EU Imaging Report R4
1.0.0-ballot - ci-build 150

EU Imaging Report R4, published by HL7 Europe. This guide is not an authorized publication; it is the continuous build for version 1.0.0-ballot built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/hl7-eu/imaging-r4/ and changes regularly. See the Directory of published versions

Resource Profile: DiagnosticReport: Imaging Report: Obligations - Detailed Descriptions

Draft as of 2026-10-21

Definitions for the diagnostic-report-obligation-eu-imaging resource profile

See the documentation on how to interpret the contents of this table

0. DiagnosticReport
Definition

Diagnostic Report EU core


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

ShortDiagnostic Report EU coreA Diagnostic report - a combination of request information, atomic results, images, interpretation, as well as formatted reports
Comments

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

Control0..*
Is Modifierfalse
Summaryfalse
Alternate NamesReport, Test, Result, Results, Labs, Laboratory
Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
dom-6: A resource should have narrative for robust management (text.`div`.exists())
eu-imaging-dr-status-replacement: DiagnosticReport.status SHALL be 'amended' if and only if the referenced Composition replaces a prior report and has status 'final'. ((status = 'amended') = extension('http://hl7.org/fhir/5.0/StructureDefinition/extension-DiagnosticReport.composition').value.resolve().where(status = 'final' and relatesTo.where(code = 'replaces').exists()).exists())
eu-imaging-dr-status-retraction: DiagnosticReport.status SHALL be 'entered-in-error' if and only if the referenced Composition retracts a prior report by replacing it with status 'entered-in-error'. ((status = 'entered-in-error') = extension('http://hl7.org/fhir/5.0/StructureDefinition/extension-DiagnosticReport.composition').value.resolve().where(status = 'entered-in-error' and relatesTo.where(code = 'replaces').exists()).exists())
eu-imaging-dr-status-no-addendum: DiagnosticReport.status SHALL NOT be 'appended' or 'corrected'; content added or corrected after final issuance is represented as a complete replacement with status 'amended'. (status != 'appended' and status != 'corrected')
2. DiagnosticReport.implicitRules
Definition

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

ShortA set of rules under which this content was created
Comments

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

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

The base language in which the resource is written.

ShortLanguage of the resource content
Comments

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

Control0..1
BindingThe codes SHOULD be taken from CommonLanguageshttp://hl7.org/fhir/ValueSet/languages|4.0.1
(preferred to http://hl7.org/fhir/ValueSet/languages|4.0.1)

A human language.

Additional BindingsPurpose
AllLanguagesMax Binding
Typecode
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Obligations
    ObligationsActorDocumentation
    SHOULD:able-to-populateImaging Report Producer

    EHDSImagingReport.header.language

    Summaryfalse
    Requirements

    EHDSImagingReport.header.language

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

    An Extension


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

    ShortExtensionAdditional content defined by implementations
    Comments

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

    Control10..*
    TypeExtension
    Is Modifierfalse
    Summaryfalse
    Alternate Namesextensions, user content
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    SlicingThis element introduces a set of slices on DiagnosticReport.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
    • value @ url
    • Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them

      8. DiagnosticReport.extension:DiagnosticReportCompositionR5
      Slice NameDiagnosticReportCompositionR5
      Definition

      R5: DiagnosticReport.composition (new:Reference(Composition))

      ShortR5: Reference to a Composition resource for the DiagnosticReport structure (new)
      Comments

      Element DiagnosticReport.composition has a context of DiagnosticReport based on following the parent source element upwards and mapping to DiagnosticReport. Element DiagnosticReport.composition has no mapping targets in FHIR R4. Typically, this is because the element has been added (is a new element). The Composition provides structure to the content of the DiagnosticReport (and only contains contents referenced in the DiagnosticReport) - e.g., to order the sections of an anatomic pathology structured report.

      Control1..1
      This element is affected by the following invariants: ele-1
      TypeExtension(R5: Reference to a Composition resource for the DiagnosticReport structure (new)) (Extension Type: Reference(Cross-version Profile for R5.Composition for use in FHIR R4, Composition))
      Is Modifierfalse
      Obligations
        ObligationsActorDocumentation
        SHALL:able-to-populateImaging Report Producer

        EHDSImagingReport.

        Summaryfalse
        Requirements

        EHDSImagingReport.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        10. DiagnosticReport.extension:DiagnosticReportCompositionR5.extension
        Definition

        An Extension


        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.

        ShortExtensionAdditional content defined by implementations
        Comments

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

        Control0..0*
        TypeExtension
        Is Modifierfalse
        Summaryfalse
        Alternate Namesextensions, user content
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        SlicingThis element introduces a set of slices on DiagnosticReport.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
        • value @ url
        • 12. DiagnosticReport.extension:DiagnosticReportCompositionR5.url
          Definition

          Source of the definition for the extension code - a logical name or a URL.

          Shortidentifies the meaning of the extension
          Comments

          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.

          Control1..1
          Typeuri
          Is Modifierfalse
          XML FormatIn the XML format, this property is represented as an attribute.
          Summaryfalse
          Fixed Value
          {
            "url" : "http://hl7.org/fhir/5.0/StructureDefinition/extension-DiagnosticReport.composition"
          }
          <url value="http://hl7.org/fhir/5.0/StructureDefinition/extension-DiagnosticReport.composition"/>
          14. DiagnosticReport.extension:DiagnosticReportCompositionR5.value[x]
          Definition

          Reference to a Composition resource instance that provides structure for organizing the contents of the DiagnosticReport.


          Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

          ShortReference to a Composition resource for the DiagnosticReport structureValue of extension
          Control10..1
          TypeReference(Composition: Imaging Report), date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          16. DiagnosticReport.extension:note
          Slice Namenote
          Definition

          This cross-version extension represents DiagnosticReport.note from http://hl7.org/fhir/StructureDefinition/DiagnosticReport|5.0.0 for use in FHIR R4.

          ShortComments about the diagnostic report
          Control0..*
          This element is affected by the following invariants: ele-1
          TypeExtension(R5: Comments about the diagnostic report (new)) (Extension Type: Annotation)
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          18. DiagnosticReport.extension:note.extension
          Definition

          An Extension


          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.

          ShortExtensionAdditional content defined by implementations
          Comments

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

          Control0..0*
          TypeExtension
          Is Modifierfalse
          Summaryfalse
          Alternate Namesextensions, user content
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          SlicingThis element introduces a set of slices on DiagnosticReport.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
          • value @ url
          • 20. DiagnosticReport.extension:note.url
            Definition

            Source of the definition for the extension code - a logical name or a URL.

            Shortidentifies the meaning of the extension
            Comments

            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.

            Control1..1
            Typeuri
            Is Modifierfalse
            XML FormatIn the XML format, this property is represented as an attribute.
            Summaryfalse
            Fixed Value
            {
              "url" : "http://hl7.org/fhir/5.0/StructureDefinition/extension-DiagnosticReport.note"
            }
            <url value="http://hl7.org/fhir/5.0/StructureDefinition/extension-DiagnosticReport.note"/>
            22. DiagnosticReport.extension:artifactVersion
            Slice NameartifactVersion
            Definition

            The identifier that is used to identify this version of the artifact when it is referenced in a specification, model, design or instance. This is an arbitrary value managed by the artifact author and is not expected to be globally unique. For example, it might be a timestamp (e.g. yyyymmdd) if a managed version is not available. There is also no expectation that versions can be placed in a lexicographical sequence.

            ShortBusiness version of the artifact
            Control0..1
            TypeExtension(ArtifactVersion) (Extension Type: string)
            Is Modifierfalse
            Obligations
              ObligationsActorDocumentation
              MAY:able-to-populateImaging Report Producer

              EHDSImagingReport.header.version

              Summaryfalse
              Requirements

              EHDSImagingReport.header.version

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
              24. DiagnosticReport.extension:anatomical-region
              Slice Nameanatomical-region
              Definition

              The anatomical regions covered by the report, depending on the study there can be zero, one or more regions. The regions SHALL overlap with the bodysite references from ImagingStudy.serie.bodysite, if present.

              ShortThe anatomical regions covered by the study this report reports on.
              Control0..*
              TypeExtension(Extension: Anatomical Region) (Extension Type: CodeableConcept)
              Is Modifierfalse
              Summaryfalse
              Requirements

              Identifies the anatomical region covered by the report when additional anatomical context is available.

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
              26. DiagnosticReport.extension:comparison
              Slice Namecomparison
              Definition

              Studies used for comparison in part of diagnostic reporting

              ShortExtension: HL7IDR DiagnosticReport Comparison Study
              Control0..*
              TypeExtension(Extension: HL7IDR DiagnosticReport Comparison Study) (Extension Type: Reference(ImagingStudy: Reported Study, Basic-ImagingSelection: General))
              Is Modifierfalse
              Must Supporttrue
              Obligations
                ObligationsActorDocumentation
                SHALL:able-to-populateImaging Report Producer

                EHDSImagingReport.body.comparisonStudy

                Summaryfalse
                Requirements

                EHDSImagingReport.body.comparisonStudy

                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                28. DiagnosticReport.extension:patientHistory
                Slice NamepatientHistory
                Definition

                Patient history that are relevant for the report

                ShortExtension: HL7IDR Patient History
                Control0..*
                TypeExtension(Extension: HL7IDR Patient History) (Extension Type: Reference)
                Is Modifierfalse
                Must Supporttrue
                Obligations
                  ObligationsActorDocumentation
                  SHOULD:populate-if-knownImaging Report Producer

                  EHDSImagingReport.body.supportingInformation.observation, EHDSImagingReport.body.supportingInformation.condition, EHDSImagingReport.body.supportingInformation.priorMedicationAdministration, EHDSImagingReport.body.supportingInformation.device, EHDSImagingReport.body.supportingInformation.pregnancyStatus

                  Summaryfalse
                  Requirements

                  EHDSImagingReport.body.supportingInformation.observation; EHDSImagingReport.body.supportingInformation.condition; EHDSImagingReport.body.supportingInformation.priorMedicationAdministration; EHDSImagingReport.body.supportingInformation.device; EHDSImagingReport.body.supportingInformation.pregnancyStatus

                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                  30. DiagnosticReport.extension:procedure
                  Slice Nameprocedure
                  Definition

                  Imaging procedure used for the imaging acquisition and procedure specific information.

                  ShortExtension: HL7IDR Imaging Procedure
                  Control0..*
                  TypeExtension(Extension: HL7IDR Imaging Procedure) (Extension Type: Reference(Procedure: Imaging Acquisition, AdverseEvent, Observation: Radiation Dose))
                  Is Modifierfalse
                  Must Supporttrue
                  Obligations
                    ObligationsActorDocumentation
                    SHALL:able-to-populateImaging Report Producer

                    EHDSImagingReport.body.exposureInformation, EHDSImagingReport.body.examinationReport.imagingProcedures

                    Summaryfalse
                    Requirements

                    EHDSImagingReport.body.exposureInformation; EHDSImagingReport.body.examinationReport.imagingProcedures

                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                    32. DiagnosticReport.extension:finding
                    Slice Namefinding
                    Definition

                    Key images in the report

                    ShortKey image findings
                    Control0..*
                    TypeExtension(Extension: HL7IDR KeyImage Finding) (Extension Type: Reference(Observation: Imaging Finding, Key images represented as an ImagingSelection for R4, Media: Key Image, Media, DocumentReference))
                    Is Modifierfalse
                    Must Supporttrue
                    Summaryfalse
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                    34. DiagnosticReport.extension:impression
                    Slice Nameimpression
                    Definition

                    Impression in the imaging report

                    ShortExtension: HL7IDR Impression
                    Control0..*
                    TypeExtension(Extension: HL7IDR Impression) (Extension Type: Reference(Observation: Imaging Finding, Condition, Key images represented as an ImagingSelection for R4, Media: Key Image))
                    Is Modifierfalse
                    Must Supporttrue
                    Obligations
                      ObligationsActorDocumentation
                      SHALL:able-to-populateImaging Report Producer

                      EHDSImagingReport.body.examinationReport.conclusion.conditionOrFinding[x]

                      Summaryfalse
                      Requirements

                      EHDSImagingReport.body.examinationReport.conclusion.conditionOrFinding[x]

                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                      36. DiagnosticReport.extension:recommendation
                      Slice Namerecommendation
                      Definition

                      Recommendations for any follow up actions

                      ShortExtension: HL7IDR Recommendation
                      Control0..*
                      TypeExtension(Extension: HL7IDR Recommendation) (Extension Type: Reference(CarePlan, ServiceRequest))
                      Is Modifierfalse
                      Must Supporttrue
                      Obligations
                        ObligationsActorDocumentation
                        SHOULD:able-to-populateImaging Report Producer

                        EHDSImagingReport.body.recommendation

                        Summaryfalse
                        Requirements

                        EHDSImagingReport.body.recommendation

                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                        38. DiagnosticReport.extension:communication
                        Slice Namecommunication
                        Definition

                        Communications captures what communications have been made with other care providers.

                        ShortCommunications with other care providers
                        Control0..*
                        TypeExtension(Extension: HL7IDR Communication) (Extension Type: Reference)
                        Is Modifierfalse
                        Must Supporttrue
                        Summaryfalse
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                        40. DiagnosticReport.extension:informationRecipient
                        Slice NameinformationRecipient
                        Definition

                        This extension applies to the Composition resource and is used to represent an intended recipient of the composition.

                        ShortComposition: Information recipient
                        Control0..*
                        TypeExtension(Composition: Information recipient) (Extension Type: Reference(Practitioner, Device, Patient, RelatedPerson, PractitionerRole, Organization, CareTeam, Group))
                        Is Modifierfalse
                        Summaryfalse
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                        42. DiagnosticReport.modifierExtension
                        Definition

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

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

                        ShortExtensions that cannot be ignored
                        Comments

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

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

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

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

                        Identifiers assigned to this Imaging Report by the performer or other systems. It shall be common to several report versions


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

                        ShortReport identifierBusiness identifier for report
                        Comments

                        Composition.identifier SHALL be equal to one of the DiagnosticReport.identifier, if at least one exists


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

                        NoteThis is a business identifier, not a resource identifier (see discussion)
                        Control10..*
                        TypeIdentifier
                        Is Modifierfalse
                        Obligations
                          ObligationsActorDocumentation
                          SHALL:able-to-populateImaging Report Producer

                          EHDSImagingReport.header.identifier

                          Summarytrue
                          Requirements

                          EHDSImagingReport.header.identifier


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

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

                          Details concerning a service requested.

                          ShortWhat was requested
                          Comments

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

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

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

                          Alternate NamesRequest
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          SlicingThis element introduces a set of slices on DiagnosticReport.basedOn. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                          • type @ $this
                          • Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them

                            48. DiagnosticReport.basedOn:ServiceRequestOrderEuImagingaccession
                            Slice NameServiceRequestOrderEuImagingaccession
                            Definition

                            Details concerning a service requested.

                            ShortWhat was requested
                            Comments

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

                            Control0..*
                            TypeReference(ServiceRequest: Imaging Order, CarePlan, ImmunizationRecommendation, MedicationRequest, NutritionOrder, ServiceRequest)
                            Is Modifierfalse
                            Obligations
                              ObligationsActorDocumentation
                              MAY:able-to-populateImaging Report Producer

                              EHDSImagingReport.body.orderInformation.orderId

                              Summaryfalse
                              Requirements

                              EHDSImagingReport.body.orderInformation.orderId


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

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

                              The status of the diagnostic report.

                              ShortStatus of the Reportregistered | partial | preliminary | final +
                              Comments

                              DiagnosticReport.status and Composition.status shall be aligned

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

                              The status of the diagnostic report.

                              Typecode
                              Is Modifiertrue because This element is labeled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                              Obligations
                                ObligationsActorDocumentation
                                MAY:able-to-populateImaging Report Producer

                                EHDSImagingReport.header.status

                                Summarytrue
                                Requirements

                                EHDSImagingReport.header.status


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

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

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

                                ShortService category
                                Comments

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

                                Control20..*
                                BindingFor example codes, see DiagnosticServiceSectionCodeshttp://hl7.org/fhir/ValueSet/diagnostic-service-sections|4.0.1
                                (example to http://hl7.org/fhir/ValueSet/diagnostic-service-sections|4.0.1)

                                Codes for diagnostic service sections.

                                TypeCodeableConcept
                                Is Modifierfalse
                                Summarytrue
                                Alternate NamesDepartment, Sub-department, Service, Discipline
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                SlicingThis element introduces a set of slices on DiagnosticReport.category. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                • value @ $this
                                • Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them

                                  54. DiagnosticReport.category:diagnostic-service
                                  Slice Namediagnostic-service
                                  Definition

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

                                  ShortService category
                                  Comments

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

                                  Control0..1*
                                  BindingThe codes SHALL be taken from For example codes, see DiagnosticServiceSectionCodeshttp://hl7.org/fhir/ValueSet/diagnostic-service-sections|4.0.1
                                  (required to http://hl7.org/fhir/ValueSet/diagnostic-service-sections)
                                  TypeCodeableConcept
                                  Is Modifierfalse
                                  Obligations
                                    ObligationsActorDocumentation
                                    MAY:able-to-populateImaging Report Producer

                                    EHDSImagingReport.header.serviceSpecialty

                                    Summarytrue
                                    Requirements

                                    EHDSImagingReport.header.serviceSpecialty

                                    Alternate NamesDepartment, Sub-department, Service, Discipline
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    56. DiagnosticReport.category:imaging-report
                                    Slice Nameimaging-report
                                    Definition

                                    Defines the category of the report, Diagnostic imaging report.


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

                                    ShortService category
                                    Comments

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

                                    Control10..1*
                                    BindingFor example codes, see DiagnosticServiceSectionCodeshttp://hl7.org/fhir/ValueSet/diagnostic-service-sections|4.0.1
                                    (example to http://hl7.org/fhir/ValueSet/diagnostic-service-sections|4.0.1)

                                    Codes for diagnostic service sections.

                                    TypeCodeableConcept
                                    Is Modifierfalse
                                    Obligations
                                      ObligationsActorDocumentation
                                      SHALL:able-to-populateImaging Report Producer

                                      EHDSImagingReport.header.documentType

                                      Summarytrue
                                      Requirements

                                      EHDSImagingReport.header.documentType

                                      Alternate NamesDepartment, Sub-department, Service, Discipline
                                      Pattern Value
                                      {
                                        "coding" : [
                                          {
                                            "system" : "http://loinc.org",
                                            "code" : "85430-7"
                                          }
                                        ]
                                      }
                                      <category>
                                        <coding>
                                          <system value="http://loinc.org"/>
                                          <code value="85430-7"/>
                                        </coding>
                                      </category>
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      58. DiagnosticReport.category:imaging
                                      Slice Nameimaging
                                      Definition

                                      Defines the priority category of the report as defined in the API spec.


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

                                      ShortService category
                                      Comments

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

                                      Control10..1*
                                      BindingFor example codes, see DiagnosticServiceSectionCodeshttp://hl7.org/fhir/ValueSet/diagnostic-service-sections|4.0.1
                                      (example to http://hl7.org/fhir/ValueSet/diagnostic-service-sections|4.0.1)

                                      Codes for diagnostic service sections.

                                      TypeCodeableConcept
                                      Is Modifierfalse
                                      Summarytrue
                                      Alternate NamesDepartment, Sub-department, Service, Discipline
                                      Pattern Value
                                      {
                                        "coding" : [
                                          {
                                            "system" : "http://hl7.eu/fhir/health-data-api/CodeSystem/eehrxf-document-priority-category-cs",
                                            "code" : "Medical-Imaging"
                                          }
                                        ]
                                      }
                                      <category>
                                        <coding>
                                          <system value="http://hl7.eu/fhir/health-data-api/CodeSystem/eehrxf-document-priority-category-cs"/>
                                          <code value="Medical-Imaging"/>
                                        </coding>
                                      </category>
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      60. DiagnosticReport.code
                                      Definition

                                      Defines the document type, it is recommended to take this from the suggested LOINC set.


                                      A code or name that describes this diagnostic report.

                                      ShortType of Imaging Diagnostic ReportName/Code for this diagnostic report
                                      Control1..1
                                      BindingThe codes SHOULD be taken from ValueSet: Radiology Report Typeshttp://hl7.org/fhir/ValueSet/report-codes|4.0.1
                                      (preferred to http://hl7.eu/fhir/imaging/ValueSet/ImagingReportTypesEuVSEuImaging)
                                      TypeCodeableConcept
                                      Is Modifierfalse
                                      Summarytrue
                                      Alternate NamesType
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      62. DiagnosticReport.subject
                                      Definition

                                      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).


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

                                      ShortWho and/or what this report is aboutThe subject of the report - usually, but not always, the patient
                                      Control10..1
                                      TypeReference(Patient (EU core), Patient, Group, Device, Location)
                                      Is Modifierfalse
                                      Obligations
                                        ObligationsActorDocumentation
                                        SHALL:able-to-populateImaging Report Producer

                                        EHDSImagingReport.header.subject

                                        Summarytrue
                                        Requirements

                                        EHDSImagingReport.header.subject


                                        SHALL know the subject context.

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

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

                                        ShortClinically relevant time/time-period for report.
                                        Comments

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

                                        Control0..1
                                        TypeChoice of: dateTime, Period
                                        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                        Is Modifierfalse
                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                        Summarytrue
                                        Requirements

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

                                        Alternate NamesObservation time, Effective Time, Occurrence
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        SlicingThis element introduces a set of slices on DiagnosticReport.effective[x]. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
                                        • type @ $this
                                        • Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them Other type slices that contain no new information are not shown in this view

                                          66. DiagnosticReport.effective[x]:effectivePeriod
                                          Slice NameeffectivePeriod
                                          Definition

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

                                          ShortClinically relevant time/time-period for report.
                                          Comments

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

                                          Control0..1
                                          TypePeriod, dateTime
                                          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                          Is Modifierfalse
                                          Obligations
                                            ObligationsActorDocumentation
                                            SHOULD:able-to-populateImaging Report Producer

                                            EHDSImagingReport.header.period

                                            Summarytrue
                                            Requirements

                                            EHDSImagingReport.header.period


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

                                            Alternate NamesObservation time, Effective Time, Occurrence
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            69. DiagnosticReport.issued
                                            Definition

                                            The date and time that the report was issued. This is not necessarily the same as the date and time that the report was created, since a report may be revised and/or reviewed after it is created.


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

                                            ShortDate and time of report issuanceDateTime this version was made
                                            Comments

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

                                            Control0..1
                                            Typeinstant
                                            Is Modifierfalse
                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                            Obligations
                                              ObligationsActorDocumentation
                                              SHALL:able-to-populateImaging Report Producer

                                              EHDSImagingReport.header.date

                                              Summarytrue
                                              Requirements

                                              EHDSImagingReport.header.date


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

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

                                              The diagnostic service that is responsible for issuing the report.

                                              ShortResponsible Diagnostic Service.
                                              Comments

                                              If a DiagnosticReport.resultsInterpreter exists this is expected to be a Composition.author; otherwise a DiagnosticReport.performer should be an author.


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

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

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

                                              Alternate NamesLaboratory, Service, Practitioner, Department, Company, Authorized by, Director
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              SlicingThis element introduces a set of slices on DiagnosticReport.performer. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                              • profile @ $this
                                              • 73. DiagnosticReport.performer:organization
                                                Slice Nameorganization
                                                Definition

                                                The organization responsible for producing this report. In case practitioners produce them in their private practices, they will be accounted as an organization for this purpose.


                                                The diagnostic service that is responsible for issuing the report.

                                                ShortThe organization producer of this reportResponsible Diagnostic Service
                                                Comments

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

                                                Control0..*
                                                TypeReference(Organization (EU core), Practitioner, PractitionerRole, Organization, CareTeam)
                                                Is Modifierfalse
                                                Obligations
                                                  ObligationsActorDocumentation
                                                  SHALL:able-to-populateImaging Report Producer

                                                  EHDSImagingReport.header.author[x]

                                                  SHOULD:processImaging Report Consumer

                                                  EHDSImagingReport.header.author[x]

                                                  Summarytrue
                                                  Requirements

                                                  EHDSImagingReport.header.author[x]


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

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

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

                                                  ShortPrimary result interpreter
                                                  Comments

                                                  If a DiagnosticReport.resultsInterpreter exists this is expected to be a Composition.author; otherwise a DiagnosticReport.performer should be an author.


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

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

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

                                                  Alternate NamesAnalyzed by, Reported by
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  SlicingThis element introduces a set of slices on DiagnosticReport.resultsInterpreter. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                  • profile @ resolve()
                                                  • 77. DiagnosticReport.resultsInterpreter:author
                                                    Slice Nameauthor
                                                    Definition

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

                                                    ShortPrimary interpreter of resultsPrimary result interpreter
                                                    Comments

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

                                                    Control0..*
                                                    TypeReference(PractitionerRole (EU core), Practitioner, PractitionerRole, Organization, CareTeam)
                                                    Is Modifierfalse
                                                    Obligations
                                                      ObligationsActorDocumentation
                                                      SHALL:able-to-populateImaging Report Producer

                                                      EHDSImagingReport.header.author[x]

                                                      Summarytrue
                                                      Requirements

                                                      EHDSImagingReport.header.author[x]


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

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

                                                      Detailed description of the findings on the imaging study. The findings should be described in a clear and concise manner, using standardized anatomic, pathologic, and radiologic terminology whenever possible.


                                                      Observations that are part of this diagnostic report.

                                                      ShortFindingsObservations
                                                      Comments

                                                      Observations can contain observations.

                                                      Control0..*
                                                      TypeReference(Observation: Imaging Finding, Observation: Narrative Report, Observation)
                                                      Is Modifierfalse
                                                      Must Supporttrue
                                                      Must Support TypesNo must-support rules about the choice of types/profiles
                                                      Obligations
                                                        ObligationsActorDocumentation
                                                        SHALL:able-to-populateImaging Report Producer

                                                        EHDSImagingReport.body.examinationReport.results[x], EHDSImagingReport.body.examinationReport.conclusion.impression

                                                        Summaryfalse
                                                        Requirements

                                                        EHDSImagingReport.body.examinationReport.results[x]; EHDSImagingReport.body.examinationReport.conclusion.impression


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

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

                                                        A list of additional data, other then presented form of the report, associated with this report. This data is generally created during the diagnostic process, and may be directly of the patient, or of treated specimens (i.e. slides of interest).


                                                        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).

                                                        ShortAdditional data (like images, diagrams or documents) associated with this reportKey images associated with this report
                                                        Control0..*
                                                        TypeBackboneElement
                                                        Is Modifierfalse
                                                        Obligations
                                                          ObligationsActorDocumentation
                                                          SHOULD:able-to-populateImaging Report Producer

                                                          EHDSImagingReport.attachments

                                                          Summarytrue
                                                          Requirements

                                                          EHDSImagingReport.attachments


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

                                                          Alternate NamesDICOM, Slides, Scans, DICOM; Slides; Scans; Pictures; Documents; Diagrams
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          83. DiagnosticReport.media.modifierExtension
                                                          Definition

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

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

                                                          ShortExtensions that cannot be ignored even if unrecognized
                                                          Comments

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

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

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

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

                                                          A reference to the image or data associated with this report.


                                                          Reference to the image source.

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

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

                                                          ShortEntire report as issued (pdf recommended)
                                                          Comments

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

                                                          Control0..*
                                                          TypeAttachment
                                                          Is Modifierfalse
                                                          Obligations
                                                            ObligationsActorDocumentation
                                                            SHOULD:able-to-populateImaging Report Producer

                                                            EHDSImagingReport.presentedForm

                                                            Summaryfalse
                                                            Requirements

                                                            EHDSImagingReport.presentedForm


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

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

                                                            See the documentation on how to interpret the contents of this table

                                                            0. DiagnosticReport
                                                            2. DiagnosticReport.language
                                                            Obligations
                                                              ObligationsActorDocumentation
                                                              SHOULD:able-to-populateImaging Report Producer

                                                              EHDSImagingReport.header.language

                                                              Requirements

                                                              EHDSImagingReport.header.language

                                                              4. DiagnosticReport.extension:DiagnosticReportCompositionR5
                                                              Slice NameDiagnosticReportCompositionR5
                                                              Obligations
                                                                ObligationsActorDocumentation
                                                                SHALL:able-to-populateImaging Report Producer

                                                                EHDSImagingReport.

                                                                Requirements

                                                                EHDSImagingReport.

                                                                6. DiagnosticReport.extension:artifactVersion
                                                                Slice NameartifactVersion
                                                                Obligations
                                                                  ObligationsActorDocumentation
                                                                  MAY:able-to-populateImaging Report Producer

                                                                  EHDSImagingReport.header.version

                                                                  Requirements

                                                                  EHDSImagingReport.header.version

                                                                  8. DiagnosticReport.extension:comparison
                                                                  Slice Namecomparison
                                                                  Obligations
                                                                    ObligationsActorDocumentation
                                                                    SHALL:able-to-populateImaging Report Producer

                                                                    EHDSImagingReport.body.comparisonStudy

                                                                    Requirements

                                                                    EHDSImagingReport.body.comparisonStudy

                                                                    10. DiagnosticReport.extension:patientHistory
                                                                    Slice NamepatientHistory
                                                                    Obligations
                                                                      ObligationsActorDocumentation
                                                                      SHOULD:populate-if-knownImaging Report Producer

                                                                      EHDSImagingReport.body.supportingInformation.observation, EHDSImagingReport.body.supportingInformation.condition, EHDSImagingReport.body.supportingInformation.priorMedicationAdministration, EHDSImagingReport.body.supportingInformation.device, EHDSImagingReport.body.supportingInformation.pregnancyStatus

                                                                      Requirements

                                                                      EHDSImagingReport.body.supportingInformation.observation; EHDSImagingReport.body.supportingInformation.condition; EHDSImagingReport.body.supportingInformation.priorMedicationAdministration; EHDSImagingReport.body.supportingInformation.device; EHDSImagingReport.body.supportingInformation.pregnancyStatus

                                                                      12. DiagnosticReport.extension:procedure
                                                                      Slice Nameprocedure
                                                                      Obligations
                                                                        ObligationsActorDocumentation
                                                                        SHALL:able-to-populateImaging Report Producer

                                                                        EHDSImagingReport.body.exposureInformation, EHDSImagingReport.body.examinationReport.imagingProcedures

                                                                        Requirements

                                                                        EHDSImagingReport.body.exposureInformation; EHDSImagingReport.body.examinationReport.imagingProcedures

                                                                        14. DiagnosticReport.extension:impression
                                                                        Slice Nameimpression
                                                                        Obligations
                                                                          ObligationsActorDocumentation
                                                                          SHALL:able-to-populateImaging Report Producer

                                                                          EHDSImagingReport.body.examinationReport.conclusion.conditionOrFinding[x]

                                                                          Requirements

                                                                          EHDSImagingReport.body.examinationReport.conclusion.conditionOrFinding[x]

                                                                          16. DiagnosticReport.extension:recommendation
                                                                          Slice Namerecommendation
                                                                          Obligations
                                                                            ObligationsActorDocumentation
                                                                            SHOULD:able-to-populateImaging Report Producer

                                                                            EHDSImagingReport.body.recommendation

                                                                            Requirements

                                                                            EHDSImagingReport.body.recommendation

                                                                            18. DiagnosticReport.identifier
                                                                            NoteThis is a business identifier, not a resource identifier (see discussion)
                                                                            Obligations
                                                                              ObligationsActorDocumentation
                                                                              SHALL:able-to-populateImaging Report Producer

                                                                              EHDSImagingReport.header.identifier

                                                                              Requirements

                                                                              EHDSImagingReport.header.identifier

                                                                              20. DiagnosticReport.basedOn:ServiceRequestOrderEuImagingaccession
                                                                              Slice NameServiceRequestOrderEuImagingaccession
                                                                              Obligations
                                                                                ObligationsActorDocumentation
                                                                                MAY:able-to-populateImaging Report Producer

                                                                                EHDSImagingReport.body.orderInformation.orderId

                                                                                Requirements

                                                                                EHDSImagingReport.body.orderInformation.orderId

                                                                                22. DiagnosticReport.status
                                                                                Obligations
                                                                                  ObligationsActorDocumentation
                                                                                  MAY:able-to-populateImaging Report Producer

                                                                                  EHDSImagingReport.header.status

                                                                                  Requirements

                                                                                  EHDSImagingReport.header.status

                                                                                  24. DiagnosticReport.category:diagnostic-service
                                                                                  Slice Namediagnostic-service
                                                                                  Obligations
                                                                                    ObligationsActorDocumentation
                                                                                    MAY:able-to-populateImaging Report Producer

                                                                                    EHDSImagingReport.header.serviceSpecialty

                                                                                    Requirements

                                                                                    EHDSImagingReport.header.serviceSpecialty

                                                                                    26. DiagnosticReport.category:imaging-report
                                                                                    Slice Nameimaging-report
                                                                                    Obligations
                                                                                      ObligationsActorDocumentation
                                                                                      SHALL:able-to-populateImaging Report Producer

                                                                                      EHDSImagingReport.header.documentType

                                                                                      Requirements

                                                                                      EHDSImagingReport.header.documentType

                                                                                      28. DiagnosticReport.subject
                                                                                      Obligations
                                                                                        ObligationsActorDocumentation
                                                                                        SHALL:able-to-populateImaging Report Producer

                                                                                        EHDSImagingReport.header.subject

                                                                                        Requirements

                                                                                        EHDSImagingReport.header.subject

                                                                                        30. DiagnosticReport.effective[x]
                                                                                        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                        SlicingThis element introduces a set of slices on DiagnosticReport.effective[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                        • type @ $this
                                                                                        • Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them Other type slices that contain no new information are not shown in this view

                                                                                          32. DiagnosticReport.effective[x]:effectivePeriod
                                                                                          Slice NameeffectivePeriod
                                                                                          Control0..1
                                                                                          TypePeriod
                                                                                          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                          Obligations
                                                                                            ObligationsActorDocumentation
                                                                                            SHOULD:able-to-populateImaging Report Producer

                                                                                            EHDSImagingReport.header.period

                                                                                            Requirements

                                                                                            EHDSImagingReport.header.period

                                                                                            34. DiagnosticReport.issued
                                                                                            Obligations
                                                                                              ObligationsActorDocumentation
                                                                                              SHALL:able-to-populateImaging Report Producer

                                                                                              EHDSImagingReport.header.date

                                                                                              Requirements

                                                                                              EHDSImagingReport.header.date

                                                                                              36. DiagnosticReport.performer:organization
                                                                                              Slice Nameorganization
                                                                                              Obligations
                                                                                                ObligationsActorDocumentation
                                                                                                SHALL:able-to-populateImaging Report Producer

                                                                                                EHDSImagingReport.header.author[x]

                                                                                                SHOULD:processImaging Report Consumer

                                                                                                EHDSImagingReport.header.author[x]

                                                                                                Requirements

                                                                                                EHDSImagingReport.header.author[x]

                                                                                                38. DiagnosticReport.resultsInterpreter:author
                                                                                                Slice Nameauthor
                                                                                                Obligations
                                                                                                  ObligationsActorDocumentation
                                                                                                  SHALL:able-to-populateImaging Report Producer

                                                                                                  EHDSImagingReport.header.author[x]

                                                                                                  Requirements

                                                                                                  EHDSImagingReport.header.author[x]

                                                                                                  40. DiagnosticReport.result
                                                                                                  Obligations
                                                                                                    ObligationsActorDocumentation
                                                                                                    SHALL:able-to-populateImaging Report Producer

                                                                                                    EHDSImagingReport.body.examinationReport.results[x], EHDSImagingReport.body.examinationReport.conclusion.impression

                                                                                                    Requirements

                                                                                                    EHDSImagingReport.body.examinationReport.results[x]; EHDSImagingReport.body.examinationReport.conclusion.impression

                                                                                                    42. DiagnosticReport.media
                                                                                                    Obligations
                                                                                                      ObligationsActorDocumentation
                                                                                                      SHOULD:able-to-populateImaging Report Producer

                                                                                                      EHDSImagingReport.attachments

                                                                                                      Requirements

                                                                                                      EHDSImagingReport.attachments

                                                                                                      44. DiagnosticReport.presentedForm
                                                                                                      Obligations
                                                                                                        ObligationsActorDocumentation
                                                                                                        SHOULD:able-to-populateImaging Report Producer

                                                                                                        EHDSImagingReport.presentedForm

                                                                                                        Requirements

                                                                                                        EHDSImagingReport.presentedForm

                                                                                                        See the documentation on how to interpret the contents of this table

                                                                                                        0. DiagnosticReport
                                                                                                        Definition

                                                                                                        Diagnostic Report EU core

                                                                                                        ShortDiagnostic Report EU core
                                                                                                        Comments

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

                                                                                                        Control0..*
                                                                                                        Is Modifierfalse
                                                                                                        Summaryfalse
                                                                                                        Alternate NamesReport, Test, Result, Results, Labs, Laboratory
                                                                                                        Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
                                                                                                        dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
                                                                                                        dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
                                                                                                        dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
                                                                                                        dom-6: A resource should have narrative for robust management (text.`div`.exists())
                                                                                                        eu-imaging-dr-status-replacement: DiagnosticReport.status SHALL be 'amended' if and only if the referenced Composition replaces a prior report and has status 'final'. ((status = 'amended') = extension('http://hl7.org/fhir/5.0/StructureDefinition/extension-DiagnosticReport.composition').value.resolve().where(status = 'final' and relatesTo.where(code = 'replaces').exists()).exists())
                                                                                                        eu-imaging-dr-status-retraction: DiagnosticReport.status SHALL be 'entered-in-error' if and only if the referenced Composition retracts a prior report by replacing it with status 'entered-in-error'. ((status = 'entered-in-error') = extension('http://hl7.org/fhir/5.0/StructureDefinition/extension-DiagnosticReport.composition').value.resolve().where(status = 'entered-in-error' and relatesTo.where(code = 'replaces').exists()).exists())
                                                                                                        eu-imaging-dr-status-no-addendum: DiagnosticReport.status SHALL NOT be 'appended' or 'corrected'; content added or corrected after final issuance is represented as a complete replacement with status 'amended'. (status != 'appended' and status != 'corrected')
                                                                                                        2. DiagnosticReport.id
                                                                                                        Definition

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

                                                                                                        ShortLogical id of this artifact
                                                                                                        Comments

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

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

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

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

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

                                                                                                        ShortA set of rules under which this content was created
                                                                                                        Comments

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

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

                                                                                                        The base language in which the resource is written.

                                                                                                        ShortLanguage of the resource content
                                                                                                        Comments

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

                                                                                                        Control0..1
                                                                                                        BindingThe codes SHOULD be taken from CommonLanguages
                                                                                                        (preferred to http://hl7.org/fhir/ValueSet/languages|4.0.1)

                                                                                                        A human language.

                                                                                                        Additional BindingsPurpose
                                                                                                        AllLanguagesMax Binding
                                                                                                        Typecode
                                                                                                        Is Modifierfalse
                                                                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                        Obligations
                                                                                                          ObligationsActorDocumentation
                                                                                                          SHOULD:able-to-populateImaging Report Producer

                                                                                                          EHDSImagingReport.header.language

                                                                                                          Summaryfalse
                                                                                                          Requirements

                                                                                                          EHDSImagingReport.header.language

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

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

                                                                                                          ShortText summary of the resource, for human interpretation
                                                                                                          Comments

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

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

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

                                                                                                          ShortContained, inline Resources
                                                                                                          Comments

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

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

                                                                                                          An Extension

                                                                                                          ShortExtension
                                                                                                          Control1..*
                                                                                                          TypeExtension
                                                                                                          Is Modifierfalse
                                                                                                          Summaryfalse
                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                          SlicingThis element introduces a set of slices on DiagnosticReport.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                          • value @ url
                                                                                                          • Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them

                                                                                                            16. DiagnosticReport.extension:DiagnosticReportCompositionR5
                                                                                                            Slice NameDiagnosticReportCompositionR5
                                                                                                            Definition

                                                                                                            R5: DiagnosticReport.composition (new:Reference(Composition))

                                                                                                            ShortR5: Reference to a Composition resource for the DiagnosticReport structure (new)
                                                                                                            Comments

                                                                                                            Element DiagnosticReport.composition has a context of DiagnosticReport based on following the parent source element upwards and mapping to DiagnosticReport. Element DiagnosticReport.composition has no mapping targets in FHIR R4. Typically, this is because the element has been added (is a new element). The Composition provides structure to the content of the DiagnosticReport (and only contains contents referenced in the DiagnosticReport) - e.g., to order the sections of an anatomic pathology structured report.

                                                                                                            Control1..1
                                                                                                            This element is affected by the following invariants: ele-1
                                                                                                            TypeExtension(R5: Reference to a Composition resource for the DiagnosticReport structure (new)) (Extension Type: Reference(Cross-version Profile for R5.Composition for use in FHIR R4, Composition))
                                                                                                            Is Modifierfalse
                                                                                                            Obligations
                                                                                                              ObligationsActorDocumentation
                                                                                                              SHALL:able-to-populateImaging Report Producer

                                                                                                              EHDSImagingReport.

                                                                                                              Summaryfalse
                                                                                                              Requirements

                                                                                                              EHDSImagingReport.

                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                              18. DiagnosticReport.extension:DiagnosticReportCompositionR5.id
                                                                                                              Definition

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

                                                                                                              ShortUnique id for inter-element referencing
                                                                                                              Control0..1
                                                                                                              Typestring
                                                                                                              Is Modifierfalse
                                                                                                              XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                              Summaryfalse
                                                                                                              20. DiagnosticReport.extension:DiagnosticReportCompositionR5.extension
                                                                                                              Definition

                                                                                                              An Extension

                                                                                                              ShortExtension
                                                                                                              Control0..0
                                                                                                              TypeExtension
                                                                                                              Is Modifierfalse
                                                                                                              Summaryfalse
                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                              SlicingThis element introduces a set of slices on DiagnosticReport.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                              • value @ url
                                                                                                              • 22. DiagnosticReport.extension:DiagnosticReportCompositionR5.url
                                                                                                                Definition

                                                                                                                Source of the definition for the extension code - a logical name or a URL.

                                                                                                                Shortidentifies the meaning of the extension
                                                                                                                Comments

                                                                                                                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.

                                                                                                                Control1..1
                                                                                                                Typeuri
                                                                                                                Is Modifierfalse
                                                                                                                XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                                Summaryfalse
                                                                                                                Fixed Value
                                                                                                                {
                                                                                                                  "url" : "http://hl7.org/fhir/5.0/StructureDefinition/extension-DiagnosticReport.composition"
                                                                                                                }
                                                                                                                <url value="http://hl7.org/fhir/5.0/StructureDefinition/extension-DiagnosticReport.composition"/>
                                                                                                                24. DiagnosticReport.extension:DiagnosticReportCompositionR5.value[x]
                                                                                                                Definition

                                                                                                                Reference to a Composition resource instance that provides structure for organizing the contents of the DiagnosticReport.

                                                                                                                ShortReference to a Composition resource for the DiagnosticReport structure
                                                                                                                Control1..1
                                                                                                                TypeReference(Composition: Imaging Report)
                                                                                                                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                                                Is Modifierfalse
                                                                                                                Summaryfalse
                                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                26. DiagnosticReport.extension:note
                                                                                                                Slice Namenote
                                                                                                                Definition

                                                                                                                This cross-version extension represents DiagnosticReport.note from http://hl7.org/fhir/StructureDefinition/DiagnosticReport|5.0.0 for use in FHIR R4.

                                                                                                                ShortComments about the diagnostic report
                                                                                                                Control0..*
                                                                                                                This element is affected by the following invariants: ele-1
                                                                                                                TypeExtension(R5: Comments about the diagnostic report (new)) (Extension Type: Annotation)
                                                                                                                Is Modifierfalse
                                                                                                                Summaryfalse
                                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                28. DiagnosticReport.extension:note.id
                                                                                                                Definition

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

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

                                                                                                                An Extension

                                                                                                                ShortExtension
                                                                                                                Control0..0
                                                                                                                TypeExtension
                                                                                                                Is Modifierfalse
                                                                                                                Summaryfalse
                                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                SlicingThis element introduces a set of slices on DiagnosticReport.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                                • value @ url
                                                                                                                • 32. DiagnosticReport.extension:note.url
                                                                                                                  Definition

                                                                                                                  Source of the definition for the extension code - a logical name or a URL.

                                                                                                                  Shortidentifies the meaning of the extension
                                                                                                                  Comments

                                                                                                                  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.

                                                                                                                  Control1..1
                                                                                                                  Typeuri
                                                                                                                  Is Modifierfalse
                                                                                                                  XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                                  Summaryfalse
                                                                                                                  Fixed Value
                                                                                                                  {
                                                                                                                    "url" : "http://hl7.org/fhir/5.0/StructureDefinition/extension-DiagnosticReport.note"
                                                                                                                  }
                                                                                                                  <url value="http://hl7.org/fhir/5.0/StructureDefinition/extension-DiagnosticReport.note"/>
                                                                                                                  34. DiagnosticReport.extension:note.value[x]
                                                                                                                  Definition

                                                                                                                  This cross-version extension represents DiagnosticReport.note from http://hl7.org/fhir/StructureDefinition/DiagnosticReport|5.0.0 for use in FHIR R4.

                                                                                                                  ShortComments about the diagnostic report
                                                                                                                  Control0..1
                                                                                                                  TypeAnnotation
                                                                                                                  [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                                                  Is Modifierfalse
                                                                                                                  Summaryfalse
                                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                  36. DiagnosticReport.extension:note.value[x].id
                                                                                                                  Definition

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

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

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

                                                                                                                  ShortAdditional content defined by implementations
                                                                                                                  Comments

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

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

                                                                                                                    The type of annotation. This extension can be used to map the v2 NTE-4 comment type field.

                                                                                                                    ShortThe type of annotation
                                                                                                                    Comments

                                                                                                                    This is used to identify the type of annotation.

                                                                                                                    Control0..*
                                                                                                                    TypeExtension(Annotation type) (Extension Type: CodeableConcept)
                                                                                                                    Is Modifierfalse
                                                                                                                    Summaryfalse
                                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                    42. DiagnosticReport.extension:note.value[x].extension:annotation-type.id
                                                                                                                    Definition

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

                                                                                                                    ShortUnique id for inter-element referencing
                                                                                                                    Control0..1
                                                                                                                    This element is affected by the following invariants: ele-1
                                                                                                                    Typeid
                                                                                                                    Is Modifierfalse
                                                                                                                    XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                                    Summaryfalse
                                                                                                                    44. DiagnosticReport.extension:note.value[x].extension:annotation-type.extension
                                                                                                                    Definition

                                                                                                                    An Extension

                                                                                                                    ShortExtension
                                                                                                                    Control0..0
                                                                                                                    TypeExtension
                                                                                                                    Is Modifierfalse
                                                                                                                    Summaryfalse
                                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                    SlicingThis element introduces a set of slices on DiagnosticReport.extension.value[x].extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                                    • value @ url
                                                                                                                    • 46. DiagnosticReport.extension:note.value[x].extension:annotation-type.url
                                                                                                                      Definition

                                                                                                                      Source of the definition for the extension code - a logical name or a URL.

                                                                                                                      Shortidentifies the meaning of the extension
                                                                                                                      Comments

                                                                                                                      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.

                                                                                                                      Control1..1
                                                                                                                      Typeuri
                                                                                                                      Is Modifierfalse
                                                                                                                      XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                                      Summaryfalse
                                                                                                                      Fixed Value
                                                                                                                      {
                                                                                                                        "url" : "http://hl7.org/fhir/StructureDefinition/annotationType"
                                                                                                                      }
                                                                                                                      <url value="http://hl7.org/fhir/StructureDefinition/annotationType"/>
                                                                                                                      48. DiagnosticReport.extension:note.value[x].extension:annotation-type.value[x]
                                                                                                                      Definition

                                                                                                                      Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

                                                                                                                      ShortType of note
                                                                                                                      Control1..1
                                                                                                                      This element is affected by the following invariants: ext-1
                                                                                                                      BindingFor example codes, see hl7VS-commentType
                                                                                                                      (example to http://terminology.hl7.org/ValueSet/v2-0364)
                                                                                                                      TypeCodeableConcept
                                                                                                                      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                                                      Is Modifierfalse
                                                                                                                      Summaryfalse
                                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                      50. DiagnosticReport.extension:note.value[x].author[x]
                                                                                                                      Definition

                                                                                                                      The individual responsible for making the annotation.

                                                                                                                      ShortIndividual responsible for the annotation
                                                                                                                      Comments

                                                                                                                      Organization is used when there's no need for specific attribution as to who made the comment.

                                                                                                                      Control0..1
                                                                                                                      TypeChoice of: Reference(Practitioner, Patient, RelatedPerson, Organization), string
                                                                                                                      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                                                      Is Modifierfalse
                                                                                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                      Summarytrue
                                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                      52. DiagnosticReport.extension:note.value[x].time
                                                                                                                      Definition

                                                                                                                      Indicates when this particular annotation was made.

                                                                                                                      ShortWhen the annotation was made
                                                                                                                      Control0..1
                                                                                                                      TypedateTime
                                                                                                                      Is Modifierfalse
                                                                                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                      Summarytrue
                                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                      54. DiagnosticReport.extension:note.value[x].text
                                                                                                                      Definition

                                                                                                                      The text of the annotation in markdown format.

                                                                                                                      ShortThe annotation - text content (as markdown)
                                                                                                                      Control1..1
                                                                                                                      Typemarkdown
                                                                                                                      Is Modifierfalse
                                                                                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                      Summarytrue
                                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                      56. DiagnosticReport.extension:artifactVersion
                                                                                                                      Slice NameartifactVersion
                                                                                                                      Definition

                                                                                                                      The identifier that is used to identify this version of the artifact when it is referenced in a specification, model, design or instance. This is an arbitrary value managed by the artifact author and is not expected to be globally unique. For example, it might be a timestamp (e.g. yyyymmdd) if a managed version is not available. There is also no expectation that versions can be placed in a lexicographical sequence.

                                                                                                                      ShortBusiness version of the artifact
                                                                                                                      Control0..1
                                                                                                                      TypeExtension(ArtifactVersion) (Extension Type: string)
                                                                                                                      Is Modifierfalse
                                                                                                                      Obligations
                                                                                                                        ObligationsActorDocumentation
                                                                                                                        MAY:able-to-populateImaging Report Producer

                                                                                                                        EHDSImagingReport.header.version

                                                                                                                        Summaryfalse
                                                                                                                        Requirements

                                                                                                                        EHDSImagingReport.header.version

                                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                        58. DiagnosticReport.extension:anatomical-region
                                                                                                                        Slice Nameanatomical-region
                                                                                                                        Definition

                                                                                                                        The anatomical regions covered by the report, depending on the study there can be zero, one or more regions. The regions SHALL overlap with the bodysite references from ImagingStudy.serie.bodysite, if present.

                                                                                                                        ShortThe anatomical regions covered by the study this report reports on.
                                                                                                                        Control0..*
                                                                                                                        TypeExtension(Extension: Anatomical Region) (Extension Type: CodeableConcept)
                                                                                                                        Is Modifierfalse
                                                                                                                        Summaryfalse
                                                                                                                        Requirements

                                                                                                                        Identifies the anatomical region covered by the report when additional anatomical context is available.

                                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                        60. DiagnosticReport.extension:comparison
                                                                                                                        Slice Namecomparison
                                                                                                                        Definition

                                                                                                                        Studies used for comparison in part of diagnostic reporting

                                                                                                                        ShortExtension: HL7IDR DiagnosticReport Comparison Study
                                                                                                                        Control0..*
                                                                                                                        TypeExtension(Extension: HL7IDR DiagnosticReport Comparison Study) (Extension Type: Reference(ImagingStudy: Reported Study, Basic-ImagingSelection: General))
                                                                                                                        Is Modifierfalse
                                                                                                                        Must Supporttrue
                                                                                                                        Obligations
                                                                                                                          ObligationsActorDocumentation
                                                                                                                          SHALL:able-to-populateImaging Report Producer

                                                                                                                          EHDSImagingReport.body.comparisonStudy

                                                                                                                          Summaryfalse
                                                                                                                          Requirements

                                                                                                                          EHDSImagingReport.body.comparisonStudy

                                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                          62. DiagnosticReport.extension:patientHistory
                                                                                                                          Slice NamepatientHistory
                                                                                                                          Definition

                                                                                                                          Patient history that are relevant for the report

                                                                                                                          ShortExtension: HL7IDR Patient History
                                                                                                                          Control0..*
                                                                                                                          TypeExtension(Extension: HL7IDR Patient History) (Extension Type: Reference)
                                                                                                                          Is Modifierfalse
                                                                                                                          Must Supporttrue
                                                                                                                          Obligations
                                                                                                                            ObligationsActorDocumentation
                                                                                                                            SHOULD:populate-if-knownImaging Report Producer

                                                                                                                            EHDSImagingReport.body.supportingInformation.observation, EHDSImagingReport.body.supportingInformation.condition, EHDSImagingReport.body.supportingInformation.priorMedicationAdministration, EHDSImagingReport.body.supportingInformation.device, EHDSImagingReport.body.supportingInformation.pregnancyStatus

                                                                                                                            Summaryfalse
                                                                                                                            Requirements

                                                                                                                            EHDSImagingReport.body.supportingInformation.observation; EHDSImagingReport.body.supportingInformation.condition; EHDSImagingReport.body.supportingInformation.priorMedicationAdministration; EHDSImagingReport.body.supportingInformation.device; EHDSImagingReport.body.supportingInformation.pregnancyStatus

                                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                            64. DiagnosticReport.extension:procedure
                                                                                                                            Slice Nameprocedure
                                                                                                                            Definition

                                                                                                                            Imaging procedure used for the imaging acquisition and procedure specific information.

                                                                                                                            ShortExtension: HL7IDR Imaging Procedure
                                                                                                                            Control0..*
                                                                                                                            TypeExtension(Extension: HL7IDR Imaging Procedure) (Extension Type: Reference(Procedure: Imaging Acquisition, AdverseEvent, Observation: Radiation Dose))
                                                                                                                            Is Modifierfalse
                                                                                                                            Must Supporttrue
                                                                                                                            Obligations
                                                                                                                              ObligationsActorDocumentation
                                                                                                                              SHALL:able-to-populateImaging Report Producer

                                                                                                                              EHDSImagingReport.body.exposureInformation, EHDSImagingReport.body.examinationReport.imagingProcedures

                                                                                                                              Summaryfalse
                                                                                                                              Requirements

                                                                                                                              EHDSImagingReport.body.exposureInformation; EHDSImagingReport.body.examinationReport.imagingProcedures

                                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                              66. DiagnosticReport.extension:finding
                                                                                                                              Slice Namefinding
                                                                                                                              Definition

                                                                                                                              Key images in the report

                                                                                                                              ShortKey image findings
                                                                                                                              Control0..*
                                                                                                                              TypeExtension(Extension: HL7IDR KeyImage Finding) (Extension Type: Reference(Observation: Imaging Finding, Key images represented as an ImagingSelection for R4, Media: Key Image, Media, DocumentReference))
                                                                                                                              Is Modifierfalse
                                                                                                                              Must Supporttrue
                                                                                                                              Summaryfalse
                                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                              68. DiagnosticReport.extension:impression
                                                                                                                              Slice Nameimpression
                                                                                                                              Definition

                                                                                                                              Impression in the imaging report

                                                                                                                              ShortExtension: HL7IDR Impression
                                                                                                                              Control0..*
                                                                                                                              TypeExtension(Extension: HL7IDR Impression) (Extension Type: Reference(Observation: Imaging Finding, Condition, Key images represented as an ImagingSelection for R4, Media: Key Image))
                                                                                                                              Is Modifierfalse
                                                                                                                              Must Supporttrue
                                                                                                                              Obligations
                                                                                                                                ObligationsActorDocumentation
                                                                                                                                SHALL:able-to-populateImaging Report Producer

                                                                                                                                EHDSImagingReport.body.examinationReport.conclusion.conditionOrFinding[x]

                                                                                                                                Summaryfalse
                                                                                                                                Requirements

                                                                                                                                EHDSImagingReport.body.examinationReport.conclusion.conditionOrFinding[x]

                                                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                                70. DiagnosticReport.extension:recommendation
                                                                                                                                Slice Namerecommendation
                                                                                                                                Definition

                                                                                                                                Recommendations for any follow up actions

                                                                                                                                ShortExtension: HL7IDR Recommendation
                                                                                                                                Control0..*
                                                                                                                                TypeExtension(Extension: HL7IDR Recommendation) (Extension Type: Reference(CarePlan, ServiceRequest))
                                                                                                                                Is Modifierfalse
                                                                                                                                Must Supporttrue
                                                                                                                                Obligations
                                                                                                                                  ObligationsActorDocumentation
                                                                                                                                  SHOULD:able-to-populateImaging Report Producer

                                                                                                                                  EHDSImagingReport.body.recommendation

                                                                                                                                  Summaryfalse
                                                                                                                                  Requirements

                                                                                                                                  EHDSImagingReport.body.recommendation

                                                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                                  72. DiagnosticReport.extension:communication
                                                                                                                                  Slice Namecommunication
                                                                                                                                  Definition

                                                                                                                                  Communications captures what communications have been made with other care providers.

                                                                                                                                  ShortCommunications with other care providers
                                                                                                                                  Control0..*
                                                                                                                                  TypeExtension(Extension: HL7IDR Communication) (Extension Type: Reference)
                                                                                                                                  Is Modifierfalse
                                                                                                                                  Must Supporttrue
                                                                                                                                  Summaryfalse
                                                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                                  74. DiagnosticReport.extension:informationRecipient
                                                                                                                                  Slice NameinformationRecipient
                                                                                                                                  Definition

                                                                                                                                  This extension applies to the Composition resource and is used to represent an intended recipient of the composition.

                                                                                                                                  ShortComposition: Information recipient
                                                                                                                                  Control0..*
                                                                                                                                  TypeExtension(Composition: Information recipient) (Extension Type: Reference(Practitioner, Device, Patient, RelatedPerson, PractitionerRole, Organization, CareTeam, Group))
                                                                                                                                  Is Modifierfalse
                                                                                                                                  Summaryfalse
                                                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                                  76. DiagnosticReport.modifierExtension
                                                                                                                                  Definition

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

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

                                                                                                                                  ShortExtensions that cannot be ignored
                                                                                                                                  Comments

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

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

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

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

                                                                                                                                  Identifiers assigned to this Imaging Report by the performer or other systems. It shall be common to several report versions

                                                                                                                                  ShortReport identifier
                                                                                                                                  Comments

                                                                                                                                  Composition.identifier SHALL be equal to one of the DiagnosticReport.identifier, if at least one exists

                                                                                                                                  NoteThis is a business identifier, not a resource identifier (see discussion)
                                                                                                                                  Control1..*
                                                                                                                                  TypeIdentifier
                                                                                                                                  Is Modifierfalse
                                                                                                                                  Obligations
                                                                                                                                    ObligationsActorDocumentation
                                                                                                                                    SHALL:able-to-populateImaging Report Producer

                                                                                                                                    EHDSImagingReport.header.identifier

                                                                                                                                    Summarytrue
                                                                                                                                    Requirements

                                                                                                                                    EHDSImagingReport.header.identifier

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

                                                                                                                                    Details concerning a service requested.

                                                                                                                                    ShortWhat was requested
                                                                                                                                    Comments

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

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

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

                                                                                                                                    Alternate NamesRequest
                                                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                    SlicingThis element introduces a set of slices on DiagnosticReport.basedOn. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                                                    • type @ $this
                                                                                                                                    • Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them

                                                                                                                                      82. DiagnosticReport.basedOn:ServiceRequestOrderEuImagingaccession
                                                                                                                                      Slice NameServiceRequestOrderEuImagingaccession
                                                                                                                                      Definition

                                                                                                                                      Details concerning a service requested.

                                                                                                                                      ShortWhat was requested
                                                                                                                                      Comments

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

                                                                                                                                      Control0..*
                                                                                                                                      TypeReference(ServiceRequest: Imaging Order)
                                                                                                                                      Is Modifierfalse
                                                                                                                                      Obligations
                                                                                                                                        ObligationsActorDocumentation
                                                                                                                                        MAY:able-to-populateImaging Report Producer

                                                                                                                                        EHDSImagingReport.body.orderInformation.orderId

                                                                                                                                        Summaryfalse
                                                                                                                                        Requirements

                                                                                                                                        EHDSImagingReport.body.orderInformation.orderId

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

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

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

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

                                                                                                                                        ShortAdditional content defined by implementations
                                                                                                                                        Comments

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

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

                                                                                                                                          A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

                                                                                                                                          ShortLiteral reference, Relative, internal or absolute URL
                                                                                                                                          Comments

                                                                                                                                          Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

                                                                                                                                          Control0..1
                                                                                                                                          This element is affected by the following invariants: ref-1
                                                                                                                                          Typestring
                                                                                                                                          Is Modifierfalse
                                                                                                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                                          Summarytrue
                                                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                          90. DiagnosticReport.basedOn:ServiceRequestOrderEuImagingaccession.type
                                                                                                                                          Definition

                                                                                                                                          The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

                                                                                                                                          The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

                                                                                                                                          ShortType the reference refers to (e.g. "Patient")
                                                                                                                                          Comments

                                                                                                                                          This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.

                                                                                                                                          Control0..1
                                                                                                                                          BindingUnless not suitable, these codes SHALL be taken from ResourceType
                                                                                                                                          (extensible to http://hl7.org/fhir/ValueSet/resource-types|4.0.1)

                                                                                                                                          Aa resource (or, for logical models, the URI of the logical model).

                                                                                                                                          Typeuri
                                                                                                                                          Is Modifierfalse
                                                                                                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                                          Summarytrue
                                                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                          92. DiagnosticReport.basedOn:ServiceRequestOrderEuImagingaccession.identifier
                                                                                                                                          Definition

                                                                                                                                          An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

                                                                                                                                          ShortLogical reference, when literal reference is not known
                                                                                                                                          Comments

                                                                                                                                          When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

                                                                                                                                          When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

                                                                                                                                          Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

                                                                                                                                          Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

                                                                                                                                          NoteThis is a business identifier, not a resource identifier (see discussion)
                                                                                                                                          Control0..1
                                                                                                                                          TypeIdentifier(Identifier: Accession Number)
                                                                                                                                          Is Modifierfalse
                                                                                                                                          Summarytrue
                                                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                          94. DiagnosticReport.basedOn:ServiceRequestOrderEuImagingaccession.display
                                                                                                                                          Definition

                                                                                                                                          Plain text narrative that identifies the resource in addition to the resource reference.

                                                                                                                                          ShortText alternative for the resource
                                                                                                                                          Comments

                                                                                                                                          This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

                                                                                                                                          Control0..1
                                                                                                                                          Typestring
                                                                                                                                          Is Modifierfalse
                                                                                                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                                          Summarytrue
                                                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                          96. DiagnosticReport.status
                                                                                                                                          Definition

                                                                                                                                          The status of the diagnostic report.

                                                                                                                                          ShortStatus of the Report
                                                                                                                                          Comments

                                                                                                                                          DiagnosticReport.status and Composition.status shall be aligned

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

                                                                                                                                          The status of the diagnostic report.

                                                                                                                                          Typecode
                                                                                                                                          Is Modifiertrue because This element is labeled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
                                                                                                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                                          Obligations
                                                                                                                                            ObligationsActorDocumentation
                                                                                                                                            MAY:able-to-populateImaging Report Producer

                                                                                                                                            EHDSImagingReport.header.status

                                                                                                                                            Summarytrue
                                                                                                                                            Requirements

                                                                                                                                            EHDSImagingReport.header.status

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

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

                                                                                                                                            ShortService category
                                                                                                                                            Comments

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

                                                                                                                                            Control2..*
                                                                                                                                            BindingFor example codes, see DiagnosticServiceSectionCodes
                                                                                                                                            (example to http://hl7.org/fhir/ValueSet/diagnostic-service-sections|4.0.1)

                                                                                                                                            Codes for diagnostic service sections.

                                                                                                                                            TypeCodeableConcept
                                                                                                                                            Is Modifierfalse
                                                                                                                                            Summarytrue
                                                                                                                                            Alternate NamesDepartment, Sub-department, Service, Discipline
                                                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                            SlicingThis element introduces a set of slices on DiagnosticReport.category. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                                                            • value @ $this
                                                                                                                                            • Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them

                                                                                                                                              100. DiagnosticReport.category:diagnostic-service
                                                                                                                                              Slice Namediagnostic-service
                                                                                                                                              Definition

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

                                                                                                                                              ShortService category
                                                                                                                                              Comments

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

                                                                                                                                              Control0..1
                                                                                                                                              BindingThe codes SHALL be taken from DiagnosticServiceSectionCodes
                                                                                                                                              (required to http://hl7.org/fhir/ValueSet/diagnostic-service-sections)
                                                                                                                                              TypeCodeableConcept
                                                                                                                                              Is Modifierfalse
                                                                                                                                              Obligations
                                                                                                                                                ObligationsActorDocumentation
                                                                                                                                                MAY:able-to-populateImaging Report Producer

                                                                                                                                                EHDSImagingReport.header.serviceSpecialty

                                                                                                                                                Summarytrue
                                                                                                                                                Requirements

                                                                                                                                                EHDSImagingReport.header.serviceSpecialty

                                                                                                                                                Alternate NamesDepartment, Sub-department, Service, Discipline
                                                                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                102. DiagnosticReport.category:imaging-report
                                                                                                                                                Slice Nameimaging-report
                                                                                                                                                Definition

                                                                                                                                                Defines the category of the report, Diagnostic imaging report.

                                                                                                                                                ShortService category
                                                                                                                                                Comments

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

                                                                                                                                                Control1..1
                                                                                                                                                BindingFor example codes, see DiagnosticServiceSectionCodes
                                                                                                                                                (example to http://hl7.org/fhir/ValueSet/diagnostic-service-sections|4.0.1)

                                                                                                                                                Codes for diagnostic service sections.

                                                                                                                                                TypeCodeableConcept
                                                                                                                                                Is Modifierfalse
                                                                                                                                                Obligations
                                                                                                                                                  ObligationsActorDocumentation
                                                                                                                                                  SHALL:able-to-populateImaging Report Producer

                                                                                                                                                  EHDSImagingReport.header.documentType

                                                                                                                                                  Summarytrue
                                                                                                                                                  Requirements

                                                                                                                                                  EHDSImagingReport.header.documentType

                                                                                                                                                  Alternate NamesDepartment, Sub-department, Service, Discipline
                                                                                                                                                  Pattern Value
                                                                                                                                                  {
                                                                                                                                                    "coding" : [
                                                                                                                                                      {
                                                                                                                                                        "system" : "http://loinc.org",
                                                                                                                                                        "code" : "85430-7"
                                                                                                                                                      }
                                                                                                                                                    ]
                                                                                                                                                  }
                                                                                                                                                  <category>
                                                                                                                                                    <coding>
                                                                                                                                                      <system value="http://loinc.org"/>
                                                                                                                                                      <code value="85430-7"/>
                                                                                                                                                    </coding>
                                                                                                                                                  </category>
                                                                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                  104. DiagnosticReport.category:imaging
                                                                                                                                                  Slice Nameimaging
                                                                                                                                                  Definition

                                                                                                                                                  Defines the priority category of the report as defined in the API spec.

                                                                                                                                                  ShortService category
                                                                                                                                                  Comments

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

                                                                                                                                                  Control1..1
                                                                                                                                                  BindingFor example codes, see DiagnosticServiceSectionCodes
                                                                                                                                                  (example to http://hl7.org/fhir/ValueSet/diagnostic-service-sections|4.0.1)

                                                                                                                                                  Codes for diagnostic service sections.

                                                                                                                                                  TypeCodeableConcept
                                                                                                                                                  Is Modifierfalse
                                                                                                                                                  Summarytrue
                                                                                                                                                  Alternate NamesDepartment, Sub-department, Service, Discipline
                                                                                                                                                  Pattern Value
                                                                                                                                                  {
                                                                                                                                                    "coding" : [
                                                                                                                                                      {
                                                                                                                                                        "system" : "http://hl7.eu/fhir/health-data-api/CodeSystem/eehrxf-document-priority-category-cs",
                                                                                                                                                        "code" : "Medical-Imaging"
                                                                                                                                                      }
                                                                                                                                                    ]
                                                                                                                                                  }
                                                                                                                                                  <category>
                                                                                                                                                    <coding>
                                                                                                                                                      <system value="http://hl7.eu/fhir/health-data-api/CodeSystem/eehrxf-document-priority-category-cs"/>
                                                                                                                                                      <code value="Medical-Imaging"/>
                                                                                                                                                    </coding>
                                                                                                                                                  </category>
                                                                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                  106. DiagnosticReport.code
                                                                                                                                                  Definition

                                                                                                                                                  Defines the document type, it is recommended to take this from the suggested LOINC set.

                                                                                                                                                  ShortType of Imaging Diagnostic Report
                                                                                                                                                  Control1..1
                                                                                                                                                  BindingThe codes SHOULD be taken from ValueSet: Radiology Report Types
                                                                                                                                                  (preferred to http://hl7.eu/fhir/imaging/ValueSet/ImagingReportTypesEuVSEuImaging)
                                                                                                                                                  TypeCodeableConcept
                                                                                                                                                  Is Modifierfalse
                                                                                                                                                  Summarytrue
                                                                                                                                                  Alternate NamesType
                                                                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                  108. DiagnosticReport.subject
                                                                                                                                                  Definition

                                                                                                                                                  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).

                                                                                                                                                  ShortWho and/or what this report is about
                                                                                                                                                  Control1..1
                                                                                                                                                  TypeReference(Patient (EU core))
                                                                                                                                                  Is Modifierfalse
                                                                                                                                                  Obligations
                                                                                                                                                    ObligationsActorDocumentation
                                                                                                                                                    SHALL:able-to-populateImaging Report Producer

                                                                                                                                                    EHDSImagingReport.header.subject

                                                                                                                                                    Summarytrue
                                                                                                                                                    Requirements

                                                                                                                                                    EHDSImagingReport.header.subject

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

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

                                                                                                                                                    ShortThe healthcare event which this Diagnostic Report is about (when test ordered).
                                                                                                                                                    Comments

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

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

                                                                                                                                                    Links the request to the Encounter context.

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

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

                                                                                                                                                    ShortClinically relevant time/time-period for report.
                                                                                                                                                    Comments

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

                                                                                                                                                    Control0..1
                                                                                                                                                    TypeChoice of: dateTime, Period
                                                                                                                                                    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                                                                                    Is Modifierfalse
                                                                                                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                                                    Summarytrue
                                                                                                                                                    Requirements

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

                                                                                                                                                    Alternate NamesObservation time, Effective Time, Occurrence
                                                                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                    SlicingThis element introduces a set of slices on DiagnosticReport.effective[x]. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
                                                                                                                                                    • type @ $this
                                                                                                                                                    • Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them Other type slices that contain no new information are not shown in this view

                                                                                                                                                      114. DiagnosticReport.effective[x]:effectivePeriod
                                                                                                                                                      Slice NameeffectivePeriod
                                                                                                                                                      Definition

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

                                                                                                                                                      ShortClinically relevant time/time-period for report.
                                                                                                                                                      Comments

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

                                                                                                                                                      Control0..1
                                                                                                                                                      TypePeriod
                                                                                                                                                      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                                                                                      Is Modifierfalse
                                                                                                                                                      Obligations
                                                                                                                                                        ObligationsActorDocumentation
                                                                                                                                                        SHOULD:able-to-populateImaging Report Producer

                                                                                                                                                        EHDSImagingReport.header.period

                                                                                                                                                        Summarytrue
                                                                                                                                                        Requirements

                                                                                                                                                        EHDSImagingReport.header.period

                                                                                                                                                        Alternate NamesObservation time, Effective Time, Occurrence
                                                                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                        117. DiagnosticReport.issued
                                                                                                                                                        Definition

                                                                                                                                                        The date and time that the report was issued. This is not necessarily the same as the date and time that the report was created, since a report may be revised and/or reviewed after it is created.

                                                                                                                                                        ShortDate and time of report issuance
                                                                                                                                                        Comments

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

                                                                                                                                                        Control0..1
                                                                                                                                                        Typeinstant
                                                                                                                                                        Is Modifierfalse
                                                                                                                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                                                        Obligations
                                                                                                                                                          ObligationsActorDocumentation
                                                                                                                                                          SHALL:able-to-populateImaging Report Producer

                                                                                                                                                          EHDSImagingReport.header.date

                                                                                                                                                          Summarytrue
                                                                                                                                                          Requirements

                                                                                                                                                          EHDSImagingReport.header.date

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

                                                                                                                                                          The diagnostic service that is responsible for issuing the report.

                                                                                                                                                          ShortResponsible Diagnostic Service.
                                                                                                                                                          Comments

                                                                                                                                                          If a DiagnosticReport.resultsInterpreter exists this is expected to be a Composition.author; otherwise a DiagnosticReport.performer should be an author.

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

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

                                                                                                                                                          Alternate NamesLaboratory, Service, Practitioner, Department, Company, Authorized by, Director
                                                                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                          SlicingThis element introduces a set of slices on DiagnosticReport.performer. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                                                                          • profile @ $this
                                                                                                                                                          • 121. DiagnosticReport.performer:organization
                                                                                                                                                            Slice Nameorganization
                                                                                                                                                            Definition

                                                                                                                                                            The organization responsible for producing this report. In case practitioners produce them in their private practices, they will be accounted as an organization for this purpose.

                                                                                                                                                            ShortThe organization producer of this report
                                                                                                                                                            Comments

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

                                                                                                                                                            Control0..*
                                                                                                                                                            TypeReference(Organization (EU core))
                                                                                                                                                            Is Modifierfalse
                                                                                                                                                            Obligations
                                                                                                                                                              ObligationsActorDocumentation
                                                                                                                                                              SHALL:able-to-populateImaging Report Producer

                                                                                                                                                              EHDSImagingReport.header.author[x]

                                                                                                                                                              SHOULD:processImaging Report Consumer

                                                                                                                                                              EHDSImagingReport.header.author[x]

                                                                                                                                                              Summarytrue
                                                                                                                                                              Requirements

                                                                                                                                                              EHDSImagingReport.header.author[x]

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

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

                                                                                                                                                              ShortPrimary result interpreter
                                                                                                                                                              Comments

                                                                                                                                                              If a DiagnosticReport.resultsInterpreter exists this is expected to be a Composition.author; otherwise a DiagnosticReport.performer should be an author.

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

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

                                                                                                                                                              Alternate NamesAnalyzed by, Reported by
                                                                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                              SlicingThis element introduces a set of slices on DiagnosticReport.resultsInterpreter. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                                                                              • profile @ resolve()
                                                                                                                                                              • 125. DiagnosticReport.resultsInterpreter:author
                                                                                                                                                                Slice Nameauthor
                                                                                                                                                                Definition

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

                                                                                                                                                                ShortPrimary interpreter of results
                                                                                                                                                                Comments

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

                                                                                                                                                                Control0..*
                                                                                                                                                                TypeReference(PractitionerRole (EU core))
                                                                                                                                                                Is Modifierfalse
                                                                                                                                                                Obligations
                                                                                                                                                                  ObligationsActorDocumentation
                                                                                                                                                                  SHALL:able-to-populateImaging Report Producer

                                                                                                                                                                  EHDSImagingReport.header.author[x]

                                                                                                                                                                  Summarytrue
                                                                                                                                                                  Requirements

                                                                                                                                                                  EHDSImagingReport.header.author[x]

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

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

                                                                                                                                                                  ShortSpecimens this report is based on.
                                                                                                                                                                  Comments

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

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

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

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

                                                                                                                                                                  Detailed description of the findings on the imaging study. The findings should be described in a clear and concise manner, using standardized anatomic, pathologic, and radiologic terminology whenever possible.

                                                                                                                                                                  ShortFindings
                                                                                                                                                                  Comments

                                                                                                                                                                  Observations can contain observations.

                                                                                                                                                                  Control0..*
                                                                                                                                                                  TypeReference(Observation: Imaging Finding, Observation: Narrative Report)
                                                                                                                                                                  Is Modifierfalse
                                                                                                                                                                  Must Supporttrue
                                                                                                                                                                  Must Support TypesNo must-support rules about the choice of types/profiles
                                                                                                                                                                  Obligations
                                                                                                                                                                    ObligationsActorDocumentation
                                                                                                                                                                    SHALL:able-to-populateImaging Report Producer

                                                                                                                                                                    EHDSImagingReport.body.examinationReport.results[x], EHDSImagingReport.body.examinationReport.conclusion.impression

                                                                                                                                                                    Summaryfalse
                                                                                                                                                                    Requirements

                                                                                                                                                                    EHDSImagingReport.body.examinationReport.results[x]; EHDSImagingReport.body.examinationReport.conclusion.impression

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

                                                                                                                                                                    Study subject to this report. Note: Any associated study (e.g. comparison studies) used during reporting should be tracked in the associatedStudy extension.

                                                                                                                                                                    ShortStudy subject to this report
                                                                                                                                                                    Comments

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

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

                                                                                                                                                                    A list of additional data, other then presented form of the report, associated with this report. This data is generally created during the diagnostic process, and may be directly of the patient, or of treated specimens (i.e. slides of interest).

                                                                                                                                                                    ShortAdditional data (like images, diagrams or documents) associated with this report
                                                                                                                                                                    Control0..*
                                                                                                                                                                    TypeBackboneElement
                                                                                                                                                                    Is Modifierfalse
                                                                                                                                                                    Obligations
                                                                                                                                                                      ObligationsActorDocumentation
                                                                                                                                                                      SHOULD:able-to-populateImaging Report Producer

                                                                                                                                                                      EHDSImagingReport.attachments

                                                                                                                                                                      Summarytrue
                                                                                                                                                                      Requirements

                                                                                                                                                                      EHDSImagingReport.attachments

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

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

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

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

                                                                                                                                                                      ShortAdditional content defined by implementations
                                                                                                                                                                      Comments

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

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

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

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

                                                                                                                                                                      ShortExtensions that cannot be ignored even if unrecognized
                                                                                                                                                                      Comments

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

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

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

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

                                                                                                                                                                      Allows for a comment about the image or data, such as an explanation of its significance or context within the diagnostic report.

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

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

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

                                                                                                                                                                      The provider of the report should make a comment about each image or data included in the report. This comment can provide valuable context and help the reader understand the significance of the image or data in relation to the overall findings of the report.

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

                                                                                                                                                                      A reference to the image or data associated with this report.

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

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

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

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

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

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

                                                                                                                                                                      ShortCodes for the clinical conclusion of test results
                                                                                                                                                                      Control0..*
                                                                                                                                                                      BindingFor example codes, see SNOMEDCTClinicalFindings
                                                                                                                                                                      (example to http://hl7.org/fhir/ValueSet/clinical-findings|4.0.1)

                                                                                                                                                                      Diagnosis codes provided as adjuncts to the report.

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

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

                                                                                                                                                                      ShortEntire report as issued (pdf recommended)
                                                                                                                                                                      Comments

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

                                                                                                                                                                      Control0..*
                                                                                                                                                                      TypeAttachment
                                                                                                                                                                      Is Modifierfalse
                                                                                                                                                                      Obligations
                                                                                                                                                                        ObligationsActorDocumentation
                                                                                                                                                                        SHOULD:able-to-populateImaging Report Producer

                                                                                                                                                                        EHDSImagingReport.presentedForm

                                                                                                                                                                        Summaryfalse
                                                                                                                                                                        Requirements

                                                                                                                                                                        EHDSImagingReport.presentedForm

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