NHDR Implementation Guide Release 1.0
0.1.0 - ci-build

NHDR Implementation Guide Release 1.0, published by NHDR. This guide is not an authorized publication; it is the continuous build for version 0.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/PROJ-PHILHEALTH-EA-NHDR/nhdr-fhir-ig-review-project-2/ and changes regularly. See the Directory of published versions

## Resource Profile: PH DiagnosticReport

Official URL: https://nhdr.gov.ph/fhir/StructureDefinition/PH-DiagnosticReport | Version: 0.1.0
Standards status: Draft | Computable Name: PH_DiagnosticReport
Copyright/Legal: Used by permission of HL7 International, all rights reserved Creative Commons License

The findings and interpretation of diagnostic tests performed on patients, groups of patients, products, substances, devices, and locations, and/or specimens derived from these.

Usages:

- Refer to this Profile: PH MedicationAdministration and PH ServiceRequest

You can also check for usages in the FHIR IG Statistics

### Formal Views of Profile Content

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

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

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
DiagnosticReport |  | 0..* | DiagnosticReport | A Diagnostic report - a combination of request information, atomic results, images, interpretation, as well as formatted reports
status | ?!Σ | 1..1 | code | registered | partial | preliminary | final + Binding: DiagnosticReportStatus (required): The status of the diagnostic report.
code | Σ | 1..1 | CodeableConcept | Name/Code for this diagnostic report Binding: ICD-10 Codes (required)
subject | Σ | 0..1 | Reference(PH Patient) | The subject of the report - usually, but not always, the patient
encounter | Σ | 0..1 | Reference(PH Encounter) | Health care event when test ordered
performer | Σ | 0..* | Reference(PH Practitioner | PH PractitionerRole | PH Organization | CareTeam) | Responsible Diagnostic Service
specimen |  | 0..* | Reference(PH Specimen) | Specimens this report is based on
result |  | 0..* | Reference(PH Observation) | Observations
conclusionCode |  | 0..* | CodeableConcept | Codes for the clinical conclusion of test results Binding: ICD-10 Codes (required)
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
DiagnosticReport.status | Base | required | DiagnosticReportStatus | 📍4.0.1 | FHIR Std.
DiagnosticReport.code | Base | required | ICD-10 Codes | 📦0.1.0 | This IG
DiagnosticReport.conclusionCode | Base | required | ICD-10 Codes | 📦0.1.0 | This IG

#### Constraints

Id | Grade | Path(s) | Description | Expression
dom-2 | error | DiagnosticReport | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | DiagnosticReport | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource | `contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()`
dom-4 | error | DiagnosticReport | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated | `contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()`
dom-5 | error | DiagnosticReport | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | DiagnosticReport | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`

This structure is derived from DiagnosticReport

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
DiagnosticReport |  | 0..* | DiagnosticReport | A Diagnostic report - a combination of request information, atomic results, images, interpretation, as well as formatted reports
meta |  |  |  |
Slices for extension |  |  |  | Content/Rules for all slices
extension:hfRecordedDate |  | 0..1 | dateTime | The recorded date indicating when the record was uploaded by the health facility. URL: https://nhdr.gov.ph/fhir/StructureDefinition/HFRecordedDate
extension:hfLastUpdated |  | 0..* | dateTime | The date indicating when the record was last updated by the health facility. URL: https://nhdr.gov.ph/fhir/StructureDefinition/HFLastUpdated
lastUpdated |  | 0..1 | instant | When the resource was uploaded to the NHDR.
implicitRules |  | 0..0 |  | A set of rules under which this content was created
language |  | 0..0 |  | Language of the resource content
text |  | 0..0 |  | Text summary of the resource, for human interpretation
contained |  | 0..0 |  | Contained, inline Resources
extension |  | 0..0 |  | Extension
modifierExtension |  | 0..0 |  | Extension
basedOn |  | 0..0 |  | What was requested
code |  | 1..1 | CodeableConcept | Name/Code for this diagnostic report Binding: ICD-10 Codes (required)
subject |  | 0..1 | Reference(PH Patient) | The subject of the report - usually, but not always, the patient
encounter |  | 0..1 | Reference(PH Encounter) | Health care event when test ordered
performer |  | 0..* | Reference(PH Practitioner | PH PractitionerRole | PH Organization | CareTeam) | Responsible Diagnostic Service
resultsInterpreter |  | 0..0 |  | Primary result interpreter
specimen |  | 0..* | Reference(PH Specimen) | Specimens this report is based on
result |  | 0..* | Reference(PH Observation) | Observations
imagingStudy |  | 0..0 |  | Reference to full details of imaging associated with the diagnostic report
media |  | 0..0 |  | Key images associated with this report
conclusionCode |  | 0..* | CodeableConcept | Codes for the clinical conclusion of test results Binding: ICD-10 Codes (required)
presentedForm |  | 0..0 |  | Entire report as issued
Documentation for this format

#### Terminology Bindings (Differential)

Path | Status | Usage | ValueSet | Version | Source
DiagnosticReport.code | Base | required | ICD-10 Codes | 📦0.1.0 | This IG
DiagnosticReport.conclusionCode | Base | required | ICD-10 Codes | 📦0.1.0 | This IG

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
DiagnosticReport |  | 0..* | DiagnosticReport | A Diagnostic report - a combination of request information, atomic results, images, interpretation, as well as formatted reports
id | Σ | 0..1 | id | Logical id of this artifact
meta | Σ | 0..1 | Meta | Metadata about the resource
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
extension:hfRecordedDate |  | 0..1 | dateTime | The recorded date indicating when the record was uploaded by the health facility. URL: https://nhdr.gov.ph/fhir/StructureDefinition/HFRecordedDate
extension:hfLastUpdated |  | 0..* | dateTime | The date indicating when the record was last updated by the health facility. URL: https://nhdr.gov.ph/fhir/StructureDefinition/HFLastUpdated
versionId | Σ | 0..1 | id | Version specific identifier
lastUpdated | Σ | 0..1 | instant | When the resource was uploaded to the NHDR.
source | Σ | 0..1 | uri | Identifies where the resource comes from
profile | Σ | 0..* | canonical(StructureDefinition) | Profiles this resource claims to conform to
security | Σ | 0..* | Coding | Security Labels applied to this resource Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
tag | Σ | 0..* | Coding | Tags applied to this resource Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".
identifier | Σ | 0..* | Identifier | Business identifier for report
status | ?!Σ | 1..1 | code | registered | partial | preliminary | final + Binding: DiagnosticReportStatus (required): The status of the diagnostic report.
category | Σ | 0..* | CodeableConcept | Service category Binding: DiagnosticServiceSectionCodes (example): Codes for diagnostic service sections.
code | Σ | 1..1 | CodeableConcept | Name/Code for this diagnostic report Binding: ICD-10 Codes (required)
subject | Σ | 0..1 | Reference(PH Patient) | The subject of the report - usually, but not always, the patient
encounter | Σ | 0..1 | Reference(PH Encounter) | Health care event when test ordered
effective[x] | Σ | 0..1 |  | Clinically relevant time/time-period for report
effectiveDateTime |  |  | dateTime |
effectivePeriod |  |  | Period |
issued | Σ | 0..1 | instant | DateTime this version was made
performer | Σ | 0..* | Reference(PH Practitioner | PH PractitionerRole | PH Organization | CareTeam) | Responsible Diagnostic Service
specimen |  | 0..* | Reference(PH Specimen) | Specimens this report is based on
result |  | 0..* | Reference(PH Observation) | Observations
conclusion |  | 0..1 | string | Clinical conclusion (interpretation) of test results
conclusionCode |  | 0..* | CodeableConcept | Codes for the clinical conclusion of test results Binding: ICD-10 Codes (required)
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
DiagnosticReport.meta.​security | Base | extensible | SecurityLabels | 📍4.0.1 | FHIR Std.
DiagnosticReport.meta.​tag | Base | example | Common Tags | 📍4.0.1 | FHIR Std.
DiagnosticReport.status | Base | required | DiagnosticReportStatus | 📍4.0.1 | FHIR Std.
DiagnosticReport.category | Base | example | Diagnostic Service Section Codes | 📍4.0.1 | FHIR Std.
DiagnosticReport.code | Base | required | ICD-10 Codes | 📦0.1.0 | This IG
DiagnosticReport.conclusionCode | Base | required | ICD-10 Codes | 📦0.1.0 | This IG

#### Constraints

Id | Grade | Path(s) | Description | Expression
dom-2 | error | DiagnosticReport | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | DiagnosticReport | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource | `contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()`
dom-4 | error | DiagnosticReport | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated | `contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()`
dom-5 | error | DiagnosticReport | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | DiagnosticReport | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`

This structure is derived from DiagnosticReport

Summary

Prohibited: 11 elements

Structures

This structure refers to these other structures:

- PH Patient (https://nhdr.gov.ph/fhir/StructureDefinition/PH-Patient)
- PH Encounter (https://nhdr.gov.ph/fhir/StructureDefinition/PH-Encounter)
- PH Practitioner (https://nhdr.gov.ph/fhir/StructureDefinition/PH-Practitioner)
- PH PractitionerRole (https://nhdr.gov.ph/fhir/StructureDefinition/PH-PractitionerRole)
- PH Organization (https://nhdr.gov.ph/fhir/StructureDefinition/PH-Organization)
- PH Specimen (https://nhdr.gov.ph/fhir/StructureDefinition/PH-Specimen)
- PH Observation (https://nhdr.gov.ph/fhir/StructureDefinition/PH-Observation)

Extensions

This structure refers to these extensions:

- https://nhdr.gov.ph/fhir/StructureDefinition/HFRecordedDate
- https://nhdr.gov.ph/fhir/StructureDefinition/HFLastUpdated

Key Elements View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
DiagnosticReport |  | 0..* | DiagnosticReport | A Diagnostic report - a combination of request information, atomic results, images, interpretation, as well as formatted reports
status | ?!Σ | 1..1 | code | registered | partial | preliminary | final + Binding: DiagnosticReportStatus (required): The status of the diagnostic report.
code | Σ | 1..1 | CodeableConcept | Name/Code for this diagnostic report Binding: ICD-10 Codes (required)
subject | Σ | 0..1 | Reference(PH Patient) | The subject of the report - usually, but not always, the patient
encounter | Σ | 0..1 | Reference(PH Encounter) | Health care event when test ordered
performer | Σ | 0..* | Reference(PH Practitioner | PH PractitionerRole | PH Organization | CareTeam) | Responsible Diagnostic Service
specimen |  | 0..* | Reference(PH Specimen) | Specimens this report is based on
result |  | 0..* | Reference(PH Observation) | Observations
conclusionCode |  | 0..* | CodeableConcept | Codes for the clinical conclusion of test results Binding: ICD-10 Codes (required)
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
DiagnosticReport.status | Base | required | DiagnosticReportStatus | 📍4.0.1 | FHIR Std.
DiagnosticReport.code | Base | required | ICD-10 Codes | 📦0.1.0 | This IG
DiagnosticReport.conclusionCode | Base | required | ICD-10 Codes | 📦0.1.0 | This IG

#### Constraints

Id | Grade | Path(s) | Description | Expression
dom-2 | error | DiagnosticReport | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | DiagnosticReport | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource | `contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()`
dom-4 | error | DiagnosticReport | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated | `contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()`
dom-5 | error | DiagnosticReport | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | DiagnosticReport | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`

Differential View

This structure is derived from DiagnosticReport

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
DiagnosticReport |  | 0..* | DiagnosticReport | A Diagnostic report - a combination of request information, atomic results, images, interpretation, as well as formatted reports
meta |  |  |  |
Slices for extension |  |  |  | Content/Rules for all slices
extension:hfRecordedDate |  | 0..1 | dateTime | The recorded date indicating when the record was uploaded by the health facility. URL: https://nhdr.gov.ph/fhir/StructureDefinition/HFRecordedDate
extension:hfLastUpdated |  | 0..* | dateTime | The date indicating when the record was last updated by the health facility. URL: https://nhdr.gov.ph/fhir/StructureDefinition/HFLastUpdated
lastUpdated |  | 0..1 | instant | When the resource was uploaded to the NHDR.
implicitRules |  | 0..0 |  | A set of rules under which this content was created
language |  | 0..0 |  | Language of the resource content
text |  | 0..0 |  | Text summary of the resource, for human interpretation
contained |  | 0..0 |  | Contained, inline Resources
extension |  | 0..0 |  | Extension
modifierExtension |  | 0..0 |  | Extension
basedOn |  | 0..0 |  | What was requested
code |  | 1..1 | CodeableConcept | Name/Code for this diagnostic report Binding: ICD-10 Codes (required)
subject |  | 0..1 | Reference(PH Patient) | The subject of the report - usually, but not always, the patient
encounter |  | 0..1 | Reference(PH Encounter) | Health care event when test ordered
performer |  | 0..* | Reference(PH Practitioner | PH PractitionerRole | PH Organization | CareTeam) | Responsible Diagnostic Service
resultsInterpreter |  | 0..0 |  | Primary result interpreter
specimen |  | 0..* | Reference(PH Specimen) | Specimens this report is based on
result |  | 0..* | Reference(PH Observation) | Observations
imagingStudy |  | 0..0 |  | Reference to full details of imaging associated with the diagnostic report
media |  | 0..0 |  | Key images associated with this report
conclusionCode |  | 0..* | CodeableConcept | Codes for the clinical conclusion of test results Binding: ICD-10 Codes (required)
presentedForm |  | 0..0 |  | Entire report as issued
Documentation for this format

#### Terminology Bindings (Differential)

Path | Status | Usage | ValueSet | Version | Source
DiagnosticReport.code | Base | required | ICD-10 Codes | 📦0.1.0 | This IG
DiagnosticReport.conclusionCode | Base | required | ICD-10 Codes | 📦0.1.0 | This IG

Snapshot View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
DiagnosticReport |  | 0..* | DiagnosticReport | A Diagnostic report - a combination of request information, atomic results, images, interpretation, as well as formatted reports
id | Σ | 0..1 | id | Logical id of this artifact
meta | Σ | 0..1 | Meta | Metadata about the resource
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
extension:hfRecordedDate |  | 0..1 | dateTime | The recorded date indicating when the record was uploaded by the health facility. URL: https://nhdr.gov.ph/fhir/StructureDefinition/HFRecordedDate
extension:hfLastUpdated |  | 0..* | dateTime | The date indicating when the record was last updated by the health facility. URL: https://nhdr.gov.ph/fhir/StructureDefinition/HFLastUpdated
versionId | Σ | 0..1 | id | Version specific identifier
lastUpdated | Σ | 0..1 | instant | When the resource was uploaded to the NHDR.
source | Σ | 0..1 | uri | Identifies where the resource comes from
profile | Σ | 0..* | canonical(StructureDefinition) | Profiles this resource claims to conform to
security | Σ | 0..* | Coding | Security Labels applied to this resource Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
tag | Σ | 0..* | Coding | Tags applied to this resource Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".
identifier | Σ | 0..* | Identifier | Business identifier for report
status | ?!Σ | 1..1 | code | registered | partial | preliminary | final + Binding: DiagnosticReportStatus (required): The status of the diagnostic report.
category | Σ | 0..* | CodeableConcept | Service category Binding: DiagnosticServiceSectionCodes (example): Codes for diagnostic service sections.
code | Σ | 1..1 | CodeableConcept | Name/Code for this diagnostic report Binding: ICD-10 Codes (required)
subject | Σ | 0..1 | Reference(PH Patient) | The subject of the report - usually, but not always, the patient
encounter | Σ | 0..1 | Reference(PH Encounter) | Health care event when test ordered
effective[x] | Σ | 0..1 |  | Clinically relevant time/time-period for report
effectiveDateTime |  |  | dateTime |
effectivePeriod |  |  | Period |
issued | Σ | 0..1 | instant | DateTime this version was made
performer | Σ | 0..* | Reference(PH Practitioner | PH PractitionerRole | PH Organization | CareTeam) | Responsible Diagnostic Service
specimen |  | 0..* | Reference(PH Specimen) | Specimens this report is based on
result |  | 0..* | Reference(PH Observation) | Observations
conclusion |  | 0..1 | string | Clinical conclusion (interpretation) of test results
conclusionCode |  | 0..* | CodeableConcept | Codes for the clinical conclusion of test results Binding: ICD-10 Codes (required)
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
DiagnosticReport.meta.​security | Base | extensible | SecurityLabels | 📍4.0.1 | FHIR Std.
DiagnosticReport.meta.​tag | Base | example | Common Tags | 📍4.0.1 | FHIR Std.
DiagnosticReport.status | Base | required | DiagnosticReportStatus | 📍4.0.1 | FHIR Std.
DiagnosticReport.category | Base | example | Diagnostic Service Section Codes | 📍4.0.1 | FHIR Std.
DiagnosticReport.code | Base | required | ICD-10 Codes | 📦0.1.0 | This IG
DiagnosticReport.conclusionCode | Base | required | ICD-10 Codes | 📦0.1.0 | This IG

#### Constraints

Id | Grade | Path(s) | Description | Expression
dom-2 | error | DiagnosticReport | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | DiagnosticReport | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource | `contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()`
dom-4 | error | DiagnosticReport | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated | `contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()`
dom-5 | error | DiagnosticReport | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | DiagnosticReport | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`

This structure is derived from DiagnosticReport

Summary

Prohibited: 11 elements

Structures

This structure refers to these other structures:

- PH Patient (https://nhdr.gov.ph/fhir/StructureDefinition/PH-Patient)
- PH Encounter (https://nhdr.gov.ph/fhir/StructureDefinition/PH-Encounter)
- PH Practitioner (https://nhdr.gov.ph/fhir/StructureDefinition/PH-Practitioner)
- PH PractitionerRole (https://nhdr.gov.ph/fhir/StructureDefinition/PH-PractitionerRole)
- PH Organization (https://nhdr.gov.ph/fhir/StructureDefinition/PH-Organization)
- PH Specimen (https://nhdr.gov.ph/fhir/StructureDefinition/PH-Specimen)
- PH Observation (https://nhdr.gov.ph/fhir/StructureDefinition/PH-Observation)

Extensions

This structure refers to these extensions:

- https://nhdr.gov.ph/fhir/StructureDefinition/HFRecordedDate
- https://nhdr.gov.ph/fhir/StructureDefinition/HFLastUpdated

Other representations of profile: CSV, Excel, Schematron