<status value="active"/> <date value="2026-03-19T18:20:23+00:00"/> <publisher value="Federal Office of Public Health FOPH"/> <contact> <name value="Federal Office of Public Health FOPH"/> <telecom> <system value="url"/> <value value="https://www.bag.admin.ch/bag/en/home/das-bag/kontakt-standort.html"/> </telecom> </contact> <description value="This CH ELM base profile constrains the DiagnosticReport resource for the purpose of laboratory test reports."/> <jurisdiction> <coding> <system value="urn:iso:std:iso:3166"/> <code value="CH"/> </coding> </jurisdiction> <copyright value="CC0-1.0"/> <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"/> </mapping> <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 value="http://fhir.ch/ig/ch-lab-report/StructureDefinition/ch-lab-diagnosticreport"/> <derivation value="constraint"/> <snapshot> <extension url="http://hl7.org/fhir/tools/StructureDefinition/snapshot-base-version"> <valueString value="2.0.0"/> </extension> <element id="DiagnosticReport"> <path value="DiagnosticReport"/> <short value="CH ELM DiagnosticReport: Laboratory Report"/> <definition value="Laboratory Report DiagnosticReport"/> <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 value="If the resource is contained in another resource, it SHALL NOT contain nested Resources"/> <expression value="contained.contained.empty()"/> <xpath value="not(parent::f:contained and f:contained)"/> <source value="http://hl7.org/fhir/StructureDefinition/DomainResource"/> </constraint> <constraint> <key value="dom-3"/> <severity value="error"/> <human value="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"/> <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 value="not(exists(for $id in f:contained/*/f:id/@value return $contained[not(parent::*/descendant::f:reference/@value=concat('#', $contained/*/id/@value) or descendant::f:reference[@value='#'])]))"/> <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 -> 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() > 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() > 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() > 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|4.0.1"/> </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 "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety."/> <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 "text blob" 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() > 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="1"/> <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() > 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"/> <isSummary value="false"/> </element> <element id="DiagnosticReport.extension:DiagnosticReportCompositionR5"> <path value="DiagnosticReport.extension"/> <sliceName value="DiagnosticReportCompositionR5"/> <short value="Associated Lab Report Composition"/> <definition value="This extension implements the R5 composition element. It allow to link this DiagnosticReport with the Composition documenting this Laboratory Report."/> <min value="1"/> <max value="1"/> <base> <path value="DomainResource.extension"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Extension"/> <profile value="http://hl7.org/fhir/5.0/StructureDefinition/extension-DiagnosticReport.composition"/> </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() > 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"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> <mapping> <identity value="rim"/> <map value="N/A"/> </mapping> </element> <element id="DiagnosticReport.extension:DiagnosticReportCompositionR5.id"> <path value="DiagnosticReport.extension.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.extension:DiagnosticReportCompositionR5.extension"> <path value="DiagnosticReport.extension.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="Extension"/> <definition value="An Extension"/> <min value="0"/> <max value="0"/> <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() > 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"/> <isSummary value="false"/> </element> <element id="DiagnosticReport.extension:DiagnosticReportCompositionR5.url"> <path value="DiagnosticReport.extension.url"/> <representation value="xmlAttr"/> <short value="identifies the meaning of the extension"/> <definition value="Source of the definition for the extension code - a logical name or a URL."/> <comment value="The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension."/> <min value="1"/> <max value="1"/> <base> <path value="Extension.url"/> <min value="1"/> <max value="1"/> </base> <type> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type"> <valueUrl value="uri"/> </extension> <code value="http://hl7.org/fhirpath/System.String"/> </type> <fixedUri value="http://hl7.org/fhir/5.0/StructureDefinition/extension-DiagnosticReport.composition"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="N/A"/> </mapping> </element> <element id="DiagnosticReport.extension:DiagnosticReportCompositionR5.value[x]"> <path value="DiagnosticReport.extension.value[x]"/> <short value="Value of extension"/> <definition value="Value of extension - must be one of a constrained set of the data types (see [Extensibility](http://hl7.org/fhir/R4/extensibility.html) for a list)."/> <min value="1"/> <max value="1"/> <base> <path value="Extension.value[x]"/> <min value="0"/> <max value="1"/> </base> <type> <code value="Reference"/> <targetProfile value="http://fhir.ch/ig/ch-lab-report/StructureDefinition/ch-lab-report-composition"/> </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() > 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="N/A"/> </mapping> </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() > 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="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="Persistent, unique identifier for the diagnostic report (UUID)"/> <definition value="Identifiers assigned to this Laboratory Report by the performer or other systems. It shall be common to several report versions"/> <comment value="Composition.identifier SHALL be equal to one of the DiagnosticReport.identifier, if at least one exists"/> <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="1"/> <max value="1"/> <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() > 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.identifier.id"> <path value="DiagnosticReport.identifier.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.identifier.extension"> <path value="DiagnosticReport.identifier.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() > 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"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element id="DiagnosticReport.identifier.use"> <path value="DiagnosticReport.identifier.use"/> <short value="usual | official | temp | secondary | old (If known)"/> <definition value="The purpose of this identifier."/> <comment value="Applications can assume that an identifier is permanent unless it explicitly says that it is temporary."/> <requirements value="Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers."/> <min value="0"/> <max value="1"/> <base> <path value="Identifier.use"/> <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() > id.count())"/> <xpath value="@value|f:*|h:div"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <isModifier value="true"/> <isModifierReason value="This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one."/> <isSummary value="true"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="IdentifierUse"/> </extension> <strength value="required"/> <description value="Identifies the purpose for this identifier, if known ."/> <valueSet value="http://hl7.org/fhir/ValueSet/identifier-use|4.0.1"/> </binding> <mapping> <identity value="v2"/> <map value="N/A"/> </mapping> <mapping> <identity value="rim"/> <map value="Role.code or implied by context"/> </mapping> </element> <element id="DiagnosticReport.identifier.type"> <path value="DiagnosticReport.identifier.type"/> <short value="Description of identifier"/> <definition value="A coded type for the identifier that can be used to determine which identifier to use for a specific purpose."/> <comment value="This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type."/> <requirements value="Allows users to make use of identifiers when the identifier system is not known."/> <min value="0"/> <max value="1"/> <base> <path value="Identifier.type"/> <min value="0"/> <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() > 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="IdentifierType"/> </extension> <strength value="extensible"/> <description value="A coded type for an identifier that can be used to determine which identifier to use for a specific purpose."/> <valueSet value="http://hl7.org/fhir/ValueSet/identifier-type|4.0.1"/> </binding> <mapping> <identity value="v2"/> <map value="CX.5"/> </mapping> <mapping> <identity value="rim"/> <map value="Role.code or implied by context"/> </mapping> </element> <element id="DiagnosticReport.identifier.system"> <path value="DiagnosticReport.identifier.system"/> <short value="The namespace for the identifier value"/> <definition value="Establishes the namespace for the value - that is, a URL that describes a set values that are unique."/> <comment value="Identifier.system is always case sensitive."/> <requirements value="There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers."/> <min value="1"/> <max value="1"/> <base> <path value="Identifier.system"/> <min value="0"/> <max value="1"/> </base> <type> <code value="uri"/> </type> <patternUri value="urn:ietf:rfc:3986"/> <example> <label value="General"/> <valueUri value="http://www.acme.com/identifiers/patient"/> </example> <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() > 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="CX.4 / EI-2-4"/> </mapping> <mapping> <identity value="rim"/> <map value="II.root or Role.id.root"/> </mapping> <mapping> <identity value="servd"/> <map value="./IdentifierType"/> </mapping> </element> <element id="DiagnosticReport.identifier.value"> <path value="DiagnosticReport.identifier.value"/> <short value="The value that is unique"/> <definition value="The portion of the identifier typically relevant to the user and which is unique within the context of the system."/> <comment value="If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the [Rendered Value extension](http://hl7.org/fhir/R4/extension-rendered-value.html). Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe."/> <min value="1"/> <max value="1"/> <base> <path value="Identifier.value"/> <min value="0"/> <max value="1"/> </base> <type> <code value="string"/> </type> <example> <label value="General"/> <valueString value="123456"/> </example> <example> <label value="CH ELM"/> <valueString value="urn:uuid:d494503a-7bef-4551-853c-f3dced2c518f"/> </example> <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() > id.count())"/> <xpath value="@value|f:*|h:div"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <constraint> <key value="ch-elm-doc-identifier"/> <severity value="error"/> <human value="The identifier must be an UUID."/> <expression value="startsWith('urn:uuid:')"/> <source value="http://fhir.ch/ig/ch-elm/StructureDefinition/ch-elm-diagnosticreport"/> </constraint> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="v2"/> <map value="CX.1 / EI.1"/> </mapping> <mapping> <identity value="rim"/> <map value="II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)"/> </mapping> <mapping> <identity value="servd"/> <map value="./Value"/> </mapping> </element> <element id="DiagnosticReport.identifier.period"> <path value="DiagnosticReport.identifier.period"/> <short value="Time period when id is/was valid for use"/> <definition value="Time period during which identifier is/was valid for use."/> <min value="0"/> <max value="1"/> <base> <path value="Identifier.period"/> <min value="0"/> <max value="1"/> </base> <type> <code value="Period"/> </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() > 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="CX.7 + CX.8"/> </mapping> <mapping> <identity value="rim"/> <map value="Role.effectiveTime or implied by context"/> </mapping> <mapping> <identity value="servd"/> <map value="./StartDate and ./EndDate"/> </mapping> </element> <element id="DiagnosticReport.identifier.assigner"> <path value="DiagnosticReport.identifier.assigner"/> <short value="Organization that issued id (may be just text)"/> <definition value="Organization that issued/manages the identifier."/> <comment value="The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization."/> <min value="0"/> <max value="1"/> <base> <path value="Identifier.assigner"/> <min value="0"/> <max value="1"/> </base> <type> <code value="Reference"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Organization|4.0.1"/> </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() > 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="CX.4 / (CX.4,CX.9,CX.10)"/> </mapping> <mapping> <identity value="rim"/> <map value="II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper"/> </mapping> <mapping> <identity value="servd"/> <map value="./IdentifierIssuingAuthority"/> </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="1"/> <max value="1"/> <base> <path value="DiagnosticReport.basedOn"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Reference"/> <targetProfile value="http://fhir.ch/ig/ch-elm/StructureDefinition/ch-elm-servicerequest-laboratory-order"/> </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() > 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="Status of the Report"/> <definition value="The status of the diagnostic report."/> <comment value="DiagnosticReport.status and Composition.status shall be aligned, based on the http://hl7.eu/fhir/laboratory/ConceptMap/ConceptMap-eu-diagRptStatus2CompStatus mapping"/> <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> <patternCode value="final"/> <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() > 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 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 "revise""/> </mapping> </element> <element id="DiagnosticReport.category"> <path value="DiagnosticReport.category"/> <slicing> <discriminator> <type value="value"/> <path value="$this"/> </discriminator> <rules value="open"/> </slicing> <short value="Report Category"/> <definition value="A code that classifies this laboratory report. Two basic categories has been selected in this guide: laboratory specialty and Study type. Laboratory specialty is characteristic of the laboratory that produced the test result while Study type is an arbitrary classificion of the test type."/> <comment value="DiagnosticReport.category and Composition.category shall be aligned"/> <alias value="Department"/> <alias value="Sub-department"/> <alias value="Service"/> <alias value="Discipline"/> <min value="0"/> <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() > 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|4.0.1"/> </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 < LabService].code"/> </mapping> </element> <element id="DiagnosticReport.category:studyType"> <path value="DiagnosticReport.category"/> <sliceName value="studyType"/> <short value="The way of grouping of the test results into clinically meaningful domains (e.g. hematology study, microbiology study, etc.)"/> <definition value="Laboratory services, i.e., results of tests performed, could be characterized using typology of services, commonly called study types. Study type could be seen as an attribute or grouping mechanism that assigns a common clinical sense to certain types of laboratory test results., e.g., Hemoglobin, Platelet count, etc. belongs to 'Hematology study'."/> <comment value="In comparison to the laboratory specialty which is an attribute of laboratory, study type is a categorization of laboratory service. It needs to be mentioned that classification of test to study types in not standardized."/> <alias value="Department"/> <alias value="Sub-department"/> <alias value="Service"/> <alias value="Discipline"/> <min value="0"/> <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() > id.count())"/> <xpath value="@value|f:*|h:div"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <isModifier value="false"/> <isSummary value="true"/> <binding> <strength value="required"/> <valueSet value="http://hl7.eu/fhir/laboratory/ValueSet/lab-studyType-eu-lab"/> </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 < LabService].code"/> </mapping> </element> <element id="DiagnosticReport.category:specialty"> <path value="DiagnosticReport.category"/> <sliceName value="specialty"/> <short value="The clinical domain of the laboratory performing the observation (e.g. microbiology, toxicology, chemistry)"/> <definition value="Laboratory specialty is an attribute of any laboratory setting representing professional qualification of the laboratory to execute certain kind of laboratory tests."/> <comment value="Specialty could be used as parameter for searching/querying of laboratory test results."/> <alias value="Department"/> <alias value="Sub-department"/> <alias value="Service"/> <alias value="Discipline"/> <min value="0"/> <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() > id.count())"/> <xpath value="@value|f:*|h:div"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <isModifier value="false"/> <isSummary value="true"/> <binding> <strength value="required"/> <valueSet value="http://hl7.eu/fhir/laboratory/ValueSet/lab-specialty-eu-lab"/> </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 < LabService].code"/> </mapping> </element> <element id="DiagnosticReport.code"> <path value="DiagnosticReport.code"/> <short value="Type of (Laboratory) Report"/> <definition value="Specifies that it refers to a Laboratory Report"/> <comment value="At least one DiagnosticReport.code.coding and Composition.type.coding SHALL be equal"/> <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() > id.count())"/> <xpath value="@value|f:*|h:div"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <isModifier value="false"/> <isSummary value="true"/> <binding> <strength value="preferred"/> <valueSet value="http://hl7.eu/fhir/laboratory/ValueSet/lab-reportType-eu-lab"/> </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="Who and/or what this report is about"/> <definition value="Who or what this report is about. The report can be about a human patient, a living subject, a device (e.g. a machine), a location or even a group of subjects (such as a document about a herd of livestock, or a set of patients that share a common exposure)."/> <comment value="DiagnosticReport and Composition SHALL have the same subject"/> <requirements value="SHALL know the subject context."/> <alias value="Patient"/> <min value="1"/> <max value="1"/> <base> <path value="DiagnosticReport.subject"/> <min value="0"/> <max value="1"/> </base> <type> <code value="Reference"/> <targetProfile value="http://fhir.ch/ig/ch-elm/StructureDefinition/ch-elm-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() > 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.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="The healthcare event which this Laboratory Report is about (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). DiagnosticReport and Composition SHALL have the same encounter."/> <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|4.0.1"/> </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() > 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> <type> <code value="Period"/> </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() > 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.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() > 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="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="If a DiagnosticReport.resultsInterpreter exists this is expected to be a Composition.author; otherwise a DiagnosticReport.performer should be an author."/> <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="1"/> <max value="1"/> <base> <path value="DiagnosticReport.performer"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Reference"/> <targetProfile value="http://fhir.ch/ig/ch-elm/StructureDefinition/ch-elm-organization-lab"/> </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() > 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="PRT-8 (where this PRT-4-Participation = "PO")"/> </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="If a DiagnosticReport.resultsInterpreter exists this is expected to be a Composition.author; otherwise a DiagnosticReport.performer should be an author."/> <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|4.0.1"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/PractitionerRole|4.0.1"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Organization|4.0.1"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/CareTeam|4.0.1"/> </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() > 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 = "PI")"/> </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="1"/> <max value="1"/> <base> <path value="DiagnosticReport.specimen"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Reference"/> <targetProfile value="http://fhir.ch/ig/ch-elm/StructureDefinition/ch-elm-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() > 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="SPM"/> </mapping> <mapping> <identity value="rim"/> <map value="participation[typeCode=SBJ]"/> </mapping> </element> <element id="DiagnosticReport.result"> <path value="DiagnosticReport.result"/> <short value="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="1"/> <max value="1"/> <base> <path value="DiagnosticReport.result"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Reference"/> <targetProfile value="http://fhir.ch/ig/ch-elm/StructureDefinition/ch-elm-observation-results-laboratory"/> </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() > 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="0"/> <base> <path value="DiagnosticReport.imagingStudy"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Reference"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/ImagingStudy|4.0.1"/> </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() > 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() > 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() > 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"/> <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() > 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="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() > 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="annotation"].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|4.0.1"/> </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() > 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() > 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="SPRT"].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() > 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|4.0.1"/> </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 (pdf recommended)"/> <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=""application/pdf" 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() > 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"/> <short value="CH ELM DiagnosticReport: Laboratory Report"/> </element> <element id="DiagnosticReport.identifier"> <path value="DiagnosticReport.identifier"/> <short value="Persistent, unique identifier for the diagnostic report (UUID)"/> <min value="1"/> <max value="1"/> </element> <element id="DiagnosticReport.identifier.system"> <path value="DiagnosticReport.identifier.system"/> <min value="1"/> <patternUri value="urn:ietf:rfc:3986"/> </element> <element id="DiagnosticReport.identifier.value"> <path value="DiagnosticReport.identifier.value"/> <min value="1"/> <example> <label value="CH ELM"/> <valueString value="urn:uuid:d494503a-7bef-4551-853c-f3dced2c518f"/> </example> <constraint> <key value="ch-elm-doc-identifier"/> <severity value="error"/> <human value="The identifier must be an UUID."/> <expression value="startsWith('urn:uuid:')"/> <source value="http://fhir.ch/ig/ch-elm/StructureDefinition/ch-elm-diagnosticreport"/> </constraint> </element> <element id="DiagnosticReport.basedOn"> <path value="DiagnosticReport.basedOn"/> <min value="1"/> <max value="1"/> <type> <code value="Reference"/> <targetProfile value="http://fhir.ch/ig/ch-elm/StructureDefinition/ch-elm-servicerequest-laboratory-order"/> </type> </element> <element id="DiagnosticReport.status"> <path value="DiagnosticReport.status"/> <patternCode value="final"/> </element> <element id="DiagnosticReport.subject"> <path value="DiagnosticReport.subject"/> <type> <code value="Reference"/> <targetProfile value="http://fhir.ch/ig/ch-elm/StructureDefinition/ch-elm-patient"/> </type> </element> <element id="DiagnosticReport.performer"> <path value="DiagnosticReport.performer"/> <min value="1"/> <max value="1"/> <type> <code value="Reference"/> <targetProfile value="http://fhir.ch/ig/ch-elm/StructureDefinition/ch-elm-organization-lab"/> </type> </element> <element id="DiagnosticReport.specimen"> <path value="DiagnosticReport.specimen"/> <min value="1"/> <max value="1"/> <type> <code value="Reference"/> <targetProfile value="http://fhir.ch/ig/ch-elm/StructureDefinition/ch-elm-specimen"/> </type> </element> <element id="DiagnosticReport.result"> <path value="DiagnosticReport.result"/> <min value="1"/> <max value="1"/> <type> <code value="Reference"/> <targetProfile value="http://fhir.ch/ig/ch-elm/StructureDefinition/ch-elm-observation-results-laboratory"/> </type> </element> </differential> </StructureDefinition>

Generated Narrative: StructureDefinition ch-elm-diagnosticreport

Name	Flags	Card.	Type	Description & Constraints
DiagnosticReport		0..*	ChLabDiagnosticReport	CH ELM DiagnosticReport: Laboratory Report This profile also imposes the profile DiagnosticReport: Laboratory Report
identifier		1..1	Identifier	Persistent, unique identifier for the diagnostic report (UUID)
system		1..1	uri	The namespace for the identifier value Required Pattern: urn:ietf:rfc:3986
value	C	1..1	string	The value that is unique Constraints: ch-elm-doc-identifier Example CH ELM: urn:uuid:d494503a-7bef-4551-853c-f3dced2c518f
basedOn		1..1	Reference(CH ELM ServiceRequest: Laboratory Order)	What was requested
status		1..1	code	Status of the Report Required Pattern: final
subject		1..1	Reference(CH ELM Patient)	Who and/or what this report is about
performer		1..1	Reference(CH ELM Organization: Lab)	Responsible Diagnostic Service.
specimen		1..1	Reference(CH ELM Specimen: Laboratory)	Specimens this report is based on.
result		1..1	Reference(CH ELM Observation Results: Laboratory)	results
Documentation for this format