For API details see:

• DiagnosticReport shows all of the DiagnosticReport. Including Microbiology, Pathology, and Chem-Hem.

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

This structure is derived from USCoreDiagnosticReportProfileLaboratoryReporting

Name	Flags	Card.	Type	Description & Constraints
DiagnosticReport		0..*	USCoreDiagnosticReportProfileLaboratoryReporting	A Diagnostic report - a combination of request information, atomic results, images, interpretation, as well as formatted reports
Slices for identifier		1..*	Identifier	Business identifier for report Slice: Unordered, Open by pattern:use
identifier:TOid		1..1	Identifier	Business identifier for report
use		1..1	code	usual | official | temp | secondary | old (If known) Required Pattern: usual
system	C	0..1	uri	urn:oid:2.16.840.1.113883.4.349.4.{stationNbr} TOid-startswithoid: ID system must start with urn:oid:2.16.840.1.113883.4.349.4. The next would be the {stationNbr}
value		0..1	string	`LabReportTO` | `.` | {LabReportTO.id}
identifier:casenum		0..*	Identifier	Business identifier for report
use		1..1	code	usual | official | temp | secondary | old (If known) Required Pattern: secondary
system	C	0..1	uri	urn:oid:2.16.840.1.113883.4.349.4.{stationNbr} TOid-startswithoid: ID system must start with urn:oid:2.16.840.1.113883.4.349.4. The next would be the {stationNbr}
value		0..1	string	`CaseNum` | `.` | {LabReportTO.casenum}
basedOn		0..0
status		1..1	code	registered | partial | preliminary | final +
category		2..*	CodeableConcept	Service category
Slices for category				Content/Rules for all slices
category:SPLabSlice		1..1	CodeableConcept	Service category Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0074
code		1..1	code	Symbol in syntax defined by the system Fixed Value: SP
code
coding	S	0..1	Coding	Code defined by a terminology system Required Pattern: At least the following
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 11526-1
text	S	1..1	string	Plain text representation of the concept
subject		1..1	Reference(US Core Patient Profile)	The subject of the report - usually, but not always, the patient
encounter		0..0
Slices for effective[x]		0..1	dateTime, Period	Diagnostically relevant time (typically the time of specimen collection) Slice: Unordered, Open by type:$this
effective[x]:effectiveDateTime	S	0..1	dateTime S	Diagnostically relevant time (typically the time of specimen collection)
issued		0..1	instant	When the report was released
performer		0..*	Reference(VA MHV PHR Organization | US Core Practitioner Profile) {c}	Responsible Diagnostic Service
display		0..0
resultsInterpreter		0..0
specimen	S	0..*	Reference(VA MHV PHR Lab Specimen) {c}	Specimens this report is based on
result		0..*	Reference(VA MHV PHR labTest) {c}	Observations
imagingStudy		0..0
media		0..0
conclusion		0..0
conclusionCode		0..0
presentedForm	S	0..*	Attachment	Entire report as issued
contentType		0..1	code	Mime type of the content, with charset etc. Required Pattern: text/plain
language		0..0
data		1..1	base64Binary	Data inline, base64ed
url		0..0
size		0..0
hash		0..0
title		0..0
creation		0..0
Documentation for this format

Constraints

Id	Grade	Path(s)	Details	Requirements
TOid-startswithoid	error	DiagnosticReport.identifier:TOid.system, DiagnosticReport.identifier:casenum.system	ID system must start with urn:oid:2.16.840.1.113883.4.349.4. The next would be the {stationNbr} : value.startsWith('urn:oid:2.16.840.1.113883.4.349.4.')

Name	Flags	Card.	Type	Description & Constraints
DiagnosticReport	C	0..*	USCoreDiagnosticReportProfileLaboratoryReporting	A Diagnostic report - a combination of request information, atomic results, images, interpretation, as well as formatted reports us-core-8: effective[x] SHALL be present if the status is 'partial', 'preliminary', 'final', 'amended', 'corrected' or 'appended' us-core-9: issued SHALL be present if the status is 'partial', 'preliminary', 'final', 'amended', 'corrected' or 'appended'
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
Slices for identifier	Σ	1..*	Identifier	Business identifier for report Slice: Unordered, Open by pattern:use
identifier:TOid	Σ	1..1	Identifier	Business identifier for report
use	?!Σ	1..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known . Required Pattern: usual
system	ΣC	0..1	uri	urn:oid:2.16.840.1.113883.4.349.4.{stationNbr} TOid-startswithoid: ID system must start with urn:oid:2.16.840.1.113883.4.349.4. The next would be the {stationNbr} Example General: http://www.acme.com/identifiers/patient
value	Σ	0..1	string	`LabReportTO` | `.` | {LabReportTO.id} Example General: 123456
identifier:casenum	Σ	0..*	Identifier	Business identifier for report
use	?!Σ	1..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known . Required Pattern: secondary
system	ΣC	0..1	uri	urn:oid:2.16.840.1.113883.4.349.4.{stationNbr} TOid-startswithoid: ID system must start with urn:oid:2.16.840.1.113883.4.349.4. The next would be the {stationNbr} Example General: http://www.acme.com/identifiers/patient
value	Σ	0..1	string	`CaseNum` | `.` | {LabReportTO.casenum} Example General: 123456
status	?!SΣC	1..1	code	registered | partial | preliminary | final + Binding: DiagnosticReportStatus (required)
Slices for category	SΣ	2..*	CodeableConcept	Service category Slice: Unordered, Open by pattern:$this Binding: DiagnosticServiceSectionCodes (example): Codes for diagnostic service sections.
category:LaboratorySlice	SΣ	1..1	CodeableConcept	Service category Binding: DiagnosticServiceSectionCodes (example): Codes for diagnostic service sections. Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0074
code		1..1	code	Symbol in syntax defined by the system Fixed Value: LAB
category:SPLabSlice	SΣ	1..1	CodeableConcept	Service category Binding: DiagnosticServiceSectionCodes (example): Codes for diagnostic service sections. Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0074
code		1..1	code	Symbol in syntax defined by the system Fixed Value: SP
code	SΣ	1..1	CodeableConcept	US Core Laboratory Report Order Code Binding: US Core Diagnostic Report Laboratory Codes (extensible): LOINC codes
coding	SΣ	0..1	Coding	Code defined by a terminology system Required Pattern: At least the following
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 11526-1
text	SΣ	1..1	string	Plain text representation of the concept
subject	SΣ	1..1	Reference(US Core Patient Profile)	The subject of the report - usually, but not always, the patient
Slices for effective[x]	SΣC	0..1		Diagnostically relevant time (typically the time of specimen collection) Slice: Unordered, Open by type:$this
effectiveDateTime			dateTime
effective[x]:effectiveDateTime	SΣC	0..1	dateTime	Diagnostically relevant time (typically the time of specimen collection)
issued	SΣC	0..1	instant	When the report was released
performer	SΣ	0..*	Reference(US Core Practitioner Profile) {c}	Responsible Diagnostic Service
specimen	S	0..*	Reference(VA MHV PHR Lab Specimen) {c}	Specimens this report is based on
result	S	0..*	Reference(VA MHV PHR labTest) {c}	Observations
presentedForm	S	0..*	Attachment	Entire report as issued
contentType	Σ	0..1	code	Mime type of the content, with charset etc. Binding: Mime Types (required): The mime type of an attachment. Any valid mime type is allowed. Required Pattern: text/plain
data		1..1	base64Binary	Data inline, base64ed
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
DiagnosticReport.identifier:TOid.use	required	Pattern: usual http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 from the FHIR Standard
DiagnosticReport.identifier:casenum.use	required	Pattern: secondary http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 from the FHIR Standard
DiagnosticReport.status	required	DiagnosticReportStatus http://hl7.org/fhir/ValueSet/diagnostic-report-status from the FHIR Standard
DiagnosticReport.category	example	DiagnosticServiceSectionCodes http://hl7.org/fhir/ValueSet/diagnostic-service-sections from the FHIR Standard
DiagnosticReport.category:LaboratorySlice	example	Pattern: LAB http://hl7.org/fhir/ValueSet/diagnostic-service-sections from the FHIR Standard
DiagnosticReport.category:SPLabSlice	example	Pattern: SP http://hl7.org/fhir/ValueSet/diagnostic-service-sections from the FHIR Standard
DiagnosticReport.code	extensible	USCoreDiagnosticReportLabCodes http://hl7.org/fhir/us/core/ValueSet/us-core-diagnosticreport-lab-codes
DiagnosticReport.presentedForm.contentType	required	Pattern: text/plain http://hl7.org/fhir/ValueSet/mimetypes|4.0.1 from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
TOid-startswithoid	error	DiagnosticReport.identifier:TOid.system, DiagnosticReport.identifier:casenum.system	ID system must start with urn:oid:2.16.840.1.113883.4.349.4. The next would be the {stationNbr} : value.startsWith('urn:oid:2.16.840.1.113883.4.349.4.')

Name	Flags	Card.	Type	Description & Constraints
DiagnosticReport	C	0..*	USCoreDiagnosticReportProfileLaboratoryReporting	A Diagnostic report - a combination of request information, atomic results, images, interpretation, as well as formatted reports us-core-8: effective[x] SHALL be present if the status is 'partial', 'preliminary', 'final', 'amended', 'corrected' or 'appended' us-core-9: issued SHALL be present if the status is 'partial', 'preliminary', 'final', 'amended', 'corrected' or 'appended'
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
Slices for identifier	Σ	1..*	Identifier	Business identifier for report Slice: Unordered, Open by pattern:use
identifier:TOid	Σ	1..1	Identifier	Business identifier for report
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
use	?!Σ	1..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known . Required Pattern: usual
type	Σ	0..1	CodeableConcept	Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
system	ΣC	0..1	uri	urn:oid:2.16.840.1.113883.4.349.4.{stationNbr} TOid-startswithoid: ID system must start with urn:oid:2.16.840.1.113883.4.349.4. The next would be the {stationNbr} Example General: http://www.acme.com/identifiers/patient
value	Σ	0..1	string	`LabReportTO` | `.` | {LabReportTO.id} Example General: 123456
period	Σ	0..1	Period	Time period when id is/was valid for use
assigner	Σ	0..1	Reference(Organization)	Organization that issued id (may be just text)
identifier:casenum	Σ	0..*	Identifier	Business identifier for report
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
use	?!Σ	1..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known . Required Pattern: secondary
type	Σ	0..1	CodeableConcept	Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
system	ΣC	0..1	uri	urn:oid:2.16.840.1.113883.4.349.4.{stationNbr} TOid-startswithoid: ID system must start with urn:oid:2.16.840.1.113883.4.349.4. The next would be the {stationNbr} Example General: http://www.acme.com/identifiers/patient
value	Σ	0..1	string	`CaseNum` | `.` | {LabReportTO.casenum} Example General: 123456
period	Σ	0..1	Period	Time period when id is/was valid for use
assigner	Σ	0..1	Reference(Organization)	Organization that issued id (may be just text)
status	?!SΣC	1..1	code	registered | partial | preliminary | final + Binding: DiagnosticReportStatus (required)
Slices for category	SΣ	2..*	CodeableConcept	Service category Slice: Unordered, Open by pattern:$this Binding: DiagnosticServiceSectionCodes (example): Codes for diagnostic service sections.
category:LaboratorySlice	SΣ	1..1	CodeableConcept	Service category Binding: DiagnosticServiceSectionCodes (example): Codes for diagnostic service sections. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0074
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: LAB
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
category:SPLabSlice	SΣ	1..1	CodeableConcept	Service category Binding: DiagnosticServiceSectionCodes (example): Codes for diagnostic service sections. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0074
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: SP
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
code	SΣ	1..1	CodeableConcept	US Core Laboratory Report Order Code Binding: US Core Diagnostic Report Laboratory Codes (extensible): LOINC codes
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
coding	SΣ	0..1	Coding	Code defined by a terminology system Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 11526-1
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text	SΣ	1..1	string	Plain text representation of the concept
subject	SΣ	1..1	Reference(US Core Patient Profile)	The subject of the report - usually, but not always, the patient
Slices for effective[x]	SΣC	0..1		Diagnostically relevant time (typically the time of specimen collection) Slice: Unordered, Open by type:$this
effectiveDateTime			dateTime S
effectivePeriod			Period
effective[x]:effectiveDateTime	SΣC	0..1	dateTime S	Diagnostically relevant time (typically the time of specimen collection)
issued	SΣC	0..1	instant	When the report was released
performer	SΣ	0..*	Reference(VA MHV PHR Organization | US Core Practitioner Profile S) {c}	Responsible Diagnostic Service
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
reference	ΣC	0..1	string	Literal reference, Relative, internal or absolute URL
type	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	Σ	0..1	Identifier	Logical reference, when literal reference is not known
specimen	S	0..*	Reference(VA MHV PHR Lab Specimen) {c}	Specimens this report is based on
result	S	0..*	Reference(VA MHV PHR labTest) {c}	Observations
presentedForm	S	0..*	Attachment	Entire report as issued
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
contentType	Σ	0..1	code	Mime type of the content, with charset etc. Binding: Mime Types (required): The mime type of an attachment. Any valid mime type is allowed. Required Pattern: text/plain
data		1..1	base64Binary	Data inline, base64ed
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
DiagnosticReport.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding http://hl7.org/fhir/ValueSet/languages from the FHIR Standard
DiagnosticReport.identifier:TOid.use	required	Pattern: usual http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 from the FHIR Standard
DiagnosticReport.identifier:TOid.type	extensible	Identifier Type Codes http://hl7.org/fhir/ValueSet/identifier-type from the FHIR Standard
DiagnosticReport.identifier:casenum.use	required	Pattern: secondary http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 from the FHIR Standard
DiagnosticReport.identifier:casenum.type	extensible	Identifier Type Codes http://hl7.org/fhir/ValueSet/identifier-type from the FHIR Standard
DiagnosticReport.basedOn.type	extensible	ResourceType http://hl7.org/fhir/ValueSet/resource-types from the FHIR Standard
DiagnosticReport.status	required	DiagnosticReportStatus http://hl7.org/fhir/ValueSet/diagnostic-report-status from the FHIR Standard
DiagnosticReport.category	example	DiagnosticServiceSectionCodes http://hl7.org/fhir/ValueSet/diagnostic-service-sections from the FHIR Standard
DiagnosticReport.category:LaboratorySlice	example	Pattern: LAB http://hl7.org/fhir/ValueSet/diagnostic-service-sections from the FHIR Standard
DiagnosticReport.category:SPLabSlice	example	Pattern: SP http://hl7.org/fhir/ValueSet/diagnostic-service-sections from the FHIR Standard
DiagnosticReport.code	extensible	USCoreDiagnosticReportLabCodes http://hl7.org/fhir/us/core/ValueSet/us-core-diagnosticreport-lab-codes
DiagnosticReport.performer.type	extensible	ResourceType http://hl7.org/fhir/ValueSet/resource-types from the FHIR Standard
DiagnosticReport.presentedForm.contentType	required	Pattern: text/plain http://hl7.org/fhir/ValueSet/mimetypes|4.0.1 from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
TOid-startswithoid	error	DiagnosticReport.identifier:TOid.system, DiagnosticReport.identifier:casenum.system	ID system must start with urn:oid:2.16.840.1.113883.4.349.4. The next would be the {stationNbr} : value.startsWith('urn:oid:2.16.840.1.113883.4.349.4.')

Differential View

This structure is derived from USCoreDiagnosticReportProfileLaboratoryReporting

Name	Flags	Card.	Type	Description & Constraints
DiagnosticReport		0..*	USCoreDiagnosticReportProfileLaboratoryReporting	A Diagnostic report - a combination of request information, atomic results, images, interpretation, as well as formatted reports
Slices for identifier		1..*	Identifier	Business identifier for report Slice: Unordered, Open by pattern:use
identifier:TOid		1..1	Identifier	Business identifier for report
use		1..1	code	usual | official | temp | secondary | old (If known) Required Pattern: usual
system	C	0..1	uri	urn:oid:2.16.840.1.113883.4.349.4.{stationNbr} TOid-startswithoid: ID system must start with urn:oid:2.16.840.1.113883.4.349.4. The next would be the {stationNbr}
value		0..1	string	`LabReportTO` | `.` | {LabReportTO.id}
identifier:casenum		0..*	Identifier	Business identifier for report
use		1..1	code	usual | official | temp | secondary | old (If known) Required Pattern: secondary
system	C	0..1	uri	urn:oid:2.16.840.1.113883.4.349.4.{stationNbr} TOid-startswithoid: ID system must start with urn:oid:2.16.840.1.113883.4.349.4. The next would be the {stationNbr}
value		0..1	string	`CaseNum` | `.` | {LabReportTO.casenum}
basedOn		0..0
status		1..1	code	registered | partial | preliminary | final +
category		2..*	CodeableConcept	Service category
Slices for category				Content/Rules for all slices
category:SPLabSlice		1..1	CodeableConcept	Service category Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0074
code		1..1	code	Symbol in syntax defined by the system Fixed Value: SP
code
coding	S	0..1	Coding	Code defined by a terminology system Required Pattern: At least the following
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 11526-1
text	S	1..1	string	Plain text representation of the concept
subject		1..1	Reference(US Core Patient Profile)	The subject of the report - usually, but not always, the patient
encounter		0..0
Slices for effective[x]		0..1	dateTime, Period	Diagnostically relevant time (typically the time of specimen collection) Slice: Unordered, Open by type:$this
effective[x]:effectiveDateTime	S	0..1	dateTime S	Diagnostically relevant time (typically the time of specimen collection)
issued		0..1	instant	When the report was released
performer		0..*	Reference(VA MHV PHR Organization | US Core Practitioner Profile) {c}	Responsible Diagnostic Service
display		0..0
resultsInterpreter		0..0
specimen	S	0..*	Reference(VA MHV PHR Lab Specimen) {c}	Specimens this report is based on
result		0..*	Reference(VA MHV PHR labTest) {c}	Observations
imagingStudy		0..0
media		0..0
conclusion		0..0
conclusionCode		0..0
presentedForm	S	0..*	Attachment	Entire report as issued
contentType		0..1	code	Mime type of the content, with charset etc. Required Pattern: text/plain
language		0..0
data		1..1	base64Binary	Data inline, base64ed
url		0..0
size		0..0
hash		0..0
title		0..0
creation		0..0
Documentation for this format

Constraints

Id	Grade	Path(s)	Details	Requirements
TOid-startswithoid	error	DiagnosticReport.identifier:TOid.system, DiagnosticReport.identifier:casenum.system	ID system must start with urn:oid:2.16.840.1.113883.4.349.4. The next would be the {stationNbr} : value.startsWith('urn:oid:2.16.840.1.113883.4.349.4.')

Key Elements View

Name	Flags	Card.	Type	Description & Constraints
DiagnosticReport	C	0..*	USCoreDiagnosticReportProfileLaboratoryReporting	A Diagnostic report - a combination of request information, atomic results, images, interpretation, as well as formatted reports us-core-8: effective[x] SHALL be present if the status is 'partial', 'preliminary', 'final', 'amended', 'corrected' or 'appended' us-core-9: issued SHALL be present if the status is 'partial', 'preliminary', 'final', 'amended', 'corrected' or 'appended'
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
Slices for identifier	Σ	1..*	Identifier	Business identifier for report Slice: Unordered, Open by pattern:use
identifier:TOid	Σ	1..1	Identifier	Business identifier for report
use	?!Σ	1..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known . Required Pattern: usual
system	ΣC	0..1	uri	urn:oid:2.16.840.1.113883.4.349.4.{stationNbr} TOid-startswithoid: ID system must start with urn:oid:2.16.840.1.113883.4.349.4. The next would be the {stationNbr} Example General: http://www.acme.com/identifiers/patient
value	Σ	0..1	string	`LabReportTO` | `.` | {LabReportTO.id} Example General: 123456
identifier:casenum	Σ	0..*	Identifier	Business identifier for report
use	?!Σ	1..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known . Required Pattern: secondary
system	ΣC	0..1	uri	urn:oid:2.16.840.1.113883.4.349.4.{stationNbr} TOid-startswithoid: ID system must start with urn:oid:2.16.840.1.113883.4.349.4. The next would be the {stationNbr} Example General: http://www.acme.com/identifiers/patient
value	Σ	0..1	string	`CaseNum` | `.` | {LabReportTO.casenum} Example General: 123456
status	?!SΣC	1..1	code	registered | partial | preliminary | final + Binding: DiagnosticReportStatus (required)
Slices for category	SΣ	2..*	CodeableConcept	Service category Slice: Unordered, Open by pattern:$this Binding: DiagnosticServiceSectionCodes (example): Codes for diagnostic service sections.
category:LaboratorySlice	SΣ	1..1	CodeableConcept	Service category Binding: DiagnosticServiceSectionCodes (example): Codes for diagnostic service sections. Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0074
code		1..1	code	Symbol in syntax defined by the system Fixed Value: LAB
category:SPLabSlice	SΣ	1..1	CodeableConcept	Service category Binding: DiagnosticServiceSectionCodes (example): Codes for diagnostic service sections. Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0074
code		1..1	code	Symbol in syntax defined by the system Fixed Value: SP
code	SΣ	1..1	CodeableConcept	US Core Laboratory Report Order Code Binding: US Core Diagnostic Report Laboratory Codes (extensible): LOINC codes
coding	SΣ	0..1	Coding	Code defined by a terminology system Required Pattern: At least the following
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 11526-1
text	SΣ	1..1	string	Plain text representation of the concept
subject	SΣ	1..1	Reference(US Core Patient Profile)	The subject of the report - usually, but not always, the patient
Slices for effective[x]	SΣC	0..1		Diagnostically relevant time (typically the time of specimen collection) Slice: Unordered, Open by type:$this
effectiveDateTime			dateTime
effective[x]:effectiveDateTime	SΣC	0..1	dateTime	Diagnostically relevant time (typically the time of specimen collection)
issued	SΣC	0..1	instant	When the report was released
performer	SΣ	0..*	Reference(US Core Practitioner Profile) {c}	Responsible Diagnostic Service
specimen	S	0..*	Reference(VA MHV PHR Lab Specimen) {c}	Specimens this report is based on
result	S	0..*	Reference(VA MHV PHR labTest) {c}	Observations
presentedForm	S	0..*	Attachment	Entire report as issued
contentType	Σ	0..1	code	Mime type of the content, with charset etc. Binding: Mime Types (required): The mime type of an attachment. Any valid mime type is allowed. Required Pattern: text/plain
data		1..1	base64Binary	Data inline, base64ed
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
DiagnosticReport.identifier:TOid.use	required	Pattern: usual http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 from the FHIR Standard
DiagnosticReport.identifier:casenum.use	required	Pattern: secondary http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 from the FHIR Standard
DiagnosticReport.status	required	DiagnosticReportStatus http://hl7.org/fhir/ValueSet/diagnostic-report-status from the FHIR Standard
DiagnosticReport.category	example	DiagnosticServiceSectionCodes http://hl7.org/fhir/ValueSet/diagnostic-service-sections from the FHIR Standard
DiagnosticReport.category:LaboratorySlice	example	Pattern: LAB http://hl7.org/fhir/ValueSet/diagnostic-service-sections from the FHIR Standard
DiagnosticReport.category:SPLabSlice	example	Pattern: SP http://hl7.org/fhir/ValueSet/diagnostic-service-sections from the FHIR Standard
DiagnosticReport.code	extensible	USCoreDiagnosticReportLabCodes http://hl7.org/fhir/us/core/ValueSet/us-core-diagnosticreport-lab-codes
DiagnosticReport.presentedForm.contentType	required	Pattern: text/plain http://hl7.org/fhir/ValueSet/mimetypes|4.0.1 from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
TOid-startswithoid	error	DiagnosticReport.identifier:TOid.system, DiagnosticReport.identifier:casenum.system	ID system must start with urn:oid:2.16.840.1.113883.4.349.4. The next would be the {stationNbr} : value.startsWith('urn:oid:2.16.840.1.113883.4.349.4.')

Snapshot View

Name	Flags	Card.	Type	Description & Constraints
DiagnosticReport	C	0..*	USCoreDiagnosticReportProfileLaboratoryReporting	A Diagnostic report - a combination of request information, atomic results, images, interpretation, as well as formatted reports us-core-8: effective[x] SHALL be present if the status is 'partial', 'preliminary', 'final', 'amended', 'corrected' or 'appended' us-core-9: issued SHALL be present if the status is 'partial', 'preliminary', 'final', 'amended', 'corrected' or 'appended'
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
Slices for identifier	Σ	1..*	Identifier	Business identifier for report Slice: Unordered, Open by pattern:use
identifier:TOid	Σ	1..1	Identifier	Business identifier for report
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
use	?!Σ	1..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known . Required Pattern: usual
type	Σ	0..1	CodeableConcept	Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
system	ΣC	0..1	uri	urn:oid:2.16.840.1.113883.4.349.4.{stationNbr} TOid-startswithoid: ID system must start with urn:oid:2.16.840.1.113883.4.349.4. The next would be the {stationNbr} Example General: http://www.acme.com/identifiers/patient
value	Σ	0..1	string	`LabReportTO` | `.` | {LabReportTO.id} Example General: 123456
period	Σ	0..1	Period	Time period when id is/was valid for use
assigner	Σ	0..1	Reference(Organization)	Organization that issued id (may be just text)
identifier:casenum	Σ	0..*	Identifier	Business identifier for report
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
use	?!Σ	1..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known . Required Pattern: secondary
type	Σ	0..1	CodeableConcept	Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
system	ΣC	0..1	uri	urn:oid:2.16.840.1.113883.4.349.4.{stationNbr} TOid-startswithoid: ID system must start with urn:oid:2.16.840.1.113883.4.349.4. The next would be the {stationNbr} Example General: http://www.acme.com/identifiers/patient
value	Σ	0..1	string	`CaseNum` | `.` | {LabReportTO.casenum} Example General: 123456
period	Σ	0..1	Period	Time period when id is/was valid for use
assigner	Σ	0..1	Reference(Organization)	Organization that issued id (may be just text)
status	?!SΣC	1..1	code	registered | partial | preliminary | final + Binding: DiagnosticReportStatus (required)
Slices for category	SΣ	2..*	CodeableConcept	Service category Slice: Unordered, Open by pattern:$this Binding: DiagnosticServiceSectionCodes (example): Codes for diagnostic service sections.
category:LaboratorySlice	SΣ	1..1	CodeableConcept	Service category Binding: DiagnosticServiceSectionCodes (example): Codes for diagnostic service sections. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0074
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: LAB
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
category:SPLabSlice	SΣ	1..1	CodeableConcept	Service category Binding: DiagnosticServiceSectionCodes (example): Codes for diagnostic service sections. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0074
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: SP
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
code	SΣ	1..1	CodeableConcept	US Core Laboratory Report Order Code Binding: US Core Diagnostic Report Laboratory Codes (extensible): LOINC codes
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
coding	SΣ	0..1	Coding	Code defined by a terminology system Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 11526-1
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text	SΣ	1..1	string	Plain text representation of the concept
subject	SΣ	1..1	Reference(US Core Patient Profile)	The subject of the report - usually, but not always, the patient
Slices for effective[x]	SΣC	0..1		Diagnostically relevant time (typically the time of specimen collection) Slice: Unordered, Open by type:$this
effectiveDateTime			dateTime S
effectivePeriod			Period
effective[x]:effectiveDateTime	SΣC	0..1	dateTime S	Diagnostically relevant time (typically the time of specimen collection)
issued	SΣC	0..1	instant	When the report was released
performer	SΣ	0..*	Reference(VA MHV PHR Organization | US Core Practitioner Profile S) {c}	Responsible Diagnostic Service
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
reference	ΣC	0..1	string	Literal reference, Relative, internal or absolute URL
type	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	Σ	0..1	Identifier	Logical reference, when literal reference is not known
specimen	S	0..*	Reference(VA MHV PHR Lab Specimen) {c}	Specimens this report is based on
result	S	0..*	Reference(VA MHV PHR labTest) {c}	Observations
presentedForm	S	0..*	Attachment	Entire report as issued
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
contentType	Σ	0..1	code	Mime type of the content, with charset etc. Binding: Mime Types (required): The mime type of an attachment. Any valid mime type is allowed. Required Pattern: text/plain
data		1..1	base64Binary	Data inline, base64ed
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
DiagnosticReport.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding http://hl7.org/fhir/ValueSet/languages from the FHIR Standard
DiagnosticReport.identifier:TOid.use	required	Pattern: usual http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 from the FHIR Standard
DiagnosticReport.identifier:TOid.type	extensible	Identifier Type Codes http://hl7.org/fhir/ValueSet/identifier-type from the FHIR Standard
DiagnosticReport.identifier:casenum.use	required	Pattern: secondary http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 from the FHIR Standard
DiagnosticReport.identifier:casenum.type	extensible	Identifier Type Codes http://hl7.org/fhir/ValueSet/identifier-type from the FHIR Standard
DiagnosticReport.basedOn.type	extensible	ResourceType http://hl7.org/fhir/ValueSet/resource-types from the FHIR Standard
DiagnosticReport.status	required	DiagnosticReportStatus http://hl7.org/fhir/ValueSet/diagnostic-report-status from the FHIR Standard
DiagnosticReport.category	example	DiagnosticServiceSectionCodes http://hl7.org/fhir/ValueSet/diagnostic-service-sections from the FHIR Standard
DiagnosticReport.category:LaboratorySlice	example	Pattern: LAB http://hl7.org/fhir/ValueSet/diagnostic-service-sections from the FHIR Standard
DiagnosticReport.category:SPLabSlice	example	Pattern: SP http://hl7.org/fhir/ValueSet/diagnostic-service-sections from the FHIR Standard
DiagnosticReport.code	extensible	USCoreDiagnosticReportLabCodes http://hl7.org/fhir/us/core/ValueSet/us-core-diagnosticreport-lab-codes
DiagnosticReport.performer.type	extensible	ResourceType http://hl7.org/fhir/ValueSet/resource-types from the FHIR Standard
DiagnosticReport.presentedForm.contentType	required	Pattern: text/plain http://hl7.org/fhir/ValueSet/mimetypes|4.0.1 from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
TOid-startswithoid	error	DiagnosticReport.identifier:TOid.system, DiagnosticReport.identifier:casenum.system	ID system must start with urn:oid:2.16.840.1.113883.4.349.4. The next would be the {stationNbr} : value.startsWith('urn:oid:2.16.840.1.113883.4.349.4.')

This structure is derived from USCoreDiagnosticReportProfileLaboratoryReporting

Summary

Mandatory: 5 elements(2 nested mandatory elements)
Must-Support: 5 elements
Prohibited: 15 elements

Structures

This structure refers to these other structures:

• VA MHV PHR Organization (https://department-of-veterans-affairs.github.io/mhv-fhir-phr-mapping/StructureDefinition/VA.MHV.PHR.organization)
• US Core Practitioner Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitioner)
• VA MHV PHR Lab Specimen (https://department-of-veterans-affairs.github.io/mhv-fhir-phr-mapping/StructureDefinition/VA.MHV.PHR.LabSpecimen)
• VA MHV PHR labTest (https://department-of-veterans-affairs.github.io/mhv-fhir-phr-mapping/StructureDefinition/VA.MHV.PHR.labTest)

Slices

This structure defines the following Slices:

• The element 1 is sliced based on the value of DiagnosticReport.identifier
• The element 1 is sliced based on the value of DiagnosticReport.effective[x]

Maturity: 2

• The mock example 1
• maps to LabReportTO, LabTestTO, LabResultTO and LabSpecimenTO schema.
• Mapping from VIA - Pathology LabReportTO +
  • Examples
• This profile is based on:
  • US-Core DiagnosticReport profile for Laboratory Results Reporting and
  • US Core Laboratory Result Observation Profile and
  • FHIR Specimen as US Core didn't profile
• The LabTestTO plus LabResultTO are combined and mapped onto a FHIR Observation for laboratory result that is contained in the DiagnosticReport. The map to VIA LabTestTO and LabResultTO.
• The LabSpecimen is mapped into a Specimen resource that is contained in the DiagnosticReport. The map to VIA LabSpecimenTO.
• The use of contained means that we do not need to de-duplicate the lab tests or specimen. Note that means that the specimen and observations are no individually findable or referenceable.
• should have meta.profile set to indicate the intent to be compliant with this profile
• code.text contains the original labReportTO.title
  • code.coding also includes the type in LOINC
    • Pathology -> LOINC#11526-1 "Pathology study"
  • coding may have a supplied loinc
• category must be http://terminology.hl7.org/CodeSystem/v2-0074#LAB
  • category indicates the kind of pathology / microbiology
    • SP - Surgical Pathology -> category=v2-0074#SP
    • CY - Cytology -> category=v2-0074#CP
    • EM - Electron Microscopy
      • category=v2-0074#OTH
      • category=SNOMED#73512001 "Electron microscopic study (procedure)"
  • category also holds 0..* codes from the contained Observation.code
• VIA will stop sending us entries. so
  • Thus we will be using Index-Update-and-Delete
• There is no data available to fill out a ServiceRequest
• Note that recommendation on pathology is to just keep the overall presented form, and not bother with the observations.

Business rules

• ignore all but SP, CY, EM, and MI
  • Process Pathology and Microbiology differently
• Pathology
  • if "STATUS:" is found and not "COMPLETE", then ignore
  • if "DATE COMPLETED:" is found, consider it complete and don't ignore
    • ignore all those with no "Date completed:" in the text body
    • hold is calculated off of this (if no time is given, midnight on this day is presumed)
    • DiagnosticReport.issued

Needed examples

• need more examples
  • Need to determine what happens with deleted/entered-in-error
  • Need to better understand body site vs sample identification - labs for blood or Urine tests.
  • schema values but no examples: author, caseNumber, comment, facility
• Need mock data for CY and EM

Most common types of Pathology Labs

Surgical Pathology is going to be the most common

• PATHOLOGY SURGICAL TISSUE REQUEST
• CYTOLOGY REQUEST (this one is cytology)
• SURGICAL PATHOLOGY EXAM
• PATHOLOGY SURGICAL REQUEST
• SURGICAL TISSUE EXAM
• SURGICAL PATHOLOGY

Mapping Concerns

• how to handle specimen bodySite vs sample - "Site/Specimen: " or "Collection sample:". from KBS: in vista there is a "collection sample" 60/300 that identifies the sample, "topography" 61/.01 covers where the data came from. historic vista data is not well behaved.
  • KBS: Don't change until we get better data (Blood and urine)
• The mock data I have does give me equivalent or better values in the XML. For example I get a date and time in the xml, but only a date in the text. Many values are not found in the text body, but are in the XML. Should we only use the parsed text if we don't have a value in the XML?
• is LabReportTO.facility a location or organization?
• va.gov would like to have the location where the sample was given. Historically this has been the interpretation of the Vista Site, which is really the vista site where the data resides.
• accession Number might not be an actual accession number. Evidence is that the value given is just the date and casenumber. Given that this is not currently needed, it might be best to not preserve it at all.

Mapping

Pathology and MicroBiology are processed differently. The text report is processed line by line to extract out some elements. See labReportTO/text {foo} where foo is the string searched for. In MHV legacy eVault, the parsed text is used.