"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="Entity. Role, or Act"/>
      </mapping>
      <mapping>
        <identity value="workflow"/>
        <map value="Event"/>
      </mapping>
      <mapping>
        <identity value="v2"/>
        <map value="ORU -&gt; OBR"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="Observation[classCode=OBS, moodCode=EVN]"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.id">
      <path value="DiagnosticReport.id"/>
      <short value="Logical id of this artifact"/>
      <definition
                  value="The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes."/>
      <comment
               value="The only time that a resource does not have an id is when it is being submitted to the server using a create operation."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Resource.id"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="id"/>
        </extension>
        <code value="http://hl7.org/fhirpath/System.String"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="true"/>
    </element>
    <element id="DiagnosticReport.meta">
      <path value="DiagnosticReport.meta"/>
      <short value="Metadata about the resource"/>
      <definition
                  value="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."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Resource.meta"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Meta"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
    </element>
    <element id="DiagnosticReport.implicitRules">
      <path value="DiagnosticReport.implicitRules"/>
      <short value="A set of rules under which this content was created"/>
      <definition
                  value="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."/>
      <comment
               value="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."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Resource.implicitRules"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="uri"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="true"/>
      <isModifierReason
                        value="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"/>
      <isSummary value="true"/>
    </element>
    <element id="DiagnosticReport.language">
      <path value="DiagnosticReport.language"/>
      <short value="Language of the resource content"/>
      <definition
                  value="The base language in which the resource is written."/>
      <comment
               value="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)."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Resource.language"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="code"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <binding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet">
          <valueCanonical value="http://hl7.org/fhir/ValueSet/all-languages"/>
        </extension>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="Language"/>
        </extension>
        <strength value="preferred"/>
        <description value="A human language."/>
        <valueSet value="http://hl7.org/fhir/ValueSet/languages"/>
      </binding>
    </element>
    <element id="DiagnosticReport.text">
      <path value="DiagnosticReport.text"/>
      <short value="Text summary of the resource, for human interpretation"/>
      <definition
                  value="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 &quot;clinically safe&quot; for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety."/>
      <comment
               value="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 &quot;text blob&quot; or where text is additionally entered raw or narrated and encoded information is added later."/>
      <alias value="narrative"/>
      <alias value="html"/>
      <alias value="xhtml"/>
      <alias value="display"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="DomainResource.text"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Narrative"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="Act.text?"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.contained">
      <path value="DiagnosticReport.contained"/>
      <short value="Contained, inline Resources"/>
      <definition
                  value="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."/>
      <comment
               value="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."/>
      <alias value="inline resources"/>
      <alias value="anonymous resources"/>
      <alias value="contained resources"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="DomainResource.contained"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Resource"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.extension">
      <path value="DiagnosticReport.extension"/>
      <slicing>
        <discriminator>
          <type value="value"/>
          <path value="url"/>
        </discriminator>
        <ordered value="false"/>
        <rules value="open"/>
      </slicing>
      <short value="Extension"/>
      <definition value="An Extension"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="DomainResource.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ext-1"/>
        <severity value="error"/>
        <human value="Must have either extensions or value[x], not both"/>
        <expression value="extension.exists() != value.exists()"/>
        <xpath
               value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="false"/>
    </element>
    <element id="DiagnosticReport.extension:genomics-artifact">
      <path value="DiagnosticReport.extension"/>
      <sliceName value="genomics-artifact"/>
      <short value="Genomics Artifact"/>
      <definition
                  value="Captures citations, evidence and other supporting documentation for the observation or report."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="DomainResource.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://hl7.org/fhir/uv/genomics-reporting/StructureDefinition/genomics-artifact"/>
      </type>
      <condition value="ele-1"/>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ext-1"/>
        <severity value="error"/>
        <human value="Must have either extensions or value[x], not both"/>
        <expression value="extension.exists() != value.exists()"/>
        <xpath
               value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
      </constraint>
      <isModifier value="false"/>
    </element>
    <element id="DiagnosticReport.extension:genomics-file">
      <path value="DiagnosticReport.extension"/>
      <sliceName value="genomics-file"/>
      <short value="Genomics File"/>
      <definition
                  value="Used to transmit the contents of or links to files that were produced as part of the testing process. Examples are VCF, BAM, CRAM, and other similar files."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="DomainResource.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://hl7.org/fhir/uv/genomics-reporting/StructureDefinition/genomics-file"/>
      </type>
      <condition value="ele-1"/>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ext-1"/>
        <severity value="error"/>
        <human value="Must have either extensions or value[x], not both"/>
        <expression value="extension.exists() != value.exists()"/>
        <xpath
               value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
      </constraint>
      <isModifier value="false"/>
    </element>
    <element id="DiagnosticReport.extension:recommended-action">
      <path value="DiagnosticReport.extension"/>
      <sliceName value="recommended-action"/>
      <short value="Recommended Action"/>
      <definition
                  value="References a proposed action that is recommended based on the results of the diagnostic report."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="DomainResource.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://hl7.org/fhir/uv/genomics-reporting/StructureDefinition/recommended-action"/>
      </type>
      <condition value="ele-1"/>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ext-1"/>
        <severity value="error"/>
        <human value="Must have either extensions or value[x], not both"/>
        <expression value="extension.exists() != value.exists()"/>
        <xpath
               value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
      </constraint>
      <isModifier value="false"/>
    </element>
    <element id="DiagnosticReport.extension:genomics-risk-assessment">
      <path value="DiagnosticReport.extension"/>
      <sliceName value="genomics-risk-assessment"/>
      <short value="Genomics Risk Assessment"/>
      <definition
                  value="RiskAssessment delivered as part of a genomics report or observation"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="DomainResource.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://hl7.org/fhir/uv/genomics-reporting/StructureDefinition/genomics-risk-assessment"/>
      </type>
      <condition value="ele-1"/>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ext-1"/>
        <severity value="error"/>
        <human value="Must have either extensions or value[x], not both"/>
        <expression value="extension.exists() != value.exists()"/>
        <xpath
               value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
      </constraint>
      <isModifier value="false"/>
    </element>
    <element id="DiagnosticReport.extension:coded-note">
      <path value="DiagnosticReport.extension"/>
      <sliceName value="coded-note"/>
      <short
             value="Comments about the report that also contain a coded type"/>
      <definition
                  value="Adds codified notes to a report to capture additional content"/>
      <comment
               value="May include general statements about the report, or statements about significant, unexpected or unreliable results values, or information about its source when relevant to its interpretation.
The CodedAnnotation data type, while not allowing for or intending to make the content computable, does allow the author to indicate the type of note. This does not replace the use of results or conclusion or conclusionCode.
One important note is that Annotation is a FHIR data type, this is **NOT** about annotations in the genomic context."/>
      <requirements
                    value="Need to be able to provide free text additional information. Notes SHALL NOT contain information which can be captured in a structured way."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="DomainResource.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://hl7.org/fhir/uv/genomics-reporting/StructureDefinition/genomic-report-note"/>
      </type>
      <condition value="ele-1"/>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ext-1"/>
        <severity value="error"/>
        <human value="Must have either extensions or value[x], not both"/>
        <expression value="extension.exists() != value.exists()"/>
        <xpath
               value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
      </constraint>
      <isModifier value="false"/>
    </element>
    <element id="DiagnosticReport.extension:supporting-info">
      <path value="DiagnosticReport.extension"/>
      <sliceName value="supporting-info"/>
      <short value="Other information that may be relevant to this event."/>
      <definition
                  value="Other resources *from the patient record* that may be relevant to the event.  The information from these resources was either used to create the instance or is provided to help with its interpretation.  This extension **should not** be used if more specific  inline elements  or extensions are available.  For example, use `Observation.hasMember`  instead of supportingInformation for  representing the members of an Observation panel."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="DomainResource.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://hl7.org/fhir/StructureDefinition/workflow-supportingInfo"/>
      </type>
      <condition value="ele-1"/>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ext-1"/>
        <severity value="error"/>
        <human value="Must have either extensions or value[x], not both"/>
        <expression value="extension.exists() != value.exists()"/>
        <xpath
               value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
      </constraint>
      <isModifier value="false"/>
    </element>
    <element id="DiagnosticReport.modifierExtension">
      <path value="DiagnosticReport.modifierExtension"/>
      <short value="Extensions that cannot be ignored"/>
      <definition
                  value="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)."/>
      <comment
               value="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."/>
      <requirements
                    value="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](http://hl7.org/fhir/R4/extensibility.html#modifierExtension)."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="DomainResource.modifierExtension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ext-1"/>
        <severity value="error"/>
        <human value="Must have either extensions or value[x], not both"/>
        <expression value="extension.exists() != value.exists()"/>
        <xpath
               value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
      </constraint>
      <isModifier value="true"/>
      <isModifierReason
                        value="Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.identifier">
      <path value="DiagnosticReport.identifier"/>
      <short value="Business identifier for report"/>
      <definition
                  value="Identifiers assigned to this report by the performer or other systems."/>
      <comment
               value="Usually assigned by the Information System of the diagnostic service provider (filler id)."/>
      <requirements
                    value="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."/>
      <alias value="ReportID"/>
      <alias value="Filler ID"/>
      <alias value="Placer ID"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="DiagnosticReport.identifier"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Identifier"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="workflow"/>
        <map value="Event.identifier"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="FiveWs.identifier"/>
      </mapping>
      <mapping>
        <identity value="v2"/>
        <map
             value="OBR-51/ for globally unique filler ID  - OBR-3 , For non-globally unique filler-id the flller/placer number must be combined with the universal service Id -  OBR-2(if present)+OBR-3+OBR-4"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="id"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.basedOn">
      <path value="DiagnosticReport.basedOn"/>
      <short value="What was requested"/>
      <definition value="Details concerning a service requested."/>
      <comment
               value="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."/>
      <requirements
                    value="This allows tracing of authorization for the report and tracking whether proposals/recommendations were acted upon."/>
      <alias value="Request"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="DiagnosticReport.basedOn"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/CarePlan"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/ImmunizationRecommendation"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/MedicationRequest"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/NutritionOrder"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/ServiceRequest"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="workflow"/>
        <map value="Event.basedOn"/>
      </mapping>
      <mapping>
        <identity value="v2"/>
        <map value="ORC? OBR-2/3?"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="outboundRelationship[typeCode=FLFS].target"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.status">
      <path value="DiagnosticReport.status"/>
      <short value="registered | partial | preliminary | final +"/>
      <definition value="The status of the diagnostic report."/>
      <requirements
                    value="Diagnostic services routinely issue provisional/incomplete reports, and sometimes withdraw previously released reports."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="DiagnosticReport.status"/>
        <min value="1"/>
        <max value="1"/>
      </base>
      <type>
        <code value="code"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <mustSupport value="true"/>
      <isModifier value="true"/>
      <isModifierReason
                        value="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"/>
      <isSummary value="true"/>
      <binding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="DiagnosticReportStatus"/>
        </extension>
        <strength value="required"/>
        <description value="The status of the diagnostic report."/>
        <valueSet
                  value="http://hl7.org/fhir/ValueSet/diagnostic-report-status|4.0.1"/>
      </binding>
      <mapping>
        <identity value="workflow"/>
        <map value="Event.status"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="FiveWs.status"/>
      </mapping>
      <mapping>
        <identity value="v2"/>
        <map value="OBR-25 (not 1:1 mapping)"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map
             value="statusCode  Note: final and amended are distinguished by whether observation is the subject of a ControlAct event of type &quot;revise&quot;"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.category">
      <path value="DiagnosticReport.category"/>
      <slicing>
        <discriminator>
          <type value="pattern"/>
          <path value="coding"/>
        </discriminator>
        <description value="Slice based on the category code pattern"/>
        <rules value="open"/>
      </slicing>
      <short value="Service category"/>
      <definition
                  value="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."/>
      <comment
               value="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."/>
      <alias value="Department"/>
      <alias value="Sub-department"/>
      <alias value="Service"/>
      <alias value="Discipline"/>
      <min value="1"/>
      <max value="*"/>
      <base>
        <path value="DiagnosticReport.category"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <binding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="DiagnosticServiceSection"/>
        </extension>
        <strength value="example"/>
        <description value="Codes for diagnostic service sections."/>
        <valueSet
                  value="http://hl7.org/fhir/ValueSet/diagnostic-service-sections"/>
      </binding>
      <mapping>
        <identity value="w5"/>
        <map value="FiveWs.class"/>
      </mapping>
      <mapping>
        <identity value="v2"/>
        <map value="OBR-24"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map
             value="inboundRelationship[typeCode=COMP].source[classCode=LIST, moodCode=EVN, code &lt; LabService].code"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.category:Genetics">
      <path value="DiagnosticReport.category"/>
      <sliceName value="Genetics"/>
      <short value="Service category"/>
      <definition
                  value="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."/>
      <comment
               value="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."/>
      <alias value="Department"/>
      <alias value="Sub-department"/>
      <alias value="Service"/>
      <alias value="Discipline"/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="DiagnosticReport.category"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <binding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="DiagnosticServiceSection"/>
        </extension>
        <strength value="example"/>
        <description value="Codes for diagnostic service sections."/>
        <valueSet
                  value="http://hl7.org/fhir/ValueSet/diagnostic-service-sections"/>
      </binding>
      <mapping>
        <identity value="w5"/>
        <map value="FiveWs.class"/>
      </mapping>
      <mapping>
        <identity value="v2"/>
        <map value="OBR-24"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map
             value="inboundRelationship[typeCode=COMP].source[classCode=LIST, moodCode=EVN, code &lt; LabService].code"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.category:Genetics.id">
      <path value="DiagnosticReport.category.id"/>
      <representation value="xmlAttr"/>
      <short value="Unique id for inter-element referencing"/>
      <definition
                  value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Element.id"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string"/>
        </extension>
        <code value="http://hl7.org/fhirpath/System.String"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.category:Genetics.extension">
      <path value="DiagnosticReport.category.extension"/>
      <slicing>
        <discriminator>
          <type value="value"/>
          <path value="url"/>
        </discriminator>
        <description value="Extensions are always sliced by (at least) url"/>
        <rules value="open"/>
      </slicing>
      <short value="Additional content defined by implementations"/>
      <definition
                  value="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."/>
      <comment
               value="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."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Element.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ext-1"/>
        <severity value="error"/>
        <human value="Must have either extensions or value[x], not both"/>
        <expression value="extension.exists() != value.exists()"/>
        <xpath
               value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.category:Genetics.coding">
      <path value="DiagnosticReport.category.coding"/>
      <short value="Code defined by a terminology system"/>
      <definition
                  value="A reference to a code defined by a terminology system."/>
      <comment
               value="Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information.  Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true."/>
      <requirements
                    value="Allows for alternative encodings within a code system, and translations to other code systems."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="CodeableConcept.coding"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Coding"/>
      </type>
      <patternCoding>
        <system value="http://terminology.hl7.org/CodeSystem/v2-0074"/>
        <code value="GE"/>
      </patternCoding>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="C*E.1-8, C*E.10-22"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="union(., ./translation)"/>
      </mapping>
      <mapping>
        <identity value="orim"/>
        <map
             value="fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.category:Genetics.text">
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
        <valueBoolean value="true"/>
      </extension>
      <path value="DiagnosticReport.category.text"/>
      <short value="Plain text representation of the concept"/>
      <definition
                  value="A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user."/>
      <comment
               value="Very often the text is the same as a displayName of one of the codings."/>
      <requirements
                    value="The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="CodeableConcept.text"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="C*E.9. But note many systems use C*E.2 for this"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map
             value="./originalText[mediaType/code=&quot;text/plain&quot;]/data"/>
      </mapping>
      <mapping>
        <identity value="orim"/>
        <map
             value="fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.code">
      <path value="DiagnosticReport.code"/>
      <short value="Name/Code for this diagnostic report"/>
      <definition
                  value="A code or name that describes this diagnostic report."/>
      <alias value="Type"/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="DiagnosticReport.code"/>
        <min value="1"/>
        <max value="1"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <binding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="DiagnosticReportCodes"/>
        </extension>
        <strength value="preferred"/>
        <description value="Codes that describe Diagnostic Reports."/>
        <valueSet value="http://hl7.org/fhir/ValueSet/report-codes"/>
      </binding>
      <mapping>
        <identity value="workflow"/>
        <map value="Event.code"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="FiveWs.what[x]"/>
      </mapping>
      <mapping>
        <identity value="v2"/>
        <map
             value="OBR-4 (HL7 v2 doesn't provide an easy way to indicate both the ordered test and the performed panel)"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="code"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.subject">
      <path value="DiagnosticReport.subject"/>
      <short
             value="The subject of the report - usually, but not always, the patient"/>
      <definition
                  value="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."/>
      <requirements value="SHALL know the subject context."/>
      <alias value="Patient"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="DiagnosticReport.subject"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-cancer-patient"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="workflow"/>
        <map value="Event.subject"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="FiveWs.subject[x]"/>
      </mapping>
      <mapping>
        <identity value="v2"/>
        <map value="PID-3 (no HL7 v2 mapping for Group or Device)"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="participation[typeCode=SBJ]"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="FiveWs.subject"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.encounter">
      <path value="DiagnosticReport.encounter"/>
      <short value="Health care event when test ordered"/>
      <definition
                  value="The healthcare event  (e.g. a patient and healthcare provider interaction) which this DiagnosticReport is about."/>
      <comment
               value="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)."/>
      <requirements value="Links the request to the Encounter context."/>
      <alias value="Context"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="DiagnosticReport.encounter"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/Encounter"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="workflow"/>
        <map value="Event.encounter"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="FiveWs.context"/>
      </mapping>
      <mapping>
        <identity value="v2"/>
        <map value="PV1-19"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map
             value="inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN]"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.effective[x]">
      <path value="DiagnosticReport.effective[x]"/>
      <short value="Clinically relevant time/time-period for report"/>
      <definition
                  value="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."/>
      <comment
               value="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."/>
      <requirements
                    value="Need to know where in the patient history to file/present this report."/>
      <alias value="Observation time"/>
      <alias value="Effective Time"/>
      <alias value="Occurrence"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="DiagnosticReport.effective[x]"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="dateTime"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="workflow"/>
        <map value="Event.occurrence[x]"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="FiveWs.done[x]"/>
      </mapping>
      <mapping>
        <identity value="v2"/>
        <map value="OBR-7"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="effectiveTime"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.issued">
      <path value="DiagnosticReport.issued"/>
      <short value="DateTime this version was made"/>
      <definition
                  value="The date and time that this version of the report was made available to providers, typically after the report was reviewed and verified."/>
      <comment
               value="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."/>
      <requirements
                    value="Clinicians need to be able to check the date that the report was released."/>
      <alias value="Date published"/>
      <alias value="Date Issued"/>
      <alias value="Date Verified"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="DiagnosticReport.issued"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="instant"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="w5"/>
        <map value="FiveWs.recorded"/>
      </mapping>
      <mapping>
        <identity value="v2"/>
        <map value="OBR-22"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="participation[typeCode=VRF or AUT].time"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.performer">
      <path value="DiagnosticReport.performer"/>
      <short value="Responsible Diagnostic Service"/>
      <definition
                  value="The diagnostic service that is responsible for issuing the report."/>
      <comment
               value="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."/>
      <requirements
                    value="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."/>
      <alias value="Laboratory"/>
      <alias value="Service"/>
      <alias value="Practitioner"/>
      <alias value="Department"/>
      <alias value="Company"/>
      <alias value="Authorized by"/>
      <alias value="Director"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="DiagnosticReport.performer"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/Practitioner"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/PractitionerRole"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/Organization"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/CareTeam"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="workflow"/>
        <map value="Event.performer.actor"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="FiveWs.actor"/>
      </mapping>
      <mapping>
        <identity value="v2"/>
        <map value="PRT-8 (where this PRT-4-Participation = &quot;PO&quot;)"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".participation[typeCode=PRF]"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.resultsInterpreter">
      <path value="DiagnosticReport.resultsInterpreter"/>
      <short value="Primary result interpreter"/>
      <definition
                  value="The practitioner or organization that is responsible for the report's conclusions and interpretations."/>
      <comment
               value="Might not be the same entity that takes responsibility for the clinical report."/>
      <requirements
                    value="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."/>
      <alias value="Analyzed by"/>
      <alias value="Reported by"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="DiagnosticReport.resultsInterpreter"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/Practitioner"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/PractitionerRole"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/Organization"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/CareTeam"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="workflow"/>
        <map value="Event.performer.actor"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="FiveWs.actor"/>
      </mapping>
      <mapping>
        <identity value="v2"/>
        <map
             value="OBR-32, PRT-8 (where this PRT-4-Participation = &quot;PI&quot;)"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".participation[typeCode=PRF]"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.specimen">
      <path value="DiagnosticReport.specimen"/>
      <short value="Specimens this report is based on"/>
      <definition
                  value="Details about the specimens on which this diagnostic report is based."/>
      <comment
               value="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."/>
      <requirements
                    value="Need to be able to report information about the collected specimens on which the report is based."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="DiagnosticReport.specimen"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-human-specimen"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="v2"/>
        <map value="SPM"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="participation[typeCode=SBJ]"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.result">
      <path value="DiagnosticReport.result"/>
      <slicing>
        <discriminator>
          <type value="profile"/>
          <path value="resolve()"/>
        </discriminator>
        <description
                     value="Slice based on the reference profile and code pattern"/>
        <rules value="open"/>
      </slicing>
      <short value="Observations"/>
      <definition
                  value="[Observations](http://hl7.org/fhir/R4/observation.html)  that are part of this diagnostic report."/>
      <comment value="Observations can contain observations."/>
      <requirements
                    value="Need to support individual results, or  groups of results, where the result grouping is arbitrary, but meaningful."/>
      <alias value="Data"/>
      <alias value="Atomic Value"/>
      <alias value="Result"/>
      <alias value="Atomic result"/>
      <alias value="Data"/>
      <alias value="Test"/>
      <alias value="Analyte"/>
      <alias value="Battery"/>
      <alias value="Organizer"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="DiagnosticReport.result"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/Observation"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="v2"/>
        <map value="OBXs"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="outboundRelationship[typeCode=COMP].target"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.result:overall">
      <path value="DiagnosticReport.result"/>
      <sliceName value="overall"/>
      <short value="Assessment of overall results"/>
      <definition
                  value="[Observations](http://hl7.org/fhir/R4/observation.html)  that are part of this diagnostic report."/>
      <comment value="Observations can contain observations."/>
      <requirements
                    value="Need to support individual results, or  groups of results, where the result grouping is arbitrary, but meaningful."/>
      <alias value="Data"/>
      <alias value="Atomic Value"/>
      <alias value="Result"/>
      <alias value="Atomic result"/>
      <alias value="Data"/>
      <alias value="Test"/>
      <alias value="Analyte"/>
      <alias value="Battery"/>
      <alias value="Organizer"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="DiagnosticReport.result"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/uv/genomics-reporting/StructureDefinition/overall-interpretation"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="v2"/>
        <map value="OBXs"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="outboundRelationship[typeCode=COMP].target"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.result:diagnostic-implication">
      <path value="DiagnosticReport.result"/>
      <sliceName value="diagnostic-implication"/>
      <short value="Diagnostic Implication"/>
      <definition
                  value="[Observations](http://hl7.org/fhir/R4/observation.html)  that are part of this diagnostic report."/>
      <comment value="Observations can contain observations."/>
      <requirements
                    value="Need to support individual results, or  groups of results, where the result grouping is arbitrary, but meaningful."/>
      <alias value="Data"/>
      <alias value="Atomic Value"/>
      <alias value="Result"/>
      <alias value="Atomic result"/>
      <alias value="Data"/>
      <alias value="Test"/>
      <alias value="Analyte"/>
      <alias value="Battery"/>
      <alias value="Organizer"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="DiagnosticReport.result"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/uv/genomics-reporting/StructureDefinition/diagnostic-implication"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="v2"/>
        <map value="OBXs"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="outboundRelationship[typeCode=COMP].target"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.result:therapeutic-implication">
      <path value="DiagnosticReport.result"/>
      <sliceName value="therapeutic-implication"/>
      <short value="Therapeutic Implication"/>
      <definition
                  value="[Observations](http://hl7.org/fhir/R4/observation.html)  that are part of this diagnostic report."/>
      <comment value="Observations can contain observations."/>
      <requirements
                    value="Need to support individual results, or  groups of results, where the result grouping is arbitrary, but meaningful."/>
      <alias value="Data"/>
      <alias value="Atomic Value"/>
      <alias value="Result"/>
      <alias value="Atomic result"/>
      <alias value="Data"/>
      <alias value="Test"/>
      <alias value="Analyte"/>
      <alias value="Battery"/>
      <alias value="Organizer"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="DiagnosticReport.result"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/uv/genomics-reporting/StructureDefinition/therapeutic-implication"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="v2"/>
        <map value="OBXs"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="outboundRelationship[typeCode=COMP].target"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.result:variant">
      <path value="DiagnosticReport.result"/>
      <sliceName value="variant"/>
      <short value="Variant"/>
      <definition
                  value="[Observations](http://hl7.org/fhir/R4/observation.html)  that are part of this diagnostic report."/>
      <comment value="Observations can contain observations."/>
      <requirements
                    value="Need to support individual results, or  groups of results, where the result grouping is arbitrary, but meaningful."/>
      <alias value="Data"/>
      <alias value="Atomic Value"/>
      <alias value="Result"/>
      <alias value="Atomic result"/>
      <alias value="Data"/>
      <alias value="Test"/>
      <alias value="Analyte"/>
      <alias value="Battery"/>
      <alias value="Organizer"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="DiagnosticReport.result"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-genomic-variant"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="v2"/>
        <map value="OBXs"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="outboundRelationship[typeCode=COMP].target"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.result:sequence-phase-relation">
      <path value="DiagnosticReport.result"/>
      <sliceName value="sequence-phase-relation"/>
      <short value="Sequence Phase Relationship"/>
      <definition
                  value="[Observations](http://hl7.org/fhir/R4/observation.html)  that are part of this diagnostic report."/>
      <comment value="Observations can contain observations."/>
      <requirements
                    value="Need to support individual results, or  groups of results, where the result grouping is arbitrary, but meaningful."/>
      <alias value="Data"/>
      <alias value="Atomic Value"/>
      <alias value="Result"/>
      <alias value="Atomic result"/>
      <alias value="Data"/>
      <alias value="Test"/>
      <alias value="Analyte"/>
      <alias value="Battery"/>
      <alias value="Organizer"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="DiagnosticReport.result"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/uv/genomics-reporting/StructureDefinition/sequence-phase-relationship"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="v2"/>
        <map value="OBXs"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="outboundRelationship[typeCode=COMP].target"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.result:region-studied">
      <path value="DiagnosticReport.result"/>
      <sliceName value="region-studied"/>
      <short value="Region Studied"/>
      <definition
                  value="[Observations](http://hl7.org/fhir/R4/observation.html)  that are part of this diagnostic report."/>
      <comment value="Observations can contain observations."/>
      <requirements
                    value="Need to support individual results, or  groups of results, where the result grouping is arbitrary, but meaningful."/>
      <alias value="Data"/>
      <alias value="Atomic Value"/>
      <alias value="Result"/>
      <alias value="Atomic result"/>
      <alias value="Data"/>
      <alias value="Test"/>
      <alias value="Analyte"/>
      <alias value="Battery"/>
      <alias value="Organizer"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="DiagnosticReport.result"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-genomic-region-studied"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="v2"/>
        <map value="OBXs"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="outboundRelationship[typeCode=COMP].target"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.result:genotype">
      <path value="DiagnosticReport.result"/>
      <sliceName value="genotype"/>
      <short value="Genotype"/>
      <definition
                  value="[Observations](http://hl7.org/fhir/R4/observation.html)  that are part of this diagnostic report."/>
      <comment value="Observations can contain observations."/>
      <requirements
                    value="Need to support individual results, or  groups of results, where the result grouping is arbitrary, but meaningful."/>
      <alias value="Data"/>
      <alias value="Atomic Value"/>
      <alias value="Result"/>
      <alias value="Atomic result"/>
      <alias value="Data"/>
      <alias value="Test"/>
      <alias value="Analyte"/>
      <alias value="Battery"/>
      <alias value="Organizer"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="DiagnosticReport.result"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/uv/genomics-reporting/StructureDefinition/genotype"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="v2"/>
        <map value="OBXs"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="outboundRelationship[typeCode=COMP].target"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.result:haplotype">
      <path value="DiagnosticReport.result"/>
      <sliceName value="haplotype"/>
      <short value="Haplotype"/>
      <definition
                  value="[Observations](http://hl7.org/fhir/R4/observation.html)  that are part of this diagnostic report."/>
      <comment value="Observations can contain observations."/>
      <requirements
                    value="Need to support individual results, or  groups of results, where the result grouping is arbitrary, but meaningful."/>
      <alias value="Data"/>
      <alias value="Atomic Value"/>
      <alias value="Result"/>
      <alias value="Atomic result"/>
      <alias value="Data"/>
      <alias value="Test"/>
      <alias value="Analyte"/>
      <alias value="Battery"/>
      <alias value="Organizer"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="DiagnosticReport.result"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/uv/genomics-reporting/StructureDefinition/haplotype"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="v2"/>
        <map value="OBXs"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="outboundRelationship[typeCode=COMP].target"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.imagingStudy">
      <path value="DiagnosticReport.imagingStudy"/>
      <short
             value="Reference to full details of imaging associated with the diagnostic report"/>
      <definition
                  value="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."/>
      <comment
               value="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."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="DiagnosticReport.imagingStudy"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/ImagingStudy"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map
             value="outboundRelationship[typeCode=COMP].target[classsCode=DGIMG, moodCode=EVN]"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.media">
      <path value="DiagnosticReport.media"/>
      <short value="Key images associated with this report"/>
      <definition
                  value="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)."/>
      <requirements
                    value="Many diagnostic services include images in the report as part of their service."/>
      <alias value="DICOM"/>
      <alias value="Slides"/>
      <alias value="Scans"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="DiagnosticReport.media"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="BackboneElement"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="OBX?"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="outboundRelationship[typeCode=COMP].target"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.media.id">
      <path value="DiagnosticReport.media.id"/>
      <representation value="xmlAttr"/>
      <short value="Unique id for inter-element referencing"/>
      <definition
                  value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Element.id"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string"/>
        </extension>
        <code value="http://hl7.org/fhirpath/System.String"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.media.extension">
      <path value="DiagnosticReport.media.extension"/>
      <short value="Additional content defined by implementations"/>
      <definition
                  value="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."/>
      <comment
               value="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."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Element.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ext-1"/>
        <severity value="error"/>
        <human value="Must have either extensions or value[x], not both"/>
        <expression value="extension.exists() != value.exists()"/>
        <xpath
               value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.media.modifierExtension">
      <path value="DiagnosticReport.media.modifierExtension"/>
      <short value="Extensions that cannot be ignored even if unrecognized"/>
      <definition
                  value="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)."/>
      <comment
               value="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."/>
      <requirements
                    value="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](http://hl7.org/fhir/R4/extensibility.html#modifierExtension)."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <alias value="modifiers"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="BackboneElement.modifierExtension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ext-1"/>
        <severity value="error"/>
        <human value="Must have either extensions or value[x], not both"/>
        <expression value="extension.exists() != value.exists()"/>
        <xpath
               value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
      </constraint>
      <isModifier value="true"/>
      <isModifierReason
                        value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.media.comment">
      <path value="DiagnosticReport.media.comment"/>
      <short value="Comment about the image (e.g. explanation)"/>
      <definition
                  value="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."/>
      <comment
               value="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."/>
      <requirements
                    value="The provider of the report should make a comment about each image included in the report."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="DiagnosticReport.media.comment"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map
             value=".inboundRelationship[typeCode=COMP].source[classCode=OBS, moodCode=EVN, code=&quot;annotation&quot;].value"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.media.link">
      <path value="DiagnosticReport.media.link"/>
      <short value="Reference to the image source"/>
      <definition value="Reference to the image source."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="DiagnosticReport.media.link"/>
        <min value="1"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Reference"/>
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Media"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value=".value.reference"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.conclusion">
      <path value="DiagnosticReport.conclusion"/>
      <short value="Clinical conclusion (interpretation) of test results"/>
      <definition
                  value="Concise and clinically contextualized summary conclusion (interpretation/impression) of the diagnostic report."/>
      <requirements
                    value="Need to be able to provide a conclusion that is not lost among the basic result data."/>
      <alias value="Report"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="DiagnosticReport.conclusion"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="v2"/>
        <map value="OBX"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map
             value="inboundRelationship[typeCode=&quot;SPRT&quot;].source[classCode=OBS, moodCode=EVN, code=LOINC:48767-8].value (type=ST)"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.conclusionCode">
      <path value="DiagnosticReport.conclusionCode"/>
      <short value="Codes for the clinical conclusion of test results"/>
      <definition
                  value="One or more codes that represent the summary conclusion (interpretation/impression) of the diagnostic report."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="DiagnosticReport.conclusionCode"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <binding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="AdjunctDiagnosis"/>
        </extension>
        <strength value="example"/>
        <description
                     value="Diagnosis codes provided as adjuncts to the report."/>
        <valueSet value="http://hl7.org/fhir/ValueSet/clinical-findings"/>
      </binding>
      <mapping>
        <identity value="v2"/>
        <map value="OBX"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map
             value="inboundRelationship[typeCode=SPRT].source[classCode=OBS, moodCode=EVN, code=LOINC:54531-9].value (type=CD)"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.presentedForm">
      <path value="DiagnosticReport.presentedForm"/>
      <short value="Entire report as issued"/>
      <definition
                  value="Rich text representation of the entire result as issued by the diagnostic service. Multiple formats are allowed but they SHALL be semantically equivalent."/>
      <comment
               value="&quot;application/pdf&quot; is recommended as the most reliable and interoperable in this context."/>
      <requirements
                    value="Gives laboratory the ability to provide its own fully formatted report for clinical fidelity."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="DiagnosticReport.presentedForm"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Attachment"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="v2"/>
        <map value="OBX"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="text (type=ED)"/>
      </mapping>
    </element>
  </snapshot>
  <differential>
    <element id="DiagnosticReport">
      <path value="DiagnosticReport"/>
    </element>
    <element id="DiagnosticReport.status">
      <path value="DiagnosticReport.status"/>
      <mustSupport value="true"/>
    </element>
    <element id="DiagnosticReport.category">
      <path value="DiagnosticReport.category"/>
      <mustSupport value="true"/>
    </element>
    <element id="DiagnosticReport.category:Genetics">
      <path value="DiagnosticReport.category"/>
      <sliceName value="Genetics"/>
    </element>
    <element id="DiagnosticReport.category:Genetics.coding">
      <path value="DiagnosticReport.category.coding"/>
      <max value="1"/>
    </element>
    <element id="DiagnosticReport.code">
      <path value="DiagnosticReport.code"/>
      <mustSupport value="true"/>
    </element>
    <element id="DiagnosticReport.subject">
      <path value="DiagnosticReport.subject"/>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-cancer-patient"/>
      </type>
      <mustSupport value="true"/>
    </element>
    <element id="DiagnosticReport.effective[x]">
      <path value="DiagnosticReport.effective[x]"/>
      <mustSupport value="true"/>
    </element>
    <element id="DiagnosticReport.issued">
      <path value="DiagnosticReport.issued"/>
      <mustSupport value="true"/>
    </element>
    <element id="DiagnosticReport.performer">
      <path value="DiagnosticReport.performer"/>
      <mustSupport value="true"/>
    </element>
    <element id="DiagnosticReport.specimen">
      <path value="DiagnosticReport.specimen"/>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-human-specimen"/>
      </type>
      <mustSupport value="true"/>
    </element>
    <element id="DiagnosticReport.result">
      <path value="DiagnosticReport.result"/>
      <mustSupport value="true"/>
    </element>
    <element id="DiagnosticReport.result:variant">
      <path value="DiagnosticReport.result"/>
      <sliceName value="variant"/>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-genomic-variant"/>
      </type>
      <mustSupport value="true"/>
    </element>
    <element id="DiagnosticReport.result:region-studied">
      <path value="DiagnosticReport.result"/>
      <sliceName value="region-studied"/>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-genomic-region-studied"/>
      </type>
      <mustSupport value="true"/>
    </element>
  </differential>
</StructureDefinition>